Search Results (13)

In this study, the perception of phosphenes was used as a surrogate identifier for stimulation sites for use in retinal-degenerative diseases. We aimed to investigate the influence of adaptation, electrode montage, and direction of view on electrically induced phosphenes. We developed a practical methodology to assess non-invasive ocular electrical stimulation, addressing specific areas in the retina. Phosphene thresholds were identified under light and dark adaptation for non-invasive transorbital electrical stimulation. The location and extent characterized the morphology of electrically induced retinal phosphenes for five directions of view and for seven electrode montages in 62 participants. Our results indicated the lowest phosphene thresholds under light adaptation. Cumulative charts of phosphenes visualized the location of phosphene hot spots and their focality for the investigated directions of view and electrode montages. Under consistent light adaptation, we found changes in electrode montage generated stronger changes in the phosphenes’ morphology and distribution. Adjusting the electrodes in the orbital vicinity was more effective than changing the direction of view to shift the phosphene hot spot location to a pathological region to induce neuronal activity there. In this study, we established the first practical methodology to adapt non-invasive transorbital electrical stimulation to address specific areas in the retina. Full article

Hands-free visual assistive devices that consider the safety of the visually impaired have been researched, but many of them interfere with other senses, such as hearing. Therefore, phosphenes have been researched as a method of presenting visual information. Phosphenes are flashes that are recognized by electrical stimulation, and the presentation position can be adjusted by the electrode arrangement. However, it has been reported that the presentation position changes significantly when the eyeballs are moved as far left and right as possible. As a walking assistive device for the visually impaired, the fluctuation of the presentation position of phosphenes may cause safety problems. This study used the Hess test to verify the positional fluctuation of phosphenes associated with eye movement and compared it with eye movement during walking to discuss safety. As a result, the range of the change in the presentation position of phosphenes was significantly large when subjects moved their eyes to the peripheral vision, the same as in the previous study. On the other hand, the presentation position of phosphenes did not change significantly within the range of eye movement during walking (±15 deg). Our results suggest that there is the possibility that serious safety issues will not happen with assistive devices for the visually impaired who use phosphenes. Full article

Retinal prosthetic devices aim to repair some vision in visually impaired patients by electrically stimulating neural cells in the visual system. Although there have been several notable advancements in the creation of electrically stimulated small dot-like perceptions, a deeper comprehension of the physical properties of phosphenes is still necessary. This study analyzes the influence of two independent electrode array topologies to achieve single-localized stimulation while the retina is electrically stimulated: a two-dimensional (2D) hexagon-shaped array reported in clinical studies and a patented three-dimensional (3D) linear electrode carrier. For both, cell stimulation is verified in COMSOL Multiphysics by developing a lifelike 3D computational model that includes the relevant retinal interface elements and dynamics of the voltage-gated ionic channels. The evoked percepts previously described in clinical studies using the 2D array are strongly associated with our simulation-based findings, allowing for the development of analytical models of the evoked percepts. Moreover, our findings identify differences between visual sensations induced by the arrays. The 2D array showed drawbacks during stimulation; similarly, the state-of-the-art 2D visual prostheses provide only dot-like visual sensations in close proximity to the electrode. The 3D design could offer a technique for improving cell selectivity because it requires low-intensity threshold activation which results in volumes of stimulation similar to the volume surrounded by a solitary RGC. Our research establishes a proof-of-concept technique for determining the utility of the 3D electrode array for selectively activating individual RGCs at the highest density via small-sized electrodes while maintaining electrochemical safety. Full article

This study presents phosphenotron, a device for enhancing the sensory spatial resolution of phosphenes in the visual field (VF). The phosphenotron employs a non-invasive transcranial alternating current stimulation (NITACS) to modulate brain activity by applying weak electrical currents to the scalp or face. NITACS’s unique application induces phosphenes, a phenomenon where light is perceived without external stimuli. Unlike previous invasive methods, NITACS offers a non-invasive approach to create these effects. The study focused on assessing the spatial resolution of NITACS-induced phosphenes, crucial for advancements in visual aid technology and neuroscience. Eight participants were subjected to NITACS using a novel electrode arrangement around the eye orbits. Results showed that NITACS could generate spatially defined phosphene patterns in the VF, varying among individuals but consistently appearing within their VF and remaining stable through multiple stimulations. The study established optimal parameters for vibrant phosphene induction without discomfort and identified electrode positions that altered phosphene locations within different VF regions. Receiver Operating characteristics analysis indicated a specificity of 70.7%, sensitivity of 73.9%, and a control trial accuracy of 98.4%. These findings suggest that NITACS is a promising, reliable method for non-invasive visual perception modulation through phosphene generation. Full article

Background and Objectives: Cancer therapy containing anthracyclines is associated with cancer-treatment-related cardiac dysfunction and heart failure (HF). Conventional cardioprotective medications can be frequently complicated by their blood-pressure-lowering effect. Recently, elevated resting heart rate was shown to independently predict mortality in patients with cancer. As a heart rate-lowering drug without affecting blood pressure, ivabradine could present an alternative management of anthracyclines-induced cardiotoxicity. Materials and Methods: This study aimed to investigate the probable protective effects of ivabradine in cancer patients with elevated heart rate (>75 beats per minute) undergoing anthracycline chemotherapy. Patients referred by oncologists for baseline cardiovascular risk stratification before anthracycline chemotherapy who met the inclusion criteria and had no exclusion criteria were randomly assigned to one of two strategies: ivabradine 5 mg twice a day (intervention group) or controls. Electrocardiogram, transthoracic echocardiogram with global longitudinal strain (GLS), troponin I (Tn I), and N-terminal natriuretic pro-peptide (NT-proBNP) were performed at baseline, after two and four cycles of chemotherapy and at six months of follow-up. The primary endpoint was the prevention of a >15% reduction in GLS. Secondary endpoints were effects of ivabradine on Tn I, NT-proBNP, left ventricular (LV) systolic and diastolic dysfunction, right ventricle dysfunction, and myocardial work indices. Results: A total of 48 patients were enrolled in the study; 21 were randomly assigned to the ivabradine group and 27 to the control group. Reduced GLS was detected 2.9 times less often in patients receiving ivabradine than in the control group, but this change was non-significant (OR [95% CI] = 2.9 [0.544, 16.274], p = 0.208). The incidence of troponin I elevation was four times higher in the control group (OR [95% CI] = 4.0 [1.136, 14.085], p = 0.031). There was no significant change in NT-proBNP between groups, but the increase in NT-proBNP was almost 12% higher in the control group (OR [95% CI] = 1.117 [0.347, 3.594], p = 0.853). LV diastolic dysfunction was found 2.7 times more frequently in the controls (OR [95% CI] = 2.71 [0.49, 15.10], p = 0.254). Patients in the ivabradine group were less likely to be diagnosed with mild asymptomatic CTRCD during the study (p = 0.045). No differences in right ventricle function were noted. A significant difference was found between the groups in global constructive work and global work index at six months in favour of the ivabradine group (p = 0.014 and p = 0.025). Ivabradine had no adverse effects on intracardiac conduction, ventricular repolarization, or blood pressure. However, visual side effects (phosphenes) were reported in 14.3% of patients. Conclusions: Ivabradine is a safe, well-tolerated drug that has shown possible cardioprotective properties reducing the incidence of mild asymptomatic cancer-therapy-induced cardiac dysfunction, characterised by a new rise in troponin concentrations and diminished myocardial performance in anthracycline-treated women with breast cancer and increased heart rate. However, more extensive multicentre trials are needed to provide more robust evidence. Full article

Using a phosphene has been discussed as a means of informing the visually impaired of the position of an obstacle. Obstacles underfoot have a risk, so it is necessary to inform the visually impaired. A previous study clarified a method of presenting phosphene in three directions in the lower vision; however, the simultaneous presentation of these phosphenes has not been discussed. Another study discussing the effect of electrical interference when stimulating the eyeball with multiple electrodes indicated that it is important to select appropriate stimulation factors to avoid this effect. However, when the stimulation electrodes are arranged remarkably close, there is a high possibility that the stimulus factor presented in the previous study will not apply. In this study, a method for simultaneously presenting phosphenes in the lower vision is presented. The electrode arrangements reported in the previous study to present phosphene in the lower field of vision are used, and the difficulty in the simultaneous presentation of multiple phosphenes in the lower vision is the focus. In this paper, the method of designing the stimulation factors is discussed numerically when the electrodes are arranged remarkably close. As a result, it is shown that stimulation factors different from the previous research were appropriate depending on the distance between the electrodes. Full article

The utility of currently available cortical prosthetic vision systems is disappointing. The essential features of a neuromorphic device that is predicted to enhance vision provided by available systems follow from a hypothesis which states that the objective and subjective aspects of cortical prosthetic vision jointly constitute patterns that emerge from specified synaptic interactions. The research reported here completes several required steps in developing an emulation of this device: (1) replication of small-scale simulations that are consistent with the hypothesis using the NEST (Écublens, Vaud, Switzerland) simulator, which can also be used for full-scale network emulation by a neuromorphic computer; (2) testing whether results consistent with the hypothesis survive increasing the scale and duration of simulations; (3) establishing a method that uses numbers of spikes produced by network neurons to report the number of phosphenes produced by cortical stimulation; and (4) simulating essential functions of a neuromorphic device which is predicted to enhance current prosthetic systems. NEST simulations replicated early results and increasing their scale and duration produced results consistent with the hypothesis. A decision function created using multinomial logistic regression correctly reported the expected number of phosphenes for three sets of 2080 spike number distributions in which half of each set arises from simulations expected to yield continuous visual forms by engaging a desired visual geometry. A process for modulating electrical stimulation amplitude based on intermittent population recordings that is predicted to produce desired visual geometries was successfully simulated. Implications of these results for future research are discussed. Full article

Visual prostheses, used to assist in restoring functional vision to the visually impaired, convert captured external images into corresponding electrical stimulation patterns that are stimulated by implanted microelectrodes to induce phosphenes and eventually visual perception. Detecting and providing useful visual information to the prosthesis wearer under limited artificial vision has been an important concern in the field of visual prosthesis. Along with the development of prosthetic device design and stimulus encoding methods, researchers have explored the possibility of the application of computer vision by simulating visual perception under prosthetic vision. Effective image processing in computer vision is performed to optimize artificial visual information and improve the ability to restore various important visual functions in implant recipients, allowing them to better achieve their daily demands. This paper first reviews the recent clinical implantation of different types of visual prostheses, summarizes the artificial visual perception of implant recipients, and especially focuses on its irregularities, such as dropout and distorted phosphenes. Then, the important aspects of computer vision in the optimization of visual information processing are reviewed, and the possibilities and shortcomings of these solutions are discussed. Ultimately, the development direction and emphasis issues for improving the performance of visual prosthesis devices are summarized. Full article

Background/Aim: Lipomatous meningioma is a rare type of meningioma that is formed as the result of an accumulation of lipids inside the cell due to metabolic activity dysregulation. It differs from other types of meningiomas in its radiological and immunohistochemical characteristics. We report a rare case of a patient treated in our department for this particular type of meningioma who developed a type of migraine with the aura component as the first clinical symptom. Case Report: A 55-year-old woman presented with a migraine and reported having phosphenes in recent years. Head Computed Tomography (CT) and Magnetic Resonance Imaging (MRI) scans were performed; these showed an extensive hypodense and hypointense formation located in the left parieto-occipital region. This formation was implanted in the tentorium region, with a prevailingly adipose-type signal intensity. The patient underwent an occipital craniotomy with the total removal of the lesion. The histological examination indicated a lipomatous metaplastic meningioma. Conclusion: We reported the first case of a lipomatous meningioma presenting with a migraine with a visual aura. Seizures and headaches can be included as possible symptoms. According to the current literature, lipomatous meningiomas affect women more commonly than men. The patient of our reported case presented visual disturbances in the form of a visual aura, which occurred 10 years before finding the meningioma, and surgery dramatically improved the symptoms and quality of life. Full article

Presenting visual information, called phosphenes, is a critical method for providing information on the position of obstacles for users of walking support tools for the visually impaired. A previous study has established a method for presenting phosphenes to the right, center, and left of the visual field. However, a method for presenting information on the position of obstacles around the feet using phosphenes, which is essential for the visually impaired, has not been clarified. Therefore, in this study, a method for presenting phosphenes in the lower visual field is presented, towards the aim of realizing a safe walking support tool. Electrode placement is proposed in this paper for the presentation of phosphenes to the right, center, and left of the lower visual field based on the electrode placement method used in the previous study, which presents the phosphene in three locations of the visual field. In addition, electric field simulation is performed, focusing on the electric field value on the eyeball surface, in order to observe whether the proposed electrode placement is able to stimulate the intended region. As a result, it is shown that the intended region on the eyeball surface can be stimulated locally with each of the proposed electrode placements. Full article

Visual retinal prostheses aim to restore vision for blind individuals who suffer from outer retinal degenerative diseases, such as retinitis pigmentosa and age-related macular degeneration. Perception through retinal prostheses is very limited, but it can be improved by applying object isolation. We used an object isolation algorithm based on integral imaging to isolate objects of interest according to their depth from the camera and applied image processing manipulation to the isolated-object images. Subsequently, we applied a spatial prosthetic vision simulation that converted the isolated-object images to phosphene images. We compared the phosphene images for two types of input images, the original image (before applying object isolation), and the isolated-object image to illustrate the effects of object isolation on simulated prosthetic vision without and with multiple spatial variations of phosphenes, such as size and shape variations, spatial shifts, and dropout rate. The results show an improvement in the perceived shape, contrast, and dynamic range (number of gray levels) of objects in the phosphene image. Full article

Walking support systems are essential for blind people. In this study, the presentation of phosphene position is focused on as a method to detect obstacles for blind people. When the phosphene is used in a walking support system, it is necessary to accurately present the phosphene in at least three directions of the visual field. Controlling the presentation of phosphene position has been reported in several previous studies. However, methodologies to present phosphene in multiple directions without any electric interference have not as yet been investigated. In this study, therefore, appropriate stimulation factors are clarified by the simulation of electric field on the eyeball surface which is strongly related to the presentation of phosphene position in the visual field. As a result of the simulation, it was revealed that the distance of each electrode does not give a significant effect to the eyeball surface. However, the phase of alternating current significantly changed the electric field on the eyeball surface. From investigation of the simulation results, it was clarified that the transition of the electric field on the eyeball surface can be controlled using anti-phase stimulation. In addition, the methodology to present the phosphene at least in two directions was verified. Full article

Most of the retinal prostheses use a head-fixed camera and a video processing unit. Some studies proposed various image processing methods to improve visual perception for patients. However, previous studies only focused on using spatial information. The present study proposes a spatiotemporal pixelization method mimicking fixational eye movements to generate stimulation images for artificial retina arrays by combining spatial and temporal information. Input images were sampled with a resolution that was four times higher than the number of pixel arrays. We subsampled this image and generated four different phosphene images. We then evaluated the recognition scores of characters by sequentially presenting phosphene images with varying pixel array sizes (6 × 6, 8 × 8 and 10 × 10) and stimulus frame rates (10 Hz, 15 Hz, 20 Hz, 30 Hz, and 60 Hz). The proposed method showed the highest recognition score at a stimulus frame rate of approximately 20 Hz. The method also significantly improved the recognition score for complex characters. This method provides a new way to increase practical resolution over restricted spatial resolution by merging the higher resolution image into high-frame time slots. Full article