CORTIVIS Approach for an Intracortical Visual Prostheses
Cortical prostheses are a subgroup of visual neuroprostheses capable of evoking visual percepts in profoundly blind people through direct electrical stimulation of the occipital cortex. This approach may be the only treatment available for blindness cause
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CORTIVIS Approach for an Intracortical Visual Prostheses Eduardo Fernández and Richard A. Normann
Abstract Cortical prostheses are a subgroup of visual neuroprostheses capable of evoking visual percepts in profoundly blind people through direct electrical stimulation of the occipital cortex. This approach may be the only treatment available for blindness caused by glaucoma, end-stage retinitis pigmentosa, optic atrophy, trauma to the retinas and/or optic nerves or by diseases of the central visual pathways such as brain injuries or stroke. However the selection of a specific person for a cortical implant is not straightforward and currently there are not strict standardized criteria for accepting or rejecting a candidate. We are now facing the challenge of creating such an intracortical visual neuroprosthesis designed to interface with the occipital visual cortex as a means through which a limited but useful visual sense could be restored to these blind patients. Keywords Visual prosthesis • Artificial vision • Electrode arrays • Surgical technique • Phosphenes • Electrical stimulation • Human striate cortex • Plasticity
Key Points • The intracortical approach may be the only treatment available for pathologies affecting the entire retina, optic nerve, thalamus or the brain. • While the full restoration of vision seems to be unlikely in the near future, a cortical device can create meaningful visual percepts, resulting in a substantial improvement in the quality of life of blind and visually impaired persons. • The surgical approach for the implantation of intracortical microelectrodes is straightforward and follows standard neurosurgical procedures. • A modulation and better understanding of adaptive brain changes following vision loss is crucial for restoring a useful vision.
E. Fernández, MD, PhD (*) Department of Neural Engineering, Miguel Hernández University, CIBER BBN, Elche, Alicante, Spain e-mail: [email protected] R.A. Normann, PhD Department of Bioengineering, University of Utah, Salt Lake City, UT, USA © Springer International Publishing Switzerland 2017 V.P. Gabel (ed.), Artificial Vision, DOI 10.1007/978-3-319-41876-6_15
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E. Fernández and R.A. Normann
Principal Idea Loss of vision affects millions of people worldwide and poses extraordinary challenges to individuals in our society that relies heavily on sight. Although in recent years the techniques of molecular genetics have led to a rapid identification of a great number of genes involved in visual diseases (see https://sph.uth.edu/Retnet/ sum-dis.htm for an update of genes and loci causing retinal diseases), and there are significant advancements in the development of different approaches for artificial vision, at present there is no effective treatment for many patients who are visually handicapped as a result of degeneration or damage to the inner layers of the retina, the optic nerve or the visual pathways. Therefore, there are compelling reasons to pursue the development of a cortical visual prosthesis capable of restoring some
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