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Phosphenes produced by electrical stimulation of human occipital cortex, and their application to the development of a prosthesis for the blind
Open accessAbstract
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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“Furthermore, in contrast to the assumptions of our model, interactions between simultaneous stimulation of multiple electrodes can have an effect on the phosphene size and sometimes lead to unexpected percepts (Fernández et al., 2021; Dobelle and Mladejovsky, 1974; Bak et al., 1990).”
From Towards biologically plausible phosphene simulation for the differentiable optimization of visual cortical prostheses (2024) · cites this paper as Dobelle and Mladejovsky, 1974
In the citing paper
“They showed that visual percepts (phosphenes) could be evoked by electrical stimulation of the visual cortex via an array of electrodes implanted on the surface of a subject's visual cortex.”
From Visual percepts evoked with an intracortical 96-channel microelectrode array inserted in human occipital cortex (2021) · cites this paper as [4]
In the citing paper
“This 2-point resolution is closer than the 500 μ m resolution reported previously with a single electrode pair of gold wire electrodes (10), and about 5 times closer than has been achieved with surface electrodes (2-5, 7).”
From Visual percepts evoked with an intracortical 96-channel microelectrode array inserted in human occipital cortex (2021) · cites this paper as [4]
In the citing paper
“However, there were also some problems, such as the induction of epileptic seizures and the appearance of pain due to meningeal or scalp stimulation.”
From Toward Long-Term Communication With the Brain in the Blind by Intracortical Stimulation: Challenges and Future Prospects (2020) · cites this paper as Dobelle and Mladejovsky, 1974
In the citing paper
“Increasing the electrode density increases the risk of having a stimulation cross-talk and current summation when neighbouring electrodes are activated simultaneously.”
From Three-dimensional multilayer concentric bipolar electrodes restrict spatial activation in optic nerve stimulation (2022) · cites this paper as [7]
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Metadata
- 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
- PMC
- PMC1330721
- 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
- green
- www.ncbi.nlm.nih.gov
- 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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Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
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