From another perspective, an established state of cross-modal sensory adaptation may in fact impair the ability of an implant to elicit simple phosphenes at all, in favor of phantom perceptions related to extra-visual sensory cortices,

e.g. touch Adriamycin cell line (Kupers et al., 2006, Merabet et al., 2007 and Ptito et al., 2008a). More research needs to be done to determine the impact of neuroplasticity on the likely performance of an implant in the long term, or conversely any negative influence of the implant on the recipients׳ adaptations to blindness. The implantation of penetrating cortical electrode arrays is a major neurosurgical procedure. As with any surgery involving the opening of the skull and intradural space, there is a demonstrable risk of acute and longer-term complications resulting in a poor surgical and clinical outcome. These risks include but are not limited to postoperative hemorrhage, swelling, tissue infarction, infection, seizures and neurological deficits, each of which may delay or preclude progressing

to the implant testing stage (discussed in more detail in Section 6.2). A key component to minimizing these risks will be the selection of candidate recipients in whom the burden of comorbidities known to negatively impact on neurosurgical outcomes is acceptably low. For example, the risk of postoperative bleeding is increased by hypertension, diabetes and coagulopathy Palbociclib supplier (Seifman et al., 2011). Poor nutritional status due to advanced age, malignancy or obesity may increase the risk of infection (Walcott et al., 2012), and preoperative screening for MRSA colonization may be helpful in avoiding a complicated postoperative course in the event of infection (Harrop et al., 2012). Patients with a history of epilepsy are innately at greater risk of suffering postoperative seizures, and should be excluded (Weiss and Post,

2011). The complexity and experimental status of the implant procedure and rehabilitation SPTLC1 process dictates that obtaining informed consent, for which a detailed discussion of surgical risks is required, will need to be undertaken carefully to ensure a thorough understanding by potential recipients. The mental health and capacity of a potential recipient is therefore of paramount importance in this context, as it may potentially impact on the treating physician׳s ability to ensure that a truly informed consent can be obtained (Lane et al., 2012 and Merabet et al., 2007). Moreover, it may impact on the perception of the soundness of potential recipients׳ motivation to participate, or the likelihood of effective rehabilitation (Dagnelie, 2008 and Merabet et al., 2007). Lane et al.