Eye movements and the perceived location of phosphenes generated by intracranial primary visual cortex stimulation in the blind

Avi Caspi, Michael P. Barry, Uday K. Patel, Michelle Armenta Salas, Jessy D. Dorn, Arup Roy, Soroush Niketeghad, Robert J. Greenberg, Nader Pouratian

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Restoring sight for the blind using electrical stimulation of the visual pathways is feasible but demands an understanding of the spatial mapping of the visual world at the site of targeted stimulation, whether in the retina, thalamus, or cortex. While a visual cortex stimulator can bypass the eye and create visual percepts, there is an inherent dissociation between this stimulation and eye movements. It is unknown whether and how robustly the brain maintains the oculomotor circuitry in patients with bare- or no-light perception. Objective: To critically and quantitatively evaluate the effect of eye movements have on phosphene locations elicited by cortical stimulation that bypasses the eyes in order to restore sight in blind subjects. Methods: The NeuroPace Responsive Neurostimulator (RNS) and the Orion visual cortical prosthesis devices were used to electrically stimulate the visual cortex of blind subjects with bare or no light perception. Eye positions were recorded synchronized with stimulation and the location of the percepts were measured using a handheld marker. Results: The locations of cortical stimulation-evoked percepts are shifted based on the eye position at the time of stimulation. Measured responses can be remapped based on measured eye positions to determine the retinotopic locations associated with the implanted electrodes, with remapped responses having variance limited by pointing error. Conclusions: Eye movements dominate the perceived location of cortical stimulation-evoked phosphenes, even after years of blindness. By accounting for eye positions, we can mimic retinal mapping as in natural sight.

Original languageEnglish (US)
Pages (from-to)851-860
Number of pages10
JournalBrain Stimulation
Volume14
Issue number4
DOIs
StatePublished - Jul 1 2021

Keywords

  • Blind
  • Eye movements
  • Neurostimulation
  • Visual cortex
  • Visual prosthesis

ASJC Scopus subject areas

  • Neuroscience(all)
  • Biophysics
  • Clinical Neurology

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