Multi-functional Neuroprosthetic Systems for Restoration of Motor Function

用于恢复运动功能的多功能神经假体系统

• 批准号: 7868615
• 负责人: Paul Hunter Peckham
• 金额: $ 149.75万
• 依托单位: CASE WESTERN RESERVE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-06-01 至 2015-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7868615
• 关键词: Address; Advanced Development; Beds; Bilateral; Bladder; Bladder Control; Cervical; Cervical spinal cord injury; Clinical; Clinical Research; Coughing; Coupled; Development; Disabled Persons; Feasibility Studies; Foundations; Goals; Hand; Hand functions; Health; Human; Implant; Individual; Injury; Intestines; Leg; Motor; Movement; Musculoskeletal Equilibrium; Operative Surgical Procedures; Outcome; Outcome Assessment; Paralysed; Posture; Principal Investigator; Quadriplegia; Quality of life; Research; Spinal cord injury; System; Techniques; Technology; Testing; functional outcomes; gain of function; grasp; human subject; implantation; in vivo; multiple disability; neuroprosthesis; preclinical study; public health relevance; respiratory; restoration

DESCRIPTION (provided by applicant): Traumatic cervical-level spinal cord injury can result in permanent and extensive paralysis below the level of injury, causing the loss of multiple body functions, including hand, trunk and leg movement, bladder and bowel control, and respiratory capacity. The goal of this project is to restore these multiple functions to these individuals through a comprehensive neuroprosthetic approach that addresses the overall needs of the individual. This approach involves all aspects of the implementation, including the implanted technology, the surgical installation, and the outcomes assessment through a coordinated team approach in order to maximize the functional independence gained by the individual. With this system, we intend to provide individuals who have a mid-cervical level spinal cord injury with control over grasp, reach, cough, turning in bed, seated posture, and bladder function. This ambitious and exciting goal is made possible by the culmination of our research and clinical deployment of neuroprosthetic systems for spinal cord injured subjects over the past 30 years and our development of an advanced neuroprosthesis. We anticipate that this system will not only provide increased independence in each of the targeted body functions, but will provide an overall benefit to demonstrate significant improvements in quality of life and health outcomes. In clinical feasibility studies with spinal cord injured subjects, our clinical research teams have demonstrated the control of bilateral hand function, rolling and postural control, cough, bladder control and bowel control using chronically implanted neuroprostheses. Outcomes from each clinical study demonstrate that each system provides increased functional independence to the individual. However, to this point, it has not been possible to address each individual's holistic needs and tailor an overall approach that maximizes the function gained. Through the development of a Networked Neuroprosthetic System (NNPS), we now have the technological foundation for a multi-functional system. The strategy employed in this U01 project is to finalize the key components of our proposed holistic neuroprosthetic approach. Thus, each component of the approach, including the technology, regulatory approvals, surgical installation, outcome assessment and overall implementation, will be brought to completion during this project, culminating in the implementation of the multi-function NNPS in spinal cord injured subjects. The ultimate outcome of this project is that we will demonstrate the feasibility of addressing multiple disabilities in severely disabled individuals using an advanced neuroprosthetic system coupled with a streamlined and cohesive implementation strategy. PUBLIC HEALTH RELEVANCE The impact on the health of disabled individuals of our proposed multi-function neuroprosthesis is signficant. Individuals with cervical-level spinal cord injury should be able to regain the use of the hands for grasp and reaching, regain seating stability, regain the ability to roll over in bed, regain the ability to generate a productive cough, regain bladder function and regain bowel function.

描述（由申请人提供）：创伤性宫颈水平的脊髓损伤可能导致损伤水平的永久性和广泛的麻痹，从而导致多个身体功能的丧失，包括手，躯干和腿部运动，膀胱和肠道控制，以及呼吸能力。 该项目的目的是通过满足个人的整体需求的全面神经心理方法来恢复这些人的这些多个功能。 这种方法涉及实施的各个方面，包括植入技术，手术安装以及通过协调的团队方法评估的结果评估，以最大程度地提高个人获得的功能独立性。 使用该系统，我们打算为患有中颈脊髓损伤的个体提供控制，控制，触及，咳嗽，躺在床上，坐姿和膀胱功能。 在过去的30年中，我们的研究和神经假体系统的研究和临床部署以及我们发展了先进的神经假体的发展，这使这个雄心勃勃的令人兴奋的目标成为可能。 我们预计，该系统不仅将在每个目标的身体功能中提供提高的独立性，而且还将提供总体好处，以证明生活质量和健康成果的显着改善。 在对脊髓损伤受试者的临床可行性研究中，我们的临床研究团队证明了使用长期植入的神经植物对双边手部功能，滚动和姿势控制，咳嗽，膀胱控制和肠道控制的控制。 每项临床研究的结果表明，每个系统都为个人提供了增加的功能独立性。 但是，到目前为止，不可能满足每个人的整体需求，并量身定制一种总体方法，从而最大化获得的功能。 通过开发网络神经假体系统（NNP），我们现在拥有多功能系统的技术基础。 该U01项目中采用的策略是最终确定我们提出的整体神经假体方法的关键组成部分。 因此，该方法的每个组成部分，包括技术，法规批准，外科装置，结果评估和整体实施，都将在此项目期间完成，最终导致脊髓受伤受试者的多功能NNP的实施。 该项目的最终结果是，我们将证明使用先进的神经假体系统以及简化且具有凝聚力的实施策略来解决严重残疾人的多重残疾人的可行性。 公共卫生相关性 我们提出的多功能神经假体对残疾人的健康的影响是显着的。 颈椎损伤的人应能够恢复使用手的使用，以掌握和伸直，恢复座椅稳定性，恢复在床上滚动的能力，恢复产生富有生产力的咳嗽，恢复膀胱功能并恢复肠肠功能的能力。