Cited by 673Neuroscience and Neural EngineeringTactile and Sensory InteractionsPain Management and Treatment

Feasibility of a visual prosthesis for the blind based on intracortical micro stimulation of the visual cortex

Schmidt, E. M., Bak, M. J., Hambrecht, F. T., Kufta, C. V., O'Rourke, D. K., Vallabhanath, P.·1996·Brain

Abstract

The feasibility of producing a visual prosthesis for the blind using intracortical microstimulation (ICMS) of the visual cortex was studied in a 42-year-old woman who had been totally blind for 22 years secondary to glaucoma. Thirty-eight microelectrodes were implanted in the right visual cortex, near the occipital pole, for a period of 4 months. Percepts reported as small spots of light, called phosphenes, were produced with 34 of the 38 implanted microelectrodes. Threshold currents for phosphene generation with trains of biphasic pulses were as low as 1.9 microA, and most of the microelectrodes had thresholds below 25 microA. Phosphene brightness could be modified with stimulus amplitude, frequency and pulse duration. Repeated stimulation over a period of minutes produced a gradual decrease in phosphene brightness. Phosphenes did not flicker. The apparent size of phosphenes ranged from a "pin-point' to a "nickel' (20 mm diameter coin) held at arm's length. Phosphene size usually decreased as stimulation current was increased but increased slightly as the train length (TL) was increased. At levels of stimulation near threshold, the phosphenes were often reported to have colours. As the stimulation level was increased, the phosphenes generally became white, greyish or yellowish. Individual phosphenes appeared at different distances from the subject. When two phosphenes were simultaneously generated, the apparent distances of the individual phosphenes sometimes changed to make them appear to be at about the same distance. When three or more phosphenes were simultaneously generated, they became coplanar. Except for rare occasions, phosphenes extinguished rapidly at the termination of the stimulation train. When stimulation TLs were increased beyond 1 s, phosphenes usually disappeared before the end of the train. The duration of phosphene perception could be increased by interrupting a long stimulation train with brief pauses in stimulation. Intracortical microelectrodes spaced 500 microns apart generated separate phosphenes, but microelectrodes spaced 250 microns typically did not. This two-point resolution was about five times closer than has typically been achieved with surface stimulation. With some individual microelectrodes, a second closely spaced phosphene was sometimes produced by increasing the stimulation current. Phosphenes moved with eye movements. When up to six phosphenes were simultaneously elicited, they all moved with the same relative orientation during eye movements. All phosphenes were located in the left hemi-field with the majority above the horizontal meridian. There was a clustering of most of the phosphenes within a relatively small area of visual space. The potentially greater microelectrode density and lower power requirements of ICMS compared with surface stimulation appears encouraging for a visual prosthesis. However, further studies with blind subjects are required to optimize stimulation parameters and test complex image recognition before the feasibility of a visual prosthesis based on ICMS can be established.

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Crossref · 10.1093/brain/119.2.507

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  • In early VCP testing and in the authors' replication with sighted participants, stimulating multiple electrodes produced only isolated phosphenes that did not combine into coherent forms.

    “In early testing with VCPs, stimulation of multiple electrodes produced only percepts of multiple isolated phosphenes which did not combine into coherent forms (Dobelle et al., 1976; Schmidt et al., 1996), a finding we replicated in sighted participants implanted with intracranial electrodes for the pre-surgical evaluation of epilepsy (Bosking et al., 2018a).”

    From Dynamic Stimulation of Visual Cortex Produces Form Vision in Sighted and Blind Humans (2020) · cites this paper as Schmidt et al., 1996

    The Percepts from multiple phosphenes and Pattern recognition sections (pages unavailable in our copy) report that simultaneous stimulation produced six touching phosphenes in a vertical line, which the subject considered suitable to represent a letter or part of one. That conflicts with the claim that the phosphenes remained only isolated percepts that did not form coherent shapes. The citing authors’ replication in sighted participants is their own finding, not a finding attributed to Schmidt et al. (LLM, conf=0.85)

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  • In the study by Schmidt et al., electrodes were implanted individually and many broke early in the experiment; therefore, only very limited testing of pattern recognition could be conducted.

    “However, in the study by Schmidt et al., electrodes were implanted individually and many broke early in the experiment; therefore, only very limited testing of pattern recognition could be conducted.”

    From Visual percepts evoked with an intracortical 96-channel microelectrode array inserted in human occipital cortex (2021) · cites this paper as [10]

    The Pattern recognition section says that early breakage of lead wires limited pattern-recognition testing; Phosphene threshold currents also reports multiple broken gold leads. But the Microelectrodes section describes 12 single electrodes and 13 fastened pairs, not electrodes implanted individually. The paper attributes the breakage to leads, rather than saying the electrodes themselves broke. (LLM, conf=0.87)

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  • Phosphene size, stimulation threshold, and brightness depend on stimulation parameters such as pulse width, train length, amplitude, and frequency of stimulation.

    “Furthermore, phosphene size, stimulation threshold (defined as the minimum current to produce a visible phosphene 50% of the time) and brightness depend on stimulation parameters such as the pulse width, train length, amplitude, and frequency of stimulation (Bak et al., 1990; Schmidt et al., 1996; Winawer and Parvizi, 2016; Bosking et al., 2017; Niketeghad et al., 2020; Fernández et al., 2021).”

    From Towards biologically plausible phosphene simulation for the differentiable optimization of visual cortical prostheses (2024) · cites this paper as Schmidt et al., 1996

    The Phosphene size, Brightness modulation, Effects of pulse duration, Effects of TL and frequency, and Effect of stimulation frequency sections report that stimulation parameters affect phosphene size, brightness, and threshold current (page numbers unavailable). The parenthetical definition is not supported: Threshold testing defines threshold as the lowest current at which the subject perceived a phosphene, not the current producing a phosphene 50% of the time. (LLM, conf=0.88)

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  • There is ambivalence in reports of phosphene color, including descriptions ranging from black or white to different tones of color.

    “Regarding the color of phosphenes, there is still some ambivalence in the reports, including descriptions of phosphene color ranging from black or white to different tones of color (Tehovnik and Slocum, 2007; Tehovnik et al., 2009; Schmidt et al., 1996).”

    From Towards biologically plausible phosphene simulation for the differentiable optimization of visual cortical prostheses (2024) · cites this paper as Schmidt et al., 1996

    The “Phosphene colour” section reports phosphenes described as white, violet, yellow, blue, red, and greyish, supporting variation in reported colour. It does not report black phosphenes or assess ambivalence across reports, so those parts of the citing sentence are not supported by this paper. (LLM, conf=0.84)

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  • The present results support previous findings and show that the border between V1 and V2, located near the occipital pole, is a suitable place for a cortical visual prosthesis.

    “Our present results support previous findings (5, 10, 38, 39, 41, 42) and show that the border between V1 and V2, which is located near the occipital pole, is a suitable place for a cortical visual prosthesis (37).”

    From Visual percepts evoked with an intracortical 96-channel microelectrode array inserted in human occipital cortex (2021) · cites this paper as [10]

    The Surgical procedures section (page unavailable) places the implants near the right occipital pole, and the Concluding remarks (page unavailable) describe the results as encouraging for a visual prosthesis. The cited paper does not identify the implant site as the V1–V2 border or establish that border specifically as suitable. (LLM, conf=0.84)

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Cites

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Research works printed but not linked: 3

  1. [16]16. Pollen DA. Some perceptual effects of electrical stimulation of the visual cortex in man. In: Tower DB, editor. The nervous system, Vol. 2: the clinical neurosciences. New York: Raven Press, 1975: 519-28.
  2. [18]18. Rushton DN, Brindley GS. Short-and long-term stability of cortical electrical phosphenes. In: Rose FC, editor. Physiological aspects of clinical neurology. Oxford: Blackwell, 1977: 123-53.
  3. [20]20. Schmidt EM, Bragg JA. Simple visual reaction time as a means of quantifying brightness of electrically produced phosphenes. Vision Res 1995. In press.

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Authors
Schmidt, E. M., Bak, M. J., Hambrecht, F. T., Kufta, C. V., O'Rourke, D. K., & Vallabhanath, P.
Affiliations
  • National Institutes of Health (US)
  • Howard Hughes Medical Institute (US)
Corresponding author
Schmidt, E. M.
Venue
Brain
Published
1996
Volume
119
Issue
2
Pages
507-522
ISSN
  • 0006-8950 (ISSN-L)
  • 1460-2156
OpenAlex
W2090285495
Cited by
672
References
17
Citations by year
2026: 13 · 2025: 24 · 2024: 21 · 2023: 20 · 2022: 28 · 2021: 27 · 2020: 31 · 2019: 22 · 2018: 19 · 2017: 13 · 2016: 30 · 2015: 34 · 2014: 20 · 2013: 40 · 2012: 23
FWCI
3.37
Type
journal article
Language
en
Open access
closed
Locations
  • Brain (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › Neuroscience and Neural Engineering
  • Life Sciences › Neuroscience › Cognitive Neuroscience › Tactile and Sensory Interactions
  • Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Treatment
Keywords
visual prosthesis, intracortical microstimulation, visual cortex, phosphenes, blindness, glaucoma, two-point resolution, color perception, eye movements, threshold current, feasibility study, neuroprosthetics
MeSH terms
Adult, Blindness, Electric Stimulation, Female, Humans, Microelectrodes, Time Factors, Visual Cortex, Visual Perception

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