1
|
Chen W, Wang S, Bao J, Yu C, Jiang Q, Song J, Zheng Y, Hao Y, Xu K. Restoration of coherent reach-grasp-pull movement via sequential intraneural peripheral nerve stimulation in rats. J Neural Eng 2024; 21:046007. [PMID: 38885677 DOI: 10.1088/1741-2552/ad5935] [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: 12/21/2023] [Accepted: 06/17/2024] [Indexed: 06/20/2024]
Abstract
Objective.Peripheral nerve stimulation (PNS) has been demonstrated as an effective way to selectively activate muscles and to produce fine hand movements. However, sequential multi-joint upper limb movements, which are critical for paralysis rehabilitation, has not been tested with PNS. Here, we aimed to restore multiple upper limb joint movements through an intraneural interface with a single electrode, achieving coherent reach-grasp-pull movement tasks through sequential stimulation.Approach.A transverse intrafascicular multichannel electrode was implanted under the axilla of the rat's upper limb, traversing the musculocutaneous, radial, median, and ulnar nerves. Intramuscular electrodes were implanted into the biceps brachii (BB), triceps brachii (TB), flexor carpi radialis (FCR), and extensor carpi radialis (ECR) muscles to record electromyographic (EMG) activity and video recordings were used to capture the kinematics of elbow, wrist, and digit joints. Charge-balanced biphasic pulses were applied to different channels to recruit distinct upper limb muscles, with concurrent recording of EMG signals and joint kinematics to assess the efficacy of the stimulation. Finally, a sequential stimulation protocol was employed by generating coordinated pulses in different channels.Main results.BB, TB, FCR and ECR muscles were selectively activated and various upper limb movements, including elbow flexion, elbow extension, wrist flexion, wrist extension, digit flexion, and digit extension, were reliably generated. The modulation effects of stimulation parameters, including pulse width, amplitude, and frequency, on induced joint movements were investigated and reach-grasp-pull movement was elicited by sequential stimulation.Significance.Our results demonstrated the feasibility of sequential intraneural stimulation for functional multi-joint movement restoration, providing a new approach for clinical rehabilitation in paralyzed patients.
Collapse
Affiliation(s)
- Weihuang Chen
- Qiushi Academy for Advanced Studies (QAAS), Zhejiang University, Hangzhou, People's Republic of China
- Nanhu Brain-computer interface institute, Hangzhou 311100, People's Republic of China
- The State Key Lab of Brain-Machine Intelligence, Zhejiang University, Hangzhou 311100, People's Republic of China
- Zhejiang Provincial Key Laboratory of Cardio-Cerebral Vascular Detection Technology and Medicinal Effectiveness Appraisal, Key Laboratory of Biomedical Engineering of Education Ministry, Department of Biomedical Engineering, Zhejiang University, Hangzhou, People's Republic of China
| | - Suhao Wang
- Nanhu Brain-computer interface institute, Hangzhou 311100, People's Republic of China
- The State Key Lab of Brain-Machine Intelligence, Zhejiang University, Hangzhou 311100, People's Republic of China
- Department of Engineering Mechanics, Soft Matter Research Center, and Key Laboratory of Soft Machines and Smart Devices of Zhejiang Province, Zhejiang University, Hangzhou 310027, People's Republic of China
| | - Jieting Bao
- Zhejiang Provincial Key Laboratory of Cardio-Cerebral Vascular Detection Technology and Medicinal Effectiveness Appraisal, Key Laboratory of Biomedical Engineering of Education Ministry, Department of Biomedical Engineering, Zhejiang University, Hangzhou, People's Republic of China
| | - Chaonan Yu
- Nanhu Brain-computer interface institute, Hangzhou 311100, People's Republic of China
| | - Qianqian Jiang
- Nanhu Brain-computer interface institute, Hangzhou 311100, People's Republic of China
- The State Key Lab of Brain-Machine Intelligence, Zhejiang University, Hangzhou 311100, People's Republic of China
- Department of Engineering Mechanics, Soft Matter Research Center, and Key Laboratory of Soft Machines and Smart Devices of Zhejiang Province, Zhejiang University, Hangzhou 310027, People's Republic of China
| | - Jizhou Song
- Nanhu Brain-computer interface institute, Hangzhou 311100, People's Republic of China
- The State Key Lab of Brain-Machine Intelligence, Zhejiang University, Hangzhou 311100, People's Republic of China
- Department of Engineering Mechanics, Soft Matter Research Center, and Key Laboratory of Soft Machines and Smart Devices of Zhejiang Province, Zhejiang University, Hangzhou 310027, People's Republic of China
| | - Yongte Zheng
- Cereblink (Hangzhou) Technology Co., Ltd, Hangzhou, People's Republic of China
| | - Yaoyao Hao
- Nanhu Brain-computer interface institute, Hangzhou 311100, People's Republic of China
- The State Key Lab of Brain-Machine Intelligence, Zhejiang University, Hangzhou 311100, People's Republic of China
| | - Kedi Xu
- Qiushi Academy for Advanced Studies (QAAS), Zhejiang University, Hangzhou, People's Republic of China
- Nanhu Brain-computer interface institute, Hangzhou 311100, People's Republic of China
- The State Key Lab of Brain-Machine Intelligence, Zhejiang University, Hangzhou 311100, People's Republic of China
- Zhejiang Provincial Key Laboratory of Cardio-Cerebral Vascular Detection Technology and Medicinal Effectiveness Appraisal, Key Laboratory of Biomedical Engineering of Education Ministry, Department of Biomedical Engineering, Zhejiang University, Hangzhou, People's Republic of China
| |
Collapse
|
2
|
Xi P, Yao Q, Liu Y, He J, Tang R, Lang Y. Biomimetic Peripheral Nerve Stimulation Promotes the Rat Hindlimb Motion Modulation in Stepping: An Experimental Analysis. CYBORG AND BIONIC SYSTEMS 2024; 5:0131. [PMID: 38966124 PMCID: PMC11223769 DOI: 10.34133/cbsystems.0131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Accepted: 04/23/2024] [Indexed: 07/06/2024] Open
Abstract
Peripheral nerve stimulation is an effective neuromodulation method in patients with lower extremity movement disorders caused by stroke, spinal cord injury, or other diseases. However, most current studies on rehabilitation using sciatic nerve stimulation focus solely on ankle motor regulation through stimulation of common peroneal and tibial nerves. Using the electrical nerve stimulation method, we here achieved muscle control via different sciatic nerve branches to facilitate the regulation of lower limb movements during stepping and standing. A map of relationships between muscles and nerve segments was established to artificially activate specific nerve fibers with the biomimetic stimulation waveform. Then, characteristic curves depicting the relationship between neural electrical stimulation intensity and joint control were established. Finally, by testing the selected stimulation parameters in anesthetized rats, we confirmed that single-cathode extraneural electrical stimulation could activate combined movements to promote lower limb movements. Thus, this method is effective and reliable for use in treatment for improving and rehabilitating lower limb motor dysfunction.
Collapse
Affiliation(s)
- Pengcheng Xi
- School of Mechatronical Engineering,
Beijing Institute of Technology, Beijing, People’s Republic of China
| | - Qingyu Yao
- National Engineering Research Center of Neuromodulation,
Tsinghua University, Beijing, People’s Republic of China
| | - Yafei Liu
- School of Mechatronical Engineering,
Beijing Institute of Technology, Beijing, People’s Republic of China
| | - Jiping He
- School of Mechatronical Engineering,
Beijing Institute of Technology, Beijing, People’s Republic of China
- Beijing Innovation Center for Intelligent Robots and Systems,
Beijing Institute of Technology, Beijing, People’s Republic of China
| | - Rongyu Tang
- Institute of Semiconductors,
Chinese Academy of Science, Beijing, People’s Republic of China
| | - Yiran Lang
- School of Life Science,
Beijing Institute of Technology, Beijing, People’s Republic of China
| |
Collapse
|
3
|
Herring EZ, Graczyk EL, Memberg WD, Adams R, Fernandez Baca-Vaca G, Hutchison BC, Krall JT, Alexander BJ, Conlan EC, Alfaro KE, Bhat P, Ketting-Olivier AB, Haddix CA, Taylor DM, Tyler DJ, Sweet JA, Kirsch RF, Ajiboye AB, Miller JP. Reconnecting the Hand and Arm to the Brain: Efficacy of Neural Interfaces for Sensorimotor Restoration After Tetraplegia. Neurosurgery 2024; 94:864-874. [PMID: 37982637 DOI: 10.1227/neu.0000000000002769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 09/01/2023] [Indexed: 11/21/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Paralysis after spinal cord injury involves damage to pathways that connect neurons in the brain to peripheral nerves in the limbs. Re-establishing this communication using neural interfaces has the potential to bridge the gap and restore upper extremity function to people with high tetraplegia. We report a novel approach for restoring upper extremity function using selective peripheral nerve stimulation controlled by intracortical microelectrode recordings from sensorimotor networks, along with restoration of tactile sensation of the hand using intracortical microstimulation. METHODS A 27-year-old right-handed man with AIS-B (motor-complete, sensory-incomplete) C3-C4 tetraplegia was enrolled into the clinical trial. Six 64-channel intracortical microelectrode arrays were implanted into left hemisphere regions involved in upper extremity function, including primary motor and sensory cortices, inferior frontal gyrus, and anterior intraparietal area. Nine 16-channel extraneural peripheral nerve electrodes were implanted to allow targeted stimulation of right median, ulnar (2), radial, axillary, musculocutaneous, suprascapular, lateral pectoral, and long thoracic nerves, to produce selective muscle contractions on demand. Proof-of-concept studies were performed to demonstrate feasibility of using a brain-machine interface to read from and write to the brain for restoring motor and sensory functions of the participant's own arm and hand. RESULTS Multiunit neural activity that correlated with intended motor action was successfully recorded from intracortical arrays. Microstimulation of electrodes in somatosensory cortex produced repeatable sensory percepts of individual fingers for restoration of touch sensation. Selective electrical activation of peripheral nerves produced antigravity muscle contractions, resulting in functional movements that the participant was able to command under brain control to perform virtual and actual arm and hand movements. The system was well tolerated with no operative complications. CONCLUSION The combination of implanted cortical electrodes and nerve cuff electrodes has the potential to create bidirectional restoration of motor and sensory functions of the arm and hand after neurological injury.
Collapse
Affiliation(s)
- Eric Z Herring
- School of Medicine, Case Western Reserve University, Cleveland , Ohio , USA
- Department of Neurosurgery, The Neurological Institute, University Hospital Cleveland Medical Center, Cleveland , Ohio , USA
| | - Emily L Graczyk
- School of Medicine, Case Western Reserve University, Cleveland , Ohio , USA
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland , Ohio , USA
- Louis Stokes Cleveland Department of Veterans Affairs Medical Center, Cleveland , Ohio , USA
| | - William D Memberg
- School of Medicine, Case Western Reserve University, Cleveland , Ohio , USA
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland , Ohio , USA
- Louis Stokes Cleveland Department of Veterans Affairs Medical Center, Cleveland , Ohio , USA
| | - Robert Adams
- School of Medicine, Case Western Reserve University, Cleveland , Ohio , USA
- Department of Neurosurgery, The Neurological Institute, University Hospital Cleveland Medical Center, Cleveland , Ohio , USA
| | - Gaudalupe Fernandez Baca-Vaca
- School of Medicine, Case Western Reserve University, Cleveland , Ohio , USA
- Department of Neurosurgery, The Neurological Institute, University Hospital Cleveland Medical Center, Cleveland , Ohio , USA
| | - Brianna C Hutchison
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland , Ohio , USA
| | - John T Krall
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland , Ohio , USA
| | - Benjamin J Alexander
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland , Ohio , USA
| | - Emily C Conlan
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland , Ohio , USA
| | - Kenya E Alfaro
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland , Ohio , USA
| | - Preethisiri Bhat
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland , Ohio , USA
| | - Aaron B Ketting-Olivier
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland , Ohio , USA
| | - Chase A Haddix
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland , Ohio , USA
- Department of Neuroscience, The Cleveland Clinic, Cleveland , Ohio , USA
| | - Dawn M Taylor
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland , Ohio , USA
- Louis Stokes Cleveland Department of Veterans Affairs Medical Center, Cleveland , Ohio , USA
- Department of Neuroscience, The Cleveland Clinic, Cleveland , Ohio , USA
| | - Dustin J Tyler
- School of Medicine, Case Western Reserve University, Cleveland , Ohio , USA
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland , Ohio , USA
- Louis Stokes Cleveland Department of Veterans Affairs Medical Center, Cleveland , Ohio , USA
| | - Jennifer A Sweet
- School of Medicine, Case Western Reserve University, Cleveland , Ohio , USA
- Department of Neurosurgery, The Neurological Institute, University Hospital Cleveland Medical Center, Cleveland , Ohio , USA
| | - Robert F Kirsch
- School of Medicine, Case Western Reserve University, Cleveland , Ohio , USA
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland , Ohio , USA
- Louis Stokes Cleveland Department of Veterans Affairs Medical Center, Cleveland , Ohio , USA
| | - A Bolu Ajiboye
- School of Medicine, Case Western Reserve University, Cleveland , Ohio , USA
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland , Ohio , USA
- Louis Stokes Cleveland Department of Veterans Affairs Medical Center, Cleveland , Ohio , USA
| | - Jonathan P Miller
- School of Medicine, Case Western Reserve University, Cleveland , Ohio , USA
- Department of Neurosurgery, The Neurological Institute, University Hospital Cleveland Medical Center, Cleveland , Ohio , USA
- Louis Stokes Cleveland Department of Veterans Affairs Medical Center, Cleveland , Ohio , USA
| |
Collapse
|
4
|
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.
Collapse
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
| |
Collapse
|
5
|
Xu J, Filho JS, Nag S, Long L, Hwang E, Tejeiro C, O'Leary G, Huang Y, Kanchwala M, Abdolrazzaghi M, Tang C, Liu P, Sui Y, You H, Liu X, Zariffa J, Genov R. Fascicle-Selective Ultrasound-Powered Bidirectional Wireless Peripheral Nerve Interface IC. IEEE TRANSACTIONS ON BIOMEDICAL CIRCUITS AND SYSTEMS 2023; 17:1237-1256. [PMID: 37956015 DOI: 10.1109/tbcas.2023.3332258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2023]
Abstract
This paper presents an innovative, minimally invasive, battery-free, wireless, peripheral nervous system (PNS) neural interface, which seamlessly integrates a millimeter-scale, fascicle-selective integrated circuit (IC) with extraneural recording and stimulating channels. The system also incorporates a wearable interrogator equipped with integrated machine-learning capabilities. This PNS interface is specifically tailored for adaptive neuromodulation therapy, targeting individuals with paralysis, amputation, or chronic medical conditions. By employing a neural pathway classifier and temporal interference stimulation, the proposed interface achieves precise deep fascicle selectivity for recording and stimulation without the need for nerve penetration or compression. Ultrasonic energy harvesters facilitate wireless power harvesting and data reception, enhancing the usability of the system. Key circuit performance metrics encompass a 2.2 μVrms input-referred noise, 14-bit ENOB, and a 173 dB Schreier figure of merit (FOM) for the neural analog-to-digital converter (ADC). Additionally, the ultra-low-power radio-frequency (RF) transmitter boasts a remarkable 1.38 pJ/bit energy efficiency. In vivo experiments conducted on rat sciatic nerves provide compelling evidence of the interface's ability to selectively stimulate and record neural fascicles. The proposed PNS neural interface offers alternative treatment options for diagnosing and treating neurological disorders, as well as restoring or repairing neural functions, improving the quality of life for patients with neurological and sensory deficits.
Collapse
|
6
|
Pellot-Cestero JE, Herring EZ, Graczyk EL, Memberg WD, Kirsch RF, Ajiboye AB, Miller JP. Implanted Electrodes for Functional Electrical Stimulation to Restore Upper and Lower Extremity Function: History and Future Directions. Neurosurgery 2023; 93:965-970. [PMID: 37288972 DOI: 10.1227/neu.0000000000002561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 04/03/2023] [Indexed: 06/09/2023] Open
Abstract
Functional electrical stimulation (FES) to activate nerves and muscles in paralyzed extremities has considerable promise to improve outcome after neurological disease or injury, especially in individuals who have upper motor nerve dysfunction due to central nervous system pathology. Because technology has improved, a wide variety of methods for providing electrical stimulation to create functional movements have been developed, including muscle stimulating electrodes, nerve stimulating electrodes, and hybrid constructs. However, in spite of decades of success in experimental settings with clear functional improvements for individuals with paralysis, the technology has not yet reached widespread clinical translation. In this review, we outline the history of FES techniques and approaches and describe future directions in evolution of the technology.
Collapse
Affiliation(s)
- Joel E Pellot-Cestero
- Department of Neurosurgery, School of Medicine, Case Western Reserve University, Cleveland , Ohio , USA
- Department of Neurosurgery, The Neurological Institute, University Hospital Cleveland Medical Center, Cleveland , Ohio , USA
| | - Eric Z Herring
- Department of Neurosurgery, School of Medicine, Case Western Reserve University, Cleveland , Ohio , USA
- Department of Neurosurgery, The Neurological Institute, University Hospital Cleveland Medical Center, Cleveland , Ohio , USA
| | - Emily L Graczyk
- Department of Neurosurgery, School of Medicine, Case Western Reserve University, Cleveland , Ohio , USA
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland , Ohio , USA
- Louis Stokes Cleveland Department of Veterans Affairs Medical Center, FES Center of Excellence, Rehab. R&D Service, Cleveland , Ohio , USA
| | - William D Memberg
- Department of Neurosurgery, School of Medicine, Case Western Reserve University, Cleveland , Ohio , USA
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland , Ohio , USA
- Louis Stokes Cleveland Department of Veterans Affairs Medical Center, FES Center of Excellence, Rehab. R&D Service, Cleveland , Ohio , USA
| | - Robert F Kirsch
- Department of Neurosurgery, School of Medicine, Case Western Reserve University, Cleveland , Ohio , USA
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland , Ohio , USA
- Louis Stokes Cleveland Department of Veterans Affairs Medical Center, FES Center of Excellence, Rehab. R&D Service, Cleveland , Ohio , USA
| | - A Bolu Ajiboye
- Department of Neurosurgery, School of Medicine, Case Western Reserve University, Cleveland , Ohio , USA
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland , Ohio , USA
- Louis Stokes Cleveland Department of Veterans Affairs Medical Center, FES Center of Excellence, Rehab. R&D Service, Cleveland , Ohio , USA
| | - Jonathan P Miller
- Department of Neurosurgery, School of Medicine, Case Western Reserve University, Cleveland , Ohio , USA
- Department of Neurosurgery, The Neurological Institute, University Hospital Cleveland Medical Center, Cleveland , Ohio , USA
- Louis Stokes Cleveland Department of Veterans Affairs Medical Center, FES Center of Excellence, Rehab. R&D Service, Cleveland , Ohio , USA
| |
Collapse
|
7
|
Herring EZ, Graczyk EL, Memberg WD, Adams RD, Baca-Vaca GF, Hutchison BC, Krall JT, Alexander BJ, Conlan EC, Alfaro KE, Bhat PR, Ketting-Olivier AB, Haddix CA, Taylor DM, Tyler DJ, Kirsch RF, Ajiboye AB, Miller JP. Reconnecting the Hand and Arm to the Brain: Efficacy of Neural Interfaces for Sensorimotor Restoration after Tetraplegia. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.04.24.23288977. [PMID: 37162904 PMCID: PMC10168522 DOI: 10.1101/2023.04.24.23288977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
Background Paralysis after spinal cord injury involves damage to pathways that connect neurons in the brain to peripheral nerves in the limbs. Re-establishing this communication using neural interfaces has the potential to bridge the gap and restore upper extremity function to people with high tetraplegia. Objective We report a novel approach for restoring upper extremity function using selective peripheral nerve stimulation controlled by intracortical microelectrode recordings from sensorimotor networks, along with restoration of tactile sensation of the hand using intracortical microstimulation. Methods A right-handed man with motor-complete C3-C4 tetraplegia was enrolled into the clinical trial. Six 64-channel intracortical microelectrode arrays were implanted into left hemisphere regions involved in upper extremity function, including primary motor and sensory cortices, inferior frontal gyrus, and anterior intraparietal area. Nine 16-channel extraneural peripheral nerve electrodes were implanted to allow targeted stimulation of right median, ulnar (2), radial, axillary, musculocutaneous, suprascapular, lateral pectoral, and long thoracic nerves, to produce selective muscle contractions on demand. Proof-of-concept studies were performed to demonstrate feasibility of a bidirectional brain-machine interface to restore function of the participant's own arm and hand. Results Multi-unit neural activity that correlated with intended motor action was successfully recorded from intracortical arrays. Microstimulation of electrodes in somatosensory cortex produced repeatable sensory percepts of individual fingers for restoration of touch sensation. Selective electrical activation of peripheral nerves produced antigravity muscle contractions. The system was well tolerated with no operative complications. Conclusion The combination of implanted cortical electrodes and nerve cuff electrodes has the potential to allow restoration of motor and sensory functions of the arm and hand after neurological injury.
Collapse
Affiliation(s)
- Eric Z Herring
- School of Medicine, Case Western Reserve University, Cleveland, Ohio, USA
- The Neurological Institute, University Hospitals Cleveland Medical Center, Cleveland, OH, USA
| | - Emily L Graczyk
- School of Medicine, Case Western Reserve University, Cleveland, Ohio, USA
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, Ohio, USA
- Louis Stokes Cleveland Department of Veterans Affairs Medical Center, FES Center of Excellence, Cleveland, Ohio, USA
| | - William D Memberg
- School of Medicine, Case Western Reserve University, Cleveland, Ohio, USA
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, Ohio, USA
- Louis Stokes Cleveland Department of Veterans Affairs Medical Center, FES Center of Excellence, Cleveland, Ohio, USA
| | - Robert D Adams
- Louis Stokes Cleveland Department of Veterans Affairs Medical Center, FES Center of Excellence, Cleveland, Ohio, USA
| | | | - Brianna C Hutchison
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, Ohio, USA
| | - John T Krall
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, Ohio, USA
| | - Benjamin J Alexander
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, Ohio, USA
| | - Emily C Conlan
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, Ohio, USA
| | - Kenya E Alfaro
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, Ohio, USA
| | - Preethi R Bhat
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, Ohio, USA
| | | | - Chase A Haddix
- Department of Neuroscience, Lerner Research Institute, The Cleveland Clinic, Cleveland, Ohio, USA
| | - Dawn M Taylor
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, Ohio, USA
- Louis Stokes Cleveland Department of Veterans Affairs Medical Center, FES Center of Excellence, Cleveland, Ohio, USA
- Department of Neuroscience, Lerner Research Institute, The Cleveland Clinic, Cleveland, Ohio, USA
| | - Dustin J Tyler
- School of Medicine, Case Western Reserve University, Cleveland, Ohio, USA
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, Ohio, USA
| | - Robert F Kirsch
- School of Medicine, Case Western Reserve University, Cleveland, Ohio, USA
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, Ohio, USA
- Louis Stokes Cleveland Department of Veterans Affairs Medical Center, FES Center of Excellence, Cleveland, Ohio, USA
| | - A Bolu Ajiboye
- School of Medicine, Case Western Reserve University, Cleveland, Ohio, USA
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, Ohio, USA
- Louis Stokes Cleveland Department of Veterans Affairs Medical Center, FES Center of Excellence, Cleveland, Ohio, USA
| | - Jonathan P Miller
- School of Medicine, Case Western Reserve University, Cleveland, Ohio, USA
- The Neurological Institute, University Hospitals Cleveland Medical Center, Cleveland, OH, USA
- Louis Stokes Cleveland Department of Veterans Affairs Medical Center, FES Center of Excellence, Cleveland, Ohio, USA
| |
Collapse
|
8
|
Cimolato A, Ciotti F, Kljajić J, Valle G, Raspopovic S. Symbiotic electroneural and musculoskeletal framework to encode proprioception via neurostimulation: ProprioStim. iScience 2023; 26:106248. [PMID: 36923003 PMCID: PMC10009292 DOI: 10.1016/j.isci.2023.106248] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 11/23/2022] [Accepted: 02/16/2023] [Indexed: 02/23/2023] Open
Abstract
Peripheral nerve stimulation in amputees achieved the restoration of touch, but not proprioception, which is critical in locomotion. A plausible reason is the lack of means to artificially replicate the complex activity of proprioceptors. To uncover this, we coupled neuromuscular models from ten subjects and nerve histologies from two implanted amputees to develop ProprioStim: a framework to encode proprioception by electrical evoking neural activity in close agreement with natural proprioceptive activity. We demonstrated its feasibility through non-invasive stimulation on seven healthy subjects comparing it with standard linear charge encoding. Results showed that ProprioStim multichannel stimulation was felt more natural, and hold promises for increasing accuracy in knee angle tracking, especially in future implantable solutions. Additionally, we quantified the importance of realistic 3D-nerve models against extruded models previously adopted for further design and validation of novel neurostimulation encoding strategies. ProprioStim provides clear guidelines for the development of neurostimulation policies restoring natural proprioception.
Collapse
Affiliation(s)
- Andrea Cimolato
- Neuroengineering Lab, Department of Health Sciences and Technology, Institute for Robotics and Intelligent Systems, ETH Zürich, 8092 Zürich, Switzerland
- Rehab Technologies Lab, Fondazione Istituto Italiano di Tecnologia, 16163 Genova, Italy
- Neuroengineering and Medical Robotics Laboratory, Department of Electronics, Information and Bioengineering, Politecnico di Milano, 20133 Milan, Italy
| | - Federico Ciotti
- Neuroengineering Lab, Department of Health Sciences and Technology, Institute for Robotics and Intelligent Systems, ETH Zürich, 8092 Zürich, Switzerland
| | - Jelena Kljajić
- Institute Mihajlo Pupin, Belgrade, 11060, Serbia
- School of Electrical Engineering, University of Belgrade, Belgrade, 11120, Serbia
| | - Giacomo Valle
- Neuroengineering Lab, Department of Health Sciences and Technology, Institute for Robotics and Intelligent Systems, ETH Zürich, 8092 Zürich, Switzerland
| | - Stanisa Raspopovic
- Neuroengineering Lab, Department of Health Sciences and Technology, Institute for Robotics and Intelligent Systems, ETH Zürich, 8092 Zürich, Switzerland
| |
Collapse
|
9
|
Silveira C, Khushaba RN, Brunton E, Nazarpour K. Spatio-temporal feature extraction in sensory electroneurographic signals. PHILOSOPHICAL TRANSACTIONS. SERIES A, MATHEMATICAL, PHYSICAL, AND ENGINEERING SCIENCES 2022; 380:20210268. [PMID: 35658682 PMCID: PMC9289791 DOI: 10.1098/rsta.2021.0268] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/24/2021] [Accepted: 11/08/2021] [Indexed: 06/15/2023]
Abstract
The recording and analysis of peripheral neural signal can provide insight for various prosthetic and bioelectronics medicine applications. However, there are few studies that investigate how informative features can be extracted from population activity electroneurographic (ENG) signals. In this study, five feature extraction frameworks were implemented on sensory ENG datasets and their classification performance was compared. The datasets were collected in acute rat experiments where multi-channel nerve cuffs recorded from the sciatic nerve in response to proprioceptive stimulation of the hindlimb. A novel feature extraction framework, which incorporates spatio-temporal focus and dynamic time warping, achieved classification accuracies above 90% while keeping a low computational cost. This framework outperformed the remaining frameworks tested in this study and has improved the discrimination accuracy of the sensory signals. Thus, this study has extended the tools available to extract features from sensory population activity ENG signals. This article is part of the theme issue 'Advanced neurotechnologies: translating innovation for health and well-being'.
Collapse
Affiliation(s)
- C. Silveira
- School of Engineering, Newcastle University, Newcastle upon Tyne NE1 7RU, UK
| | - R. N. Khushaba
- Australian Center for Field Robotics, The University of Sydney, New South Wales 2006, Australia
| | - E. Brunton
- National Vision Research Institute, Australian College of Optometry, Carlton, Victoria 3053, Australia
- Department of Optometry and Vision Sciences, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, Victoria 3010, Australia
| | - K. Nazarpour
- Edinburgh Neuroprosthetics Laboratory, School of Informatics, University of Edinburgh, Edinburgh EH8 9AB, UK
| |
Collapse
|
10
|
Losanno E, Badi M, Wurth S, Borgognon S, Courtine G, Capogrosso M, Rouiller EM, Micera S. Bayesian optimization of peripheral intraneural stimulation protocols to evoke distal limb movements. J Neural Eng 2021; 18. [PMID: 34874320 DOI: 10.1088/1741-2552/ac3f6c] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Accepted: 12/02/2021] [Indexed: 11/12/2022]
Abstract
Objective.Motor neuroprostheses require the identification of stimulation protocols that effectively produce desired movements. Manual search for these protocols can be very time-consuming and often leads to suboptimal solutions, as several stimulation parameters must be personalized for each subject for a variety of target motor functions. Here, we present an algorithm that efficiently tunes peripheral intraneural stimulation protocols to elicit functionally relevant distal limb movements.Approach.We developed the algorithm using Bayesian optimization (BO) with multi-output Gaussian Processes (GPs) and defined objective functions based on coordinated muscle recruitment. We applied the algorithm offline to data acquired in rats for walking control and in monkeys for hand grasping control and compared different GP models for these two systems. We then performed a preliminary online test in a monkey to experimentally validate the functionality of our method.Main results.Offline, optimal intraneural stimulation protocols for various target motor functions were rapidly identified in both experimental scenarios. Using the model that performed best, the algorithm converged to stimuli that evoked functionally consistent movements with an average number of actions equal to 20% of the search space size in both the rat and monkey animal models. Online, the algorithm quickly guided the observations to stimuli that elicited functional hand gestures, although more selective motor outputs could have been achieved by refining the objective function used.Significance.These results demonstrate that BO can reliably and efficiently automate the tuning of peripheral neurostimulation protocols, establishing a translational framework to configure peripheral motor neuroprostheses in clinical applications. The proposed method can also potentially be applied to optimize motor functions using other stimulation modalities.
Collapse
Affiliation(s)
- E Losanno
- The Biorobotics Institute and Department of Excellent in Robotics and AI, Scuola Superiore Sant'Anna, Pisa, Italy
| | - M Badi
- Bertarelli Foundation Chair in Translational Neuroengineering, Center for Neuroprosthetics and Institute of Bioengineering, École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland
| | - S Wurth
- Bertarelli Foundation Chair in Translational Neuroengineering, Center for Neuroprosthetics and Institute of Bioengineering, École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland
| | - S Borgognon
- Department of Neuroscience and Movement Sciences, Platform of Translational Neurosciences, Section of Medicine, Faculty of Sciences and Medicine, University of Fribourg, Fribourg, Switzerland.,Center for Neuroprosthetics and BrainMind Institute, School of Life Sciences, Eécole Polytechnique Feédeérale de Lausanne (EPFL), Lausanne, Switzerland
| | - G Courtine
- Center for Neuroprosthetics and BrainMind Institute, School of Life Sciences, Eécole Polytechnique Feédeérale de Lausanne (EPFL), Lausanne, Switzerland.,Defitech Center for Interventional Neurotherapies (NeuroRestore), EPFL, University Hospital of Lausanne (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland
| | - M Capogrosso
- Department of Neurological Surgery, Rehabilitation and Neural Engineering Laboratories, University of Pittsburgh, Pittsburgh, PA, United States of America
| | - E M Rouiller
- Department of Neuroscience and Movement Sciences, Platform of Translational Neurosciences, Section of Medicine, Faculty of Sciences and Medicine, University of Fribourg, Fribourg, Switzerland
| | - S Micera
- The Biorobotics Institute and Department of Excellent in Robotics and AI, Scuola Superiore Sant'Anna, Pisa, Italy.,Bertarelli Foundation Chair in Translational Neuroengineering, Center for Neuroprosthetics and Institute of Bioengineering, École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland
| |
Collapse
|
11
|
Badi M, Wurth S, Scarpato I, Roussinova E, Losanno E, Bogaard A, Delacombaz M, Borgognon S, C Vanc Ara P, Fallegger F, Su DK, Schmidlin E, Courtine G, Bloch J, Lacour SP, Stieglitz T, Rouiller EM, Capogrosso M, Micera S. Intrafascicular peripheral nerve stimulation produces fine functional hand movements in primates. Sci Transl Med 2021; 13:eabg6463. [PMID: 34705521 DOI: 10.1126/scitranslmed.abg6463] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
[Figure: see text].
Collapse
Affiliation(s)
- Marion Badi
- Bertarelli Foundation Chair in Translational Neuroengineering, Center for Neuroprosthetics, and Institute of Bioengineering, École Polytechnique Fédérale de Lausanne (EPFL), 1015 Lausanne, Switzerland
| | - Sophie Wurth
- Bertarelli Foundation Chair in Translational Neuroengineering, Center for Neuroprosthetics, and Institute of Bioengineering, École Polytechnique Fédérale de Lausanne (EPFL), 1015 Lausanne, Switzerland
| | - Ilaria Scarpato
- Bertarelli Foundation Chair in Translational Neuroengineering, Center for Neuroprosthetics, and Institute of Bioengineering, École Polytechnique Fédérale de Lausanne (EPFL), 1015 Lausanne, Switzerland
| | - Evgenia Roussinova
- Bertarelli Foundation Chair in Translational Neuroengineering, Center for Neuroprosthetics, and Institute of Bioengineering, École Polytechnique Fédérale de Lausanne (EPFL), 1015 Lausanne, Switzerland
| | - Elena Losanno
- Biorobotics Institute and Department of Excellence in Robotics and AI, Scuola Superiore Sant'Anna, 56025 Pisa, Italy
| | - Andrew Bogaard
- Department of Neuroscience and Movement Sciences, Platform of Translational Neurosciences, Section of Medicine, Faculty of Sciences and Medicine, University of Fribourg, 1700 Fribourg, Switzerland
| | - Maude Delacombaz
- Department of Neuroscience and Movement Sciences, Platform of Translational Neurosciences, Section of Medicine, Faculty of Sciences and Medicine, University of Fribourg, 1700 Fribourg, Switzerland
| | - Simon Borgognon
- Department of Neuroscience and Movement Sciences, Platform of Translational Neurosciences, Section of Medicine, Faculty of Sciences and Medicine, University of Fribourg, 1700 Fribourg, Switzerland.,Center for Neuroprosthetics and Brain Mind Institute, School of Life Sciences, EPFL, 1015 Lausanne, Switzerland
| | - Paul C Vanc Ara
- Laboratory for Biomedical Microtechnology, Department of Microsystems Engineering-IMTEK, Bernstein Center Freiburg, and BrainLinks-BrainTools Center, University of Freiburg, 79110 Freiburg, Germany
| | - Florian Fallegger
- Bertarelli Foundation Chair in Neuroprosthetic Technology, Laboratory for Soft Bioelectronics Interface, Institute of Microengineering, Institute of Bioengineering, Centre for Neuroprosthetics, 1202 Geneva, Switzerland
| | - David K Su
- Neurological Surgery, Harborview Medical Center, Seattle, WA 98104, USA
| | - Eric Schmidlin
- Department of Neuroscience and Movement Sciences, Platform of Translational Neurosciences, Section of Medicine, Faculty of Sciences and Medicine, University of Fribourg, 1700 Fribourg, Switzerland
| | - Grégoire Courtine
- Center for Neuroprosthetics and Brain Mind Institute, School of Life Sciences, EPFL, 1015 Lausanne, Switzerland.,Defitech Center for Interventional Neurotherapies (NeuroRestore), EPFL, University Hospital of Lausanne (CHUV), and University of Lausanne (UNIL), 1015 Lausanne, Switzerland
| | - Jocelyne Bloch
- Defitech Center for Interventional Neurotherapies (NeuroRestore), EPFL, University Hospital of Lausanne (CHUV), and University of Lausanne (UNIL), 1015 Lausanne, Switzerland
| | - Stéphanie P Lacour
- Bertarelli Foundation Chair in Neuroprosthetic Technology, Laboratory for Soft Bioelectronics Interface, Institute of Microengineering, Institute of Bioengineering, Centre for Neuroprosthetics, 1202 Geneva, Switzerland
| | - Thomas Stieglitz
- Laboratory for Biomedical Microtechnology, Department of Microsystems Engineering-IMTEK, Bernstein Center Freiburg, and BrainLinks-BrainTools Center, University of Freiburg, 79110 Freiburg, Germany
| | - Eric M Rouiller
- Department of Neuroscience and Movement Sciences, Platform of Translational Neurosciences, Section of Medicine, Faculty of Sciences and Medicine, University of Fribourg, 1700 Fribourg, Switzerland
| | - Marco Capogrosso
- Department of Neuroscience and Movement Sciences, Platform of Translational Neurosciences, Section of Medicine, Faculty of Sciences and Medicine, University of Fribourg, 1700 Fribourg, Switzerland.,Department of Neurological Surgery, Rehabilitation and Neural Engineering Laboratories, University of Pittsburgh, Pittsburgh, PA 15213, USA
| | - Silvestro Micera
- Bertarelli Foundation Chair in Translational Neuroengineering, Center for Neuroprosthetics, and Institute of Bioengineering, École Polytechnique Fédérale de Lausanne (EPFL), 1015 Lausanne, Switzerland.,Biorobotics Institute and Department of Excellence in Robotics and AI, Scuola Superiore Sant'Anna, 56025 Pisa, Italy
| |
Collapse
|
12
|
Shulgach JA, Beam DW, Nanivadekar AC, Miller DM, Fulton S, Sciullo M, Ogren J, Wong L, McLaughlin BL, Yates BJ, Horn CC, Fisher LE. Selective stimulation of the ferret abdominal vagus nerve with multi-contact nerve cuff electrodes. Sci Rep 2021; 11:12925. [PMID: 34155231 PMCID: PMC8217223 DOI: 10.1038/s41598-021-91900-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Accepted: 06/01/2021] [Indexed: 12/14/2022] Open
Abstract
Dysfunction and diseases of the gastrointestinal (GI) tract are a major driver of medical care. The vagus nerve innervates and controls multiple organs of the GI tract and vagus nerve stimulation (VNS) could provide a means for affecting GI function and treating disease. However, the vagus nerve also innervates many other organs throughout the body, and off-target effects of VNS could cause major side effects such as changes in blood pressure. In this study, we aimed to achieve selective stimulation of populations of vagal afferents using a multi-contact cuff electrode wrapped around the abdominal trunks of the vagus nerve. Four-contact nerve cuff electrodes were implanted around the dorsal (N = 3) or ventral (N = 3) abdominal vagus nerve in six ferrets, and the response to stimulation was measured via a 32-channel microelectrode array (MEA) inserted into the left or right nodose ganglion. Selectivity was characterized by the ability to evoke responses in MEA channels through one bipolar pair of cuff contacts but not through the other bipolar pair. We demonstrated that it was possible to selectively activate subpopulations of vagal neurons using abdominal VNS. Additionally, we quantified the conduction velocity of evoked responses to determine what types of nerve fibers (i.e., Aδ vs. C) responded to stimulation. We also quantified the spatial organization of evoked responses in the nodose MEA to determine if there is somatotopic organization of the neurons in that ganglion. Finally, we demonstrated in a separate set of three ferrets that stimulation of the abdominal vagus via a four-contact cuff could selectively alter gastric myoelectric activity, suggesting that abdominal VNS can potentially be used to control GI function.
Collapse
Affiliation(s)
- Jonathan A Shulgach
- Department of Biomedical Engineering, Carnegie Mellon University, Pittsburgh, PA, 15213, USA.,Department of Otolaryngology, University of Pittsburgh, Pittsburgh, PA, 15213, USA
| | - Dylan W Beam
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, 15213, USA.,Center for Neural Basis of Cognition, Pittsburgh, PA, 15213, USA
| | - Ameya C Nanivadekar
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, 15213, USA.,Center for Neural Basis of Cognition, Pittsburgh, PA, 15213, USA
| | - Derek M Miller
- Department of Otolaryngology, University of Pittsburgh, Pittsburgh, PA, 15213, USA
| | - Stephanie Fulton
- UPMC Hillman Cancer Center, University of Pittsburgh, Pittsburgh, PA, 15213, USA
| | - Michael Sciullo
- UPMC Hillman Cancer Center, University of Pittsburgh, Pittsburgh, PA, 15213, USA
| | - John Ogren
- Micro-Leads Inc., Somerville, MA, 02144, USA
| | - Liane Wong
- Micro-Leads Inc., Somerville, MA, 02144, USA
| | | | - Bill J Yates
- Department of Otolaryngology, University of Pittsburgh, Pittsburgh, PA, 15213, USA.,Department of Neuroscience, University of Pittsburgh, Pittsburgh, PA, 15213, USA.,Center for Neuroscience, University of Pittsburgh, Pittsburgh, PA, 15213, USA
| | - Charles C Horn
- UPMC Hillman Cancer Center, University of Pittsburgh, Pittsburgh, PA, 15213, USA.,Center for Neuroscience, University of Pittsburgh, Pittsburgh, PA, 15213, USA.,Department of Medicine, University of Pittsburgh, Pittsburgh, PA, 15213, USA.,Department of Anesthesiology, University of Pittsburgh, Pittsburgh, PA, 15213, USA
| | - Lee E Fisher
- Department of Biomedical Engineering, Carnegie Mellon University, Pittsburgh, PA, 15213, USA. .,Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, 15213, USA. .,Center for Neural Basis of Cognition, Pittsburgh, PA, 15213, USA. .,Department of Physical Medicine and Rehabilitation, University of Pittsburgh, Pittsburgh, PA, 15213, USA.
| |
Collapse
|
13
|
Abstract
Peripheral nerve interfaces (PNIs) record and/or modulate neural activity of nerves, which are responsible for conducting sensory-motor information to and from the central nervous system, and for regulating the activity of inner organs. PNIs are used both in neuroscience research and in therapeutical applications such as precise closed-loop control of neuroprosthetic limbs, treatment of neuropathic pain and restoration of vital functions (e.g. breathing and bladder management). Implantable interfaces represent an attractive solution to directly access peripheral nerves and provide enhanced selectivity both in recording and in stimulation, compared to their non-invasive counterparts. Nevertheless, the long-term functionality of implantable PNIs is limited by tissue damage, which occurs at the implant-tissue interface, and is thus highly dependent on material properties, biocompatibility and implant design. Current research focuses on the development of mechanically compliant PNIs, which adapt to the anatomy and dynamic movements of nerves in the body thereby limiting foreign body response. In this paper, we review recent progress in the development of flexible and implantable PNIs, highlighting promising solutions related to materials selection and their associated fabrication methods, and integrated functions. We report on the variety of available interface designs (intraneural, extraneural and regenerative) and different modulation techniques (electrical, optical, chemical) emphasizing the main challenges associated with integrating such systems on compliant substrates.
Collapse
Affiliation(s)
- Valentina Paggi
- Bertarelli Foundation Chair in Neuroprosthetic Technology, Laboratory for Soft Bioelectronic Interfaces, Institute of Microengineering, Institute of Bioengineering, Centre for Neuroprosthetics, Ecole Polytechnique Fédérale de Lausanne (EPFL), 1202 Geneva, Switzerland. Equally contributing authors
| | | | | | | |
Collapse
|
14
|
Masteller A, Sankar S, Kim HB, Ding K, Liu X, All AH. Recent Developments in Prosthesis Sensors, Texture Recognition, and Sensory Stimulation for Upper Limb Prostheses. Ann Biomed Eng 2020; 49:57-74. [PMID: 33140242 DOI: 10.1007/s10439-020-02678-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Accepted: 10/22/2020] [Indexed: 12/20/2022]
Abstract
Current developments being made in upper limb prostheses are focused on replacing lost sensory information to the amputees. Providing sensory stimulation from the prosthesis can directly improve control over the prosthetic and provide a sense of body ownership. The focus of this review article is on recent developments while including foundational knowledge for some of the critical concepts in neural prostheses. Reported concepts follow the flow of information from sensors to signal processing, with emphasis on texture recognition, and then to sensory stimulation strategies that reestablish the lost sensory feedback loop. Prosthetic sensors are used to detect the physical environment, converting pressure, force, and position into electrical signals. The electrical signals can then be processed in an effort to identify the surrounding environment using distinctive characteristics such as stiffness and texture. In order for the amputee to use this information in a natural manner, there must be real-time sensory stimulation, perception, and motor control of the prosthesis. Although truly complete sensory replacement has not yet been realized, some basic percepts can be partially restored, allowing progress towards a more realistic prosthesis with natural sensations.
Collapse
Affiliation(s)
- Andrew Masteller
- Department of Biomedical Engineering, School of Medicine, Johns Hopkins University, Traylor Building, 720 Rutland Ave, Baltimore, MD, 21205, USA
| | - Sriramana Sankar
- Department of Biomedical Engineering, School of Medicine, Johns Hopkins University, Traylor Building, 720 Rutland Ave, Baltimore, MD, 21205, USA
| | - Han Biehn Kim
- Department of Biomedical Engineering, School of Medicine, Johns Hopkins University, Traylor Building, 720 Rutland Ave, Baltimore, MD, 21205, USA
| | - Keqin Ding
- Department of Biomedical Engineering, School of Medicine, Johns Hopkins University, Traylor Building, 720 Rutland Ave, Baltimore, MD, 21205, USA
| | - Xiaogang Liu
- Department of Chemistry, Faculty of Science, National University of Singapore, Building 3 Science Drive 3, 117543, Singapore, Singapore. .,The N. 1 Institute for Health, National University of Singapore, Singapore, Singapore.
| | - Angelo H All
- Department of Chemistry, Faculty of Science, Hong Kong Baptist University, # 844, RRS Building, Ho Sin Hang Campus, Hong Kong, Hong Kong.
| |
Collapse
|
15
|
Nguyen AT, Xu J, Jiang M, Luu DK, Wu T, Tam WK, Zhao W, Drealan MW, Overstreet CK, Zhao Q, Cheng J, Keefer E, Yang Z. A bioelectric neural interface towards intuitive prosthetic control for amputees. J Neural Eng 2020; 17. [PMID: 33091891 DOI: 10.1088/1741-2552/abc3d3] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Accepted: 10/22/2020] [Indexed: 01/17/2023]
Abstract
OBJECTIVE While prosthetic hands with independently actuated digits have become commercially available, state-of-the-art human-machine interfaces (HMI) only permit control over a limited set of grasp patterns, which does not enable amputees to experience sufficient improvement in their daily activities to make an active prosthesis useful. APPROACH Here we present a technology platform combining fully-integrated bioelectronics, implantable intrafascicular microelectrodes and deep learning-based artificial intelligence (AI) to facilitate this missing bridge by tapping into the intricate motor control signals of peripheral nerves. The bioelectric neural interface includes an ultra-low-noise neural recording system to sense electroneurography (ENG) signals from microelectrode arrays implanted in the residual nerves, and AI models employing the recurrent neural network (RNN) architecture to decode the subject's motor intention. MAIN RESULTS A pilot human study has been carried out on a transradial amputee. We demonstrate that the information channel established by the proposed neural interface is sufficient to provide high accuracy control of a prosthetic hand up to 15 degrees of freedom (DOF). The interface is intuitive as it directly maps complex prosthesis movements to the patient's true intention. SIGNIFICANCE Our study layouts the foundation towards not only a robust and dexterous control strategy for modern neuroprostheses at a near-natural level approaching that of the able hand, but also an intuitive conduit for connecting human minds and machines through the peripheral neural pathways. (Clinical trial identifier: NCT02994160).
Collapse
Affiliation(s)
- Anh Tuan Nguyen
- Biomedical Engineering, University of Minnesota Twin Cities, Minneapolis, Minnesota, UNITED STATES
| | - Jian Xu
- Biomedical Engineering, University of Minnesota Twin Cities, Minneapolis, Minnesota, UNITED STATES
| | - Ming Jiang
- Computer Science and Engineering, University of Minnesota Twin Cities, Minneapolis, Minnesota, UNITED STATES
| | - Diu Khue Luu
- Biomedical Engineering, University of Minnesota Twin Cities, Minneapolis, Minnesota, UNITED STATES
| | - Tong Wu
- Biomedical Engineering, University of Minnesota Twin Cities, Minneapolis, Minnesota, UNITED STATES
| | - Wing-Kin Tam
- Biomedical Engineering, University of Minnesota Twin Cities, Minneapolis, Minnesota, UNITED STATES
| | - Wenfeng Zhao
- Biomedical Engineering, University of Minnesota Twin Cities, Minneapolis, Minnesota, UNITED STATES
| | - Markus W Drealan
- Biomedical Engineering, University of Minnesota Twin Cities, Minneapolis, Minnesota, UNITED STATES
| | | | - Qi Zhao
- Computer Science and Engineering, University of Minnesota Twin Cities, Minneapolis, Minnesota, UNITED STATES
| | | | | | - Zhi Yang
- Biomedical Engineering, University of Minnesota Twin Cities, Minneapolis, Minnesota, UNITED STATES
| |
Collapse
|
16
|
Kibleur P, Tata SR, Greiner N, Conti S, Barra B, Zhuang K, Kaeser M, Ijspeert A, Capogrosso M. Spatiotemporal Maps of Proprioceptive Inputs to the Cervical Spinal Cord During Three-Dimensional Reaching and Grasping. IEEE Trans Neural Syst Rehabil Eng 2020; 28:1668-1677. [DOI: 10.1109/tnsre.2020.2986491] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
|
17
|
Naufel S, Knaack GL, Miranda R, Best TK, Fitzpatrick K, Emondi AA, Van Gieson E, McClure-Begley T. DARPA investment in peripheral nerve interfaces for prosthetics, prescriptions, and plasticity. J Neurosci Methods 2019; 332:108539. [PMID: 31805301 DOI: 10.1016/j.jneumeth.2019.108539] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2019] [Revised: 11/28/2019] [Accepted: 12/01/2019] [Indexed: 01/02/2023]
Abstract
BACKGROUND Peripheral nerve interfaces have emerged as alternative solutions for a variety of therapeutic and performance improvement applications. The Defense Advanced Research Projects Agency (DARPA) has widely invested in these interfaces to provide motor control and sensory feedback to prosthetic limbs, identify non-pharmacological interventions to treat disease, and facilitate neuromodulation to accelerate learning or improve performance on cognitive, sensory, or motor tasks. In this commentary, we highlight some of the design considerations for optimizing peripheral nerve interfaces depending on the application space. We also discuss the ethical considerations that accompany these advances.
Collapse
Affiliation(s)
| | - Gretchen L Knaack
- Quantitative Scientific Solutions, 4601 Fairfax Dr #1200, Arlington, VA 22203, USA
| | - Robbin Miranda
- Infinimetrics Corporation, 12020 Sunrise Valley Dr., Suite 100, Reston, VA 20191, USA
| | - Tyler K Best
- Booz Allen Hamilton, Inc., 3811 Fairfax Dr. Ste. 600, Arlington, VA 22203, USA
| | - Karrie Fitzpatrick
- Strategic Analysis Inc., 4075 Wilson Boulevard, Suite 200, Arlington, VA 22203 USA
| | - Al A Emondi
- Defense Advanced Research Projects Agency, Biological Technologies Office, 675 N Randolph St., Arlington, VA 22203, USA
| | - Eric Van Gieson
- Defense Advanced Research Projects Agency, Biological Technologies Office, 675 N Randolph St., Arlington, VA 22203, USA
| | - Tristan McClure-Begley
- Defense Advanced Research Projects Agency, Biological Technologies Office, 675 N Randolph St., Arlington, VA 22203, USA
| |
Collapse
|
18
|
Charkhkar H, Christie BP, Pinault GJ, Tyler DJ, Triolo RJ. A translational framework for peripheral nerve stimulating electrodes: Reviewing the journey from concept to clinic. J Neurosci Methods 2019; 328:108414. [PMID: 31472187 DOI: 10.1016/j.jneumeth.2019.108414] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2019] [Revised: 07/31/2019] [Accepted: 08/26/2019] [Indexed: 12/22/2022]
Abstract
The purpose of this review article is to describe the underlying methodology for successfully translating novel interfaces for electrical modulation of the peripheral nervous system (PNS) from basic design concepts to clinical applications and chronic human use. Despite advances in technologies to communicate directly with the nervous system, the pathway to clinical translation for most neural interfaces is not clear. FDA guidelines provide information on necessary evidence which should be generated and submitted to allow the agency evaluate safety and efficacy of a new medical device. However, a knowledge gap exists on translating neural interfaces from pre-clinical studies into the clinical domain. Our article is intended to inform the field on some of the key considerations for such a transition process specific to neural interfaces that may not be already covered by FDA guidances. This framework focuses on non-penetrating peripheral nerve stimulating electrodes that have been proven effective for motor and sensory neural prostheses and successfully transitioned from pre-clinical through first-in-human and chronic clinical deployment. We discuss the challenges of moving these neural interfaces along the translational continuum and ultimately through FDA approval for human feasibility studies. Specifically, we describe a translational process involving: quantitative human anatomy, neural modeling and simulation, acute intraoperative testing and verification, clinical demonstration with temporary percutaneous access, and finally chronic clinical deployment and functional performance. To clarify and demonstrate the importance of each step of this translational framework, we present case studies from electrodes developed at Case Western Reserve University (CWRU), specifically the spiral cuff, the Flat Interface Nerve Electrode (FINE), and the Composite FINE (C-FINE). In addition, we demonstrate that success along this translational pathway can be further expedited by: appropriate selection of well-characterized materials, validation of fabrication and sterilization protocols, well-implemented quality control measures, and quantification of impact on neural structure, health, and function. The issues and approaches identified in this review for the peripheral nervous system may also serve to accelerate the dissemination of any new neural interface into clinical practice, and consequently advance the performance, utility, and clinical value of new neural prostheses or neuromodulation systems.
Collapse
Affiliation(s)
- Hamid Charkhkar
- Department of Biomedical Engineering, Case Western Reserve University, 10900 Euclid Avenue, Cleveland, OH 44106, USA; Louis Stokes Cleveland Veteran Affairs Medical Center, 10701 East Boulevard, Cleveland, OH, 44106, USA.
| | - Breanne P Christie
- Department of Biomedical Engineering, Case Western Reserve University, 10900 Euclid Avenue, Cleveland, OH 44106, USA; Louis Stokes Cleveland Veteran Affairs Medical Center, 10701 East Boulevard, Cleveland, OH, 44106, USA
| | - Gilles J Pinault
- Louis Stokes Cleveland Veteran Affairs Medical Center, 10701 East Boulevard, Cleveland, OH, 44106, USA
| | - Dustin J Tyler
- Department of Biomedical Engineering, Case Western Reserve University, 10900 Euclid Avenue, Cleveland, OH 44106, USA; Louis Stokes Cleveland Veteran Affairs Medical Center, 10701 East Boulevard, Cleveland, OH, 44106, USA
| | - Ronald J Triolo
- Department of Biomedical Engineering, Case Western Reserve University, 10900 Euclid Avenue, Cleveland, OH 44106, USA; Louis Stokes Cleveland Veteran Affairs Medical Center, 10701 East Boulevard, Cleveland, OH, 44106, USA
| |
Collapse
|
19
|
Lancashire HT, Jiang D, Demosthenous A, Donaldson N. An ASIC for Recording and Stimulation in Stacked Microchannel Neural Interfaces. IEEE TRANSACTIONS ON BIOMEDICAL CIRCUITS AND SYSTEMS 2019; 13:259-270. [PMID: 30624225 DOI: 10.1109/tbcas.2019.2891284] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
This paper presents an active microchannel neural interface (MNI) using seven stacked application specific integrated circuits (ASICs). The approach provides a solution to the present problem of interconnect density in three-dimensional (3-D) MNIs. The 4 mm2 ASIC is implemented in 0.35 μm high-voltage CMOS technology. Each ASIC is the base for seven microchannels each with three electrodes in a pseudo-tripolar arrangement. Multiplexing allows stimulating or recording from any one of 49 channels, across seven ASICs. Connections to the ASICs are made with a five-line parallel bus. Current controlled biphasic stimulation from 5 to 500 μA has been demonstrated with switching between channels and ASICs. The high-voltage technology gives a compliance of 40 V for stimulation, appropriate for the high impedances within microchannels. High frequency biphasic stimulation, up to 40 kHz is achieved, suitable for reversible high frequency nerve blockades. Recording has been demonstrated with mV level signals; common-mode inputs are differentially distorted and limit the CMRR to 40 dB. The ASIC has been used in vitro in conjunction with an oversize (2 mm diameter) microchannel in phosphate buffered saline, demonstrating attenuation of interference from outside the microchannel and tripolar recording of signals from within the microchannel. By using five-lines for 49 active microchannels the device overcomes limitations when connecting many electrodes in a 3-D miniaturized nerve interface.
Collapse
|