In France, 300 000 people suffer from a strong speech disorder and more than 5 millions worldwide, often following brain strokes but also in case of severe tetraplegia, locked-in syndrome, neurodegenerative disease such as Amyotrophic Lateral Sclerosis or Parkinson’s disease, myopathies, or coma. The BrainSpeak project aims at developing the proof of concept of a complete paradigm to restore speech using a brain-computer interface (BCI). This speech BCI will be developed in patients undergoing a presurgical evaluation of their pharmaco-resistant epilepsy using intracranial recordings. Cortical signals will be recorded using high-density electrocorticographic and/or intracortical microelectrode arrays from motor speech areas, and decoded to control an artificial speech synthesizer in real time. The INSERM partner will implement a speech BCI clinical trial (for which a CPP approval and an ANSM authorization have recently been obtained) with CHU Grenoble in collaboration with GIPSA-Lab. To this end, we will characterize the cortical dynamics underlying speech production and imagination and decode these signals to predict overt and covert speech. Decoding will be first tested offline and then implemented online to allow subjects to control a speech synthesizer in real time. In parallel, we will carry out methodological developments to improve the BCI experimental chain. For this purpose, novel machine learning algorithms will be developed by GIPSA-Lab in collaboration with INSERM for better speech synthesis and cortical signal decoding. These algorithms will provide more intelligible speech synthesis and more efficient decoding methods adapted to the transcoding of neural recordings into speech features (articulatory or spectral trajectories). The speech BCI approach will be developed here as a proof of concept in patients having preserved brain areas and able to speak, in order to pave new routes for future speech rehabilitation in patients who cannot communicate verbally (e.g. locked-in people).

Surgical treatment of prostate cancer (one of the first cause of mortality by cancer in men) is in mutation with the introduction of robotic systems in the operating room (such as the da Vinci® telesurgery system or the ViKY® endoscope holder). However, robot assisted procedures do not exploit endo-urethral or fluorescence imaging yet, though they would allow the surgeon to “see beyond the visible”, helping him to perform his gesture optimally. These new per-operative imaging modalities are impatiently awaited by surgeons in order to bring pertinent therapeutic response to the surgical treatment of prostate cancer, a real Public Health problem doomed to increase in the future years. DEPORRA2 aims at demonstrating that we can offer the surgeon, the possibility to explore per-operatively the prostatic tissue, through an “augmented” robotic environment, by enriching the laparoscopic images with endo-urethral ultrasound imaging and with mini-camera imaging. DEPORRA2 is a “follow-up” project, in continuity with the DEPORRA project, in which we demonstrated our capacity to conceive and develop: 1) Miniature tools adapted to the radical prostatectomy problematic: flexible intraurethral ultrasound probe and associated software, bimodal fluorescence probe for the detection of the nature (prostatic / non prostatic) and quality (malignant / non malignant) of dissected tissue, stereoscopic “global vision” system; 2) Registration methods for the fusion of this multimodal information in an enriched robotic environment in view of offering the surgeon an exhaustive view of the surgical environment, based on which he will be able to undertake strategic per-operative decisions. We now need to change dimension and maturate these innovations towards medical devices ready for clinical validation. This will go through: 1) Putting in place harmonious software and navigation procedures guiding the surgeon in the realization of his gesture (e.g. avoid structures whose damage can induce a degradation of the quality of life) 2) Enhancing the most "mature" technological bricks of DEPORRA to bring them closer to clinical constraints (this will require a pushed evaluation on pre-clinical and clinical data that are currently gathered through running biomedical protocols). The less mature fluorescence characterization aspects have been removed from this follow-up project but are adressed in another running project (AAP INCA "translational research"). 3) The preparation of biomedical research in order to make a first estimation of the delivered medical service of the proposed innovations. A consortium of experts has been consituted to take up these challenges: Vermon brings its capacity to miniaturize and to dedicate ultrasound devices to the navigation of prostatic tissue; TIMC-IMAG/DyCTIM brings its expertise in the field of fluorescent tracers of the tissue nature, SQI brings its know-how in the development and risk analysis of medical devices (software + hardware). TIMC-IMAG/CAMI has a long experience in the conception and integration of multimodal systems for Computer Assisted Medical Interventions. Finally the Centre d’Investigation Clinique – Innovation Technologique of the Grenoble University Hospital brings, with its clinical partners, the environment for the support of (pre-)clinical validation of the prototypes. At the end of this industrial research project, we will have all the scientific, technical and clinical elements to make a high-stake product. DEPORRA2 will reinforce the position of complementary and highly specialized industrial actors, Vermon and SQI, by generating a niche line of business in the urology market thanks to an extremely innovative approach.

Percutaneous medical procedures, guided imagery or not, benefited from the contributions of localization tools and navigation. However, these tools remain imperfect. In the context of percutaneous procedures using a needle, we demonstrate that we can provide the physician augmented interventional environment that will allow one hand, to answer to its problem of maximizing the benefit / risk ratio and other hand, to push its limits in making gestures that are not currently considered because of under-performing tools. Two major challenges must be addressed in designing the new generation of tools to support interventional radiological procedures. 1 / as the simplifying assumption of a linear model of needle can be a major source of imprecision, with a consequence of failures of interventional gesture, the new navigation systems must take into account real-time deformation of needle. 2 / the knowledge of these deformations and thus deviations from an ideal planed trajectory requires the development of new real-time correcting methods of trajectory of the needle. A consortium of experts was formed to address these challenges: TIMA (Techniques de l’Informatique et de la Micro-électronique pour l’Architecture des systèmes intégrés), which brings its expertise in micro-fabrication and micro-sensors, demonstrated the feasibility of a new way of understanding the deformations of a needle. 3S-R (Sols, Solides, Structures, Risques) brings to the consortium its expertise in the field of physical and mechanical behavior of materials for the optimum design and modeling applications. TIMC-IMAG (Techniques de l’Ingénierie Médicale et de la Complexité - Informatique, Mathématiques et Applications de Grenoble), which is specialized in navigation systems and Computer Assisted Medical Interventions, offers a new augmented navigated environment. The CIC-IT (Clinical Investigation Center - Technological Innovation) of Grenoble University Hospital brings its expertise in the field of innovative technology in Health to early and objectively estimate the Expected Medical Services associated with innovations developed in the project. Imactis, a startup in the field of interventional radiology, provides expertise in the industrialization of needle navigation systems. The federation of these experts in a single consortium can cover all specialties (medical, software, modeling, electronics, micro-system, control, mechanical, medico-legal) needed to meet the two previous challenges. At the end of this industrial research project, all technical and scientific evidence, as well as first demonstrators will be available to demonstrate the feasibility of the proposed approach. The stakes are perceived as highly strategic, especially in the field of interventional radiology. We believe that at least six major publications will be made by the consortium. Finally, the industrial transfer of these innovations will be facilitated by the partner Imactis, which will market the products of this work through its distribution network.