A Wireless, High-Voltage Compliant, and Energy-Efficient Visual Intracortical Microstimulator

RÉSUMÉ L’objectif général de ce projet de recherche est la conception, la mise en oeuvre et la validation d’une interface sans fil intracorticale implantable en technologie CMOS avancée pour aider les personnes ayant une déficience visuelle. Les défis majeurs de cette recherche sont de répondre à la conformité à haute tension nécessaire à travers l’interface d’électrode-tissu (IET), augmenter la flexibilité dans la microstimulation et la surveillance multicanale, minimiser le budget de puissance pour un dispositif biomédical implantable, réduire la taille de l’implant et améliorer le taux de transmission sans fil des données. Par conséquent, nous présentons dans cette thèse un système de microstimulation intracorticale multi-puce basée sur une nouvelle architecture pour la transmission des données sans fil et le transfert de l’énergie se servant de couplages inductifs et capacitifs. Une première puce, un générateur de stimuli (SG) éconergétique, et une autre qui est un amplificateur de haute impédance se connectant au réseau de microélectrodes de l’étage de sortie. Les 4 canaux de générateurs de stimuli produisent des impulsions rectangulaires, demi-sinus (DS), plateau-sinus (PS) et autres types d’impulsions de courant à haut rendement énergétique. Le SG comporte un contrôleur de faible puissance, des convertisseurs numérique-analogiques (DAC) opérant en mode courant, générateurs multi-forme d’ondes et miroirs de courants alimentés sous 1.2 et 3.3V se servant pour l’interface entre les deux technologies utilisées. Le courant de stimulation du SG varie entre 2.32 et 220μA pour chaque canal. La deuxième puce (pilote de microélectrodes (MED)), une interface entre le SG et de l’arrangement de microélectrodes (MEA), fournit quatre niveaux différents de courant avec la valeur maximale de 400μA par entrée et 100μA par canal de sortie simultanément pour 8 à 16 sites de stimulation à travers les microélectrodes, connectés soit en configuration bipolaire ou monopolaire. Cette étage de sortie est hautement configurable et capable de délivrer une tension élevée pour satisfaire les conditions de l’interface à travers l’impédance de IET par rapport aux systèmes précédemment rapportés. Les valeurs nominales de plus grandes tensions d’alimentation sont de ±10V. La sortie de tension mesurée est conformément 10V/phase (anodique ou cathodique) pour les tensions d’alimentation spécifiées. L’incrémentation de tensions d’alimentation à ±13V permet de produire un courant de stimulation de 220μA par canal de sortie permettant d’élever la tension de sortie jusqu’au 20V par phase. Cet étage de sortie regroupe un commutateur haute tension pour interfacer une matrice des miroirs de courant (3.3V /20V), un registre à décalage de 32-bits à entrée sérielle, sortie parallèle, et un circuit dédié pour bloquer des états interdits.----------ABSTRACT The general objective of this research project is the design, implementation and validation of an implantable wireless intracortical interface in advanced CMOS technology to aid the visually impaired people. The major challenges in this research are to meet the required highvoltage compliance across electrode-tissue interface (ETI), increase lexibility in multichannel microstimulation and monitoring, minimize power budget for an implantable biomedical device, reduce the implant size, and enhance the data rate in wireless transmission. Therefore, we present in this thesis a multi-chip intracortical microstimulation system based on a novel architecture for wireless data and power transmission comprising inductive and capacitive couplings. The first chip is an energy-efficient stimuli generator (SG) and the second one is a highimpedance microelectrode array driver output-stage. The 4-channel stimuli-generator produces rectangular, half-sine (HS), plateau-sine (PS), and other types of energy-efficient current pulse. The SG is featured with low-power controller, current mode source- and sinkdigital- to-analog converters (DACs), multi-waveform generators, and 1.2V/3.3V interface current mirrors. The stimulation current per channel of the SG ranges from 2.32 to 220μA per channel. The second chip (microelectrode driver (MED)), an interface between the SG and the microelectrode array (MEA), supplies four different current levels with the maximum value of 400μA per input and 100μA per output channel. These currents can be delivered simultaneously to 8 to 16 stimulation sites through microelectrodes, connected either in bipolar or monopolar configuration. This output stage is highly-configurable and able to deliver higher compliance voltage across ETI impedance compared to previously reported designs. The nominal values of largest supply voltages are ±10V. The measured output compliance voltage is 10V/phase (anodic or cathodic) for the specified supply voltages. Increment of supply voltages to ±13V allows 220μA stimulation current per output channel enhancing the output compliance voltage up to 20V per phase. This output-stage is featured with a high-voltage switch-matrix, 3.3V/20V current mirrors, an on-chip 32-bit serial-in parallel-out shift register, and the forbidden state logic building blocks. The SG and MED chips have been designed and fabricated in IBM 0.13μm CMOS and Teledyne DALSA 0.8μm 5V/20V CMOS/DMOS technologies with silicon areas occupied by them 1.75 x 1.75mm2 and 4 x 4mm2 respectively. The measured DC power budgets consumed by low-and mid-voltage microchips are 2.56 and 2.1mW consecutively

Toward an energy-efficient high-voltage compliant visual intracortical multichannel stimulator

ABSTRACT: We present, in this paper, a new multichip system aimed toward building an implantable visual intracortical stimulation device. The objective is to deliver energy-optimum pulse patterns to neural sites with needed compliance voltage across high electrode–tissue interface impedance of implantable microelectrodes. The first chip is an energy-efficient stimuli generator (SG), and the second one is a high-impedance microelectrode array driver (MED) output stage. The fourchannel SG produces rectangular, half-sine, plateau-sine, and other types of current pulse with stimulation current ranging from 2.32 to 220 μA per channel. The microelectrode array driver is able to deliver 20 V per anodic or cathodic phase across the microelectrode–tissue interface for ±13 V power supplies. The MED supplies different current levels with the maximum value of 400 μA per input and 100 μA per output channel simultaneously to 8–16 stimulation sites through microelectrodes, connected either in bipolar or monopolar configuration. Both chips receive power via inductive link and data through capacitive coupling. The SG and MED chips have been fabricated in 0.13-μm CMOS and 0.8-μm 5-/20-V CMOS/double-diffused metal-oxidesemiconductor technologies. The measured dc power budgets consumed by low- and mid-voltage chips are 2.56 and 2.1 mW consecutively. The system, modular in architecture, is interfaced with a newly developed platinum-coated pyramidal microelectrode array. In vitro test results with 0.9% phosphate buffer saline show the microelectrode impedance of 70 Ωk at 1 kHz

Intracortical microstimulation of human somatosensory cortex as a source of cutaneous feedback

The field of brain computer interfaces (BCI) has been making rapid advances in decoding brain activity into control signals capable of operating neural prosthetic devices, such as dexterous robotic arms and computer cursors. Potential users of neural prostheses, including people with amputations or spinal cord injuries, retain intact brain function that can be decoded using BCIs. Recent work has demonstrated simultaneous control over up to 10 degrees-of-freedom, but the current paradigms lack a component crucial to normal motor control: somatosensory feedback. Currently, BCIs are controlled using visual feedback alone, which is important for many reaching movement and identifying target locations. However, as the actuators controlled by BCIs become more complex and include devices approximating the performance of human limbs, visual feedback becomes especially limiting, as it cannot convey information used during object manipulation, such as grip force. The objective of this work is to provide real-time, cutaneous, somatosensory feedback to users of dexterous prosthetic limbs under BCI control by applying intracortical microstimulation (ICMS) to primary somatosensory cortex (S1). Long-term microstimulation of the cortex with microelectrode arrays had never been attempted in a human prior to this work, and while this work is ultimately motivated by efforts to improve BCIs, this general approach also enables INTRACORTICAL MICROSTIMULATION OF HUMAN PRIMARY SOMATOSENSORY CORTEX AS A SOURCE OF CUTANEOUS FEEDBACK Sharlene Nicole Flesher, PhD University of Pittsburgh, 2017 v unprecedented access to the human cortex enabling investigations of more basic scientific issues surrounding cutaneous perception, its conscious components, and its role in motor planning and control. To this end, two microelectrode arrays were placed in human somatosensory cortex of a human participant. I first characterized qualities of sensations evoked via ICMS, such as percept location, modality, intensity and size, over a two-year study period. The sensations were found to be focal to a single digit, and increased in intensity linearly with pulse train amplitude, which suggests that ICMS will be a suitable means of relaying locations of object contact with single-digit precision, and a range of grasp forces can be relayed for each location. Additionally, I found these qualities to be stable over a two-year period, suggesting that delivering ICMS was not damaging the electrode-tissue interface. ICMS was then used as a real-time feedback source during BCI control of a robotic limb during tasks ranging from simple force-matching tasks to functional reach, grasp and carry tasks. Finally, we examined the relationship between pulse train parameters and conscious perception of sensations, an endeavor that until now could not have been undertaken. These results demonstrate that ICMS is a suitable means of relaying somatosensory feedback to BCI users. Adding somatosensory feedback to BCI users has the potential to improve embodiment and control of the devices, bringing this technology closer to restoring upper limb function

Direct growth of carbon nanotubes on new high-density 3D pyramid-shaped microelectrode arrays for brain-machine interfaces

Silicon micromachined, high-density, pyramid-shaped neural microelectrode arrays (MEAs) have been designed and fabricated for intracortical 3D recording and stimulation. The novel architecture of this MEA has made it unique among the currently available micromachined electrode arrays, as it has provided higher density contacts between the electrodes and targeted neural tissue facilitating recording from different depths of the brain. Our novel masking technique enhances uniform tip-exposure for variable-height electrodes and improves process time and cost significantly. The tips of the electrodes have been coated with platinum (Pt). We have reported for the first time a selective direct growth of carbon nanotubes (CNTs) on the tips of 3D MEAs using the Pt coating as a catalyzer. The average impedance of the CNT-coated electrodes at 1 kHz is 14 k. The CNT coating led to a 5-fold decrease of the impedance and a 600-fold increase in charge transfer compared with the Pt electrode

High-Density 3D Pyramid-Shaped Microelectrode Arrays for Brain-Machine Interface Applications

RÉSUMÉ Les dispositifs médicaux dédiés aux enregistrements des activités neuronales et à la stimulation de tissus nerveux sont appelés interfaces cerveau-machines. Ils offrent un potentiel important pour restaurer diverses fonctions neurologiques perdues. Un élément clé dans la mise en œuvre des dispositifs est le réseau de microélectrodes (MEAs pour MicroElectrode Arrays en anglais) servant d’interface avec les tissus nerveux. Les MEA jouent un rôle important dans les implants lors d’expérimentations chroniques, ils doivent être fiables, stables et efficaces pour l'enregistrement et la stimulation à long terme. Les propriétés électrochimiques et la compatibilité biologique des microélectrodes sont des facteurs essentiels qui doivent être prises en compte lors de leur conception et fabrication. La présente thèse traite de la conception et la fabrication de MEA en silicium micro-usiné à haute densité et en forme de pyramides qui sont destinés à l’enregistrement et la stimulation intracorticals 3D. Nous nous concentrons principalement sur les techniques de microfabrication des électrodes et le développement de procédure du revêtement de matériaux nécessaires pour la biocompatibilité et protection des dispositifs implantables. Nous élaborons des microélectrodes à hauteur variable pour enregistrer des signaux neuronaux, sans perdre la capacité de microstimulation et tout en maintenant des impédances de faibles valeurs. Cette caractéristique est obtenue en modifiant la géométrie et la composition de matériaux utilisés, ce qui facilite l'injection de charge et la résolution spatiale élevée. Nous présentons une nouvelle technique de micro-usinage 3D à nombre réduit de masques comparé aux techniques existantes. Nous décrivons la mise en œuvre d’un MEA à haute densité (25 électrodes / 1,96 mm2) et à différentes longueurs d’électrodes. En outre, une nouvelle technique de masquage à base de film sec a été développée pour obtenir de très petites surfaces actives pour les microélectrodes qui sont à hauteur variable. Nous avons réduit les étapes du procédé de masquage de 14 à 6 par rapport à la méthode classique de masquage utilisé dans la littérature. Nous avons ensuite effectué, pour la première fois, une croissance directe sélective de nanotubes de carbone sur les têtes de microélectrodes de longueurs variables en utilisant la technique du dépôt chimique en phase vapeur assisté par plasma (Plasma-Enhanced Chemical Vapor Deposition - PECVD).----------ABSTRACT Neuroprosthetic devices that can record neural activities and stimulate the central nervous system (CNS), called brain-machine interfaces (BMI), offer significant potential to restore various lost neurologic functions. A key element in functions restoration is Microelectrode arrays (MEAs) implanted in neural tissues. MEAs, which act as an interface between bioelectronic devices and neural tissues, play an important role in chronic implants and must be reliable, stable, and efficient for long-term recording and stimulation. Electrochemical properties and biological compatibility of chronic microelectrodes are essential factors that must be taken into account in their design and fabrication. The present thesis deals with the design and fabrication of silicon micromachined, high-density, pyramid-shaped neural MEAs for intracortical 3D recording and stimulation. The focused is mainly on the MEAs fabrication techniques and development of coating materials process required with implantable devices with an ultimate purpose: elaborate variable-height microelectrodes to obtain consistent recording signals from small groups of neurons without losing microstimulation capabilities, while maintaining low-impedance pathways for charge injection, high charge transfer, and high-spatial resolution by altering the geometries and material compositions of the array. In the first part of the thesis, we present a new 3D micromachining technique with a single masking step in a time and cost effective manner. A high density 25 electrodes/ 1.96 mm2 MEA with varying lengths electrodes to access neurons that are located in different depths of cortical tissue was designed and fabricated. Furthermore, a novel dry-film based masking technique for procuring extremely small active area for variable-height electrodes has been developed. With this technology, we have reduced the masking process steps from 14 to 6 compared to the conventional masking method. We have then reported for the first time a selective direct growth of carbon nanotubes (CNTs) on the tips of 3D MEAs using Plasma Enhanced Chemical Vapor Deposition (PECVD) that could enhance electrical properties of the electrodes significantly. The CNT coating led to a 5-fold decrease in impedance and a 600-fold increase in charge transfer compared with Pt electrode. Finally, we have highlighted the importance of the coating MEAs with bioactive molecules (Poly-D-lysine) and polyethylene glycol (PEG) hydrogels to minimize the immune response of the neural tissue to implanted MEAs by in vitro cell-culture tests

Génération de stimuli efficaces en énergie pour la microstimulation électrique intracorticale

RÉSUMÉ Ce mémoire a comme objectif principal la mise en oeuvre de circuits dédiés à l’amélioration de l’efficacité de la stimulation électrique de tissus situés au niveau du cortex visuel primaire. Le stimulateur proposé permet la génération de nouveaux stimuli flexibles de forme exponentielle et demi-sinusoïdale dans l’optique de réduire la consommation de puissance globale de l’implant. En plus d’être potentiellement plus efficaces que les stimulations rectangulaires standard pour exciter les tissus, ces formes d’impulsions permettraient également de réduire la concentration d’ions toxiques relâchés par les électrodes. Le second objectif de ce projet est de permettre la stimulation à pleine échelle, soit au moins 150 µA, à travers l’interface microélectrode-tissus qui est caractérisée par une impédance élevée. Un étage de sortie à haute-tension a donc également été réalisé afin de générer des tensions d’alimentation d’environ ±9 V et d’augmenter ainsi l’excursion de tension des stimuli tout en étant entièrement intégré. Une architecture comportant deux circuits intégrés indépendants est proposée dans ce mémoire. Le générateur de stimuli est implémenté dans la technologie CMOS 0,18-µ m 1,8V/3,3V de TSMC afin de limiter sa consommation de puissance. Pour ce qui est de l’étage de sortie, il est intégré à l’aide du procédé C08E CMOS/DMOS 0,8-µ m 5V/20V de DALSA Semiconductors, technologie supportant les niveaux de tension requis.Les deux puces ainsi fabriquées ont été testées. L’intensité des stimuli rectangulaires couvre une plage de 1,6 à 167,2 µ A des erreurs de non-linéarité différentielle et intégrale de 0,10 et 0,16 LSB respectivement. Les impulsions exponentielles ont une plage dynamique de 34,36 dB pour une erreur de ±0,5 dB par rapport à la fonction théorique. La consommation de puissance du générateur de stimuli atteint en moyenne 29,1 µW en mode rectangulaire et de 28,5 à 88,3 µ W en mode exponentiel. Les résultats obtenus pour la demi-sinusoïde proviennent de simulations. En moyenne, 80,2 % de la durée des impulsions demi-sinusoïdales a une erreur inférieure à ±1 % par rapport à la fonction idéale. Le générateur de stimuli complet consomme de 46,7 à 199,1 µW en mode demi-sinusoïdal. En ce qui a trait à l’étage de sortie, des tensions de 8,95 et -8,46 V sont générées avec succès, permettant à l’excursion de tension d’atteindre 13,6 V à travers une charge de 100 kΩ.----------ABSTRACT This master thesis’ main objective is the implementation of circuits dedicated to electrical stimulation efficiency enhancement for tissues in the primary visual cortex. The proposed stimulator allows novel stimuli waveform generation such as flexible exponential and half-sine pulses in order to reduce the implant’s global power consumption. In addition of being potentially more efficient to excite neural tissues than standard rectangular pulse-based stimulations, these waveforms should also reduce toxic ions concentration released by the electrodes. Moreover, this project’s second objective is to allow full-scale stimulation, i.e., at least 150 µA, through high-impedance microelectrode-tissue interfaces. A high-voltage output stage has also been realized to generate ±9 V voltage supplies to increase the voltage swing while being fully-integrated. An architecture composed of two independent integrated circuits has been proposed. The stimuli generator is implemented in TSMC CMOS 0.18-µ m 1.8V/3.3V technology to limit its power consumption. On the other hand, the output stage is integrated in C08E CMOS/DMOS 0.8- µm 5V/20V process from DALSA Semiconductors as this technology supports the required voltage levels.These two fabricated chips were tested. Rectangular stimuli intensity varies from 1.6 to 167.2 µA with differential and integral nonlinearities of 0.10 and 0.16 LSB, respectively. Exponential pulses show a dynamic range of 34.36 dB for an error of ±0.5 dB with the theoretical waveform. The stimuli generator’s power consumption reaches an average of 29.1 µW in rectangular mode and from 28.5 to 88.3 µW in exponential mode. Half-sine results are obtained from simulations. An average of 80.2 % of half-sine pulse duration has an error lower than ±1 % with the ideal sine function. The whole stimuli generator consumes from 46.7 to 199.1 µW in half-sine mode. For the output stage, voltages of 8.95 and -8.46 V are successfully generated, allowing the output voltage compliance to reach 13.6 V through a 100 kΩ load. However, this chip dissipates 51.37 mW when operating normally

Prosthetic Control and Sensory Feedback for Upper Limb Amputees

Hand amputation could dramatically degrade the life quality of amputees. Many amputees use prostheses to restore part of the hand functions. Myoelectric prosthesis provides the most dexterous control. However, they are facing high rejection rate. One of the reasons is the lack of sensory feedback. There is a need for providing sensory feedback for myoelectric prosthesis users. It can improve object manipulation abilities, enhance the perceptual embodiment of myoelectric prostheses and help reduce phantom limb pain. This PhD work focuses on building bi-directional prostheses for upper limb amputees. In the introduction chapter, first, an overview of upper limb amputee demographics and upper limb prosthesis is given. Then the human somatosensory system is briefly introduced. The next part reviews invasive and non-invasive sensory feedback methods reported in the literature. The rest of the chapter describes the motivation of the project and the thesis organization. The first step to build a bi-directional prostheses is to investigate natural and robust multifunctional prosthetic control. Most of the commerical prostheses apply non-pattern recognition based myoelectric control methods, which offers only limited functionalities. In this thesis work, pattern recognition based prosthetic control employing three commonly used and representative machine learning algorithms is investigated. Three datasets involving different levels of upper arm movements are used for testing the algorithm effectiveness. The influence of time-domain features, window and increment sizes, algorithms, and post-processing techniques are analyzed and discussed. The next three chapters address different aspects of providing sensory feedback. The first focus of sensory feedback process is the automatic phantom map detection. Many amputees have referred sensation from their missing hand on their residual limbs (phantom maps). This skin area can serve as a target for providing amputees with non-invasive tactile sensory feedback. One of the challenges of providing sensory feedback on the phantom map is to define the accurate boundary of each phantom digit because the phantom map distribution varies from person to person. Automatic phantom map detection methods based on four decomposition support vector machine algorithms and three sampling methods are proposed. The accuracy and training/ classification time of each algorithm using a dense stimulation array and two coarse stimulation arrays are presented and compared. The next focus of the thesis is to develop non-invasive tactile display. The design and psychophysical testing results of three types of non-invasive tactile feedback arrays are presented: two with vibrotactile modality and one with multi modality. For vibrotactile, two types of miniaturized vibrators: eccentric rotating masses (ERMs) and linear resonant actuators (LRAs) were first tested on healthy subjects and their effectiveness was compared. Then the ERMs are integrated into a vibrotactile glove to assess the feasibility of providing sensory feedback for unilateral upper limb amputees on the contralateral hand. For multimodal stimulation, miniature multimodal actuators integrating servomotors and vibrators were designed. The actuator can be used to deliver both high-frequency vibration and low-frequency pressures simultaneously. By utilizing two modalities at the same time, the actuator stimulates different types of mechanoreceptors and thus h

Novel Bidirectional Body - Machine Interface to Control Upper Limb Prosthesis

Objective. The journey of a bionic prosthetic user is characterized by the opportunities and limitations involved in adopting a device (the prosthesis) that should enable activities of daily living (ADL). Within this context, experiencing a bionic hand as a functional (and, possibly, embodied) limb constitutes the premise for mitigating the risk of its abandonment through the continuous use of the device. To achieve such a result, different aspects must be considered for making the artificial limb an effective support for carrying out ADLs. Among them, intuitive and robust control is fundamental to improving amputees’ quality of life using upper limb prostheses. Still, as artificial proprioception is essential to perceive the prosthesis movement without constant visual attention, a good control framework may not be enough to restore practical functionality to the limb. To overcome this, bidirectional communication between the user and the prosthesis has been recently introduced and is a requirement of utmost importance in developing prosthetic hands. Indeed, closing the control loop between the user and a prosthesis by providing artificial sensory feedback is a fundamental step towards the complete restoration of the lost sensory-motor functions. Within my PhD work, I proposed the development of a more controllable and sensitive human-like hand prosthesis, i.e., the Hannes prosthetic hand, to improve its usability and effectiveness. Approach. To achieve the objectives of this thesis work, I developed a modular and scalable software and firmware architecture to control the Hannes prosthetic multi-Degree of Freedom (DoF) system and to fit all users’ needs (hand aperture, wrist rotation, and wrist flexion in different combinations). On top of this, I developed several Pattern Recognition (PR) algorithms to translate electromyographic (EMG) activity into complex movements. However, stability and repeatability were still unmet requirements in multi-DoF upper limb systems; hence, I started by investigating different strategies to produce a more robust control. To do this, EMG signals were collected from trans-radial amputees using an array of up to six sensors placed over the skin. Secondly, I developed a vibrotactile system to implement haptic feedback to restore proprioception and create a bidirectional connection between the user and the prosthesis. Similarly, I implemented an object stiffness detection to restore tactile sensation able to connect the user with the external word. This closed-loop control between EMG and vibration feedback is essential to implementing a Bidirectional Body - Machine Interface to impact amputees’ daily life strongly. For each of these three activities: (i) implementation of robust pattern recognition control algorithms, (ii) restoration of proprioception, and (iii) restoration of the feeling of the grasped object's stiffness, I performed a study where data from healthy subjects and amputees was collected, in order to demonstrate the efficacy and usability of my implementations. In each study, I evaluated both the algorithms and the subjects’ ability to use the prosthesis by means of the F1Score parameter (offline) and the Target Achievement Control test-TAC (online). With this test, I analyzed the error rate, path efficiency, and time efficiency in completing different tasks. Main results. Among the several tested methods for Pattern Recognition, the Non-Linear Logistic Regression (NLR) resulted to be the best algorithm in terms of F1Score (99%, robustness), whereas the minimum number of electrodes needed for its functioning was determined to be 4 in the conducted offline analyses. Further, I demonstrated that its low computational burden allowed its implementation and integration on a microcontroller running at a sampling frequency of 300Hz (efficiency). Finally, the online implementation allowed the subject to simultaneously control the Hannes prosthesis DoFs, in a bioinspired and human-like way. In addition, I performed further tests with the same NLR-based control by endowing it with closed-loop proprioceptive feedback. In this scenario, the results achieved during the TAC test obtained an error rate of 15% and a path efficiency of 60% in experiments where no sources of information were available (no visual and no audio feedback). Such results demonstrated an improvement in the controllability of the system with an impact on user experience. Significance. The obtained results confirmed the hypothesis of improving robustness and efficiency of a prosthetic control thanks to of the implemented closed-loop approach. The bidirectional communication between the user and the prosthesis is capable to restore the loss of sensory functionality, with promising implications on direct translation in the clinical practice

Augmentation of Brain Function: Facts, Fiction and Controversy. Volume III: From Clinical Applications to Ethical Issues and Futuristic Ideas

The final volume in this tripartite series on Brain Augmentation is entitled “From Clinical Applications to Ethical Issues and Futuristic Ideas”. Many of the articles within this volume deal with translational efforts taking the results of experiments on laboratory animals and applying them to humans. In many cases, these interventions are intended to help people with disabilities in such a way so as to either restore or extend brain function. Traditionally, therapies in brain augmentation have included electrical and pharmacological techniques. In contrast, some of the techniques discussed in this volume add specificity by targeting select neural populations. This approach opens the door to where and how to promote the best interventions. Along the way, results have empowered the medical profession by expanding their understanding of brain function. Articles in this volume relate novel clinical solutions for a host of neurological and psychiatric conditions such as stroke, Parkinson’s disease, Huntington’s disease, epilepsy, dementia, Alzheimer’s disease, autism spectrum disorders (ASD), traumatic brain injury, and disorders of consciousness. In disease, symptoms and signs denote a departure from normal function. Brain augmentation has now been used to target both the core symptoms that provide specificity in the diagnosis of a disease, as well as other constitutional symptoms that may greatly handicap the individual. The volume provides a report on the use of repetitive transcranial magnetic stimulation (rTMS) in ASD with reported improvements of core deficits (i.e., executive functions). TMS in this regard departs from the present-day trend towards symptomatic treatment that leaves unaltered the root cause of the condition. In diseases, such as schizophrenia, brain augmentation approaches hold promise to avoid lengthy pharmacological interventions that are usually riddled with side effects or those with limiting returns as in the case of Parkinson’s disease. Brain stimulation can also be used to treat auditory verbal hallucination, visuospatial (hemispatial) neglect, and pain in patients suffering from multiple sclerosis. The brain acts as a telecommunication transceiver wherein different bandwidth of frequencies (brainwave oscillations) transmit information. Their baseline levels correlate with certain behavioral states. The proper integration of brain oscillations provides for the phenomenon of binding and central coherence. Brain augmentation may foster the normalization of brain oscillations in nervous system disorders. These techniques hold the promise of being applied remotely (under the supervision of medical personnel), thus overcoming the obstacle of travel in order to obtain healthcare. At present, traditional thinking would argue the possibility of synergism among different modalities of brain augmentation as a way of increasing their overall effectiveness and improving therapeutic selectivity. Thinking outside of the box would also provide for the implementation of brain-to-brain interfaces where techniques, proper to artificial intelligence, could allow us to surpass the limits of natural selection or enable communications between several individual brains sharing memories, or even a global brain capable of self-organization. Not all brains are created equal. Brain stimulation studies suggest large individual variability in response that may affect overall recovery/treatment, or modify desired effects of a given intervention. The subject’s age, gender, hormonal levels may affect an individual’s cortical excitability. In addition, this volume discusses the role of social interactions in the operations of augmenting technologies. Finally, augmenting methods could be applied to modulate consciousness, even though its neural mechanisms are poorly understood. Finally, this volume should be taken as a debate on social, moral and ethical issues on neurotechnologies. Brain enhancement may transform the individual into someone or something else. These techniques bypass the usual routes of accommodation to environmental exigencies that exalted our personal fortitude: learning, exercising, and diet. This will allow humans to preselect desired characteristics and realize consequent rewards without having to overcome adversity through more laborious means. The concern is that humans may be playing God, and the possibility of an expanding gap in social equity where brain enhancements may be selectively available to the wealthier individuals. These issues are discussed by a number of articles in this volume. Also discussed are the relationship between the diminishment and enhancement following the application of brain-augmenting technologies, the problem of “mind control” with BMI technologies, free will the duty to use cognitive enhancers in high-responsibility professions, determining the population of people in need of brain enhancement, informed public policy, cognitive biases, and the hype caused by the development of brain- augmenting approaches