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Manero A, Rivera V, Fu Q, Schwartzman JD, Prock-Gibbs H, Shah N, Gandhi D, White E, Crawford KE, Coathup MJ. Emerging Medical Technologies and Their Use in Bionic Repair and Human Augmentation. Bioengineering (Basel) 2024; 11:695. [PMID: 39061777 PMCID: PMC11274085 DOI: 10.3390/bioengineering11070695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2024] [Revised: 07/04/2024] [Accepted: 07/07/2024] [Indexed: 07/28/2024] Open
Abstract
As both the proportion of older people and the length of life increases globally, a rise in age-related degenerative diseases, disability, and prolonged dependency is projected. However, more sophisticated biomedical materials, as well as an improved understanding of human disease, is forecast to revolutionize the diagnosis and treatment of conditions ranging from osteoarthritis to Alzheimer's disease as well as impact disease prevention. Another, albeit quieter, revolution is also taking place within society: human augmentation. In this context, humans seek to improve themselves, metamorphosing through self-discipline or more recently, through use of emerging medical technologies, with the goal of transcending aging and mortality. In this review, and in the pursuit of improved medical care following aging, disease, disability, or injury, we first highlight cutting-edge and emerging materials-based neuroprosthetic technologies designed to restore limb or organ function. We highlight the potential for these technologies to be utilized to augment human performance beyond the range of natural performance. We discuss and explore the growing social movement of human augmentation and the idea that it is possible and desirable to use emerging technologies to push the boundaries of what it means to be a healthy human into the realm of superhuman performance and intelligence. This potential future capability is contrasted with limitations in the right-to-repair legislation, which may create challenges for patients. Now is the time for continued discussion of the ethical strategies for research, implementation, and long-term device sustainability or repair.
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Affiliation(s)
- Albert Manero
- Limbitless Solutions, University of Central Florida, 12703 Research Parkway, Suite 100, Orlando, FL 32826, USA (V.R.)
- Biionix Cluster, University of Central Florida, Orlando, FL 32827, USA; (Q.F.); (K.E.C.)
| | - Viviana Rivera
- Limbitless Solutions, University of Central Florida, 12703 Research Parkway, Suite 100, Orlando, FL 32826, USA (V.R.)
| | - Qiushi Fu
- Biionix Cluster, University of Central Florida, Orlando, FL 32827, USA; (Q.F.); (K.E.C.)
- Department of Mechanical and Aerospace Engineering, University of Central Florida, Orlando, FL 32816, USA
| | - Jonathan D. Schwartzman
- College of Medicine, University of Central Florida, Orlando, FL 32827, USA; (J.D.S.); (H.P.-G.); (N.S.); (D.G.); (E.W.)
| | - Hannah Prock-Gibbs
- College of Medicine, University of Central Florida, Orlando, FL 32827, USA; (J.D.S.); (H.P.-G.); (N.S.); (D.G.); (E.W.)
| | - Neel Shah
- College of Medicine, University of Central Florida, Orlando, FL 32827, USA; (J.D.S.); (H.P.-G.); (N.S.); (D.G.); (E.W.)
| | - Deep Gandhi
- College of Medicine, University of Central Florida, Orlando, FL 32827, USA; (J.D.S.); (H.P.-G.); (N.S.); (D.G.); (E.W.)
| | - Evan White
- College of Medicine, University of Central Florida, Orlando, FL 32827, USA; (J.D.S.); (H.P.-G.); (N.S.); (D.G.); (E.W.)
| | - Kaitlyn E. Crawford
- Biionix Cluster, University of Central Florida, Orlando, FL 32827, USA; (Q.F.); (K.E.C.)
- Department of Materials Science and Engineering, University of Central Florida, Orlando, FL 32816, USA
| | - Melanie J. Coathup
- Biionix Cluster, University of Central Florida, Orlando, FL 32827, USA; (Q.F.); (K.E.C.)
- College of Medicine, University of Central Florida, Orlando, FL 32827, USA; (J.D.S.); (H.P.-G.); (N.S.); (D.G.); (E.W.)
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Kundu A, Patrick E, Currlin S, Madler R, Delgado F, Fahmy A, Verplancke R, Ballini M, Braeken D, de Beeck MO, Maghari N, Otto KJ, Bashirullah R. Using Compound Neural Action Potentials for Functional Validation of a High-Density Intraneural Interface: A Preliminary Study. MICROMACHINES 2024; 15:280. [PMID: 38399008 PMCID: PMC10891740 DOI: 10.3390/mi15020280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Revised: 02/14/2024] [Accepted: 02/15/2024] [Indexed: 02/25/2024]
Abstract
Compound nerve action potentials (CNAPs) were used as a metric to assess the stimulation performance of a novel high-density, transverse, intrafascicular electrode in rat models. We show characteristic CNAPs recorded from distally implanted cuff electrodes. Evaluation of the CNAPs as a function of stimulus current and calculation of recruitment plots were used to obtain a qualitative approximation of the neural interface's placement and orientation inside the nerve. This method avoids elaborate surgeries required for the implantation of EMG electrodes and thus minimizes surgical complications and may accelerate the healing process of the implanted subject.
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Affiliation(s)
- Aritra Kundu
- Department of Bioengineering, Imperial College London, SW7 2AZ London, UK
- Department of Electrical and Computer Engineering, University of Florida, Gainesville, FL 32611, USA; (E.P.); (N.M.)
| | - Erin Patrick
- Department of Electrical and Computer Engineering, University of Florida, Gainesville, FL 32611, USA; (E.P.); (N.M.)
| | - Seth Currlin
- Department of Biomedical Engineering, University of Florida, Gainesville, FL 32611, USA (K.J.O.)
| | - Ryan Madler
- Department of Electrical and Computer Engineering, University of Florida, Gainesville, FL 32611, USA; (E.P.); (N.M.)
| | - Francisco Delgado
- Department of Biomedical Engineering, University of Florida, Gainesville, FL 32611, USA (K.J.O.)
| | - Ahmed Fahmy
- Department of Electrical and Computer Engineering, University of Florida, Gainesville, FL 32611, USA; (E.P.); (N.M.)
| | - Rik Verplancke
- Centre for Microsystems Technology (CMST), IMEC and Ghent University, 9052 Zwijnaarde, Belgium (M.O.d.B.)
| | | | | | - Maaike Op de Beeck
- Centre for Microsystems Technology (CMST), IMEC and Ghent University, 9052 Zwijnaarde, Belgium (M.O.d.B.)
- IMEC, Kapeldreef 75, 3001 Leuven, Belgium;
| | - Nima Maghari
- Department of Electrical and Computer Engineering, University of Florida, Gainesville, FL 32611, USA; (E.P.); (N.M.)
| | - Kevin J. Otto
- Department of Biomedical Engineering, University of Florida, Gainesville, FL 32611, USA (K.J.O.)
| | - Rizwan Bashirullah
- Department of Electrical and Computer Engineering, University of Florida, Gainesville, FL 32611, USA; (E.P.); (N.M.)
- Galvani Bioelectronics, South San Francisco, CA 94080, USA
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Thota AK, Jung R. Accelerating neurotechnology development using an Agile methodology. Front Neurosci 2024; 18:1328540. [PMID: 38435056 PMCID: PMC10904481 DOI: 10.3389/fnins.2024.1328540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Accepted: 01/18/2024] [Indexed: 03/05/2024] Open
Abstract
Novel bioelectronic medical devices that target neural control of visceral organs (e.g., liver, gut, spleen) or inflammatory reflex pathways are innovative class III medical devices like implantable cardiac pacemakers that are lifesaving and life-sustaining medical devices. Bringing innovative neurotechnologies early into the market and the hands of treatment providers would benefit a large population of patients inflicted with autonomic and chronic immune disorders. Medical device manufacturers and software developers widely use the Waterfall methodology to implement design controls through verification and validation. In the Waterfall methodology, after identifying user needs, a functional unit is fabricated following the verification loop (design, build, and verify) and then validated against user needs. Considerable time can lapse in building, verifying, and validating the product because this methodology has limitations for adjusting to unanticipated changes. The time lost in device development can cause significant delays in final production, increase costs, and may even result in the abandonment of the device development. Software developers have successfully implemented an Agile methodology that overcomes these limitations in developing medical software. However, Agile methodology is not routinely used to develop medical devices with implantable hardware because of the increased regulatory burden of the need to conduct animal and human studies. Here, we provide the pros and cons of the Waterfall methodology and make a case for adopting the Agile methodology in developing medical devices with physical components. We utilize a peripheral nerve interface as an example device to illustrate the use of the Agile approach to develop neurotechnologies.
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Affiliation(s)
- Anil Kumar Thota
- Adaptive Neural Systems Group, The Institute for Integrative and Innovative Research, University of Arkansas, Fayetteville, AR, United States
| | - Ranu Jung
- Adaptive Neural Systems Group, The Institute for Integrative and Innovative Research, University of Arkansas, Fayetteville, AR, United States
- Biomedical Engineering Department, University of Arkansas, Fayetteville, AR, United States
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Tian Y, Vaskov AK, Adidharma W, Cederna PS, Kemp SW. Merging Humans and Neuroprosthetics through Regenerative Peripheral Nerve Interfaces. Semin Plast Surg 2024; 38:10-18. [PMID: 38495064 PMCID: PMC10942838 DOI: 10.1055/s-0044-1779028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/19/2024]
Abstract
Limb amputations can be devastating and significantly affect an individual's independence, leading to functional and psychosocial challenges in nearly 2 million people in the United States alone. Over the past decade, robotic devices driven by neural signals such as neuroprostheses have shown great potential to restore the lost function of limbs, allowing amputees to regain movement and sensation. However, current neuroprosthetic interfaces have challenges in both signal quality and long-term stability. To overcome these limitations and work toward creating bionic limbs, the Neuromuscular Laboratory at University of Michigan Plastic Surgery has developed the Regenerative Peripheral Nerve Interface (RPNI). This surgical construct embeds a transected peripheral nerve into a free muscle graft, effectively amplifying small peripheral nerve signals to provide enhanced control signals for a neuroprosthetic limb. Furthermore, the RPNI has the potential to provide sensory feedback to the user and facilitate neuroprosthesis embodiment. This review focuses on the animal studies and clinical trials of the RPNI to recapitulate the promising trajectory toward neurobionics where the boundary between an artificial device and the human body becomes indistinct. This paper also sheds light on the prospects of the improvement and dissemination of the RPNI technology.
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Affiliation(s)
- Yucheng Tian
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, Michigan
| | - Alex K. Vaskov
- Section of Plastic Surgery, Department of Surgery, University of Michigan, Ann Arbor, Michigan
| | - Widya Adidharma
- Section of Plastic Surgery, Department of Surgery, University of Michigan, Ann Arbor, Michigan
| | - Paul S. Cederna
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, Michigan
- Section of Plastic Surgery, Department of Surgery, University of Michigan, Ann Arbor, Michigan
| | - Stephen W.P. Kemp
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, Michigan
- Section of Plastic Surgery, Department of Surgery, University of Michigan, Ann Arbor, Michigan
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Taghlabi KM, Cruz-Garza JG, Hassan T, Potnis O, Bhenderu LS, Guerrero JR, Whitehead RE, Wu Y, Luan L, Xie C, Robinson JT, Faraji AH. Clinical outcomes of peripheral nerve interfaces for rehabilitation in paralysis and amputation: a literature review. J Neural Eng 2024; 21:011001. [PMID: 38237175 DOI: 10.1088/1741-2552/ad200f] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 01/18/2024] [Indexed: 02/02/2024]
Abstract
Peripheral nerve interfaces (PNIs) are electrical systems designed to integrate with peripheral nerves in patients, such as following central nervous system (CNS) injuries to augment or replace CNS control and restore function. We review the literature for clinical trials and studies containing clinical outcome measures to explore the utility of human applications of PNIs. We discuss the various types of electrodes currently used for PNI systems and their functionalities and limitations. We discuss important design characteristics of PNI systems, including biocompatibility, resolution and specificity, efficacy, and longevity, to highlight their importance in the current and future development of PNIs. The clinical outcomes of PNI systems are also discussed. Finally, we review relevant PNI clinical trials that were conducted, up to the present date, to restore the sensory and motor function of upper or lower limbs in amputees, spinal cord injury patients, or intact individuals and describe their significant findings. This review highlights the current progress in the field of PNIs and serves as a foundation for future development and application of PNI systems.
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Affiliation(s)
- Khaled M Taghlabi
- Department of Neurological Surgery, Houston Methodist Hospital, Houston, TX 77030, United States of America
- Center for Neural Systems Restoration, Houston Methodist Research Institute, Houston, TX 77030, United States of America
- Clinical Innovations Laboratory, Houston Methodist Research Institute, Houston, TX 77030, United States of America
| | - Jesus G Cruz-Garza
- Department of Neurological Surgery, Houston Methodist Hospital, Houston, TX 77030, United States of America
- Center for Neural Systems Restoration, Houston Methodist Research Institute, Houston, TX 77030, United States of America
- Clinical Innovations Laboratory, Houston Methodist Research Institute, Houston, TX 77030, United States of America
| | - Taimur Hassan
- Department of Neurological Surgery, Houston Methodist Hospital, Houston, TX 77030, United States of America
- Center for Neural Systems Restoration, Houston Methodist Research Institute, Houston, TX 77030, United States of America
- Clinical Innovations Laboratory, Houston Methodist Research Institute, Houston, TX 77030, United States of America
- School of Medicine, Texas A&M University, Bryan, TX 77807, United States of America
| | - Ojas Potnis
- Department of Neurological Surgery, Houston Methodist Hospital, Houston, TX 77030, United States of America
- Center for Neural Systems Restoration, Houston Methodist Research Institute, Houston, TX 77030, United States of America
- Clinical Innovations Laboratory, Houston Methodist Research Institute, Houston, TX 77030, United States of America
- School of Engineering Medicine, Texas A&M University, Houston, TX 77030, United States of America
| | - Lokeshwar S Bhenderu
- Department of Neurological Surgery, Houston Methodist Hospital, Houston, TX 77030, United States of America
- Center for Neural Systems Restoration, Houston Methodist Research Institute, Houston, TX 77030, United States of America
- Clinical Innovations Laboratory, Houston Methodist Research Institute, Houston, TX 77030, United States of America
- School of Medicine, Texas A&M University, Bryan, TX 77807, United States of America
| | - Jaime R Guerrero
- Department of Neurological Surgery, Houston Methodist Hospital, Houston, TX 77030, United States of America
- Center for Neural Systems Restoration, Houston Methodist Research Institute, Houston, TX 77030, United States of America
- Clinical Innovations Laboratory, Houston Methodist Research Institute, Houston, TX 77030, United States of America
| | - Rachael E Whitehead
- Department of Academic Affairs, Houston Methodist Academic Institute, Houston, TX 77030, United States of America
| | - Yu Wu
- Rice Neuroengineering Initiative, Rice University, Houston, TX 77005, United States of America
- Department of Electrical and Computer Engineering, Rice University, Houston, TX 77005, United States of America
| | - Lan Luan
- Rice Neuroengineering Initiative, Rice University, Houston, TX 77005, United States of America
- Department of Electrical and Computer Engineering, Rice University, Houston, TX 77005, United States of America
| | - Chong Xie
- Rice Neuroengineering Initiative, Rice University, Houston, TX 77005, United States of America
- Department of Electrical and Computer Engineering, Rice University, Houston, TX 77005, United States of America
| | - Jacob T Robinson
- Rice Neuroengineering Initiative, Rice University, Houston, TX 77005, United States of America
- Department of Electrical and Computer Engineering, Rice University, Houston, TX 77005, United States of America
| | - Amir H Faraji
- Department of Neurological Surgery, Houston Methodist Hospital, Houston, TX 77030, United States of America
- Center for Neural Systems Restoration, Houston Methodist Research Institute, Houston, TX 77030, United States of America
- Clinical Innovations Laboratory, Houston Methodist Research Institute, Houston, TX 77030, United States of America
- Rice Neuroengineering Initiative, Rice University, Houston, TX 77005, United States of America
- Department of Electrical and Computer Engineering, Rice University, Houston, TX 77005, United States of America
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6
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Miranda JA, Rapeaux A, Samper IC, Silveira C, Willé DR, Hunsberger GE, Dopson WJ, Yao H, Karicherla A, Chew DJ. Functional Electrochemistry: On-Nerve Assessment of Electrode Materials for Electrochemistry and Functional Neurostimulation. IEEE OPEN JOURNAL OF ENGINEERING IN MEDICINE AND BIOLOGY 2024; 5:59-65. [PMID: 38445242 PMCID: PMC10914184 DOI: 10.1109/ojemb.2024.3356818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Revised: 12/26/2023] [Accepted: 01/15/2024] [Indexed: 03/07/2024] Open
Abstract
Emerging therapies in bioelectronic medicine highlight the need for deeper understanding of electrode material performance in the context of tissue stimulation. Electrochemical properties are characterized on the benchtop, facilitating standardization across experiments. On-nerve electrochemistry differs from benchtop characterization and the relationship between electrochemical performance and nerve activation thresholds are not commonly established. This relationship is important in understanding differences between electrical stimulation requirements and electrode performance. We report functional electrochemistry as a follow-up to benchtop testing, describing a novel experimental approach for evaluating on-nerve electrochemical performance in the context of nerve activation. An ex-vivo rat sciatic nerve preparation was developed to quantify activation thresholds of fiber subtypes and electrode material charge injection limits for platinum iridium, iridium oxide, titanium nitride and PEDOT. Finally, we address experimental complexities arising in these studies, and demonstrate statistical solutions that support rigorous material performance comparisons for decision making in neural interface development.
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Affiliation(s)
| | - Adrien Rapeaux
- Galvani Bioelectonics Ltd., StevenageSG1 2NYHertfordshireU.K.
- Imperial College LondonSW7 2BXLondonU.K.
| | - Isabelle C. Samper
- Galvani Bioelectonics Ltd., StevenageSG1 2NYHertfordshireU.K.
- Global Health LabsBellevueWA98007USA
| | - Carolina Silveira
- Galvani Bioelectonics Ltd., StevenageSG1 2NYHertfordshireU.K.
- Medicines and Healthcare Products Regulatory AgencyE14 4PULondonU.K.
| | | | | | | | - Huanfen Yao
- Verily Life Sciences LLCSan FranciscoCA94080-4804USA
- Google LLCMountain ViewCA94043USA
| | - Annapurna Karicherla
- Verily Life Sciences LLCSan FranciscoCA94080-4804USA
- Microsoft Corp.Mountain ViewCA94043USA
| | - Daniel J. Chew
- Galvani Bioelectonics Ltd., StevenageSG1 2NYHertfordshireU.K.
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7
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Ionescu ON, Franti E, Carbunaru V, Moldovan C, Dinulescu S, Ion M, Dragomir DC, Mihailescu CM, Lascar I, Oproiu AM, Neagu TP, Costea R, Dascalu M, Teleanu MD, Ionescu G, Teleanu R. System of Implantable Electrodes for Neural Signal Acquisition and Stimulation for Wirelessly Connected Forearm Prosthesis. BIOSENSORS 2024; 14:31. [PMID: 38248408 PMCID: PMC10813559 DOI: 10.3390/bios14010031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Revised: 12/31/2023] [Accepted: 01/02/2024] [Indexed: 01/23/2024]
Abstract
There is great interest in the development of prosthetic limbs capable of complex activities that are wirelessly connected to the patient's neural system. Although some progress has been achieved in this area, one of the main problems encountered is the selective acquisition of nerve impulses and the closing of the automation loop through the selective stimulation of the sensitive branches of the patient. Large-scale research and development have achieved so-called "cuff electrodes"; however, they present a big disadvantage: they are not selective. In this article, we present the progress made in the development of an implantable system of plug neural microelectrodes that relate to the biological nerve tissue and can be used for the selective acquisition of neuronal signals and for the stimulation of specific nerve fascicles. The developed plug electrodes are also advantageous due to their small thickness, as they do not trigger nerve inflammation. In addition, the results of the conducted tests on a sous scrofa subject are presented.
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Affiliation(s)
- Octavian Narcis Ionescu
- Faculty of Mechanical and Electrical Engineering, Petroleum and Gas University from Ploiesti, 100680 Ploiesti, Romania; (O.N.I.); (G.I.)
- National Institute for Research and Development for Microtechnology Bucharest, 077190 Bucharest, Romania; (C.M.); (S.D.); (M.I.); (D.C.D.); (C.M.M.)
| | - Eduard Franti
- National Institute for Research and Development for Microtechnology Bucharest, 077190 Bucharest, Romania; (C.M.); (S.D.); (M.I.); (D.C.D.); (C.M.M.)
- ICIA, Centre of New Electronic Architectures, 061071 Bucharest, Romania;
| | - Vlad Carbunaru
- Emergency Clinic Hospital Bucharest, 014461 Bucharest, Romania; (V.C.); (I.L.); (A.M.O.); (T.P.N.)
- University of Medicine and Pharmacy UMF Carol Davila, 050474 Bucharest, Romania; (M.D.T.); (R.T.)
| | - Carmen Moldovan
- National Institute for Research and Development for Microtechnology Bucharest, 077190 Bucharest, Romania; (C.M.); (S.D.); (M.I.); (D.C.D.); (C.M.M.)
| | - Silviu Dinulescu
- National Institute for Research and Development for Microtechnology Bucharest, 077190 Bucharest, Romania; (C.M.); (S.D.); (M.I.); (D.C.D.); (C.M.M.)
| | - Marian Ion
- National Institute for Research and Development for Microtechnology Bucharest, 077190 Bucharest, Romania; (C.M.); (S.D.); (M.I.); (D.C.D.); (C.M.M.)
| | - David Catalin Dragomir
- National Institute for Research and Development for Microtechnology Bucharest, 077190 Bucharest, Romania; (C.M.); (S.D.); (M.I.); (D.C.D.); (C.M.M.)
| | - Carmen Marinela Mihailescu
- National Institute for Research and Development for Microtechnology Bucharest, 077190 Bucharest, Romania; (C.M.); (S.D.); (M.I.); (D.C.D.); (C.M.M.)
| | - Ioan Lascar
- Emergency Clinic Hospital Bucharest, 014461 Bucharest, Romania; (V.C.); (I.L.); (A.M.O.); (T.P.N.)
- University of Medicine and Pharmacy UMF Carol Davila, 050474 Bucharest, Romania; (M.D.T.); (R.T.)
| | - Ana Maria Oproiu
- Emergency Clinic Hospital Bucharest, 014461 Bucharest, Romania; (V.C.); (I.L.); (A.M.O.); (T.P.N.)
- University of Medicine and Pharmacy UMF Carol Davila, 050474 Bucharest, Romania; (M.D.T.); (R.T.)
| | - Tiberiu Paul Neagu
- Emergency Clinic Hospital Bucharest, 014461 Bucharest, Romania; (V.C.); (I.L.); (A.M.O.); (T.P.N.)
- University of Medicine and Pharmacy UMF Carol Davila, 050474 Bucharest, Romania; (M.D.T.); (R.T.)
| | - Ruxandra Costea
- Faculty of Veterinary Medicine, University of Agricultural Sciences and Veterinary Medicine of Bucharest, 011464 Bucharest, Romania;
| | - Monica Dascalu
- ICIA, Centre of New Electronic Architectures, 061071 Bucharest, Romania;
- Faculty of Electronics, Telecommunications and Information Technology, National University of Science and Technology Politehnica of Bucharest, 060042 Bucharest, Romania
| | - Mihai Daniel Teleanu
- University of Medicine and Pharmacy UMF Carol Davila, 050474 Bucharest, Romania; (M.D.T.); (R.T.)
| | - Gabriela Ionescu
- Faculty of Mechanical and Electrical Engineering, Petroleum and Gas University from Ploiesti, 100680 Ploiesti, Romania; (O.N.I.); (G.I.)
| | - Raluca Teleanu
- University of Medicine and Pharmacy UMF Carol Davila, 050474 Bucharest, Romania; (M.D.T.); (R.T.)
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Lyu X, Hu Y, Shi S, Wang S, Li H, Wang Y, Zhou K. Hydrogel Bioelectronics for Health Monitoring. BIOSENSORS 2023; 13:815. [PMID: 37622901 PMCID: PMC10452556 DOI: 10.3390/bios13080815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 08/07/2023] [Accepted: 08/09/2023] [Indexed: 08/26/2023]
Abstract
Hydrogels are considered an ideal platform for personalized healthcare due to their unique characteristics, such as their outstanding softness, appealing biocompatibility, excellent mechanical properties, etc. Owing to the high similarity between hydrogels and biological tissues, hydrogels have emerged as a promising material candidate for next generation bioelectronic interfaces. In this review, we discuss (i) the introduction of hydrogel and its traditional applications, (ii) the work principles of hydrogel in bioelectronics, (iii) the recent advances in hydrogel bioelectronics for health monitoring, and (iv) the outlook for future hydrogel bioelectronics' development.
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Affiliation(s)
- Xinyan Lyu
- School of Science and Engineering, The Chinese University of Hong Kong, Shenzhen 518172, China; (X.L.); (S.W.); (H.L.)
| | - Yan Hu
- The First Affiliated Hospital, Xi’an Jiaotong University, Xi’an 710061, China; (Y.H.); (S.S.)
| | - Shuai Shi
- The First Affiliated Hospital, Xi’an Jiaotong University, Xi’an 710061, China; (Y.H.); (S.S.)
| | - Siyuan Wang
- School of Science and Engineering, The Chinese University of Hong Kong, Shenzhen 518172, China; (X.L.); (S.W.); (H.L.)
| | - Haowen Li
- School of Science and Engineering, The Chinese University of Hong Kong, Shenzhen 518172, China; (X.L.); (S.W.); (H.L.)
| | - Yuheng Wang
- Faculty of Electrical Engineering and Computer Science, Ningbo University, Ningbo 315211, China;
| | - Kun Zhou
- School of Science and Engineering, The Chinese University of Hong Kong, Shenzhen 518172, China; (X.L.); (S.W.); (H.L.)
- The First Affiliated Hospital, Xi’an Jiaotong University, Xi’an 710061, China; (Y.H.); (S.S.)
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9
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Nazari V, Zheng YP. Controlling Upper Limb Prostheses Using Sonomyography (SMG): A Review. SENSORS (BASEL, SWITZERLAND) 2023; 23:1885. [PMID: 36850483 PMCID: PMC9959820 DOI: 10.3390/s23041885] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 02/01/2023] [Accepted: 02/06/2023] [Indexed: 06/18/2023]
Abstract
This paper presents a critical review and comparison of the results of recently published studies in the fields of human-machine interface and the use of sonomyography (SMG) for the control of upper limb prothesis. For this review paper, a combination of the keywords "Human Machine Interface", "Sonomyography", "Ultrasound", "Upper Limb Prosthesis", "Artificial Intelligence", and "Non-Invasive Sensors" was used to search for articles on Google Scholar and PubMed. Sixty-one articles were found, of which fifty-nine were used in this review. For a comparison of the different ultrasound modes, feature extraction methods, and machine learning algorithms, 16 articles were used. Various modes of ultrasound devices for prosthetic control, various machine learning algorithms for classifying different hand gestures, and various feature extraction methods for increasing the accuracy of artificial intelligence used in their controlling systems are reviewed in this article. The results of the review article show that ultrasound sensing has the potential to be used as a viable human-machine interface in order to control bionic hands with multiple degrees of freedom. Moreover, different hand gestures can be classified by different machine learning algorithms trained with extracted features from collected data with an accuracy of around 95%.
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Affiliation(s)
- Vaheh Nazari
- Department of Biomedical Engineering, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Yong-Ping Zheng
- Department of Biomedical Engineering, The Hong Kong Polytechnic University, Hong Kong SAR, China
- Research Institute for Smart Ageing, The Hong Kong Polytechnic University, Hong Kong SAR, China
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Avdeew Y, Le Rolle V, Laval VB, Gestreau C, Hernandez A. Optimal selection of multipolar electrode configurations for nerve burst detection. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2022; 2022:4123-4126. [PMID: 36085945 DOI: 10.1109/embc48229.2022.9871144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Nerve cuff electrodes are commonly used for neural stimulation and recording applications. Usually, these electrodes are composed of a limited set of metal rings, disposed around the nerve. Although widely used, this technology may be insufficient to record and stimulate in a more selective manner. Higher resolution electrodes, usually composed of a matrix of independent contact points, have been proposed in this sense. These electrodes allow for the exploration of a wide variety of bipolar or multipolar setups, for selective recording and stimulation. In this study, we propose a method to optimally select such multipolar setups and to quantitatively evaluate the performance of a multi-contact neural organic electrode (OE) in recording burst discharges from the rat's phrenic nerve. A 16-channel OE was wrapped around the phrenic nerve (studied electrode) and a suction electrode was applied to the cut-end of the same nerve (gold standard electrode). Analysis of all possible combinations of bipoles and tripoles from the OE were carried out to assess the improvement in the recording performance, measured as the signal-to-noise ratio, compared to the gold standard. The results showed that the bipolar and tripolar configuration significantly increased the overall recording performance. Such configurations are therefore essential to improve nerve burst detection.
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11
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Koh RGL, Zariffa J, Jabban L, Yen SC, Donaldson N, Metcalfe BW. Tutorial: A guide to techniques for analysing recordings from the peripheral nervous system. J Neural Eng 2022; 19. [PMID: 35772397 DOI: 10.1088/1741-2552/ac7d74] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Accepted: 06/30/2022] [Indexed: 11/11/2022]
Abstract
The nervous system, through a combination of conscious and automatic processes, enables the regulation of the body and its interactions with the environment. The peripheral nervous system is an excellent target for technologies that seek to modulate, restore or enhance these abilities as it carries sensory and motor information that most directly relates to a target organ or function. However, many applications require a combination of both an effective peripheral nerve interface and effective signal processing techniques to provide selective and stable recordings. While there are many reviews on the design of peripheral nerve interfaces, reviews of data analysis techniques and translational considerations are limited. Thus, this tutorial aims to support new and existing researchers in the understanding of the general guiding principles, and introduces a taxonomy for electrode configurations, techniques and translational models to consider.
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Affiliation(s)
- Ryan G L Koh
- IBBME, University of Toronto, Rosebrugh Bldg, 164 College St Room 407, Toronto, Ontario, M5S 3G9, CANADA
| | - Jose Zariffa
- Research, Toronto Rehabilitation Institute - University Health Network, 550 University Ave, #12-102, Toronto, Ontario, M5G 2A2, CANADA
| | - Leen Jabban
- Electronic and Electrical Engineering, University of Bath, Electronic and Electrical Engineering, Claverton Down, Bath, Bath, BA2 7AY, UNITED KINGDOM OF GREAT BRITAIN AND NORTHERN IRELAND
| | - Shih-Cheng Yen
- Engineering Design and Innovation Centre, National University of Singapore, 21 Lower Kent Ridge Road, Singapore, 119077, SINGAPORE
| | - Nick Donaldson
- Medical Physics and Bioengineering, University College London, Gower Street, London, WC1E 6BT, UNITED KINGDOM OF GREAT BRITAIN AND NORTHERN IRELAND
| | - Benjamin W Metcalfe
- Electronics & Electrical Engineering, University of Bath, Claverton Down, Bath, Somerset, BA2 7JY, UNITED KINGDOM OF GREAT BRITAIN AND NORTHERN IRELAND
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12
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Tringides CM, Mooney DJ. Materials for Implantable Surface Electrode Arrays: Current Status and Future Directions. ADVANCED MATERIALS (DEERFIELD BEACH, FLA.) 2022; 34:e2107207. [PMID: 34716730 DOI: 10.1002/adma.202107207] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Revised: 10/26/2021] [Indexed: 06/13/2023]
Abstract
Surface electrode arrays are mainly fabricated from rigid or elastic materials, and precisely manipulated ductile metal films, which offer limited stretchability. However, the living tissues to which they are applied are nonlinear viscoelastic materials, which can undergo significant mechanical deformation in dynamic biological environments. Further, the same arrays and compositions are often repurposed for vastly different tissues rather than optimizing the materials and mechanical properties of the implant for the target application. By first characterizing the desired biological environment, and then designing a technology for a particular organ, surface electrode arrays may be more conformable, and offer better interfaces to tissues while causing less damage. Here, the various materials used in each component of a surface electrode array are first reviewed, and then electrically active implants in three specific biological systems, the nervous system, the muscular system, and skin, are described. Finally, the fabrication of next-generation surface arrays that overcome current limitations is discussed.
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Affiliation(s)
- Christina M Tringides
- Harvard Program in Biophysics, Harvard University, Cambridge, MA, 02138, USA
- Harvard-MIT Division in Health Sciences and Technology, Massachusetts Institute of Technology, Cambridge, MA, 02139, USA
- Wyss Institute for Biologically Inspired Engineering, Harvard University, Cambridge, MA, 02138, USA
| | - David J Mooney
- Wyss Institute for Biologically Inspired Engineering, Harvard University, Cambridge, MA, 02138, USA
- John A. Paulson School of Engineering and Applied Sciences, Harvard University, Cambridge, MA, 02138, USA
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13
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Emerging trends and prospects of electroconductive bioinks for cell-laden and functional 3D bioprinting. Biodes Manuf 2022. [DOI: 10.1007/s42242-021-00169-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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14
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A Review of Haptic Feedback through Peripheral Nerve Stimulation for Upper Extremity Prosthetics. CURRENT OPINION IN BIOMEDICAL ENGINEERING 2022. [DOI: 10.1016/j.cobme.2022.100368] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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15
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Koppaka S, Hess-Dunning A, Tyler DJ. Directed stimulation with interfascicular interfaces for peripheral nerve stimulation. J Neural Eng 2021; 18. [PMID: 34706351 DOI: 10.1088/1741-2552/ac33e8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2021] [Accepted: 10/27/2021] [Indexed: 01/10/2023]
Abstract
Objective.Computational models have shown that directional electrical contacts placed within the epineurium, between the fascicles, and not penetrating the perineurium, can achieve selectivity levels similar to point source contacts placed within the fascicle. The objective of this study is to test, in a murine model, the hypothesis that directed interfascicular contacts are selective.Approach.Multiple interfascicular electrodes with directional contacts, exposed on a single face, were implanted in the sciatic nerves of 32 rabbits. Fine-wire intramuscular wire electrodes were implanted to measure electromyographic (EMG) activity from medial and lateral gastrocnemius, soleus, and tibialis anterior muscles.Main results.The recruitment data demonstrated that directed interfascicular interfaces, which do not penetrate the perineurium, selectively activate different axon populations.Significance.Interfascicular interfaces that are inside the nerve, but do not penetrate the perineurium are an alternative to intrafascicular interfaces and may offer additional selectivity compared to extraneural approaches.
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Affiliation(s)
- Smruta Koppaka
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH, United States of America.,Louis Stokes Cleveland VA Medical Center, Rehabilitation R&D, Cleveland, OH, United States of America.,Advanced Platform Technology (APT) Center, Cleveland, OH, United States of America
| | - Allison Hess-Dunning
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH, United States of America.,Louis Stokes Cleveland VA Medical Center, Rehabilitation R&D, Cleveland, OH, United States of America.,Advanced Platform Technology (APT) Center, Cleveland, OH, United States of America
| | - Dustin J Tyler
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH, United States of America.,Louis Stokes Cleveland VA Medical Center, Rehabilitation R&D, Cleveland, OH, United States of America.,Advanced Platform Technology (APT) Center, Cleveland, OH, United States of America
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16
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Liu Y, Feig VR, Bao Z. Conjugated Polymer for Implantable Electronics toward Clinical Application. Adv Healthc Mater 2021; 10:e2001916. [PMID: 33899347 DOI: 10.1002/adhm.202001916] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Revised: 12/13/2020] [Indexed: 12/21/2022]
Abstract
Owing to their excellent mechanical flexibility, mixed-conducting electrical property, and extraordinary chemical turnability, conjugated polymers have been demonstrated to be an ideal bioelectronic interface to deliver therapeutic effect in many different chronic diseases. This review article summarizes the latest advances in implantable electronics using conjugated polymers as electroactive materials and identifies remaining challenges and opportunities for developing electronic medicine. Examples of conjugated polymer-based bioelectronic devices are selectively reviewed in human clinical studies or animal studies with the potential for clinical adoption. The unique properties of conjugated polymers are highlighted and exemplified as potential solutions to address the specific challenges in electronic medicine.
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Affiliation(s)
- Yuxin Liu
- Institute of Materials Research and Engineering Agency for Science, Technology and Research Singapore 138634 Singapore
| | - Vivian Rachel Feig
- Division of Gastroenterology, Department of Medicine, Brigham and Women’s Hospital Harvard Medical School Boston MA 02115 USA
| | - Zhenan Bao
- Department of Chemical Engineering Stanford University Stanford CA 94305 USA
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17
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Assessment of the Use of Multi-Channel Organic Electrodes to Record ENG on Small Nerves: Application to Phrenic Nerve Burst Detection. SENSORS 2021; 21:s21165594. [PMID: 34451031 PMCID: PMC8402313 DOI: 10.3390/s21165594] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 07/21/2021] [Accepted: 08/07/2021] [Indexed: 12/26/2022]
Abstract
Effective closed-loop neuromodulation relies on the acquisition of appropriate physiological control variables and the delivery of an appropriate stimulation signal. In particular, electroneurogram (ENG) data acquired from a set of electrodes applied at the surface of the nerve may be used as a potential control variable in this field. Improved electrode technologies and data processing methods are clearly needed in this context. In this work, we evaluated a new electrode technology based on multichannel organic electrodes (OE) and applied a signal processing chain in order to detect respiratory-related bursts from the phrenic nerve. Phrenic ENG (pENG) were acquired from nine Long Evans rats in situ preparations. For each preparation, a 16-channel OE was applied around the phrenic nerve’s surface and a suction electrode was applied to the cut end of the same nerve. The former electrode provided input multivariate pENG signals while the latter electrode provided the gold standard for data analysis. Correlations between OE signals and that from the gold standard were estimated. Signal to noise ratio (SNR) and ROC curves were built to quantify phrenic bursts detection performance. Correlation score showed the ability of the OE to record high-quality pENG. Our methods allowed good phrenic bursts detection. However, we failed to demonstrate a spatial selectivity from the multiple pENG recorded with our OE matrix. Altogether, our results suggest that highly flexible and biocompatible multi-channel electrode may represent an interesting alternative to metallic cuff electrodes to perform nerve bursts detection and/or closed-loop neuromodulation.
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18
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Karczewski AM, Dingle AM, Poore SO. The Need to Work Arm in Arm: Calling for Collaboration in Delivering Neuroprosthetic Limb Replacements. Front Neurorobot 2021; 15:711028. [PMID: 34366820 PMCID: PMC8334559 DOI: 10.3389/fnbot.2021.711028] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Accepted: 06/22/2021] [Indexed: 11/21/2022] Open
Abstract
Over the last few decades there has been a push to enhance the use of advanced prosthetics within the fields of biomedical engineering, neuroscience, and surgery. Through the development of peripheral neural interfaces and invasive electrodes, an individual's own nervous system can be used to control a prosthesis. With novel improvements in neural recording and signal decoding, this intimate communication has paved the way for bidirectional and intuitive control of prostheses. While various collaborations between engineers and surgeons have led to considerable success with motor control and pain management, it has been significantly more challenging to restore sensation. Many of the existing peripheral neural interfaces have demonstrated success in one of these modalities; however, none are currently able to fully restore limb function. Though this is in part due to the complexity of the human somatosensory system and stability of bioelectronics, the fragmentary and as-yet uncoordinated nature of the neuroprosthetic industry further complicates this advancement. In this review, we provide a comprehensive overview of the current field of neuroprosthetics and explore potential strategies to address its unique challenges. These include exploration of electrodes, surgical techniques, control methods, and prosthetic technology. Additionally, we propose a new approach to optimizing prosthetic limb function and facilitating clinical application by capitalizing on available resources. It is incumbent upon academia and industry to encourage collaboration and utilization of different peripheral neural interfaces in combination with each other to create versatile limbs that not only improve function but quality of life. Despite the rapidly evolving technology, if the field continues to work in divided "silos," we will delay achieving the critical, valuable outcome: creating a prosthetic limb that is right for the patient and positively affects their life.
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Affiliation(s)
| | - Aaron M. Dingle
- Division of Plastic Surgery, Department of Surgery, University of Wisconsin–Madison, Madison, WI, United States
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19
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Cuttaz EA, Chapman CAR, Syed O, Goding JA, Green RA. Stretchable, Fully Polymeric Electrode Arrays for Peripheral Nerve Stimulation. ADVANCED SCIENCE (WEINHEIM, BADEN-WURTTEMBERG, GERMANY) 2021; 8:2004033. [PMID: 33898185 PMCID: PMC8061359 DOI: 10.1002/advs.202004033] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Revised: 01/19/2021] [Indexed: 05/08/2023]
Abstract
There is a critical need to transition research level flexible polymer bioelectronics toward the clinic by demonstrating both reliability in fabrication and stable device performance. Conductive elastomers (CEs) are composites of conductive polymers in elastomeric matrices that provide both flexibility and enhanced electrochemical properties compared to conventional metallic electrodes. This work focuses on the development of nerve cuff devices and the assessment of the device functionality at each development stage, from CE material to fully polymeric electrode arrays. Two device types are fabricated by laser machining of a thick and thin CE sheet variant on an insulative polydimethylsiloxane substrate and lamination into tubing to produce pre-curled cuffs. Device performance and stability following sterilization and mechanical loading are compared to a state-of-the-art stretchable metallic nerve cuff. The CE cuffs are found to be electrically and mechanically stable with improved charge transfer properties compared to the commercial cuff. All devices are applied to an ex vivo whole sciatic nerve and shown to be functional, with the CE cuffs demonstrating superior charge transfer and electrochemical safety in the biological environment.
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Affiliation(s)
- Estelle A. Cuttaz
- Department of BioengineeringImperial CollegeSouth KensingtonLondonSW7 2AZUK
| | | | - Omaer Syed
- Department of BioengineeringImperial CollegeSouth KensingtonLondonSW7 2AZUK
| | - Josef A. Goding
- Department of BioengineeringImperial CollegeSouth KensingtonLondonSW7 2AZUK
| | - Rylie A. Green
- Department of BioengineeringImperial CollegeSouth KensingtonLondonSW7 2AZUK
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20
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Kundu A, Fahmy A, Madler R, Otto K, Patrick E, Principe J, Maghari N, Bashirullah R. A multi-channel peripheral nerve stimulator with integrate-and-fire encoding. J Med Eng Technol 2021; 45:187-196. [PMID: 33729074 DOI: 10.1080/03091902.2021.1891311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Activation of peripheral nervous system (PNS) fibres to produce variable tactile and proprioceptive sensations in advanced bidirectional prosthetic limbs relies on neural stimulators with high spatial selectivity, dynamic range and resolution. A multi-channel application-specific integrated circuit (ASIC) is developed for PNS fibre activation using a wide dynamic range (10 nA-5 mA), high-resolution (30 nA step, 100 ns pulse accuracy) current stimulator, dissipating 0.73-2.75 mW at 3 V. The ASIC also enables encoding of external pressure signals via an integrate-and-fire methodology. Electrophysiological data of compound nerve action potentials were recorded for a range of stimulus amplitudes and pulse widths. This data was used to benchmark the performance of the ASIC with a known neural stimulator.
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Affiliation(s)
- Aritra Kundu
- Department of Neurology, Dell Medical School, The University of Texas at Austin, Austin, TX, USA
| | - Ahmed Fahmy
- Department of Electrical and Computer Engineering, University of Florida, Gainesville, FL, USA
| | - Ryan Madler
- Department of Electrical and Computer Engineering, University of Florida, Gainesville, FL, USA
| | - Kevin Otto
- Department of Biomedical Engineering, University of Florida, Gainesville, FL, USA
| | - Erin Patrick
- Department of Electrical and Computer Engineering, University of Florida, Gainesville, FL, USA
| | - Jose Principe
- Department of Electrical and Computer Engineering, University of Florida, Gainesville, FL, USA
| | - Nima Maghari
- Department of Electrical and Computer Engineering, University of Florida, Gainesville, FL, USA
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21
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Converging Robotic Technologies in Targeted Neural Rehabilitation: A Review of Emerging Solutions and Challenges. SENSORS 2021; 21:s21062084. [PMID: 33809721 PMCID: PMC8002299 DOI: 10.3390/s21062084] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Revised: 03/05/2021] [Accepted: 03/11/2021] [Indexed: 11/17/2022]
Abstract
Recent advances in the field of neural rehabilitation, facilitated through technological innovation and improved neurophysiological knowledge of impaired motor control, have opened up new research directions. Such advances increase the relevance of existing interventions, as well as allow novel methodologies and technological synergies. New approaches attempt to partially overcome long-term disability caused by spinal cord injury, using either invasive bridging technologies or noninvasive human-machine interfaces. Muscular dystrophies benefit from electromyography and novel sensors that shed light on underlying neuromotor mechanisms in people with Duchenne. Novel wearable robotics devices are being tailored to specific patient populations, such as traumatic brain injury, stroke, and amputated individuals. In addition, developments in robot-assisted rehabilitation may enhance motor learning and generate movement repetitions by decoding the brain activity of patients during therapy. This is further facilitated by artificial intelligence algorithms coupled with faster electronics. The practical impact of integrating such technologies with neural rehabilitation treatment can be substantial. They can potentially empower nontechnically trained individuals-namely, family members and professional carers-to alter the programming of neural rehabilitation robotic setups, to actively get involved and intervene promptly at the point of care. This narrative review considers existing and emerging neural rehabilitation technologies through the perspective of replacing or restoring functions, enhancing, or improving natural neural output, as well as promoting or recruiting dormant neuroplasticity. Upon conclusion, we discuss the future directions for neural rehabilitation research, diagnosis, and treatment based on the discussed technologies and their major roadblocks. This future may eventually become possible through technological evolution and convergence of mutually beneficial technologies to create hybrid solutions.
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22
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Abstract
When nerves are damaged by trauma or disease, they are still capable of firing off electrical command signals that originate from the brain. Furthermore, those damaged nerves have an innate ability to partially regenerate, so they can heal from trauma and even reinnervate new muscle targets. For an amputee who has his/her damaged nerves surgically reconstructed, the electrical signals that are generated by the reinnervated muscle tissue can be sensed and interpreted with bioelectronics to control assistive devices or robotic prostheses. No two amputees will have identical physiologies because there are many surgical options for reconstructing residual limbs, which may in turn impact how well someone can interface with a robotic prosthesis later on. In this review, we aim to investigate what the literature has to say about different pathways for peripheral nerve regeneration and how each pathway can impact the neuromuscular tissue’s final electrophysiology. This information is important because it can guide us in planning the development of future bioelectronic devices, such as prosthetic limbs or neurostimulators. Future devices will primarily have to interface with tissue that has undergone some natural regeneration process, and so we have explored and reported here what is known about the bioelectrical features of neuromuscular tissue regeneration.
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23
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Chari A, Budhdeo S, Sparks R, Barone DG, Marcus HJ, Pereira EAC, Tisdall MM. Brain-Machine Interfaces: The Role of the Neurosurgeon. World Neurosurg 2020; 146:140-147. [PMID: 33197630 DOI: 10.1016/j.wneu.2020.11.028] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Revised: 11/04/2020] [Accepted: 11/05/2020] [Indexed: 12/26/2022]
Abstract
Neurotechnology is set to expand rapidly in the coming years as technological innovations in hardware and software are translated to the clinical setting. Given our unique access to patients with neurologic disorders, expertise with which to guide appropriate treatments, and technical skills to implant brain-machine interfaces (BMIs), neurosurgeons have a key role to play in the progress of this field. We outline the current state and key challenges in this rapidly advancing field, including implant technology, implant recipients, implantation methodology, implant function, and ethical, regulatory, and economic considerations. Our key message is to encourage the neurosurgical community to proactively engage in collaborating with other health care professionals, engineers, scientists, ethicists, and regulators in tackling these issues. By doing so, we will equip ourselves with the skills and expertise to drive the field forward and avoid being mere technicians in an industry driven by those around us.
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Affiliation(s)
- Aswin Chari
- Developmental Neurosciences, Great Ormond Street Institute of Child Health, University College London, London, United Kingdom; Department of Neurosurgery, Great Ormond Street Hospital, London, United Kingdom.
| | - Sanjay Budhdeo
- Department for Clinical and Movement Neurosciences, Queen Square Institute of Neurology, University College London, London, United Kingdom; Department of Neurology, National Hospital for Neurology and Neurosurgery, London, United Kingdom; OwkinInc, New York, New York, USA
| | - Rachel Sparks
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom
| | - Damiano G Barone
- Division of Neurosurgery, Department of Clinical Neurosciences, University of Cambridge, Cambridge, United Kingdom
| | - Hani J Marcus
- Department of Neurosurgery, National Hospital for Neurology and Neurosurgery, London, United Kingdom; Wellcome EPSRC Centre for Interventional and Surgical Sciences, University College London, London, United Kingdom
| | - Erlick A C Pereira
- Neurosciences Research Centre, Molecular and Clinical Sciences Research Institute, St George's, University of London, United Kingdom
| | - Martin M Tisdall
- Developmental Neurosciences, Great Ormond Street Institute of Child Health, University College London, London, United Kingdom; Department of Neurosurgery, Great Ormond Street Hospital, London, United Kingdom
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24
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Williams I, Brunton E, Rapeaux A, Liu Y, Luan S, Nazarpour K, Constandinou T. SenseBack - An Implantable System for Bidirectional Neural Interfacing. IEEE TRANSACTIONS ON BIOMEDICAL CIRCUITS AND SYSTEMS 2020; PP:1079-1087. [PMID: 32915746 DOI: 10.1109/tbcas.2020.3022839] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Chronic in-vivo neurophysiology experiments require highly miniaturized, remotely powered multi-channel neural interfaces which are currently lacking in power or flexibility post implantation. To resolve this problem we present the SenseBack system, a post-implantation reprogrammable wireless 32-channel bidirectional neural interfacing device that can enable chronic peripheral electrophysiology experiments in freely behaving small animals. The large number of channels for a peripheral neural interface, coupled with fully implantable hardware and complete software flexibility enable complex in-vivo studies where the system can adapt to evolving study needs as they arise. In complementary \textit{ex-vivo} and \textit{in-vivo} preparations, we demonstrate that this system can record neural signals and perform high-voltage, bipolar stimulation on any channel. In addition, we demonstrate transcutaneous power delivery and Bluetooth 5 data communication with a PC. The SenseBack system is capable of stimulation on any channel with 20 V of compliance and up to 315 A of current, and highly configurable recording with per-channel adjustable gain and filtering with 8 sets of 10-bit ADCs to sample data at 20 kHz for each channel. To our knowledge this is the first such implantable research platform offering this level of performance and flexibility post-implantation (including complete reprogramming even after encapsulation) for small animal electrophysiology. Here we present initial acute trials, demonstrations and progress towards a system that we expect to enable a wide range of electrophysiology experiments in freely behaving animals.
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25
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Yildiz KA, Shin AY, Kaufman KR. Interfaces with the peripheral nervous system for the control of a neuroprosthetic limb: a review. J Neuroeng Rehabil 2020; 17:43. [PMID: 32151268 PMCID: PMC7063740 DOI: 10.1186/s12984-020-00667-5] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Accepted: 02/17/2020] [Indexed: 12/22/2022] Open
Abstract
The field of prosthetics has been evolving and advancing over the past decade, as patients with missing extremities are expecting to control their prostheses in as normal a way as possible. Scientists have attempted to satisfy this expectation by designing a connection between the nervous system of the patient and the prosthetic limb, creating the field of neuroprosthetics. In this paper, we broadly review the techniques used to bridge the patient's peripheral nervous system to a prosthetic limb. First, we describe the electrical methods including myoelectric systems, surgical innovations and the role of nerve electrodes. We then describe non-electrical methods used alone or in combination with electrical methods. Design concerns from an engineering point of view are explored, and novel improvements to obtain a more stable interface are described. Finally, a critique of the methods with respect to their long-term impacts is provided. In this review, nerve electrodes are found to be one of the most promising interfaces in the future for intuitive user control. Clinical trials with larger patient populations, and for longer periods of time for certain interfaces, will help to evaluate the clinical application of nerve electrodes.
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Affiliation(s)
- Kadir A Yildiz
- Motion Analysis Laboratory, Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USA
| | - Alexander Y Shin
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USA
| | - Kenton R Kaufman
- Motion Analysis Laboratory, Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USA.
- Motion Analysis Laboratory, W. Hall Wendel, Jr., Musculoskeletal Research, 200 First Street SW, Rochester, MN, 55905, USA.
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26
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Elyahoodayan S, Larson C, Cobo AM, Meng E, Song D. Acute in vivo testing of a polymer cuff electrode with integrated microfluidic channels for stimulation, recording, and drug delivery on rat sciatic nerve. J Neurosci Methods 2020; 336:108634. [PMID: 32068010 DOI: 10.1016/j.jneumeth.2020.108634] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Revised: 02/11/2020] [Accepted: 02/11/2020] [Indexed: 01/15/2023]
Abstract
BACKGROUND Extraneural cuffs are among the least invasive peripheral nerve interfaces as they remain outside the nerve. However, compared with more invasive interfaces, these electrodes may suffer from lower selectivity and sensitivity since the targeted nerve fibers are more distanced from the electrodes. NEW METHOD A lyse-and-attract cuff electrode (LACE) was enabled by microfabrication and developed to improve selectivity and sensitivity while maintaining a cuff format. Its engineering design was described in previous work. LACE is a hybrid cuff that integrates both microelectrodes and microfluidic channels. The ultimate goal is to increase fascicular selectivity and sensitivity by focal delivery via the microchannels of (1) lysing agent to remove connective tissue separating electrodes from nerve fibers, and (2) neurotrophic factors to promote axonal sprouting of the exposed nerve fibers into microfluidic channels where electrodes are embedded. Here, we focus on demonstrating in vivo function of microfluidics and microelectrodes in an acute preparation in which we evaluate the ability to focally remove connective tissue and record and stimulate with microchannel-embedded microelectrodes neural activity in rat sciatic nerves. COMPARISON WITH EXISTING METHODS While extraneural interfaces prioritize nerve health and intraneural interfaces prioritize functionality, LACE represents a new extraneural approach which could potentially excel at both aims. RESULTS Surgical implantation demonstrate preservation of LACE function following careful and minimal handling. In vivo electrical evaluation demonstrates the ability of microelectrodes placed within microfluidic channels to successfully stimulate and record compound action potentials from rat sciatic nerve. Furthermore, collagen-rich epineurium was focally removed following infusion of collagenase via microchannels and confirmed via microscopy. CONCLUSION The feasibility of using a cuff having integrated microelectrodes and microfluidics to stimulate, record, and deliver drug to focally lyse away the epineurium layer was demonstrated in acute experiments on rat sciatic nerve.
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Affiliation(s)
- Sahar Elyahoodayan
- Department of Biomedical Engineering, University of Southern California, Los Angeles, CA 90089, USA.
| | - Christopher Larson
- Department of Biomedical Engineering, University of Southern California, Los Angeles, CA 90089, USA.
| | - Angelica M Cobo
- Department of Biomedical Engineering, University of Southern California, Los Angeles, CA 90089, USA.
| | - Ellis Meng
- Department of Biomedical Engineering, University of Southern California, Los Angeles, CA 90089, USA; Department of Electrical and Computer Engineering, University of Southern California, Los Angeles, CA, 90089, USA.
| | - Dong Song
- Department of Biomedical Engineering, University of Southern California, Los Angeles, CA 90089, USA; Neuroscience Graduate Program, University of Southern California, Los Angeles, CA, 90089, USA.
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Yang W, Gong Y, Li W. A Review: Electrode and Packaging Materials for Neurophysiology Recording Implants. Front Bioeng Biotechnol 2020; 8:622923. [PMID: 33585422 PMCID: PMC7873964 DOI: 10.3389/fbioe.2020.622923] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Accepted: 12/10/2020] [Indexed: 01/28/2023] Open
Abstract
To date, a wide variety of neural tissue implants have been developed for neurophysiology recording from living tissues. An ideal neural implant should minimize the damage to the tissue and perform reliably and accurately for long periods of time. Therefore, the materials utilized to fabricate the neural recording implants become a critical factor. The materials of these devices could be classified into two broad categories: electrode materials as well as packaging and substrate materials. In this review, inorganic (metals and semiconductors), organic (conducting polymers), and carbon-based (graphene and carbon nanostructures) electrode materials are reviewed individually in terms of various neural recording devices that are reported in recent years. Properties of these materials, including electrical properties, mechanical properties, stability, biodegradability/bioresorbability, biocompatibility, and optical properties, and their critical importance to neural recording quality and device capabilities, are discussed. For the packaging and substrate materials, different material properties are desired for the chronic implantation of devices in the complex environment of the body, such as biocompatibility and moisture and gas hermeticity. This review summarizes common solid and soft packaging materials used in a variety of neural interface electrode designs, as well as their packaging performances. Besides, several biopolymers typically applied over the electrode package to reinforce the mechanical rigidity of devices during insertion, or to reduce the immune response and inflammation at the device-tissue interfaces are highlighted. Finally, a benchmark analysis of the discussed materials and an outlook of the future research trends are concluded.
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Affiliation(s)
- Weiyang Yang
- Microtechnology Lab, Department of Electrical and Computer Engineering, Michigan State University, East Lansing, MI, United States
| | - Yan Gong
- Microtechnology Lab, Department of Electrical and Computer Engineering, Michigan State University, East Lansing, MI, United States
| | - Wen Li
- Microtechnology Lab, Department of Electrical and Computer Engineering, Michigan State University, East Lansing, MI, United States
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Shoffstall AJ, Capadona JR. Bioelectronic Neural Implants. Biomater Sci 2020. [DOI: 10.1016/b978-0-12-816137-1.00073-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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29
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A review for the peripheral nerve interface designer. J Neurosci Methods 2019; 332:108523. [PMID: 31743684 DOI: 10.1016/j.jneumeth.2019.108523] [Citation(s) in RCA: 55] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Revised: 11/14/2019] [Accepted: 11/15/2019] [Indexed: 12/11/2022]
Abstract
Informational density and relative accessibility of the peripheral nervous system make it an attractive site for therapeutic intervention. Electrode-based electrophysiological interfaces with peripheral nerves have been under development since the 1960s and, for several applications, have seen widespread clinical implementation. However, many applications require a combination of neural target resolution and stability which has thus far eluded existing peripheral nerve interfaces (PNIs). With the goal of aiding PNI designers in development of devices that meet the demands of next-generation applications, this review seeks to collect and present practical considerations and best practices which emerge from the literature, including both lessons learned during early PNI development and recent ideas. Fundamental and practical principles guiding PNI design are reviewed, followed by an updated and critical account of existing PNI designs and strategies. Finally, a brief survey of in vitro and in vivo PNI characterization methods is presented.
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Tam WK, Wu T, Zhao Q, Keefer E, Yang Z. Human motor decoding from neural signals: a review. BMC Biomed Eng 2019; 1:22. [PMID: 32903354 PMCID: PMC7422484 DOI: 10.1186/s42490-019-0022-z] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2019] [Accepted: 07/21/2019] [Indexed: 01/24/2023] Open
Abstract
Many people suffer from movement disability due to amputation or neurological diseases. Fortunately, with modern neurotechnology now it is possible to intercept motor control signals at various points along the neural transduction pathway and use that to drive external devices for communication or control. Here we will review the latest developments in human motor decoding. We reviewed the various strategies to decode motor intention from human and their respective advantages and challenges. Neural control signals can be intercepted at various points in the neural signal transduction pathway, including the brain (electroencephalography, electrocorticography, intracortical recordings), the nerves (peripheral nerve recordings) and the muscles (electromyography). We systematically discussed the sites of signal acquisition, available neural features, signal processing techniques and decoding algorithms in each of these potential interception points. Examples of applications and the current state-of-the-art performance were also reviewed. Although great strides have been made in human motor decoding, we are still far away from achieving naturalistic and dexterous control like our native limbs. Concerted efforts from material scientists, electrical engineers, and healthcare professionals are needed to further advance the field and make the technology widely available in clinical use.
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Affiliation(s)
- Wing-kin Tam
- Department of Biomedical Engineering, University of Minnesota Twin Cities, 7-105 Hasselmo Hall, 312 Church St. SE, Minnesota, 55455 USA
| | - Tong Wu
- Department of Biomedical Engineering, University of Minnesota Twin Cities, 7-105 Hasselmo Hall, 312 Church St. SE, Minnesota, 55455 USA
| | - Qi Zhao
- Department of Computer Science and Engineering, University of Minnesota Twin Cities, 4-192 Keller Hall, 200 Union Street SE, Minnesota, 55455 USA
| | - Edward Keefer
- Nerves Incorporated, Dallas, TX P. O. Box 141295 USA
| | - Zhi Yang
- Department of Biomedical Engineering, University of Minnesota Twin Cities, 7-105 Hasselmo Hall, 312 Church St. SE, Minnesota, 55455 USA
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