8 General discussion The work in this dissertation explores the benefits of digital simulations for the optimization of cortical visual prostheses. Specifically, the presented studies address three central themes: i) functional prototyping with naturalistic simulation experiments ii) automated optimization with virtual implant users, and iii) accounting for the biology of neurostimulation for a more patient-centered design. 8.1. Naturalistic prototyping of hardware & software Functional vision testing with simulated prosthetic vision The studies presented inChapters2and6share similarities with a large body of simulation research that investigated functional benefits of visual prosthetics in natural tasks (Cha et al., 1992b; Dagnelie et al., 2007; Parikh et al., 2013; Srivastava et al., 2009; van Rheede et al., 2010; Zapf et al., 2016). Simulated prosthetic vision (SPV) here provides a complementary framework that can model ahead of the clinical reality of neural interfacing. Important milestones have been accomplished by recent brain stimulation studies (Beauchamp et al., 2020; Chen et al., 2020; Fernández et al., 2021; Oswalt et al., 2021) and clinical studies with first generation retinal implants (Ho et al., 2015; Stingl et al., 2015). The results include successful recognition of edges, gratings, spatial patterns, or even letter reading. Nevertheless, these tasks are still of a relatively basic nature due to the restricted visual quality produced by contemporary devices. Although efforts have been undertaken (e.g., seeGeruschat et al., 2015), it remains difficult to evaluate the daily life benefits. SPV research can provide a framework that can model ahead of clinical reality. Therefore, in addition to basic visual function testing, it enables testing of functional vision in naturalistic tasks, evaluating and prototyping the expected benefits of future implant designs. Mobility as an example case Serving as an indicative test-case of complex daily life activities, the focus in this dissertation is put on mobility skills. Mobility significantly affects social participation and personal autonomy for individuals with blindness (Aciem & Mazzotta, 2013; Wong, 2018). Furthermore, successful mobility relies on many visual processes such as object recognition, optic flow processing and many other processes (Cornelissen & van den Dobbelsteen, 1999; Marron & Bailey, 1982). The considerable complexity and the significant daily life relevance of mobility make it an ideal naturalistic test case for early-stage non-invasive functional prototyping. 115
RkJQdWJsaXNoZXIy MTk4NDMw