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BMS1052 > NEUROPROSTHETICS AND ETHICS > Flashcards

NEUROPROSTHETICS AND ETHICS Flashcards

1
Q

How can you replace lost function?

A
  • Stimulate neural activity

- Record neural activity & control device

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2
Q

What does the cochlear implant directly stimulate?

A
  • Hair cells of cochlear

- Spinal ganglion neurons

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3
Q

Why does the cochlear implant work?

A
  • Because of tonopony in cochlear (different regions of brain possess different sound frequencies)
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4
Q

What applications do sensory prosthesis involve?

A
  • Auditory
  • Visual
  • Pain relief
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5
Q

What applications does motor prosthesis involve?

A
  • Controlling movement

- Bladder control

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6
Q

What applications does cognitive related prosthesis invovle?

A
  • Parkingsons
  • Depression
  • “mind reading”
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7
Q

What is parkingsons disease in terms of the pathway?

A
  • Loss of dopiminergic neurons in substanisa nigra (SNc)

- Leas to increased inhibition oof VLo, so reduced cortical activation and hypokinesia

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8
Q

What is bradykinesia?

A
  • Reduced amplitude/ velocity of voluntary movement

- Symptom of Parkingsons

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9
Q

What are some surgical treatments for Parkingsons?

A
  • Removing the sub- thalalmic nucles (STN) or the GPi
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10
Q

Is surgical treatment for parkingsons reversible?

A

NO! This treatment is irreversible - lesions

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11
Q

What is an alternative treatment for parkingsons?

A

Deep Brain Stimulation (DBS)

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12
Q

Why is DBS good?

A

Because it is reversible and controllable (unlike lesion surgery)

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13
Q

Is DBS reversible?

A

YES! This is the one where the patients are awake

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14
Q

What is the most likely neural mechanism of DBS?

A
  • Chronic inhibition is the MOST LIKELY neural mechanism but not well understood
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15
Q

Are mechanisms of how DBS works clear?

A

NO! They are still unclear so we can only make predictions

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16
Q

What level COULD DBS be mediated at?

A
  • The level of axons, cell bodies, efferent axons, or astrocytes
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17
Q

What COULD be other mechanisms of DBS in more detail?

A
  • To modulate (suppress) firing rates in the stimulating area (this is the simplest explanation)
  • To NORMALISE irregular burst firing rates
  • To desynchronise low frequeny oscillations in cortical loop
  • To increase adenosine release from astrocytes, depressing excitatory transmission in the thalamus
  • Only clear that the stimulation works
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18
Q

Which categories of blindness can the bionic eye prosthetic be related to?

A
  1. Age related Macular Degeneration (AMD)

2. Retinitis pigmentosa

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19
Q

What is a side effect of surgical treatment (lesion surgery) for parkingsons disease?

A
  • Imbalance in ability to initiate movement can swing too far in the other direction, leading to hyperkineasia and generation of unwanted movements.
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20
Q

What is AMD (Age related Macular Degeneration)?

A
  • Degeneration of photoreceptors in macular region

- Unable to detect details such as faces only shapes

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21
Q

How come AMD is a good target for prosthesis?

A
  • Because the retinal ganglion cells are still intact so they can be stimulated (the axons can be stimulated)
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22
Q

What is Retinitis Pigmentosa?

A

A heritable, degenerative eye disease

  • Retinal ganglion cells also remain intact
  • 1.5 mill worldwide
  • causes tunnel vision
  • in advanced stages can only detect light/ dark
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23
Q

What are some symptoms for retinal pigmentosa?

A
  • Tunnel vision (no peripheral) OR peripheral vision (no central vision)
  • Slow adjustment from light to dark
  • Extreme tiredness
  • Poor colour separation
    (Peripheral retina is primarily rods)
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24
Q

What are advantages of retinal implants?

A
  • Faster, lower risk surgery

- Can access anywhere in retina

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25
Q

What are the DISADVANTAGES of retinal implants?

A
  • Could lead to retinal detachment
  • Implant needs to be robust to eye movement
  • ONLY suitable IF retinal ganglion cells are intact (in the early condition)
  • RGCs travel horizontally across the retinal surface- so not clear what is being stimulated
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26
Q

What are phosphenes?

A
  • Artificial light perception (e.g. when you rub your eyes or hit your head)
27
Q

What will electrical stimulation of small regions of cortex activate?

A
  • Activate neurons with adjacent receptive fields

- this should lead to perception of something in corresponding visual field location

28
Q

What are the advantages of cortical implants?

A

Larger surface area to implant electrodes

- suitable if retina is completely damaged or degraded ( so available to ALL blind patients)

29
Q

What are the disadvantages of cortical implants?

A
  • Only some potions of visual field are on the surface of V1 (others are in the sulci)
  • Implants with penetrating electrodes need to be robust to large head movements
  • Infection risks are greater
30
Q

How can DBS produce chronic inhibition, but a visual prosthesis produces focal excitation?

A
  • NOT WELL KNOWN
  • Possibly different rates and types of stimulation
  • Different currents and types of electrodes
  • could also suffer from post-excitation inhibition (for visual prosthesis but hasn’t been detected)
31
Q

When is it possible to record EMGS for a muscle to control a device?

A
  • If peripheral muscles and nerves are intact (easier to learn to use but less flexible)
32
Q

What is a more powerful/ more flexible approach to motor prosthesis?

A
  • Record the activity ( from an EEG(brain), or electrode in or on brain)) in the motor cortex, then decode the intention and move the robotic arm or wheelchair
  • Harder to learn to use. but more flexible /powerful
33
Q

What are the limitations with EMG based forearm prosthesis?

A
  • Hand has roughly 27 degrees of freedom but hand prosthesis only has 1 df so not flexible (but not necessary to aim to have a lot of DF because a lot can be done with 5 )
  • There is NO somatosensory feedback (no feel for tension/force when picking up something)
34
Q

What are some more advanced prostheses?

A
  • osseo-integrated implant with subcutaneous stimulation and recording
  • Provides biofeedback
  • much higher quality recording
35
Q

Does EMG prosthesis have good or poor spatial resolution?

A

Limited spatial resolution with surface (skin) electrodes

36
Q

What is a requirement for the motor neurons for EMG based prosthesis?

A
  • That the LMNs must be intact (signals in muscles being recorded)
  • LMNs can also be recruited to different muscles (like in woman with no arm at all-recruited to pectoralis muscle to control prosthesis)
37
Q

What is a good thing about EMG based prosthesis in terms of learning time?

A
  • Patient can learn to use it quite quickly
38
Q

What is cortical motor prosthesis?

A
  • If arm is missing, brain signals can be encoded instead

e. g. electrode array implanted into primary motor or pre motor area (M1 or PMA)

39
Q

What is the feature that allows cortical motor prosthesis to work?

A
  • ## The somatotopic organisation (adjacent neurons associated with controlling similar types of movement
40
Q

How does cortical motor prosthesis work?

A
  • Neurons in M1 are tuned for the direction a movement is going to be made
  • transmitters and receivers can detect the position moving hand
  • different nuerons in M1 will respond when monkey reaches in different directions (direction tuning)
41
Q

What is the challenge with direction of movement control?

A
  • to convert real-tme spiking activity recorded from 96 electrodes into a control signal for a robotic arm
42
Q

What funds the majority of biomedical research in the country?

A
  • Australian code for care and use of scientific purposes 8th ed 2013 (‘The Code’)
43
Q

According to the code, what is an animal?

A
  • live, non-human vertebrate (fish, amphibians, reptiles,, livestock, birds, mammals, cephalopods (octopi, squid) )
44
Q

What organisms are not considered animals by the code?

A
  • Invertebrates (Insects, spiders, cockroches)
45
Q

What are ethics according to ‘the code’ ?

A
  • Framework in which actions can be considered good or bad, right or wrong.
  • Applied education of what should or shouldn’t be done when animals are proposed for use, or used for scientific purposes.
46
Q

What is a ‘scientific purpose’?

A
  • Medical Research, education, increasing knowledge
47
Q

What is section 1 of the code?

A
  • Respect for animals must underpin all decisions and actions involving the care and use of animals for scientific purposes
48
Q

How is section 1 of the code deomonstrated?

A
  • Using animals only when it is JUSTIFIED
  • applying the 3 R’s
  • supporting animals wellbeing
  • avoiding or minimising harm (pain and distress)
  • Knowing and accepting ones responsibilities
49
Q

What is justification in ‘the code’ ?

A
  • Researchers have to demonstrate that:
  • Proposed project has scientific or educational merit and has potential benefit for humans, animals, or environment
  • Prove that NO ALTERNATIVES are available
50
Q

What are the 3 R’s ?

A
  • Replacement
  • Reduction
  • Refinement
51
Q

As a scientist, can you take animals from the pound to be used?

A
  • NO!

- Must be from an approved and licensed place (because this doesn’t fit into the 3 R’s)

52
Q

What is the first R of Replacement?

A
  • Methods that replace, or partially replace the use of animals must be considered and implemented
  • Existing databases should be examined to see if there is already data that can be analysed
53
Q

What Replacement techniques are there?

A
  • Epidemiologcial data
  • Physical and chemical analysis
  • In vitro systems
  • Non sentient organisms (can’t feel pain)
  • Cadavers
  • Clinical use
54
Q

What is Reduction in the code?

A
  • Number of animals in the project to be kept to a minimum (reduced) to achieve proposed aim and satisfy GOOD STATISTICAL DESIGN
  • Can RESUSE animals (but requires AEC approval) -should not result in greater harm to animal
  • Have tissue bank available
  • DON’T BREED TO EXCESS!
55
Q

Why is it sometimes not good to use too few animals?

A

Because if you us too few animals, data could be insignificant and animals are then ‘wasted’

56
Q

In what circumstances can activities with animals be repeated? (Reduction R in code)

A
  • UNLESS it is to demonstrate sound experimental design, statistical analysis, or if you need to re-confirm results with one or more researchers
57
Q

What is the Refinement R in the code?

A
  • Supporting animal wellbeing and safeguard
  • People doing procedures on animals must be competent or people must be under supervision of someone who is competent
  • Duration of activities must be NO LONGER than required to meet the aim
58
Q

In a sentence, refinement is ‘Refinement of…

A

techniques used to minimise adverse impacts on animals’ (most advanced methods)

59
Q

How is the code put into practice?

A
  • Every proposal reviewed by animal ethics committee

- They think about the 3 R’s

60
Q

Which is the most important person on an animal ethics committee?

A
  • Category A person (Usually a VET)
61
Q

Who are the people on an ethics committee?

A
  • Chairperson (can be any)
  • CATEGORY A - VET
  • CATEGORY B- scientist or teacher with experience using animals for scientific purposes
  • CATEGORY C- Person representing animal welfare (not associated with institution e.g. RSPCA
  • CATEGORY D- A layperson- never been involved with scientific use of animals
62
Q

How does AEC evaluate proposal?

A
  1. Lab head submits proposal ( proposed experiments, justification, no. of animals, animal welfare description, consider pain and distress- also how animal is going to be monitored
  2. Each committee member reads proposal
  3. Committee meets to see if anything needs to be altered
  4. Can take many months depending on resubmission amount
63
Q

What things do the AEC consider?

A
  • Three R’s
  • Justification
  • Appropriate pain relief and anaesthesia
  • Enriched environment
  • Consider if the scientists know how to carry out techniques

BMS1052 (14 decks)

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