Taylor G. Hobbs

Intracortical microstimulation (ICMS) of somatosensory cortex can restore a sense of touch to people with spinal cord injury. In this early feasibility clinical trial (NCT01894802), we evaluated the safety, efficacy, and longevity of ICMS because there is a paucity of such long-term studies in humans. This information is crucial to the development of clinical neuromodulation devices, particularly for restoring touch, hearing, and vision. ICMS was delivered to five participants with spinal cord injury who were each implanted with two Blackrock NeuroPort microelectrode arrays in the hand representation of Brodmann's area 1. Across implant durations spanning 2 to 10 years, we measured single-electrode detection thresholds, projected fields, quality reports, and electrode health characteristics. ICMS-related adverse events were documented throughout. More than 168 million ICMS pulses were delivered across a combined implant duration of 27 years without any serious adverse events or direct negative effects on electrode health. ICMS consistently evoked sensations localized to the hand. Rarely, sensations persisted for brief periods after stimulation offset (3 to 25 events across participants). ICMS detection thresholds increased slowly over time (about 3.5 microamperes per year), but 64 ± 13% of the electrodes still reliably evoked tactile sensations (about 21% decrease in functional electrodes), including 60% of the electrodes after 10 years in one participant. The quality and projected field coverage of ICMS-evoked sensations were both consistent. Delivering ICMS to the somatosensory cortex was safe and effective, consistently evoking informative somatosensory percepts as long as 10 years, demonstrating the clinical promise of ICMS for sensory restoration.

The sense of touch is fundamental for dexterous manipulation, object interaction, and body awareness. It is primarily processed in the somatosensory cortex (SC), yet our understanding of how tactile information is encoded at the level of neural populations and single neurons in humans remains limited. It is unclear how natural tactile signals are represented in SC and how they may be influenced by visual inputs, as well as how closely sensory and motor cortices interact during passive touch. Here, we investigated the neural basis of touch in the human SC using chronically implanted microelectrode arrays in three participants. By delivering controlled mechanical stimuli, we characterized neural responses to natural touch and mapped detailed somatotopic receptive fields (the patch of skin that elicits neural responses when stimulated) in humans, including multi-digit representations. Surprisingly, we also found strong, clearly somatotopic activation in the motor cortex (MC) during passive touch, even in the absence of movement, highlighting a tight and functionally relevant sensorimotor coupling. We further examined how vision shapes tactile processing by comparing neural activity during actual touch with and without vision, and during observation of touch on another person's hand. While touch to the participants' hands elicited robust, event-locked, and somatotopically organized responses in the SC, observation of tactile actions alone did not produce significant activation, suggesting limited vicarious encoding at this level. These findings provide a detailed characterization of human touch processing at the level of neuronal populations and give insights for the design of microstimulation strategies of the SC for the restoration of touch.

Background: Intracortical microstimulation (ICMS) of somatosensory cortex can restore a sense of touch to people with spinal cord injury (SCI). In this early-feasibility clinical trial, we evaluate the safety, efficacy, and longevity of ICMS as there is a paucity of such long-term studies in humans. This information is crucial to the development of clinical neuromodulation devices, particularly for restoring touch, hearing, and vision. Methods: ICMS was delivered to five participants with SCI who were each implanted with two Blackrock NeuroPort microelectrode arrays in the hand representation of Brodmann’s Area 1. Across implant durations spanning two to ten years, we measured single-electrode detection thresholds, projected fields, quality reports, and electrode health characteristics. ICMS-related adverse events were documented throughout. Results: Over 168 million ICMS pulses were delivered across a combined implant duration of 24 years without any serious adverse events or direct negative effects on electrode health. ICMS consistently evoked sensations localized to the hand. Rarely, sensations persisted for brief periods after stimulation offset (3–25 events across participants). ICMS detection thresholds increased slowly over time (∼3.5 μA/year), but 62±15% of the electrodes still reliably evoke tactile sensations (∼25% decrease in functional electrodes), including 55% of the electrodes after 10 years in one participant. The quality and projected field coverage of ICMS-evoked sensations were both consistent. Conclusions: Delivering ICMS to somatosensory cortex was safe and reliable, consistently evoking informative somatosensory percepts as long as 10 years, demonstrating the clinical promise of ICMS for sensory restoration. (Funded by NIH; ClinicalTrials.gov: NCT01894802 ).

Objective. Intracortical microstimulation (ICMS) of human somatosensory cortex evokes tactile percepts that people describe as originating from their own body, but are not always described as feeling natural. It remains unclear whether stimulation parameters such as amplitude, frequency, and spatiotemporal patterns across electrodes can be chosen to increase the naturalness of these artificial tactile percepts. Approach. In this study, we investigated whether biomimetic stimulation patterns—ICMS patterns that reproduce essential features of natural neural activity—increased the perceived naturalness of ICMS-evoked sensations compared to a non-biomimetic pattern in three people with cervical spinal cord injuries. All participants had electrode arrays implanted in their somatosensory cortices. Rather than qualitatively asking which pattern felt more natural, participants directly compared natural residual percepts, delivered by mechanical indentation on a sensate region of their hand, to artificial percepts evoked by ICMS and were asked whether linear non-biomimetic or biomimetic stimulation felt most like the mechanical indentation. Main results. We show that simple biomimetic ICMS, which modulated the stimulation amplitude on a single electrode, was perceived as being more like a mechanical indentation reference on 32% of the electrodes. We also tested an advanced biomimetic stimulation scheme that captured more of the spatiotemporal dynamics of cortical activity using co-modulated stimulation amplitudes and frequencies across four electrodes. Here, ICMS felt more like the mechanical reference for 75% of the electrode groups. Finally, biomimetic stimulus trains required less charge than their non-biomimetic counterparts to create an intensity-matched sensation. Significance. We conclude that ICMS encoding schemes that mimic naturally occurring neural spatiotemporal activation patterns in the somatosensory cortex feel more like an actual touch than non-biomimetic encoding schemes. This also suggests that using key elements of neuronal activity can be a useful conceptual guide to constrain the large stimulus parameter space when designing future stimulation strategies. This work is a part of Clinical Trial NCT01894802.

Intracortical microstimulation (ICMS) is a method for restoring sensation to people with paralysis as part of a bidirectional brain–computer interface (BCI) to restore upper limb function. Evoking tactile sensations of the hand through ICMS requires precise targeting of implanted electrodes. Here we describe the presurgical imaging procedures used to generate functional maps of the hand area of the somatosensory cortex and subsequent planning that guided the implantation of intracortical microelectrode arrays. In five participants with cervical spinal cord injury, across two study locations, this procedure successfully enabled ICMS‐evoked sensations localized to at least the first four digits of the hand. The imaging and planning procedures developed through this clinical trial provide a roadmap for other BCI studies to ensure the successful placement of stimulation electrodes.

Tactile feedback from brain-controlled bionic hands can be partially restored via intracortical microstimulation (ICMS) of the primary somatosensory cortex. In ICMS, the location of percepts depends on the electrode’s location and the percept intensity depends on the stimulation frequency and amplitude. Sensors on a bionic hand can thus be linked to somatotopically appropriate electrodes, and the contact force of each sensor can be used to determine the amplitude of a stimulus. Here we report a systematic investigation of the localization and intensity of ICMS-evoked percepts in three participants with cervical spinal cord injury. A retrospective analysis of projected fields showed that they were typically composed of a focal hotspot with diffuse borders, arrayed somatotopically in keeping with their underlying receptive fields and stable throughout the duration of the study. When testing the participants’ ability to rapidly localize a single ICMS presentation, individual electrodes typically evoked only weak sensations, making object localization and discrimination difficult. However, overlapping projected fields from multiple electrodes produced more localizable and intense sensations and allowed for a more precise use of a bionic hand.

Objective Intracortical microstimulation (ICMS) of human somatosensory cortex evokes tactile percepts that people describe as originating from their own body, but are not always described as feeling natural. It remains unclear whether stimulation parameters such as amplitude, frequency, and spatiotemporal patterns across electrodes can be chosen to increase the naturalness of these artificial tactile percepts. Approach In this study, we investigated whether biomimetic stimulation patterns – ICMS patterns that reproduce essential features of natural neural activity – increased the perceived naturalness of ICMS-evoked sensations compared to a non-biomimetic pattern in three people with cervical spinal cord injuries. All participants had electrode arrays implanted in their somatosensory cortices. Rather than qualitatively asking which pattern felt more natural, participants directly compared natural residual percepts, delivered by mechanical indentation on a sensate region of their hand, to artificial percepts evoked by ICMS and were asked whether linear non-biomimetic or biomimetic stimulation felt most like the mechanical indentation. Main Results We show that simple biomimetic ICMS, which modulated the stimulation amplitude on a single electrode, was perceived as being more like a mechanical indentation reference on 32% of the electrodes. We also tested an advanced biomimetic stimulation scheme that captured more of the spatiotemporal dynamics of cortical activity using co-modulated stimulation amplitudes and frequencies across four electrodes. Here, ICMS felt more like the mechanical reference for 75% of the electrode groups. Finally, biomimetic stimulation required less stimulus charge than their non-biomimetic counterparts. Significance We conclude that ICMS encoding schemes that mimic naturally occurring neural spatiotemporal activation patterns in somatosensory cortex feel more like an actual touch than non-biomimetic encoding schemes. This also suggests that using key elements of neuronal activity can be a useful conceptual guide to constrain the large stimulus parameter space when designing future stimulation strategies.

Intracortical microstimulation (ICMS) is a method for restoring sensation to people with paralysis as part of a bidirectional brain-computer interface to restore upper limb function. Evoking tactile sensations of the hand through ICMS requires precise targeting of implanted electrodes. Here we describe the presurgical imaging procedures used to generate functional maps of the hand area of the somatosensory cortex and subsequent planning that guided the implantation of intracortical microelectrode arrays. In five participants with cervical spinal cord injury, across two study locations, this procedure successfully enabled ICMS-evoked sensations localized to at least the first four digits of the hand. The imaging and planning procedures developed through this clinical trial provide a roadmap for other brain-computer interface studies to ensure successful placement of stimulation electrodes.

A bstract: Time-order error, a psychophysical phenomenon in which the duration in between successive stimuli alters perception, has been studied for decades by neuroscientists and psychologists. To date, however, the locus of these effects is unknown. We use intracortical microstimulation of somatosensory cortex in humans as a tool to bypass initial stages of processing and restrict the possible locations that signals could be modified. We find that, using both amplitude discrimination and magnitude estimation paradigms, intracortical microstimulation reliably evoked time-order errors across all participants. Points of subjective equality were symmetrically shifted during amplitude discrimination experiments and the intensity of a successive stimulus was perceived as being more intense when compared to single stimulus trials in magnitude estimation experiments. The error was reduced for both paradigms at longer inter-stimulus intervals. These results show that direct activation of primary somatosensory cortex is sufficient to induce time-order errors.