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The New England Journal of Medicine Jul 2021Technology to restore the ability to communicate in paralyzed persons who cannot speak has the potential to improve autonomy and quality of life. An approach that...
BACKGROUND
Technology to restore the ability to communicate in paralyzed persons who cannot speak has the potential to improve autonomy and quality of life. An approach that decodes words and sentences directly from the cerebral cortical activity of such patients may represent an advancement over existing methods for assisted communication.
METHODS
We implanted a subdural, high-density, multielectrode array over the area of the sensorimotor cortex that controls speech in a person with anarthria (the loss of the ability to articulate speech) and spastic quadriparesis caused by a brain-stem stroke. Over the course of 48 sessions, we recorded 22 hours of cortical activity while the participant attempted to say individual words from a vocabulary set of 50 words. We used deep-learning algorithms to create computational models for the detection and classification of words from patterns in the recorded cortical activity. We applied these computational models, as well as a natural-language model that yielded next-word probabilities given the preceding words in a sequence, to decode full sentences as the participant attempted to say them.
RESULTS
We decoded sentences from the participant's cortical activity in real time at a median rate of 15.2 words per minute, with a median word error rate of 25.6%. In post hoc analyses, we detected 98% of the attempts by the participant to produce individual words, and we classified words with 47.1% accuracy using cortical signals that were stable throughout the 81-week study period.
CONCLUSIONS
In a person with anarthria and spastic quadriparesis caused by a brain-stem stroke, words and sentences were decoded directly from cortical activity during attempted speech with the use of deep-learning models and a natural-language model. (Funded by Facebook and others; ClinicalTrials.gov number, NCT03698149.).
Topics: Adult; Brain Stem Infarctions; Brain-Computer Interfaces; Deep Learning; Dysarthria; Electrocorticography; Electrodes, Implanted; Humans; Male; Natural Language Processing; Neural Prostheses; Quadriplegia; Sensorimotor Cortex; Speech
PubMed: 34260835
DOI: 10.1056/NEJMoa2027540 -
Cureus Dec 2022Metronidazole is an antibiotic often used to treat bacterial infections in the vagina, skin, liver, stomach, joints, brain and spinal cord, heart, lungs, or...
Metronidazole is an antibiotic often used to treat bacterial infections in the vagina, skin, liver, stomach, joints, brain and spinal cord, heart, lungs, or bloodstream. It is an essential drug for treating anaerobic bacterial infections, microaerophilic bacterial infections, and protozoal infections. It is cytotoxic to many facultative anaerobic microorganisms. Metronidazole can be taken by most children and adults but might not be suitable for some people. It may produce different neurologic side effects like cerebellar dysfunction, peripheral neuropathy, vestibulotoxicity, visual impairment, encephalopathy, ataxic gait, seizures, dysarthria, and cochleotoxicity. We report a case of a gentleman in his early 60s with a liver abscess and a history of three weeks of use of metronidazole therapy presenting with altered sensorium, abnormal gait, and slurring of speech. MRI brain showed bilateral symmetrical hyperintensities involving the dentate nuclei of the cerebellum and dorsal brain stem without evidence of any diffusion restriction suggestive of metronidazole-induced encephalopathy (MIE).
PubMed: 36721588
DOI: 10.7759/cureus.33133 -
Brain Sciences Dec 2023In recent decades, we have witnessed a wealth of theoretical work and proof-of-principle studies on dysarthria, including descriptions and classifications of dysarthric...
In recent decades, we have witnessed a wealth of theoretical work and proof-of-principle studies on dysarthria, including descriptions and classifications of dysarthric speech patterns, new and refined assessment methods, and innovative experimental intervention trials [...].
PubMed: 38248226
DOI: 10.3390/brainsci14010011 -
Journal of the Neurological Sciences Dec 2022The spinocerebellar ataxias (SCA) are a heterogeneous group of neurodegenerative disorders with an autosomal dominant inheritance. Symptoms include poor coordination and... (Review)
Review
The spinocerebellar ataxias (SCA) are a heterogeneous group of neurodegenerative disorders with an autosomal dominant inheritance. Symptoms include poor coordination and balance, peripheral neuropathy, impaired vision, incontinence, respiratory insufficiency, dysphagia, and dysarthria. Although many patients with SCA have respiratory-related complications, the exact mechanism and extent of this pathology remain unclear. This review aims to provide an update on the recent clinical and preclinical scientific findings on neuropathology causing respiratory insufficiency in SCA.
Topics: Humans; Neurology; Spinocerebellar Ataxias; Respiratory Insufficiency; Dysarthria; Deglutition Disorders
PubMed: 36410186
DOI: 10.1016/j.jns.2022.120493 -
Ugeskrift For Laeger Jan 2023Sudden pain of the eye, nose or face can be a symptom of stroke located to the pons. This case report is about a 73-year-old women with acute debut of right-sided...
Sudden pain of the eye, nose or face can be a symptom of stroke located to the pons. This case report is about a 73-year-old women with acute debut of right-sided hemiparesis, ataxia, gait disturbance, dysarthria, hemisensory defects and contralateral burning eye pain. MRI showed acute ischaemia of the left pons. The case adds to the growing literature of this rare presentation of posterior circulation stroke.
Topics: Humans; Female; Aged; Eye Pain; Pons; Stroke; Brain Stem Infarctions; Magnetic Resonance Imaging
PubMed: 36760190
DOI: No ID Found