DSpace Angular :: Browsing by Author "Shivdasani, Mohit"

Browsing by Author "Shivdasani, Mohit"

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Acute Cochlear Nucleus Compression Alters Tuning Properties of Inferior Colliculus Neurons
(Karger Publishers, 2009) Crea, Katherine; Shivdasani, Mohit; Argent, Rebecca; Mauger, Stefan; Rathbone, Graeme; O'Leary, Stephen; Paolini, Antonio
Auditory brainstem implants (ABI) have been used in neurofibromatosis type 2 (NF2) patients in an attempt to restore hearing sensation, with limited clinical success. Factors associated with poor clinical outcomes for NF2 ABI patients include larger tumour size, longer duration of hearing loss, and brainstem distortion and/or deformation caused by tumours that compress the brainstem. The present study investigated changes in tuning properties of inferior colliculus (IC) neurons following compression of the contralateral cochlear nucleus (CN). The left CN in adult rats (n = 8) was exposed and a 32-channel acute recording probe inserted along the tonotopic gradient of the right IC. In 4 animals, an ethylene vinyl acetate bead was applied to the exposed CN. Three recordings were made corresponding to T(1) = 0 min (before compression), T(2) = 45 min (during compression) and T(3) = 225 min (following bead removal/recovery). Recordings consisted of a response area protocol using pure tones of various frequencies and intensities (1-44 kHz; 10-70 dB SPL) to determine the characteristic frequency for each probe site. Compression of the CN led to sharpened tuning curves, decreased spike rate, and increased threshold and characteristic frequency in the IC. Reversal of compression enabled these variables, excluding threshold, to recover to baseline. NF2 patients may have poorer ABI performance due to damage to the physical structure of the CN, resulting in alterations to the tonotopic organisation of the auditory pathway which may complicate ABI implantation and activation.
An all-diamond, hermetic electrical feedthrough array for a retinal prosthesis
(Elsevier, 2014-01) Ganesan, Kumaravelu; Garrett, David; Ahnood, Arman; Shivdasani, Mohit; Tong, Wei; Turnley, Ann; Fox, Kate; Meffin, Hamish; Prawer, Steven
The interface between medical implants and the human nervous system is rapidly becoming more and more complex. This rise in complexity is driving the need for increasing numbers of densely packed electrical feedthroughs to carry signals to and from implanted devices. This is particularly crucial in the field of neural prosthesis where high resolution stimulating or recording arrays near peripheral nerves or in the brain could dramatically improve the performance of these devices. Here we describe a flexible strategy for implementing high density, high count arrays of hermetic electrical feedthroughs by forming conducting nitrogen doped nanocrystalline diamond channels within an insulating polycrystalline diamond substrate. A unique feature of these arrays is that the feedthroughs can themselves be used as stimulating electrodes for neural tissue. Our particular application is such a feedthrough, designed as a component of a retinal implant to restore vision to the blind. The hermeticity of the feedthroughs means that the array can also form part of an implantable capsule which can interface directly with internal electronic chips. The hermeticity of the array is demonstrated by helium leak tests and electrical and electrochemical characterisation of the feedthroughs is described. The nitrogen doped nanocrystalline diamond forming the electrical feedthroughs is shown to be non cyctotoxic. New fabrication strategies, such as the one described here, combined with the exceptional biostability of diamond can be exploited to generate a range of biomedical implants that last for the lifetime of the user without fear of degradation.
The Appearance of Phosphenes Elicited Using a Suprachoroidal Retinal Prosthesis
(iOVS, 2016-09) Sinclair, Nicholas; Shivdasani, Mohit; Perera, Thushara; Gillespie, Lisa; McDermott, Hugh; Ayton, Lauren; Blamey, Peter
Purpose: Phosphenes are the fundamental building blocks for presenting meaningful visual information to the visually impaired using a bionic eye device. The aim of this study was to characterize the size, shape, and location of phosphenes elicited using a suprachoroidal retinal prosthesis. Methods: Three patients with profound vision loss due to retinitis pigmentosa were implanted with a suprachoroidal electrode array, which was used to deliver charge-balanced biphasic constant-current pulses at various rates, amplitudes, and durations to produce phosphenes. Tasks assessing phosphene appearance, location, overlap, and the patients' ability to recognize phosphenes were performed using a custom psychophysics setup. Results: Phosphenes were reliably elicited in all three patients, with marked differences in the reported appearances between patients and between electrodes. Phosphene shapes ranged from simple blobs to complex forms with multiple components in both space and time. Phosphene locations within the visual field generally corresponded to the retinotopic position of the stimulating electrodes. Overlap between phosphenes elicited from adjacent electrodes was observed with one patient, which reduced with increasing electrode separation. In a randomized recognition task, two patients correctly identified the electrode being stimulated for 57.2% and 23% of trials, respectively. Conclusions: Phosphenes of varying complexity were successfully elicited in all three patients, indicating that the suprachoroidal space is an efficacious site for electrically stimulating the retina. The recognition scores obtained with two patients suggest that a suprachoroidal implant can elicit phosphenes containing unique information. This information may be useful when combining phosphenes into more complex and meaningful images that provide functional vision.
Are long stimulus pulse durations the answer to improving spatial resolution in retinal prostheses?
(Annals of Translational Medicine, 2016-11) Petoe, Matthew; Shivdasani, Mohit
Retinal prostheses can provide artificial vision to patients with degenerate retinae by electrically stimulating the remaining inner retinal neurons. The evoked perception is generally adequate for light localization, but of limited spatial resolution owing to the indiscriminate activation of multiple retinal cell types, leading to distortions in the perceived image. Here we present a perspective on a recent work by Weitz and colleagues who demonstrate a focal confinement of retinal ganglion cell (RGC) activation when using extended pulse durations in the stimulation waveform. Using real-time calcium imaging, they provide evidence that long pulse durations selectively stimulate inner retinal neurons, whilst avoiding unwanted axonal activations. The application of this stimulation technique may provide enhanced spatial resolution for retinal prosthesis users. These experiments provide a robust analysis of the effects of increasing pulse duration and introduce the potential for alternative stimulation paradigms in retinal prostheses.
Audiovisual integration in noise by children and adults
(Elsevier,, 2010) Barutchu, Ayla; Danaher, Jaclyn; Crewther, Sheila; Innes-Brown, Hamish; Shivdasani, Mohit; Paolini, Antonio
The aim of this study was to investigate the development of multisensory facilitation in primary school age children under conditions of auditory noise. Motor reaction times and accuracy were recorded from 8-year-olds, 10-year-olds and adults during an auditory, a visual, and an audiovisual detection task. Auditory signal-to-noise ratios (SNRs) of 30, 22, 12 and 9 dB across the different age groups were compared. Multisensory facilitation was greater in adults than in children, though performance for all age-groups was affected by the presence of background noise. It is posited that changes in multisensory facilitation with increased auditory noise may be due to changes in attention bias.
An automated system for rapid evaluation of high-density electrode arrays in neural prostheses
(Institute of Physics, 2011-06) John, Sam; Shivdasani, Mohit; Leuenberger, James; Fallon, James; Shepherd, Robert; Millard, Rodney; Rathbone, Graeme; Williams, Chris
The success of high density electrode arrays for use in neural prostheses depends on efficient impedance monitoring and fault detection. Conventional methods of impedance testing and fault detection are time consuming and are not always suited for in-vivo assessment of high density electrode arrays. Additionally the ability to evaluate impedances and faults such as open and short circuits both, in-vitro and in-vivo are important to ensure safe and effective stimulation. In the present work we describe an automated system for the rapid evaluation of high density electrode arrays. The system uses a current pulse similar to that used to stimulate neural tissue and measures the voltage across the electrode in order to calculate the impedance. The switching of the system was validated by emulating a high density electrode array using light emitting diodes and a resistor- capacitor network. The system was tested in-vitro and in-vivo using a range of commercially available and in-house developed electrode arrays. The system accurately identified faults on an 84 electrode array in less than 20 seconds and reliably measured impedances up to 110 kn using a 200µA, 250 µs per phase current pulse. This system has direct application for screening high density electrode arrays in both a clinical and experimental setting.
Cortical activation following chronic passive implantation of a wide-field suprachoroidal retinal prosthesis
(IOP Publishing, 2014-06) Villalobos, Joel; Fallon, James; Nayagam, David; Shivdasani, Mohit; Luu, Chi; Allen, Penelope; Shepherd, Robert; Williams, Chris
OBJECTIVE: The research goal is to develop a wide-field retinal stimulating array for prosthetic vision. This study aimed at evaluating the efficacy of a suprachoroidal electrode array in evoking visual cortex activity after long term implantation. APPROACH: A planar silicone based electrode array (8 mm × 19 mm) was implanted into the suprachoroidal space in cats (ntotal = 10). It consisted of 20 platinum stimulating electrodes (600 μm diameter) and a trans-scleral cable terminated in a subcutaneous connector. Three months after implantation (nchronic = 6), or immediately after implantation (nacute = 4), an electrophysiological study was performed. Electrode total impedance was measured from voltage transients using 500 μs, 1 mA pulses. Electrically evoked potentials (EEPs) and multi-unit activity were recorded from the visual cortex in response to monopolar retinal stimulation. Dynamic range and cortical activation spread were calculated from the multi-unit recordings. MAIN RESULTS: The mean electrode total impedance in vivo following 3 months was 12.5 ± 0.3 kΩ. EEPs were recorded for 98% of the electrodes. The median evoked potential threshold was 150 nC (charge density 53 μC cm(-2)). The lowest stimulation thresholds were found proximal to the area centralis. Mean thresholds from multiunit activity were lower for chronic (181 ± 14 nC) compared to acute (322 ± 20 nC) electrodes (P < 0.001), but there was no difference in dynamic range or cortical activation spread. SIGNIFICANCE: Suprachoroidal stimulation threshold was lower in chronic than acute implantation and was within safe charge limits for platinum. Electrode-tissue impedance following chronic implantation was higher, indicating the need for sufficient compliance voltage (e.g. 12.8 V for mean impedance, threshold and dynamic range). The wide-field suprachoroidal array reliably activated the retina after chronic implantation.
Creating virtual electrodes with two-dimensional current steering
(IOP Publishing Ltd, 2018-02) Spencer, Thomas; Fallon, James; Shivdasani, Mohit
OBJECTIVE: Current steering techniques have shown promise in retinal prostheses as a way to increase the number of distinct percepts elicitable without increasing the number of implanted electrodes. Previously, it has been shown that 'virtual' electrodes can be created between simultaneously stimulated electrode pairs, producing unique cortical response patterns. This study investigated whether virtual electrodes could be created using two-dimensional current steering, and whether these virtual electrodes can produce cortical responses with predictable spatial characteristics. Approach: Normally-sighted eyes of seven adult anaesthetised cats were implanted with a 42-channel electrode array in the suprachoroidal space and multi-unit neural activity was recorded from the visual cortex. Stimuli were delivered to individual physical electrodes, or electrodes grouped into triangular, rectangular, and hexagonal arrangements. Varying proportions of charge were applied to each electrode in a group to "steer" current and create virtual electrodes. The centroids of cortical responses to stimulation of virtual electrodes were compared to those evoked by stimulation of single physical electrodes. Results: Responses to stimulation of groups of up to six electrodes with equal ratios of charge on each electrode resulted in cortical activation patterns that were similar to those elicited by the central physical electrode (Centroid's: RM ANOVA on Ranks, p>0.05; Neural Spread: Stats Test; p>0.05). We were also able to steer the centroid of activation towards the direction of any of the electrodes of the group by applying a greater charge to that electrode, but the movement in the centroid was not found to be significant. Significance: The results suggest that current steering is possible in two dimensions between up to at least six electrodes, indicating it may be possible to increase the number of percepts in patients without increasing the number of physical electrodes. Being able to reproduce spatial characteristics of responses to individual physical electrodes suggests that this technique could also be used to compensate for faulty electrodes.
Determining the Contribution of Retinotopic Discrimination to Localization Performance With a Suprachoroidal Retinal Prosthesis
(IOVS, 2017-06) Petoe, Matthew; McCarthy, Chris; Shivdasani, Mohit; Sinclair, Nicholas; Scott, Adele; Ayton, Lauren; Barnes, Nick; Bionic Vision Australia Consortium
Purpose: With a retinal prosthesis connected to a head-mounted camera, subjects can perform low vision tasks using a combination of electrode discrimination and head-directed localization. The objective of the present study was to investigate the contribution of retinotopic electrode discrimination (perception corresponding to the arrangement of the implanted electrodes with respect to their position beneath the retina) to visual performance for three recipients of a 24-channel suprachoroidal retinal implant. Proficiency in retinotopic discrimination may allow good performance with smaller head movements, and identification of this ability would be useful for targeted rehabilitation. Methods: Three participants with retinitis pigmentosa performed localization and grating acuity assessments using a suprachoroidal retinal prosthesis. We compared retinotopic and nonretinotopic electrode mapping and hypothesized that participants with measurable acuity in a normal retinotopic condition would be negatively impacted by the nonretinotopic condition. We also expected that participants without measurable acuity would preferentially use head movement over retinotopic information. Results: Only one participant was able to complete the grating acuity task. In the localization task, this participant exhibited significantly greater head movements and significantly lower localization scores when using the nonretinotopic electrode mapping. There was no significant difference in localization performance or head movement for the remaining two subjects when comparing retinotopic to nonretinotopic electrode mapping. Conclusions: Successful discrimination of retinotopic information is possible with a suprachoroidal retinal prosthesis. Head movement behavior during a localization task can be modified using a nonretinotopic mapping. Behavioral comparisons using retinotopic and nonretinotopic electrode mapping may be able to highlight deficiencies in retinotopic discrimination, with a view to address these deficiencies in a rehabilitation environment. (ClinicalTrials.gov number, NCT01603576).
Development and Characterization of a Sucrose Microneedle Neural Electrode Delivery System
(Wiley, 2017-12) Apollo, Nicholas; Jiang, Jonathon; Cheung, Warwick; Baquier, Sebastien; Lai, Alan; Mirebedini, Azadeh; Foroughi, Javad; Wallace, Gordon; Shivdasani, Mohit; Prawer, Steven; Chen, Shou; Williams, Richard; Cook, Mark; Nayagam, David; Garrett, David
Stable brain–machine interfaces present extraordinary therapeutic and scientific promise. However, the electrode–tissue interface is susceptible to instability and damage during long-term implantation. Soft, flexible electrodes demonstrate improved longevity, but pose a new challenge with regard to simple and accurate surgical implantation. A high aspect ratio water-soluble microneedle is developed based on sucrose which permits straightforward surgical implantation of soft, flexible microelectrodes. Here, a description of the microneedle manufacturing process is presented, along with in vitro and in vivo safety and efficacy assessments. Successful fabrication requires control of the glass transition temperature of aqueous sucrose solutions. The insertion force of 5 different microneedle electrode vehicles is studied in agarose brain phantoms, with the sucrose microneedle eliciting the lowest insertion force and strain energy transfer. Short- and long-term assessments of the pathological response to sucrose microneedle implantations in the brain suggest minimal tissue reactions, comparable to those observed following stainless-steel hypodermic needle punctures. Finally, microelectrodes fabricated from graphene, carbon nanotubes, or platinum are embedded in sucrose microneedles and implanted into an epileptic rat model for 22 d. All electrodes are functional throughout the implantation period, with the graphene electrode exhibiting the largest seizure signal-to-noise ratio and only modest changes in impedance.
Development of a Magnetic Attachment Method for Bionic Eye Applications
(Wiley Periodicals, Inc., 2016) Fox, Kate; Meffin, Hamish; Burns, Owen; Abbott, Carla; Allen, Penelope; Opie, Nicholas; McGowan, Ceara; Yeoh, Jonathon; Ahnood, Arman; Luu, Chi; Cicione, Rosemary; Saudners, Alexia; McPhedran, Michelle; Cardamone, Lisa; Villalobos, Joel; Garrett, David; Nayagam, David; Apollo, Nicholas; Ganesan, Kumaravelu; Shivdasani, Mohit; Stacey, Alastair; Escudie, Mathilde; Lichter, Samantha; Shepherd, Robert; Prawer, Stephen
Successful visual prostheses require stable, long-term attachment. Epiretinal prostheses, in particular, require attachment methods to fix the prosthesis onto the retina. The most common method is fixation with a retinal tack; however, tacks cause retinal trauma, and surgical proficiency is important to ensure optimal placement of the prosthesis near the macula. Accordingly, alternate attachment methods are required. In this study, we detail a novel method of magnetic attachment for an epiretinal prosthesis using two prostheses components positioned on opposing sides of the retina. The magnetic attachment technique was piloted in a feline animal model (chronic, nonrecovery implantation). We also detail a new method to reliably control the magnet coupling force using heat. It was found that the force exerted upon the tissue that separates the two components could be minimized as the measured force is proportionately smaller at the working distance. We thus detail, for the first time, a surgical method using customized magnets to position and affix an epiretinal prosthesis on the retina. The position of the epiretinal prosthesis is reliable, and its location on the retina is accurately controlled by the placement of a secondary magnet in the suprachoroidal location. The electrode position above the retina is less than 50 microns at the center of the device, although there were pressure points seen at the two edges due to curvature misalignment. The degree of retinal compression found in this study was unacceptably high; nevertheless, the normal structure of the retina remained intact under the electrodes.
Effect of current focusing on the sensitivity of inferior colliculus neurons to amplitude-modulated stimulation
(American Physiological Society, 2016-06) George, Shefin; Shivdasani, Mohit; Fallon, James
In multichannel cochlear implants (CIs), current is delivered to specific electrodes along the cochlea in the form of amplitude-modulated pulse trains, to convey temporal and spectral cues. Our previous studies have shown that focused multipolar (FMP) and tripolar (TP) stimulation produce more restricted neural activation and reduced channel interactions in the inferior colliculus (IC) compared with traditional monopolar (MP) stimulation, suggesting that focusing of stimulation could produce better transmission of spectral information. The present study explored the capability of IC neurons to detect modulated CI stimulation with FMP and TP stimulation compared with MP stimulation. The study examined multiunit responses of IC neurons in acutely deafened guinea pigs by systematically varying the stimulation configuration, modulation depth, and stimulation level. Stimuli were sinusoidal amplitude-modulated pulse trains (carrier rate of 120 pulses/s). Modulation sensitivity was quantified by measuring modulation detection thresholds (MDTs), defined as the lowest modulation depth required to differentiate the response of a modulated stimulus from an unmodulated one. Whereas MP stimulation showed significantly lower MDTs than FMP and TP stimulation (P values <0.05) at stimulation
Electrical stimulation of retinal ganglion cells with diamond and the development of an all diamond retinal prosthesis
(Elsevier, 2012-08) Hadjinicolaou, Alex; Leung, Ronald; Garrett, David; Ganesan, Kumaravelu; Fox, Kate; Nayagam, David; Shivdasani, Mohit; Meffin, Hamish; Ibbotson, Michael; Prawer, Steven; O'Brien, Brendan
Electrically conducting diamond films grown on platinum foil for neural stimulation
(IOP Publishing, 2019-07) Sikder, Kabir; Shivdasani, Mohit; Fallon, James; Seligman, Peter; Ganesan, Kumaravelu; Villalobos, Joel; Prawer, Steven; Garrett, David
Objective With the strong drive towards miniaturization of active implantable medical devices and the need to improve the resolution of neural stimulation arrays, there is keen interest in the manufacture of small electrodes capable of safe, continuous stimulation. Traditional materials such as platinum do not possess the necessary electrochemical properties to stimulate neurons safely when electrodes are very small (i.e. typically less than about 300 um (78400 microm2)). While there are several commercially viable alternative electrode materials such as titanium nitride and iridium oxide, an attractive approach is modification of existing Pt arrays via a high electrochemical capacitance material coating. Such a composite electrode could still take advantage of the wide range of fabrication techniques used to make platinum-based devices. The coating, however, must be biocompatible, exhibit good adhesion and ideally be long lasting when implanted in the body. Approach Platinum foils were roughened to various degrees with regular arrays of laser milled pits. Conducting diamond films were grown on the foils by microwave plasma chemical vapor deposition. The adhesion strength of the films to the platinum was assessed by prolonged sonication and accelerated aging. Electrochemical properties were evaluated and compared to previous work. Main results In line with previous results, diamond coatings increased the charge injection capacity of the platinum foil by more than 300% after functionalization within an oxygen plasma. Roughening of the underlying platinum substrate by laser milling was required to generate strong adhesion between the diamond and the Pt foil. Electrical stress testing, near the limits of safe operation, showed that the diamond films were more electrochemically stable than platinum controls. Significance The article describes a new method to protect platinum electrodes from degradation in vivo. A 300% increase in charge injection means that device designers can safely employ diamond coated platinum stimulation electrodes at much smaller sizes and greater density than is possible for platinum. .
Electrophysiological channel interactions using focused multipolar stimulation for cochlear implants
(IOP Publishing Ltd, 2015-09) George, Shefin; Shivdasani, Mohit; Wise, Andrew; Shepherd, Robert; Fallon, James
Objective. Speech intelligibility with existing multichannel cochlear implants (CIs) is thought to be limited by poor spatial selectivity and interactions between CI channels caused by overlapping activation with monopolar (MP) stimulation. Our previous studies have shown that focused multipolar (FMP) and tripolar (TP) stimulation produce more restricted neural activation in the inferior colliculus (IC), compared to MP stimulation. Approach. This study explored interactions in the IC produced by simultaneous stimulation of two CI channels. We recorded multi-unit neural activity in the IC of anaesthetized cats with normal and severely degenerated spiral ganglion neuron populations in response to FMP, TP and MP stimulation from a 14 channel CI. Stimuli were applied to a 'fixed' CI channel, chosen toward the middle of the cochlear electrode array, and the effects of simultaneously stimulating a more apical 'test' CI channel were measured as a function of spatial separation between the two stimulation channels and stimulus level of the fixed channel. Channel interactions were quantified by changes in neural responses and IC threshold (i.e., threshold shift) elicited by simultaneous stimulation of two CI channels, compared to stimulation of the test channel alone. Main results. Channel interactions were significantly lower for FMP and TP than for MP stimulation (p < 0.001), whereas no significant difference was observed between FMP and TP stimulation. With MP stimulation, threshold shifts increased with decreased inter-electrode spacing and increased stimulus levels of the fixed channel. For FMP and TP stimulation, channel interactions were found to be similar for different inter-electrode spacing and stimulus levels of the fixed channel. Significance. The present study demonstrates how the degree of channel interactions in a CI can be controlled using stimulation configurations such as FMP and TP; such knowledge is essential in enhancing CI function in complex acoustic environments.
Evaluation of focused multipolar stimulation for cochlear implants in acutely deafened cats
(IOP Publishing, 2014-11) George, Shefin; Wise, Andrew; Shivdasani, Mohit; Shepherd, Robert; Fallon, James
OBJECTIVE: The conductive nature of the fluids and tissues of the cochlea can lead to broad activation of spiral ganglion neurons using contemporary cochlear implant stimulation configurations such as monopolar (MP) stimulation. The relatively poor spatial selectivity is thought to limit implant performance, particularly in noisy environments. Several current focusing techniques have been proposed to reduce the spread of activation with the aim towards achieving improved clinical performance. APPROACH: The present research evaluated the efficacy of focused multipolar (FMP) stimulation, a relatively new focusing technique in the cochlea, and compared its efficacy to both MP stimulation and tripolar (TP) stimulation. The spread of neural activity across the inferior colliculus (IC), measured by recording the spatial tuning curve, was used as a measure of spatial selectivity. Adult cats (n = 6) were acutely deafened and implanted with an intracochlear electrode array before multi-unit responses were recorded across the cochleotopic gradient of the contralateral IC. Recordings were made in response to acoustic and electrical stimulation using the MP, TP and FMP configurations. MAIN RESULTS: FMP and TP stimulation resulted in greater spatial selectivity than MP stimulation. However, thresholds were significantly higher (p < 0.001) for FMP and TP stimulation compared to MP stimulation. There were no differences found in spatial selectivity and threshold between FMP and TP stimulation. SIGNIFICANCE: The greater spatial selectivity of FMP and TP stimulation would be expected to result in improved clinical performance. However, further research will be required to demonstrate the efficacy of these modes of stimulation after longer durations of deafness.
Evaluation of stimulus parameters and electrode geometry for an effective suprachoroidal retinal prosthesis
(IOP Publishing Ltd, 2010) Shivdasani, Mohit; Luu, Chi; Cicione, Rosemary; Fallon, James; Allen, Penny; Leuenberger, James; Suaning, Gregg; Lovell, Nigel; Shepherd, Robert; Williams, Chris
Several approaches have been proposed for placement of retinal prostheses; epiretinal, sub-retinal, and suprachoroidal. We aimed to systematically evaluate the effectiveness of varying a range of stimulus parameters and electrode geometry for a suprachoroidal electrode array, using cortical evoked responses to monopolar electrical stimulation in cats. Our results indicate that charge thresholds were not dependent on electrode size, pulse widths or position of the return electrode tested, but were dependent on the number of sites stimulated in parallel. Further, we found that the combination of monopolar stimulation with large diameter electrodes, wide pulse widths and parallel stimulation minimized the voltage requirements for stimulation. These results provide useful insights for the design specifications of a low voltage suprachoroidal stimulator.
Factors Affecting Perceptual Thresholds in a Suprachoroidal Retinal Prosthesis
(The Association for Research in Vision and Ophthalmology Inc, 2014-10) Shivdasani, Mohit; Sinclair, Nicholas; Dimitrov, Peter; Varsamidis, Mary; Ayton, Lauren; Luu, Chi; Perera, Thushara; McDermott, Hugh; Blamey, Peter
PURPOSE: The suprachoroidal location for a retinal prosthesis provides advantages over other locations in terms of a simplified surgical procedure and a potentially more stable electrode-neural interface. The aim of this study was to assess the factors affecting perceptual thresholds, and to optimize stimulus parameters to achieve the lowest thresholds in patients implanted with a suprachoroidal retinal prosthesis. METHODS: Three patients with profound vision loss from retinitis pigmentosa were implanted with a suprachoroidal array. Perceptual thresholds measured on individual electrodes were analyzed as a function of stimulus (return configuration, pulse polarity, pulse width, interphase gap, and rate), electrode (area and number of ganged electrodes), and clinical (retinal thickness and electrode-retina distance) parameters. RESULTS: A total of 92.8% of 904 measurements made up to 680 days post implantation yielded thresholds (range, 44-436 nanocoulombs [nC]) below the safe charge limit. Thresholds were found to vary between individuals and to depend significantly on electrode-retina distance, negligibly on retinal thickness, and not on electrode area or the number of ganged electrodes. Lowest thresholds were achieved when using a monopolar return, anodic-first polarity, short pulse widths (100 μs) combined with long interphase gaps (500 μs), and high stimulation rates (≥400 pulses per second [pps]). CONCLUSIONS: With suprachoroidal stimulation, anodic-first pulses with a monopolar return are most efficacious. To enable high rates, an appropriate combination of pulse width and interphase gap must be chosen to ensure low thresholds and electrode voltages. Electrode-retina distance needs to be monitored carefully owing to its influence on thresholds. These results inform implantable stimulator specifications for a suprachoroidal retinal prosthesis. (ClinicalTrials.gov number, NCT01603576.).
Gaze compensation as a technique for improving hand-eye coordination in prosthetic vision
(ARVO, 2018-01) Titchener, Samuel; Shivdasani, Mohit; Fallon, James; Petoe, Matthew
Purpose: Shifting the region-of-interest within the input image to compensate for gaze shifts (“gaze compensation”) may improve hand–eye coordination in visual prostheses that incorporate an external camera. The present study investigated the effects of eye movement on hand-eye coordination under simulated prosthetic vision (SPV), and measured the coordination benefits of gaze compensation. Methods: Seven healthy-sighted subjects performed a target localization-pointing task under SPV. Three conditions were tested, modeling: retinally stabilized phosphenes (uncompensated); gaze compensation; and no phosphene movement (center-fixed). The error in pointing was quantified for each condition. Results: Gaze compensation yielded a significantly smaller pointing error than the uncompensated condition for six of seven subjects, and a similar or smaller pointing error than the center-fixed condition for all subjects (two-way ANOVA, P < 0.05). Pointing error eccentricity and gaze eccentricity were moderately correlated in the uncompensated condition (azimuth: R2 = 0.47; elevation: R2 = 0.51) but not in the gaze-compensated condition (azimuth: R2 = 0.01; elevation: R2 = 0.00). Increased variability in gaze at the time of pointing was correlated with greater reduction in pointing error in the center-fixed condition compared with the uncompensated condition (R2 = 0.64). Conclusions: Eccentric eye position impedes hand–eye coordination in SPV. While limiting eye eccentricity in uncompensated viewing can reduce errors, gaze compensation is effective in improving coordination for subjects unable to maintain fixation. Translational Relevance: The results highlight the present necessity for suppressing eye movement and support the use of gaze compensation to improve hand–eye coordination and localization performance in prosthetic vision.
Head and Gaze Behavior in Retinitis Pigmentosa
(ARVO, 2019-05) Titchener, Samuel; Ayton, Lauren; Abbott, Carla; Fallon, James; Shivdasani, Mohit; Caruso, Emily; Sivarajah, Pyrawy; Petoe, Matthew
Purpose: Peripheral visual field loss (PVFL) due to retinitis pigmentosa (RP) decreases saccades to areas of visual defect, leading to a habitually confined range of eye movement. We investigated the relative contributions of head and eye movement in RP patients and normal-sighted controls to determine whether this reduced eye movement is offset by increased head movement. Methods: Eye-head coordination was examined in 18 early-moderate RP patients, 4 late-stage RP patients, and 19 normal-sighted controls. Three metrics were extracted: the extent of eye, head, and total gaze (eye+head) movement while viewing a naturalistic scene; head gain, the ratio of head movement to total gaze movement during smooth pursuit; and the customary oculomotor range (COMR), the orbital range within which the eye is preferentially maintained during a pro-saccade task. Results: The late-stage RP group had minimal gaze movement and could not discern the naturalistic scene. Variance in head position in early-moderate RP was significantly greater than in controls, whereas variance in total gaze was similar. Head gain was greater in early-moderate RP than in controls, whereas COMR was smaller. Across groups, visual field extent was negatively correlated with head gain and positively correlated with COMR. Accounting for age effects, these results demonstrate increased head movement at the expense of eye movement in participants with PVFL. Conclusions: RP is associated with an increased propensity for head movement during gaze shifts, and the magnitude of this effect is dependent on the severity of visual field loss.

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