Cited by 470Neuroscience and Neural EngineeringTactile and Sensory InteractionsPain Management and Treatment

Phosphenes produced by electrical stimulation of human occipital cortex, and their application to the development of a prosthesis for the blind

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Dobelle, W. H., Mladejovsky, M. G.·1974·The Journal of Physiology

Abstract

1. To explore the feasibility of a visual prosthesis for the blind, human visual cortex has been stimulated during a series of surgical procedures on conscious volunteers undergoing other occipital lobe surgery. 2. Area no. 17 seems the most effective locus for such stimulation, at least in sighted or recently hemianopic patients. 3. Changes in electrode size and configuration, or in stimulus parameters, have little effect on subjective sensation. 4. Thresholds do vary depending on parameters, but not electrode size, and these effects have been studied. 5. Painful effects are associated with stimulation of the dura, but not of the calcarine artery and associated vessels. 6. Stimulation of a single electrode usually produces one phosphene, whose size ranges from tiny punctate sensations like ‘a star in the sky’ up to a large coin at arm's length. Very large elongated phosphenes, like those seen by Brindley's second patient, have not been reported despite the number of patients, electrodes, and combinations of stimulus parameters tested. These large phosphenes may be an effect of prolonged blindness. 7. Stimulation substantially above threshold may produce a second conjugate phosphene, inverted about the horizontal meridian. 8. Stimulation of a single electrode may also produce multiple phosphenes with no differential threshold. 9. Chromatic effects and/or phosphene flicker may, or may not occur. This can vary from point to point on the same patient. 10. Phosphenes fade after 10–15 sec of continuous stimulation. 11. All phosphenes move proportionately with voluntary eye movements, within the accuracy of our mapping techniques. 12. Brightness modulation can easily be achieved by changing pulse amplitude. 13. The position of phosphenes in the visual field corresponds only roughly with expectations based on classical maps showing the projection of the visual field onto the cortex. 14. Patients can usually discriminate phosphenes produced by 1 mm 2 electrodes on 3 mm centres, although this seems to be close to the limit of resolution. 15. Patterns of up to four phosphenes produced by four electrodes have been recognized. However, a variety of complex interactions have been reported. 16. Multiple phosphenes are co‐planar, although patients are unable to estimate their distance. 17. Phosphenes appear immediately when stimulation is begun, and disappear immediately upon cessation of stimulation. 18. Future work must concentrate on blind volunteers to explore possible differences in subjective sensation produced after prolonged blindness, and to explore more complex pattern presentation which requires substantial periods of time with any given patient.

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Crossref · 10.1113/jphysiol.1974.sp010766

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Authors
Dobelle, W. H., & Mladejovsky, M. G.
Venue
The Journal of Physiology
Publisher
Wiley
Published
1974-12
Volume
243
Issue
2
Pages
553-576
ISSN
  • 0022-3751 (ISSN-L)
  • 1469-7793
OpenAlex
W2018103408
Cited by
468
References
11
Citations by year
2026: 12 · 2025: 12 · 2024: 7 · 2023: 14 · 2022: 20 · 2021: 16 · 2020: 19 · 2019: 11 · 2018: 17 · 2017: 11 · 2016: 19 · 2015: 17 · 2014: 15 · 2013: 25 · 2012: 22
FWCI
1.08
Type
journal article
Language
en
Open access
Locations
  • The Journal of Physiology (publishedVersion)
  • PubMed Central (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
phosphenes, visual prosthesis, visual cortex stimulation, occipital lobe, blind patients, area 17, electrode configuration, stimulation threshold, brightness modulation, electrode spacing, hemianopia
MeSH terms
Adult, Aged, Arteriovenous Malformations, Astrocytoma, Blindness, Electric Stimulation, Electrodes, Eye Movements, Female, Humans, Male, Meningioma, Methods, Middle Aged, Occipital Lobe, Pain, Pulse, Vision, Ocular, Visual Cortex, Prostheses and Implants

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