脳コンピューター・インターフェースにより、ALS患者が再び「話す」ことが可能に(Brain-computer interface allows man with ALS to ‘speak’ again)

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2024-08-14 ブラウン大学

BrainGate研究チームは、脳信号を最大97%の精度で音声に変換するブレイン・コンピュータ・インターフェース(BCI)を開発しました。この技術は、筋萎縮性側索硬化症(ALS)などで発話能力を失った人々にとって重要な進展です。脳内に埋め込まれたセンサーが、発話を試みる際の脳信号を解読し、それをテキストに変換してコンピュータが音声として読み上げます。この技術は、特にパラリシスによる発話困難な患者にとって希望をもたらすものです。

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高精度で迅速な校正が可能な音声神経人工器官 An Accurate and Rapidly Calibrating Speech Neuroprosthesis

Nicholas S. Card, Ph.D. , Maitreyee Wairagkar, Ph.D., Carrina Iacobacci, B.S., Xianda Hou, M.S., Tyler Singer-Clark, B.S., Francis R. Willett, Ph.D., Erin M. Kunz, M.S., +10, and David M. Brandman, M.D., Ph.D.
New England Journal of Medicine  Published: August 14, 2024
DOI: 10.1056/NEJMoa2314132

Abstract

Background
Brain–computer interfaces can enable communication for people with paralysis by transforming cortical activity associated with attempted speech into text on a computer screen. Communication with brain–computer interfaces has been restricted by extensive training requirements and limited accuracy.

Methods
A 45-year-old man with amyotrophic lateral sclerosis (ALS) with tetraparesis and severe dysarthria underwent surgical implantation of four microelectrode arrays into his left ventral precentral gyrus 5 years after the onset of the illness; these arrays recorded neural activity from 256 intracortical electrodes. We report the results of decoding his cortical neural activity as he attempted to speak in both prompted and unstructured conversational contexts. Decoded words were displayed on a screen and then vocalized with the use of text-to-speech software designed to sound like his pre-ALS voice.

Results
On the first day of use (25 days after surgery), the neuroprosthesis achieved 99.6% accuracy with a 50-word vocabulary. Calibration of the neuroprosthesis required 30 minutes of cortical recordings while the participant attempted to speak, followed by subsequent processing. On the second day, after 1.4 additional hours of system training, the neuroprosthesis achieved 90.2% accuracy using a 125,000-word vocabulary. With further training data, the neuroprosthesis sustained 97.5% accuracy over a period of 8.4 months after surgical implantation, and the participant used it to communicate in self-paced conversations at a rate of approximately 32 words per minute for more than 248 cumulative hours.

Conclusions
In a person with ALS and severe dysarthria, an intracortical speech neuroprosthesis reached a level of performance suitable to restore conversational communication after brief training. (Funded by the Office of the Assistant Secretary of Defense for Health Affairs and others; BrainGate2 ClinicalTrials.gov number, NCT00912041.)

医療・健康
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