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Ding K, Rakhshan M, Paredes-Acuña N, Cheng G, Thakor NV. Sensory integration for neuroprostheses: from functional benefits to neural correlates. Med Biol Eng Comput 2024; 62:2939-2960. [PMID: 38760597 DOI: 10.1007/s11517-024-03118-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Accepted: 04/19/2024] [Indexed: 05/19/2024]
Abstract
In the field of sensory neuroprostheses, one ultimate goal is for individuals to perceive artificial somatosensory information and use the prosthesis with high complexity that resembles an intact system. To this end, research has shown that stimulation-elicited somatosensory information improves prosthesis perception and task performance. While studies strive to achieve sensory integration, a crucial phenomenon that entails naturalistic interaction with the environment, this topic has not been commensurately reviewed. Therefore, here we present a perspective for understanding sensory integration in neuroprostheses. First, we review the engineering aspects and functional outcomes in sensory neuroprosthesis studies. In this context, we summarize studies that have suggested sensory integration. We focus on how they have used stimulation-elicited percepts to maximize and improve the reliability of somatosensory information. Next, we review studies that have suggested multisensory integration. These works have demonstrated that congruent and simultaneous multisensory inputs provided cognitive benefits such that an individual experiences a greater sense of authority over prosthesis movements (i.e., agency) and perceives the prosthesis as part of their own (i.e., ownership). Thereafter, we present the theoretical and neuroscience framework of sensory integration. We investigate how behavioral models and neural recordings have been applied in the context of sensory integration. Sensory integration models developed from intact-limb individuals have led the way to sensory neuroprosthesis studies to demonstrate multisensory integration. Neural recordings have been used to show how multisensory inputs are processed across cortical areas. Lastly, we discuss some ongoing research and challenges in achieving and understanding sensory integration in sensory neuroprostheses. Resolving these challenges would help to develop future strategies to improve the sensory feedback of a neuroprosthetic system.
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Affiliation(s)
- Keqin Ding
- Department of Biomedical Engineering, Johns Hopkins School of Medicine, Baltimore, MD, 21205, USA.
| | - Mohsen Rakhshan
- Department of Electrical and Computer Engineering, University of Central Florida, Orlando, FL, 32816, USA
- Disability, Aging, and Technology Cluster, University of Central Florida, Orlando, FL, 32816, USA
| | - Natalia Paredes-Acuña
- Institute for Cognitive Systems, School of Computation, Information and Technology, Technical University of Munich, 80333, Munich, Germany
| | - Gordon Cheng
- Institute for Cognitive Systems, School of Computation, Information and Technology, Technical University of Munich, 80333, Munich, Germany
| | - Nitish V Thakor
- Department of Biomedical Engineering, Johns Hopkins School of Medicine, Baltimore, MD, 21205, USA
- Department of Electrical and Computer Engineering, Johns Hopkins University, Baltimore, MD, 21205, USA
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2
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Carnicer-Lombarte A, Boys AJ, Güemes A, Gurke J, Velasco-Bosom S, Hilton S, Barone DG, Malliaras GG. Ultraconformable cuff implants for long-term bidirectional interfacing of peripheral nerves at sub-nerve resolutions. Nat Commun 2024; 15:7523. [PMID: 39214981 PMCID: PMC11364531 DOI: 10.1038/s41467-024-51988-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2024] [Accepted: 08/21/2024] [Indexed: 09/04/2024] Open
Abstract
Implantable devices interfacing with peripheral nerves exhibit limited longevity and resolution. Poor nerve-electrode interface quality, invasive surgical placement and development of foreign body reaction combine to limit research and clinical application of these devices. Here, we develop cuff implants with a conformable design that achieve high-quality and stable interfacing with nerves in chronic implantation scenarios. When implanted in sensorimotor nerves of the arm in awake rats for 21 days, the devices record nerve action potentials with fascicle-specific resolution and extract from these the conduction velocity and direction of propagation. The cuffs exhibit high biocompatibility, producing lower levels of fibrotic scarring than clinically equivalent PDMS silicone cuffs. In addition to recording nerve activity, the devices are able to modulate nerve activity at sub-nerve resolution to produce a wide range of paw movements. When used in a partial nerve ligation rodent model, the cuffs identify and characterise changes in nerve C fibre activity associated with the development of neuropathic pain in freely-moving animals. The developed implantable devices represent a platform enabling new forms of fine nerve signal sensing and modulation, with applications in physiology research and closed-loop therapeutics.
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Affiliation(s)
- Alejandro Carnicer-Lombarte
- University of Cambridge, Electrical Engineering Division, 9 JJ Thomson Ave, Cambridge, CB3 0FA, United Kingdom
| | - Alexander J Boys
- University of Cambridge, Department of Chemical Engineering and Biotechnology, Cambridge, CB2 0QQ, United Kingdom
| | - Amparo Güemes
- University of Cambridge, Electrical Engineering Division, 9 JJ Thomson Ave, Cambridge, CB3 0FA, United Kingdom
| | - Johannes Gurke
- University of Cambridge, Electrical Engineering Division, 9 JJ Thomson Ave, Cambridge, CB3 0FA, United Kingdom
- University of Potsdam, Institute of Chemistry, Karl-Liebknecht-Str. 24-25, 14476, Potsdam, Germany
| | - Santiago Velasco-Bosom
- University of Cambridge, Electrical Engineering Division, 9 JJ Thomson Ave, Cambridge, CB3 0FA, United Kingdom
| | - Sam Hilton
- University of Cambridge, Electrical Engineering Division, 9 JJ Thomson Ave, Cambridge, CB3 0FA, United Kingdom
| | - Damiano G Barone
- University of Cambridge, Electrical Engineering Division, 9 JJ Thomson Ave, Cambridge, CB3 0FA, United Kingdom.
- University of Cambridge, School of Clinical Medicine, Department of Clinical Neurosciences, Cambridge Biomedical Campus, Cambridge, CB2 0QQ, United Kingdom.
| | - George G Malliaras
- University of Cambridge, Electrical Engineering Division, 9 JJ Thomson Ave, Cambridge, CB3 0FA, United Kingdom.
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3
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Nanivadekar AC, Bose R, Petersen BA, Okorokova EV, Sarma D, Madonna TJ, Barra B, Farooqui J, Dalrymple AN, Levy I, Helm ER, Miele VJ, Boninger ML, Capogrosso M, Bensmaia SJ, Weber DJ, Fisher LE. Restoration of sensory feedback from the foot and reduction of phantom limb pain via closed-loop spinal cord stimulation. Nat Biomed Eng 2024; 8:992-1003. [PMID: 38097809 DOI: 10.1038/s41551-023-01153-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Accepted: 10/27/2023] [Indexed: 12/30/2023]
Abstract
Restoring somatosensory feedback in individuals with lower-limb amputations would reduce the risk of falls and alleviate phantom limb pain. Here we show, in three individuals with transtibial amputation (one traumatic and two owing to diabetic peripheral neuropathy), that sensations from the missing foot, with control over their location and intensity, can be evoked via lateral lumbosacral spinal cord stimulation with commercially available electrodes and by modulating the intensity of stimulation in real time on the basis of signals from a wireless pressure-sensitive shoe insole. The restored somatosensation via closed-loop stimulation improved balance control (with a 19-point improvement in the composite score of the Sensory Organization Test in one individual) and gait stability (with a 5-point improvement in the Functional Gait Assessment in one individual). And over the implantation period of the stimulation leads, the three individuals experienced a clinically meaningful decrease in phantom limb pain (with an average reduction of nearly 70% on a visual analogue scale). Our findings support the further clinical assessment of lower-limb neuroprostheses providing somatosensory feedback.
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Affiliation(s)
- Ameya C Nanivadekar
- Rehab Neural Engineering Labs, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, USA
- Center for the Neural Basis of Cognition, Pittsburgh, PA, USA
| | - Rohit Bose
- Rehab Neural Engineering Labs, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, USA
- Center for the Neural Basis of Cognition, Pittsburgh, PA, USA
| | - Bailey A Petersen
- Rehab Neural Engineering Labs, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, USA
- Center for the Neural Basis of Cognition, Pittsburgh, PA, USA
| | - Elizaveta V Okorokova
- Department of Organismal Biology and Anatomy, University of Chicago, Chicago, IL, USA
| | - Devapratim Sarma
- Rehab Neural Engineering Labs, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Mechanical Engineering, Carnegie Mellon University, Pittsburgh, PA, USA
| | - Tyler J Madonna
- Rehab Neural Engineering Labs, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Physical Medicine and Rehabilitation, University of Pittsburgh, Pittsburgh, PA, USA
| | - Beatrice Barra
- Rehab Neural Engineering Labs, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Neuroscience and Movement Science, University of Fribourg, Fribourg, Switzerland
| | - Juhi Farooqui
- Rehab Neural Engineering Labs, University of Pittsburgh, Pittsburgh, PA, USA
- Center for the Neural Basis of Cognition, Pittsburgh, PA, USA
| | - Ashley N Dalrymple
- Rehab Neural Engineering Labs, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Mechanical Engineering, Carnegie Mellon University, Pittsburgh, PA, USA
- Department of Biomedical Engineering, University of Utah, Salt Lake City, UT, USA
- Department of Physical Medicine and Rehabilitation, University of Utah, Salt Lake City, UT, USA
| | - Isaiah Levy
- Department of Physical Medicine and Rehabilitation, University of Pittsburgh, Pittsburgh, PA, USA
| | - Eric R Helm
- Department of Physical Medicine and Rehabilitation, University of Pittsburgh, Pittsburgh, PA, USA
| | - Vincent J Miele
- Department of Neurological Surgery, University of Pittsburgh, Pittsburgh, PA, USA
| | - Michael L Boninger
- Rehab Neural Engineering Labs, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, USA
- Center for the Neural Basis of Cognition, Pittsburgh, PA, USA
- Department of Physical Medicine and Rehabilitation, University of Pittsburgh, Pittsburgh, PA, USA
| | - Marco Capogrosso
- Rehab Neural Engineering Labs, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, USA
- Center for the Neural Basis of Cognition, Pittsburgh, PA, USA
- Department of Neurological Surgery, University of Pittsburgh, Pittsburgh, PA, USA
| | - Sliman J Bensmaia
- Department of Organismal Biology and Anatomy, University of Chicago, Chicago, IL, USA
| | - Douglas J Weber
- Rehab Neural Engineering Labs, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Mechanical Engineering, Carnegie Mellon University, Pittsburgh, PA, USA
| | - Lee E Fisher
- Rehab Neural Engineering Labs, University of Pittsburgh, Pittsburgh, PA, USA.
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, USA.
- Center for the Neural Basis of Cognition, Pittsburgh, PA, USA.
- Department of Physical Medicine and Rehabilitation, University of Pittsburgh, Pittsburgh, PA, USA.
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Malešević N, Antfolk C. Sensory feedback in upper limb prosthetics: advances and challenges. Nat Rev Neurol 2024; 20:449-450. [PMID: 38945981 DOI: 10.1038/s41582-024-00987-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/02/2024]
Affiliation(s)
- Nebojša Malešević
- Department of Biomedical Engineering, Faculty of Engineering, Lund University, Lund, Sweden
| | - Christian Antfolk
- Department of Biomedical Engineering, Faculty of Engineering, Lund University, Lund, Sweden.
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Micera S, Shokur S. Our research path toward the restoration of natural sensations in hand prostheses. Artif Organs 2024. [PMID: 38994666 DOI: 10.1111/aor.14823] [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: 06/16/2024] [Accepted: 06/24/2024] [Indexed: 07/13/2024]
Abstract
The human hand, with its intricate sensory capabilities, plays a pivotal role in our daily interactions with the world. This remarkable organ possesses a wide range of natural sensors that enrich our experiences, enabling us to perceive touch, position, and temperature. These natural sensors work in concert to provide us with a rich sensory experience, enabling us to distinguish between various textures, gauge the force of our grip, determine the position of our fingers without needing to see them, perceive the temperature of objects we come into contact with or detect if a cloth is wet or dry. This complex sensory system is fundamental to our ability to manipulate objects, explore our surroundings, and interact with the world and people around us. In this article, we summarize the research performed in our laboratories over the years and our findings to restore both touch, position, and temperature modalities. The combination of intraneural stimulation, sensory substitution, and wearable technology opens new possibilities for enhancing sensory feedback in prosthetic hands, promising improved functionality and a closer approximation to natural sensory experiences for individuals with limb differences.
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Affiliation(s)
- Silvestro Micera
- Bertarelli Foundation Chair in Translational Neuroengineering, Neuro-X Institute, School of Engineering, Ecole Polytechnique Federale de Lausanne (EPFL), Lausanne, Switzerland
- The BioRobotics Institute, Interdisciplinary Health Center, and Department of Excellence in Robotics and AI Scuola Superiore Sant'Anna, Pisa, Italy
| | - Solaiman Shokur
- Bertarelli Foundation Chair in Translational Neuroengineering, Neuro-X Institute, School of Engineering, Ecole Polytechnique Federale de Lausanne (EPFL), Lausanne, Switzerland
- The BioRobotics Institute, Interdisciplinary Health Center, and Department of Excellence in Robotics and AI Scuola Superiore Sant'Anna, Pisa, Italy
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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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Xu J, Mawase F, Schieber MH. Evolution, biomechanics, and neurobiology converge to explain selective finger motor control. Physiol Rev 2024; 104:983-1020. [PMID: 38385888 DOI: 10.1152/physrev.00030.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 01/16/2024] [Accepted: 02/15/2024] [Indexed: 02/23/2024] Open
Abstract
Humans use their fingers to perform a variety of tasks, from simple grasping to manipulating objects, to typing and playing musical instruments, a variety wider than any other species. The more sophisticated the task, the more it involves individuated finger movements, those in which one or more selected fingers perform an intended action while the motion of other digits is constrained. Here we review the neurobiology of such individuated finger movements. We consider their evolutionary origins, the extent to which finger movements are in fact individuated, and the evolved features of neuromuscular control that both enable and limit individuation. We go on to discuss other features of motor control that combine with individuation to create dexterity, the impairment of individuation by disease, and the broad extent of capabilities that individuation confers on humans. We comment on the challenges facing the development of a truly dexterous bionic hand. We conclude by identifying topics for future investigation that will advance our understanding of how neural networks interact across multiple regions of the central nervous system to create individuated movements for the skills humans use to express their cognitive activity.
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Affiliation(s)
- Jing Xu
- Department of Kinesiology, University of Georgia, Athens, Georgia, United States
| | - Firas Mawase
- Department of Biomedical Engineering, Israel Institute of Technology, Haifa, Israel
| | - Marc H Schieber
- Departments of Neurology and Neuroscience, University of Rochester, Rochester, New York, United States
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Flanagan W, Becraft K, Warren H, Stavrakis AI, Bernthal NM, Hardin TJ, Clites TR. Prosthetic Limb Attachment via Electromagnetic Attraction Through a Closed Skin Envelope. IEEE Trans Biomed Eng 2024; 71:1552-1564. [PMID: 38090864 DOI: 10.1109/tbme.2023.3342652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/23/2024]
Abstract
OBJECTIVE Current socket-based methods of prosthetic limb attachment are responsible for many of the dominant problems reported by persons with amputation. In this work, we introduce a new paradigm for attachment via electromagnetic attraction between a bone-anchored ferromagnetic implant and an external electromagnet. Our objective was to develop a design framework for electromagnetic attachment, and to evaluate this framework in the context of transfemoral amputation. METHODS We first used inverse dynamics to calculate the forces required to suspend a knee-ankle-foot prosthesis during gait. We then conducted cadaveric dissections to inform implant geometry and design a surgical methodology for covering the implant. We also developed an in silico framework to investigate how electromagnet design affects system performance. Simulations were validated against benchtop testing of a custom-built electromagnet. RESULTS The physical electromagnet matched simulations, with a root-mean-square percentage error of 4.2% between measured and predicted forces. Using this electromagnet, we estimate that suspension of a prosthesis during gait would require 33 W of average power. After 200 and 1000 steps of simulated walking, the temperature at the skin would increase 2.3 °C and 15.4 °C relative to ambient, respectively. CONCLUSION Our design framework produced an implant and electromagnet that could feasibly suspend a knee-ankle-foot prosthesis during short walking bouts. Future work will focus on optimization of this system to reduce heating during longer bouts. SIGNIFICANCE This work demonstrates the initial feasibility of an electromagnetic prosthetic attachment paradigm that has the potential to increase comfort and improve residual limb health for persons with amputation.
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Yang S, Zhong S, Jin X, Fan G, Liao X, Yang X, He S. Mapping the hotspots and future trends of electrical stimulation for peripheral nerve injury: A bibliometric analysis from 2002 to 2023. Int Wound J 2024; 21:e14511. [PMID: 38084069 PMCID: PMC10958100 DOI: 10.1111/iwj.14511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Accepted: 11/09/2023] [Indexed: 01/14/2024] Open
Abstract
Peripheral nerve injuries often result in severe personal and social burden, and even with surgical treatment, patients continue to have poor clinical outcomes. Over the past two decades, electrical stimulation has been shown to promote axonal regeneration and alleviate refractory neuropathic pain. The aim of this study was to analyse this field using a bibliometric approach. Literature was searched through Web of Science Core Collection (WOSCC) for the years 2002-2023. Literature analysis included: (1) Describing publication trends in the field. (2) Exploring collaborative network relationships. (3) Finding research advances and research hotspots in the field. (4) Summarizing research trends in the field. With the number of studies in this field still increasing, a total of 693 publications were included in the analysis. This field of research is interdisciplinary in nature. Research hotspots include peripheral nerve regeneration, the treatment of neuropathic pain, materials for nerve injury repair, and the restoration of sensory function in patients with peripheral nerve injury. Correspondingly, the development of nerve conduits and systems for peripheral nerve electrical stimulation, clinical trials of peripheral nerve electrical stimulation, and tactile recovery and movement for amputees have shown significant promise as future research trends in this field.
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Affiliation(s)
- Sheng Yang
- Department of Orthopedic, Spinal Pain Research Institute, Shanghai Tenth People's HospitalTongji University School of MedicineShanghaiChina
| | - Sen Zhong
- Shanghai Tongji HospitalTongji University School of MedicineShanghaiChina
| | - Xuehan Jin
- Department of Orthopedic, Shanghai Tenth People's HospitalTongji University School of MedicineShanghaiChina
| | - Guoxin Fan
- National Key Clinical Pain Medicine of ChinaHuazhong University of Science and Technology Union Shenzhen HospitalShenzhenChina
| | - Xiang Liao
- National Key Clinical Pain Medicine of ChinaHuazhong University of Science and Technology Union Shenzhen HospitalShenzhenChina
| | - Xun Yang
- Department of Traumatic Orthopedics, Shenzhen Second People's Hospital, The First Affiliated Hospital, Shenzhen Translational Medicine InstituteShenzhen UniversityShenzhenChina
| | - Shisheng He
- Department of Orthopedic, Spinal Pain Research Institute, Shanghai Tenth People's HospitalTongji University School of MedicineShanghaiChina
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Mereu F, Cordella F, Paolini R, Scarpelli A, Demofonti A, Zollo L, Gruppioni E. A Sensory Feedback Neural Stimulator Prototype for Both Implantable and Wearable Applications. MICROMACHINES 2024; 15:480. [PMID: 38675291 PMCID: PMC11051761 DOI: 10.3390/mi15040480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Revised: 03/23/2024] [Accepted: 03/29/2024] [Indexed: 04/28/2024]
Abstract
The restoration of sensory feedback is one of the current challenges in the field of prosthetics. This work, following the analysis of the various types of sensory feedback, aims to present a prototype device that could be used both for implantable applications to perform PNS and for wearable applications, performing TENS, to restore sensory feedback. The two systems are composed of three electronic boards that are presented in detail, as well as the bench tests carried out. To the authors' best knowledge, this work presents the first device that can be used in a dual scenario for restoring sensory feedback. Both the implantable and wearable versions respected the expected values regarding the stimulation parameters. In its implantable version, the proposed system allows simultaneous and independent stimulation of 30 channels. Furthermore, the capacity of the wearable version to elicit somatic sensations was evaluated on healthy participants demonstrating performance comparable with commercial solutions.
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Affiliation(s)
- Federico Mereu
- Centro Protesi Inail, Vigorso di Budrio, 40054 Bologna, Italy;
- Unit of Advanced Robotics and Human-Centred Technologies, Università Campus Bio-Medico di Roma, 00128 Rome, Italy; (F.C.); (R.P.); (A.S.); (A.D.); (L.Z.)
| | - Francesca Cordella
- Unit of Advanced Robotics and Human-Centred Technologies, Università Campus Bio-Medico di Roma, 00128 Rome, Italy; (F.C.); (R.P.); (A.S.); (A.D.); (L.Z.)
| | - Roberto Paolini
- Unit of Advanced Robotics and Human-Centred Technologies, Università Campus Bio-Medico di Roma, 00128 Rome, Italy; (F.C.); (R.P.); (A.S.); (A.D.); (L.Z.)
| | - Alessia Scarpelli
- Unit of Advanced Robotics and Human-Centred Technologies, Università Campus Bio-Medico di Roma, 00128 Rome, Italy; (F.C.); (R.P.); (A.S.); (A.D.); (L.Z.)
| | - Andrea Demofonti
- Unit of Advanced Robotics and Human-Centred Technologies, Università Campus Bio-Medico di Roma, 00128 Rome, Italy; (F.C.); (R.P.); (A.S.); (A.D.); (L.Z.)
| | - Loredana Zollo
- Unit of Advanced Robotics and Human-Centred Technologies, Università Campus Bio-Medico di Roma, 00128 Rome, Italy; (F.C.); (R.P.); (A.S.); (A.D.); (L.Z.)
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11
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Thomas WM, Zuniga SA, Sondh I, Leber M, Solzbacher F, Lenarz T, Lim HH, Warren DJ, Rieth L, Adams ME. Development of a feline model for preclinical research of a new translabyrinthine auditory nerve implant. Front Neurosci 2024; 18:1308663. [PMID: 38379760 PMCID: PMC10877721 DOI: 10.3389/fnins.2024.1308663] [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: 10/16/2023] [Accepted: 01/02/2024] [Indexed: 02/22/2024] Open
Abstract
Cochlear implants are among the most successful neural prosthetic devices to date but exhibit poor frequency selectivity and the inability to consistently activate apical (low frequency) spiral ganglion neurons. These issues can limit hearing performance in many cochlear implant patients, especially for understanding speech in noisy environments and in perceiving or appreciating more complex inputs such as music and multiple talkers. For cochlear implants, electrical current must pass through the bony wall of the cochlea, leading to widespread activation of auditory nerve fibers. Cochlear implants also cannot be implanted in some individuals with an obstruction or severe malformations of the cochlea. Alternatively, intraneural stimulation delivered via an auditory nerve implant could provide direct contact with neural fibers and thus reduce unwanted current spread. More confined current during stimulation can increase selectivity of frequency fiber activation. Furthermore, devices such as the Utah Slanted Electrode Array can provide access to the full cross section of the auditory nerve, including low frequency fibers that are difficult to reach using a cochlear implant. However, further scientific and preclinical research of these Utah Slanted Electrode Array devices is limited by the lack of a chronic large animal model for the auditory nerve implant, especially one that leverages an appropriate surgical approach relevant for human translation. This paper presents a newly developed transbullar translabyrinthine surgical approach for implanting the auditory nerve implant into the cat auditory nerve. In our first of a series of studies, we demonstrate a surgical approach in non-recovery experiments that enables implantation of the auditory nerve implant into the auditory nerve, without damaging the device and enabling effective activation of the auditory nerve fibers, as measured by electrode impedances and electrically evoked auditory brainstem responses. These positive results motivate performing future chronic cat studies to assess the long-term stability and function of these auditory nerve implant devices, as well as development of novel stimulation strategies that can be translated to human patients.
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Affiliation(s)
- W. Mitchel Thomas
- Department of Biomedical Engineering, University of Utah, Salt Lake City, UT, United States
| | - Steven A. Zuniga
- Department of Otolaryngology-Head and Neck Surgery, University of Minnesota, Minneapolis, MN, United States
| | - Inderbir Sondh
- Department of Biomedical Engineering, University of Minnesota, Minneapolis, MN, United States
| | - Moritz Leber
- Blackrock Neurotech, Salt Lake City, UT, United States
| | - Florian Solzbacher
- Blackrock Neurotech, Salt Lake City, UT, United States
- Department of Electrical and Computer Engineering, University of Utah, Salt Lake City, UT, United States
| | - Thomas Lenarz
- Department of Otorhinolaryngology, Medical University of Hannover, Hannover, Germany
| | - Hubert H. Lim
- Department of Otolaryngology-Head and Neck Surgery, University of Minnesota, Minneapolis, MN, United States
- Department of Biomedical Engineering, University of Minnesota, Minneapolis, MN, United States
| | - David J. Warren
- Department of Biomedical Engineering, University of Utah, Salt Lake City, UT, United States
- Department of Electrical and Computer Engineering, University of Utah, Salt Lake City, UT, United States
| | - Loren Rieth
- Department Mechanical and Aerospace Engineering, West Virginia University, Morgantown, WV, United States
| | - Meredith E. Adams
- Department of Otolaryngology-Head and Neck Surgery, University of Minnesota, Minneapolis, MN, United States
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12
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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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13
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Donati E, Valle G. Neuromorphic hardware for somatosensory neuroprostheses. Nat Commun 2024; 15:556. [PMID: 38228580 PMCID: PMC10791662 DOI: 10.1038/s41467-024-44723-3] [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: 11/10/2022] [Accepted: 01/03/2024] [Indexed: 01/18/2024] Open
Abstract
In individuals with sensory-motor impairments, missing limb functions can be restored using neuroprosthetic devices that directly interface with the nervous system. However, restoring the natural tactile experience through electrical neural stimulation requires complex encoding strategies. Indeed, they are presently limited in effectively conveying or restoring tactile sensations by bandwidth constraints. Neuromorphic technology, which mimics the natural behavior of neurons and synapses, holds promise for replicating the encoding of natural touch, potentially informing neurostimulation design. In this perspective, we propose that incorporating neuromorphic technologies into neuroprostheses could be an effective approach for developing more natural human-machine interfaces, potentially leading to advancements in device performance, acceptability, and embeddability. We also highlight ongoing challenges and the required actions to facilitate the future integration of these advanced technologies.
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Affiliation(s)
- Elisa Donati
- Institute of Neuroinformatics, University of Zurich and ETH Zurich, Zurich, Switzerland.
| | - Giacomo Valle
- Department of Organismal Biology and Anatomy, University of Chicago, Chicago, IL, USA.
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14
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Gonzalez MA, Nwokeabia C, Vaskov AK, Vu PP, Lu CW, Patil PG, Cederna PS, Chestek CA, Gates DH. Electrical Stimulation of Regenerative Peripheral Nerve Interfaces (RPNIs) Induces Referred Sensations in People With Upper Limb Loss. IEEE Trans Neural Syst Rehabil Eng 2024; 32:339-349. [PMID: 38145529 PMCID: PMC10938368 DOI: 10.1109/tnsre.2023.3345164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2023]
Abstract
Individuals with upper limb loss lack sensation of the missing hand, which can negatively impact their daily function. Several groups have attempted to restore this sensation through electrical stimulation of residual nerves. The purpose of this study was to explore the utility of regenerative peripheral nerve interfaces (RPNIs) in eliciting referred sensation. In four participants with upper limb loss, we characterized the quality and location of sensation elicited through electrical stimulation of RPNIs over time. We also measured functional stimulation ranges (sensory perception and discomfort thresholds), sensitivity to changes in stimulation amplitude, and ability to differentiate objects of different stiffness and sizes. Over a period of up to 54 months, stimulation of RPNIs elicited sensations that were consistent in quality (e.g. tingling, kinesthesia) and were perceived in the missing hand and forearm. The location of elicited sensation was partially-stable to stable in 13 of 14 RPNIs. For 5 of 7 RPNIs tested, participants demonstrated a sensitivity to changes in stimulation amplitude, with an average just noticeable difference of 45 nC. In a case study, one participant was provided RPNI stimulation proportional to prosthetic grip force. She identified four objects of different sizes and stiffness with 56% accuracy with stimulation alone and 100% accuracy when stimulation was combined with visual feedback of hand position. Collectively, these experiments suggest that RPNIs have the potential to be used in future bi-directional prosthetic systems.
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15
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Kotamraju BP, Eggers TE, McCallum GA, Durand DM. Selective chronic recording in small nerve fascicles of sciatic nerve with carbon nanotube yarns in rats. J Neural Eng 2024; 20:066041. [PMID: 38100824 PMCID: PMC10765114 DOI: 10.1088/1741-2552/ad1611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 11/15/2023] [Accepted: 12/15/2023] [Indexed: 12/17/2023]
Abstract
Objective. The primary challenge faced in the field of neural rehabilitation engineering is the limited advancement in nerve interface technology, which currently fails to match the mechanical properties of small-diameter nerve fascicles. Novel developments are necessary to enable long-term, chronic recording from a multitude of small fascicles, allowing for the recovery of motor intent and sensory signals.Approach. In this study, we analyze the chronic recording capabilities of carbon nanotube yarn electrodes in the peripheral somatic nervous system. The electrodes were surgically implanted in the sciatic nerve's three individual fascicles in rats, enabling the recording of neural activity during gait. Signal-to-noise ratio (SNR) and information theory were employed to analyze the data, demonstrating the superior recording capabilities of the electrodes. Flat interface nerve electrode and thin-film longitudinal intrafascicular electrode electrodes were used as a references to assess the results from SNR and information theory analysis.Main results. The electrodes exhibited the ability to record chronic signals with SNRs reaching as high as 15 dB, providing 12 bits of information for the sciatic nerve, a significant improvement over previous methods. Furthermore, the study revealed that the SNR and information content of the neural signals remained consistent over a period of 12 weeks across three different fascicles, indicating the stability of the interface. The signals recorded from these electrodes were also analyzed for selectivity using information theory metrics, which showed an information sharing of approximately 1.4 bits across the fascicles.Significance. The ability to safely and reliably record from multiple fascicles of different nerves simultaneously over extended periods of time holds substantial implications for the field of neural and rehabilitation engineering. This advancement addresses the limitation of current nerve interface technologies and opens up new possibilities for enhancing neural rehabilitation and control.
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Affiliation(s)
- B P Kotamraju
- Case Western Reserve University, Neural Engineering Center, Biomedical Engineering, Cleveland, OH, United States of America
| | - Thomas E Eggers
- Department of Neurosurgery, Emory University, Atlanta, GA, United States of America
| | - Grant A McCallum
- Case Western Reserve University, Neural Engineering Center, Biomedical Engineering, Cleveland, OH, United States of America
| | - Dominique M Durand
- Case Western Reserve University, Neural Engineering Center, Biomedical Engineering, Cleveland, OH, United States of America
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16
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Manoharan S, Park H. Characterization of perception by transcutaneous electrical Stimulation in terms of tingling intensity and temporal dynamics. Biomed Eng Lett 2024; 14:35-44. [PMID: 38186955 PMCID: PMC10770012 DOI: 10.1007/s13534-023-00308-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 07/12/2023] [Accepted: 07/28/2023] [Indexed: 01/09/2024] Open
Abstract
Electrotactile feedback is a cost-effective and versatile method to provide new information or to augment intrinsic tactile feedback. As tactile feedback provides critical information for human-environment interaction, electrotactile feedback, accordingly, has many purposes to improve the quality of human-environment interaction in both direct and remote settings. However, electrotactile feedback overlays tingling sensation on top of the natural tactile feedback. To better characterize electrotactile feedback and understand the origin of the tingling sensation, a need arises to characterize the human perception of electrotactile feedback qualitatively and quantitatively, while varying the key stimulation parameters, namely amplitude and frequency. This study consists of two experiments. In the first experiment, the voltage for each subject was characterized by setting perception and discomfort thresholds. In the second experiment, subjects received electrical stimulation in 9 different combinations of voltages and frequencies. On delivering stimulation with each parameter combination, subjects reported their perception in two comparative scales-pressure vs. tingling and constant vs. pulsing. Subjects also reported the location of perception for stimulation with every parameter combination. More tingling and less pressure was reported as frequency increased, while the tingling-pressure percept was not affected by the amplitude change. Additionally, less pulsing and more constant was reported as frequency increased, while the pulsing-constant percept was not affected by the amplitude change. Concurrently, the normalized level of voltage thresholds was decreased as frequency increased. Dependency of tingling-pressure percept on stimulation frequency suggests that incongruency between the stimulation frequency and the natural firing rate of the sensory neuron would be an important factor of the tingling sensation. This study is a steppingstone to further demystify the origin of the tingling percept caused by electrical stimulation, thus broadening the use of transcutaneous electrical stimulation as a way of providing tactile cue or augmentation.
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Affiliation(s)
- Stefan Manoharan
- Department of Electrical and Computer Engineering, Texas A&M University, College Station, TX USA
| | - Hangue Park
- Department of Electrical and Computer Engineering, Texas A&M University, College Station, TX USA
- Department of Biomedical Engineering, Sungkyunkwan University, Suwon, South Korea
- Department of Intelligent Precision Healthcare Convergence, Sungkyunkwan University, Suwon, South Korea
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17
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Pan L, Ren Z, Zhu K, Li J. Eliciting tactile sensations in the hand through non-invasive proximal nerve stimulation: a feasibility study. Med Biol Eng Comput 2023; 61:3225-3232. [PMID: 37721698 DOI: 10.1007/s11517-023-02923-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Accepted: 08/29/2023] [Indexed: 09/19/2023]
Abstract
Recently, non-invasive proximal nerve stimulation has been widely investigated to restore tactile sensations. It has been demonstrated that tactile sensations in the hand could be elicited by nerve stimulation on the upper arm. However, it is still unknown whether tactile sensations could be elicited by stimulation at a proximal location close to the neck. In this study, non-invasive proximal nerve stimulation tests were performed to elicit tactile sensations in the hand of subjects. Six Ag/AgCl gel electrodes (2 × 3) were placed on the supraclavicular fossa where the proximal parts of the brachial plexus nerves were located. Then, fifteen potential electrode pairs were tested to explore whether tactile sensations could be elicited by non-invasive proximal nerve stimulation. Eight able-bodied subjects (male) were recruited to participate in the test. The stimulated sensation regions in the hand and the sensory intensity were reported and recorded during the experiment. The results demonstrated that the tactile sensations in various regions in the hand could be elicited through non-invasive nerve stimulation at the proximal location close to the neck.
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Affiliation(s)
- Lizhi Pan
- The Key Laboratory of Mechanism Theory and Equipment Design of Ministry of Education, School of Mechanical Engineering, Tianjin University, 135 Yaguan Road, Jinnan District, Tianjin, 300350, China
| | - Zhihao Ren
- The Key Laboratory of Mechanism Theory and Equipment Design of Ministry of Education, School of Mechanical Engineering, Tianjin University, 135 Yaguan Road, Jinnan District, Tianjin, 300350, China
| | - Kun Zhu
- The Key Laboratory of Mechanism Theory and Equipment Design of Ministry of Education, School of Mechanical Engineering, Tianjin University, 135 Yaguan Road, Jinnan District, Tianjin, 300350, China
| | - Jianmin Li
- The Key Laboratory of Mechanism Theory and Equipment Design of Ministry of Education, School of Mechanical Engineering, Tianjin University, 135 Yaguan Road, Jinnan District, Tianjin, 300350, China.
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18
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Ortiz-Catalan M, Zbinden J, Millenaar J, D'Accolti D, Controzzi M, Clemente F, Cappello L, Earley EJ, Mastinu E, Kolankowska J, Munoz-Novoa M, Jönsson S, Cipriani C, Sassu P, Brånemark R. A highly integrated bionic hand with neural control and feedback for use in daily life. Sci Robot 2023; 8:eadf7360. [PMID: 37820004 DOI: 10.1126/scirobotics.adf7360] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Accepted: 09/14/2023] [Indexed: 10/13/2023]
Abstract
Restoration of sensorimotor function after amputation has remained challenging because of the lack of human-machine interfaces that provide reliable control, feedback, and attachment. Here, we present the clinical implementation of a transradial neuromusculoskeletal prosthesis-a bionic hand connected directly to the user's nervous and skeletal systems. In one person with unilateral below-elbow amputation, titanium implants were placed intramedullary in the radius and ulna bones, and electromuscular constructs were created surgically by transferring the severed nerves to free muscle grafts. The native muscles, free muscle grafts, and ulnar nerve were implanted with electrodes. Percutaneous extensions from the titanium implants provided direct skeletal attachment and bidirectional communication between the implanted electrodes and a prosthetic hand. Operation of the bionic hand in daily life resulted in improved prosthetic function, reduced postamputation, and increased quality of life. Sensations elicited via direct neural stimulation were consistently perceived on the phantom hand throughout the study. To date, the patient continues using the prosthesis in daily life. The functionality of conventional artificial limbs is hindered by discomfort and limited and unreliable control. Neuromusculoskeletal interfaces can overcome these hurdles and provide the means for the everyday use of a prosthesis with reliable neural control fixated into the skeleton.
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Affiliation(s)
- Max Ortiz-Catalan
- Center for Bionics and Pain Research, Mölndal, Sweden
- Bionics Institute, Melbourne, Australia
- Department of Electrical Engineering, Chalmers University of Technology, Gothenburg, Sweden
- University of Melbourne, Melbourne, Australia
| | - Jan Zbinden
- Center for Bionics and Pain Research, Mölndal, Sweden
- Department of Electrical Engineering, Chalmers University of Technology, Gothenburg, Sweden
| | | | - Daniele D'Accolti
- Biorobotics Institute, Scuola Superiore Sant'Anna, Pisa, Italy
- Department of Excellence in Robotics and AI, Scuola Superiore Sant'Anna, Pisa, Italy
| | - Marco Controzzi
- Biorobotics Institute, Scuola Superiore Sant'Anna, Pisa, Italy
- Department of Excellence in Robotics and AI, Scuola Superiore Sant'Anna, Pisa, Italy
| | | | - Leonardo Cappello
- Biorobotics Institute, Scuola Superiore Sant'Anna, Pisa, Italy
- Department of Excellence in Robotics and AI, Scuola Superiore Sant'Anna, Pisa, Italy
| | - Eric J Earley
- Center for Bionics and Pain Research, Mölndal, Sweden
- Department of Electrical Engineering, Chalmers University of Technology, Gothenburg, Sweden
- Osseointegration Research Consortium, University of Colorado, Aurora, CO, USA
| | - Enzo Mastinu
- Center for Bionics and Pain Research, Mölndal, Sweden
- Department of Electrical Engineering, Chalmers University of Technology, Gothenburg, Sweden
- Biorobotics Institute, Scuola Superiore Sant'Anna, Pisa, Italy
- Department of Excellence in Robotics and AI, Scuola Superiore Sant'Anna, Pisa, Italy
| | | | - Maria Munoz-Novoa
- Center for Bionics and Pain Research, Mölndal, Sweden
- Center for Advanced Reconstruction of Extremities, Sahlgrenska University Hospital, Mölndal, Sweden
| | - Stewe Jönsson
- TeamOlmed, Department of Upper Limb Prosthetics, Kungsbacka, Sweden
| | - Christian Cipriani
- Biorobotics Institute, Scuola Superiore Sant'Anna, Pisa, Italy
- Department of Excellence in Robotics and AI, Scuola Superiore Sant'Anna, Pisa, Italy
| | - Paolo Sassu
- Center for Bionics and Pain Research, Mölndal, Sweden
- Department of Hand Surgery, Sahlgrenska University Hospital, Mölndal, Sweden
- Department of Orthopaedics, IRCCS, Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Rickard Brånemark
- Integrum AB, Mölndal, Sweden
- Department of Orthopaedics, Gothenburg University, Gothenburg, Sweden
- K. Lisa Yang Center for Bionics, MIT Media Lab, Massachusetts Institute of Technology, Cambridge, MA, USA
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19
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Farina D, Vujaklija I, Brånemark R, Bull AMJ, Dietl H, Graimann B, Hargrove LJ, Hoffmann KP, Huang HH, Ingvarsson T, Janusson HB, Kristjánsson K, Kuiken T, Micera S, Stieglitz T, Sturma A, Tyler D, Weir RFF, Aszmann OC. Toward higher-performance bionic limbs for wider clinical use. Nat Biomed Eng 2023; 7:473-485. [PMID: 34059810 DOI: 10.1038/s41551-021-00732-x] [Citation(s) in RCA: 87] [Impact Index Per Article: 87.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Accepted: 04/01/2021] [Indexed: 12/19/2022]
Abstract
Most prosthetic limbs can autonomously move with dexterity, yet they are not perceived by the user as belonging to their own body. Robotic limbs can convey information about the environment with higher precision than biological limbs, but their actual performance is substantially limited by current technologies for the interfacing of the robotic devices with the body and for transferring motor and sensory information bidirectionally between the prosthesis and the user. In this Perspective, we argue that direct skeletal attachment of bionic devices via osseointegration, the amplification of neural signals by targeted muscle innervation, improved prosthesis control via implanted muscle sensors and advanced algorithms, and the provision of sensory feedback by means of electrodes implanted in peripheral nerves, should all be leveraged towards the creation of a new generation of high-performance bionic limbs. These technologies have been clinically tested in humans, and alongside mechanical redesigns and adequate rehabilitation training should facilitate the wider clinical use of bionic limbs.
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Affiliation(s)
- Dario Farina
- Department of Bioengineering, Imperial College London, London, UK.
| | - Ivan Vujaklija
- Department of Electrical Engineering and Automation, Aalto University, Espoo, Finland
| | - Rickard Brånemark
- Center for Extreme Bionics, Biomechatronics Group, MIT Media Lab, Massachusetts Institute of Technology, Cambridge, MA, USA
- Department of Orthopaedics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Anthony M J Bull
- Department of Bioengineering, Imperial College London, London, UK
| | - Hans Dietl
- Ottobock Products SE & Co. KGaA, Vienna, Austria
| | | | - Levi J Hargrove
- Center for Bionic Medicine, Shirley Ryan AbilityLab, Chicago, IL, USA
- Department of Physical Medicine & Rehabilitation, Northwestern University, Chicago, IL, USA
- Department of Biomedical Engineering, Northwestern University, Chicago, IL, USA
| | - Klaus-Peter Hoffmann
- Department of Medical Engineering & Neuroprosthetics, Fraunhofer-Institut für Biomedizinische Technik, Sulzbach, Germany
| | - He Helen Huang
- NCSU/UNC Joint Department of Biomedical Engineering, North Carolina State University, Raleigh, NC, USA
- University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Thorvaldur Ingvarsson
- Department of Research and Development, Össur Iceland, Reykjavík, Iceland
- Faculty of Medicine, University of Iceland, Reykjavík, Iceland
| | - Hilmar Bragi Janusson
- School of Engineering and Natural Sciences, University of Iceland, Reykjavík, Iceland
| | | | - Todd Kuiken
- Center for Bionic Medicine, Shirley Ryan AbilityLab, Chicago, IL, USA
- Department of Physical Medicine & Rehabilitation, Northwestern University, Chicago, IL, USA
- Department of Biomedical Engineering, Northwestern University, Chicago, IL, USA
| | - Silvestro Micera
- The Biorobotics Institute and Department of Excellence in Robotics and AI, Scuola Superiore Sant'Anna, Pontedera, Italy
- Department of Excellence in Robotics and AI, Scuola Superiore Sant'Anna, Pontedera, Italy
- Bertarelli Foundation Chair in Translational NeuroEngineering, Center for Neuroprosthetics and Institute of Bioengineering, School of Engineering, Ecole Polytechnique Federale de Lausanne, Lausanne, Switzerland
| | - Thomas Stieglitz
- Laboratory for Biomedical Microtechnology, Department of Microsystems Engineering-IMTEK, BrainLinks-BrainTools Center and Bernstein Center Freiburg, University of Freiburg, Freiburg, Germany
| | - Agnes Sturma
- Department of Bioengineering, Imperial College London, London, UK
- Clinical Laboratory for Bionic Extremity Reconstruction, Department of Plastic and Reconstructive Surgery, Medical University of Vienna, Vienna, Austria
| | - Dustin Tyler
- Case School of Engineering, Case Western Reserve University, Cleveland, OH, USA
- Louis Stokes Veterans Affairs Medical Centre, Cleveland, OH, USA
| | - Richard F Ff Weir
- Biomechatronics Development Laboratory, Bioengineering Department, University of Colorado Denver and VA Eastern Colorado Healthcare System, Aurora, CO, USA
| | - Oskar C Aszmann
- Clinical Laboratory for Bionic Extremity Reconstruction, Department of Plastic and Reconstructive Surgery, Medical University of Vienna, Vienna, Austria
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20
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Patel PR, Welle EJ, Letner JG, Shen H, Bullard AJ, Caldwell CM, Vega-Medina A, Richie JM, Thayer HE, Patil PG, Cai D, Chestek CA. Utah array characterization and histological analysis of a multi-year implant in non-human primate motor and sensory cortices. J Neural Eng 2023; 20:10.1088/1741-2552/acab86. [PMID: 36595323 PMCID: PMC9954796 DOI: 10.1088/1741-2552/acab86] [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: 08/22/2022] [Accepted: 12/14/2022] [Indexed: 12/15/2022]
Abstract
Objective.The Utah array is widely used in both clinical studies and neuroscience. It has a strong track record of safety. However, it is also known that implanted electrodes promote the formation of scar tissue in the immediate vicinity of the electrodes, which may negatively impact the ability to record neural waveforms. This scarring response has been primarily studied in rodents, which may have a very different response than primate brain.Approach.Here, we present a rare nonhuman primate histological dataset (n= 1 rhesus macaque) obtained 848 and 590 d after implantation in two brain hemispheres. For 2 of 4 arrays that remained within the cortex, NeuN was used to stain for neuron somata at three different depths along the shanks. Images were filtered and denoised, with neurons then counted in the vicinity of the arrays as well as a nearby section of control tissue. Additionally, 3 of 4 arrays were imaged with a scanning electrode microscope to evaluate any materials damage that might be present.Main results.Overall, we found a 63% percent reduction in the number of neurons surrounding the electrode shanks compared to control areas. In terms of materials, the arrays remained largely intact with metal and Parylene C present, though tip breakage and cracks were observed on many electrodes.Significance.Overall, these results suggest that the tissue response in the nonhuman primate brain shows similar neuron loss to previous studies using rodents. Electrode improvements, for example using smaller or softer probes, may therefore substantially improve the tissue response and potentially improve the neuronal recording yield in primate cortex.
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Affiliation(s)
- Paras R. Patel
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI 48109, United States of America
| | - Elissa J. Welle
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI 48109, United States of America
| | - Joseph G. Letner
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI 48109, United States of America
| | - Hao Shen
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI 48109, United States of America
| | - Autumn J. Bullard
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI 48109, United States of America
| | - Ciara M. Caldwell
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI 48109, United States of America
| | - Alexis Vega-Medina
- Department of Molecular, Cellular, and Developmental Biology, University of Michigan, Ann Arbor, MI 48019, United States of America,Neuroscience Graduate Program, University of Michigan Medical School, Ann Arbor, MI 48109, United States of America
| | - Julianna M. Richie
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI 48109, United States of America
| | - Hope E. Thayer
- Department of Mechanical Engineering, University of Michigan, Ann Arbor, MI 48109, United States of America
| | - Parag G. Patil
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI 48109, United States of America,Department of Neurosurgery, University of Michigan Medical School, Ann Arbor, MI 48109, United States of America,Department of Neurology, University of Michigan Medical School, Ann Arbor, MI 48109, United States of America,Neuroscience Graduate Program, University of Michigan Medical School, Ann Arbor, MI 48109, United States of America
| | - Dawen Cai
- Neuroscience Graduate Program, University of Michigan Medical School, Ann Arbor, MI 48109, United States of America,Department of Biophysics, University of Michigan, Ann Arbor, MI 48109, United States of America,Department of Cell and Developmental Biology, University of Michigan Medical School, Ann Arbor, MI 48019, United States of America
| | - Cynthia A. Chestek
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI 48109, United States of America,Neuroscience Graduate Program, University of Michigan Medical School, Ann Arbor, MI 48109, United States of America,Department of Electrical Engineering and Computer Science, University of Michigan, Ann Arbor, MI 48109, United States of America,Robotics Program, University of Michigan, Ann Arbor, MI 48109, United States of America, Corresponding author:
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21
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Gupta A, Vardalakis N, Wagner FB. Neuroprosthetics: from sensorimotor to cognitive disorders. Commun Biol 2023; 6:14. [PMID: 36609559 PMCID: PMC9823108 DOI: 10.1038/s42003-022-04390-w] [Citation(s) in RCA: 15] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Accepted: 12/19/2022] [Indexed: 01/07/2023] Open
Abstract
Neuroprosthetics is a multidisciplinary field at the interface between neurosciences and biomedical engineering, which aims at replacing or modulating parts of the nervous system that get disrupted in neurological disorders or after injury. Although neuroprostheses have steadily evolved over the past 60 years in the field of sensory and motor disorders, their application to higher-order cognitive functions is still at a relatively preliminary stage. Nevertheless, a recent series of proof-of-concept studies suggest that electrical neuromodulation strategies might also be useful in alleviating some cognitive and memory deficits, in particular in the context of dementia. Here, we review the evolution of neuroprosthetics from sensorimotor to cognitive disorders, highlighting important common principles such as the need for neuroprosthetic systems that enable multisite bidirectional interactions with the nervous system.
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Affiliation(s)
- Ankur Gupta
- grid.462010.1Univ. Bordeaux, CNRS, IMN, UMR 5293, F-33000 Bordeaux, France
| | | | - Fabien B. Wagner
- grid.462010.1Univ. Bordeaux, CNRS, IMN, UMR 5293, F-33000 Bordeaux, France
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22
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Lee C, Vaskov AK, Gonzalez MA, Vu PP, Davis AJ, Cederna PS, Chestek CA, Gates DH. Use of regenerative peripheral nerve interfaces and intramuscular electrodes to improve prosthetic grasp selection: a case study. J Neural Eng 2022; 19:10.1088/1741-2552/ac9e1c. [PMID: 36317254 PMCID: PMC9942093 DOI: 10.1088/1741-2552/ac9e1c] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Accepted: 10/27/2022] [Indexed: 11/16/2022]
Abstract
Objective.Advanced myoelectric hands enable users to select from multiple functional grasps. Current methods for controlling these hands are unintuitive and require frequent recalibration. This case study assessed the performance of tasks involving grasp selection, object interaction, and dynamic postural changes using intramuscular electrodes with regenerative peripheral nerve interfaces (RPNIs) and residual muscles.Approach.One female with unilateral transradial amputation participated in a series of experiments to compare the performance of grasp selection controllers with RPNIs and intramuscular control signals with controllers using surface electrodes. These experiments included a virtual grasp-matching task with and without a concurrent cognitive task and physical tasks with a prosthesis including standardized functional assessments and a functional assessment where the individual made a cup of coffee ('Coffee Task') that required grasp transitions.Main results.In the virtual environment, the participant was able to select between four functional grasps with higher accuracy using the RPNI controller (92.5%) compared to surface controllers (81.9%). With the concurrent cognitive task, performance of the virtual task was more consistent with RPNI controllers (reduced accuracy by 1.1%) compared to with surface controllers (4.8%). When RPNI signals were excluded from the controller with intramuscular electromyography (i.e. residual muscles only), grasp selection accuracy decreased by up to 24%. The participant completed the Coffee Task with 11.7% longer completion time with the surface controller than with the RPNI controller. She also completed the Coffee Task with 11 fewer transition errors out of a maximum of 25 total errors when using the RPNI controller compared to surface controller.Significance.The use of RPNI signals in concert with residual muscles and intramuscular electrodes can improve grasp selection accuracy in both virtual and physical environments. This approach yielded consistent performance without recalibration needs while reducing cognitive load associated with pattern recognition for myoelectric control (clinical trial registration number NCT03260400).
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Affiliation(s)
- Christina Lee
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, USA
| | - Alex K. Vaskov
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, USA
| | | | - Philip P. Vu
- Section of Plastic Surgery, University of Michigan, Ann Arbor, MI, USA
| | - Alicia J. Davis
- Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, MI, USA
| | - Paul S. Cederna
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, USA
- Section of Plastic Surgery, University of Michigan, Ann Arbor, MI, USA
| | - Cynthia A. Chestek
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, USA
- Robotics Institute, University of Michigan, Ann Arbor, MI, USA
| | - Deanna H. Gates
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, USA
- Robotics Institute, University of Michigan, Ann Arbor, MI, USA
- School of Kinesiology, University of Michigan, Ann Arbor, MI, USA
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23
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Valle G. Peripheral neurostimulation for encoding artificial somatosensations. Eur J Neurosci 2022; 56:5888-5901. [PMID: 36097134 PMCID: PMC9826263 DOI: 10.1111/ejn.15822] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2022] [Revised: 08/08/2022] [Accepted: 09/08/2022] [Indexed: 01/11/2023]
Abstract
The direct neural stimulation of peripheral or central nervous systems has been shown as an effective tool to treat neurological conditions. The electrical activation of the nervous sensory pathway can be adopted to restore the artificial sense of touch and proprioception in people suffering from sensory-motor disorders. The modulation of the neural stimulation parameters has a direct effect on the electrically induced sensations, both when targeting the somatosensory cortex and the peripheral somatic nerves. The properties of the artificial sensations perceived, as their location, quality and intensity are strongly dependent on the direct modulation of pulse width, amplitude and frequency of the neural stimulation. Different sensory encoding schemes have been tested in patients showing distinct effects and outcomes according to their impact on the neural activation. Here, I reported the most adopted neural stimulation strategies to artificially encode somatosensation into the peripheral nervous system. The real-time implementation of these strategies in bionic devices is crucial to exploit the artificial sensory feedback in prosthetics. Thus, neural stimulation becomes a tool to directly communicate with the human nervous system. Given the importance of adding artificial sensory information to neuroprosthetic devices to improve their control and functionality, the choice of an optimal neural stimulation paradigm could increase the impact of prosthetic devices on the quality of life of people with sensorimotor disabilities.
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Affiliation(s)
- Giacomo Valle
- Laboratory for Neuroengineering, Department of Health Sciences and TechnologyInstitute for Robotics and Intelligent Systems, ETH ZürichZürichSwitzerland
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24
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Gonzalez M, Bismuth A, Lee C, Chestek CA, Gates DH. Artificial referred sensation in upper and lower limb prosthesis users: a systematic review. J Neural Eng 2022; 19:10.1088/1741-2552/ac8c38. [PMID: 36001115 PMCID: PMC9514130 DOI: 10.1088/1741-2552/ac8c38] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Accepted: 08/23/2022] [Indexed: 11/12/2022]
Abstract
Objective.Electrical stimulation can induce sensation in the phantom limb of individuals with amputation. It is difficult to generalize existing findings as there are many approaches to delivering stimulation and to assessing the characteristics and benefits of sensation. Therefore, the goal of this systematic review was to explore the stimulation parameters that effectively elicited referred sensation, the qualities of elicited sensation, and how the utility of referred sensation was assessed.Approach.We searched PubMed, Web of Science, and Engineering Village through January of 2022 to identify relevant papers. We included papers which electrically induced referred sensation in individuals with limb loss and excluded papers that did not contain stimulation parameters or outcome measures pertaining to stimulation. We extracted information on participant demographics, stimulation approaches, and participant outcomes.Main results.After applying exclusion criteria, 49 papers were included covering nine stimulation methods. Amplitude was the most commonly adjusted parameter (n= 25), followed by frequency (n= 22), and pulse width (n= 15). Of the 63 reports of sensation quality, most reported feelings of pressure (n= 52), paresthesia (n= 48), or vibration (n= 40) while less than half (n= 29) reported a sense of position or movement. Most papers evaluated the functional benefits of sensation (n= 33) using force matching or object identification tasks, while fewer papers quantified subjective measures (n= 16) such as pain or embodiment. Only 15 studies (36%) observed percept intensity, quality, or location over multiple sessions.Significance.Most studies that measured functional performance demonstrated some benefit to providing participants with sensory feedback. However, few studies could experimentally manipulate sensation location or quality. Direct comparisons between studies were limited by variability in methodologies and outcome measures. As such, we offer recommendations to aid in more standardized reporting for future research.
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Affiliation(s)
- Michael Gonzalez
- Department of Robotics, University of Michigan, Ann Arbor, MI, United States of America
| | - Alex Bismuth
- School of Kinesiology, University of Michigan, Ann Arbor, MI, United States of America
| | - Christina Lee
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, United States of America
| | - Cynthia A Chestek
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, United States of America
| | - Deanna H Gates
- School of Kinesiology, University of Michigan, Ann Arbor, MI, United States of America
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25
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Atkinson EW, Kuliasha CA, Kasper M, Furniturewalla A, Lim AS, Jiracek-Sapieha L, Brake A, Gormaley A, Rivera-Llabres V, Singh I, Spearman B, Rinaldi-Ramos CM, Schmidt CE, Judy JW, Otto KJ. Examining the in vivo functionality of the Magnetically Aligned Regenerative Tissue-Engineered Electronic Nerve Interface (MARTEENI). J Neural Eng 2022; 19. [PMID: 35998559 DOI: 10.1088/1741-2552/ac8bfe] [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: 05/24/2022] [Accepted: 08/23/2022] [Indexed: 11/11/2022]
Abstract
OBJECTIVE Although neural-enabled prostheses have been used to restore some lost functionality in clinical trials, they have faced difficulty in achieving high degree of freedom, natural use compared to healthy limbs. This study investigated the in vivo functionality of a flexible and scalable regenerative peripheral-nerve interface suspended within a microchannel-embedded, tissue-engineered hydrogel (the Magnetically Aligned Regenerative Tissue-Engineered Electronic Nerve Interface, MARTEENI) as a potential approach to improving current issues in peripheral nerve interfaces. APPROACH Assembled MARTEENI devices were implanted in the gaps of severed sciatic nerves in Lewis rats. Both acute and chronic electrophysiology were recorded, and channel-isolated activity was examined. In terminal experiments, evoked activity during paw compression and stimulus response curves generated from proximal nerve stimulation were examined. Electrochemical impedance spectroscopy was performed to assess the complex impedance of recording sites during chronic data collection. Features of the foreign-body response in non-functional implants were examined using immunohistological methods. MAIN RESULTS Channel-isolated activity was observed in acute, chronic, and terminal experiments and showed a typically biphasic morphology with peak-to-peak amplitudes varying between 50 to 500 µV. For chronic experiments, electrophysiology was observed for 77 days post-implant. Within the templated hydrogel, regenerating axons formed minifascicles that varied in both size and axon count and were also found to surround device threads. No axons were found to penetrate the foreign-body response. Together these results suggest the MARTEENI is a promising approach for interfacing with peripheral nerves. SIGNIFICANCE Findings demonstrate a high likelihood that observed electrophysiological activity recorded from implanted MARTEENIs originated from neural tissue. The variation in minifascicle size seen histologically suggests that amplitude distributions observed in functional MARTEENIs may be due to a combination of individual axon and mini-compound action potentials. This study provided an assessment of a functional MARTEENI in an in vivo animal model for the first time.
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Affiliation(s)
- Eric W Atkinson
- College of Medicine, University of Florida, 1064 Center Dr., New Engineering Building, Gainesville, 32611-7011, UNITED STATES
| | - Cary A Kuliasha
- Electrical and Computer Engineering, University of Florida, 968 Center Dr., New Engineering Building, Gainesville, Florida, 32611-7011, UNITED STATES
| | - Mary Kasper
- J. Crayton Pruitt Family Department of Biomedical Engineering, University of Florida, 1275 Center Drive, P.O. Box 116131, Gainesville, Florida, 32611-7011, UNITED STATES
| | - Abbas Furniturewalla
- Electrical and Computer Engineering, University of Florida, 968 Center Dr., New Engineering Building, Gainesville, Florida, 32611-7011, UNITED STATES
| | - Alexander S Lim
- J. Crayton Pruitt Family Department of Biomedical Engineering, University of Florida, 1275 Center Dr., P.O. Box 117200, Gainesville, Florida, 32611-7011, UNITED STATES
| | - Ladan Jiracek-Sapieha
- Electrical and Computer Engineering, University of Florida, 968 Center Dr., Gainesville, Florida, 32611-7011, UNITED STATES
| | - Alexis Brake
- J. Crayton Pruitt Family Department of Biomedical Engineering, University of Florida, 1064 Center Dr., New Engineering Building, Gainesville, 32611-7011, UNITED STATES
| | - Anne Gormaley
- J. Crayton Pruitt Family Department of Biomedical Engineering, University of Florida, 1064 Center Dr., New Engineering Building, Gainesville, 32611-7011, UNITED STATES
| | - Victor Rivera-Llabres
- Chemistry, University of Florida, P.O. Box 117200, Gainesville, Florida, 32611-7011, UNITED STATES
| | - Ishita Singh
- Chemical Engineering, University of Florida, 1030 Center Drive, Gainesville, Florida, 32611-7011, UNITED STATES
| | - Benjamin Spearman
- J. Crayton Pruitt Family Department of Biomedical Engineering, University of Florida, 1064 Center Dr., New Engineering Building, Gainesville, 32611-7011, UNITED STATES
| | - Carlos M Rinaldi-Ramos
- J. Crayton Pruitt Family Department of Biomedical Engineering, University of Florida, 1275 Center Dr, Gainesville, Florida, 32610, UNITED STATES
| | - Christine E Schmidt
- Biomedical Engineering Program, University of Florida, P.O. Box 116131, Gainesville , Florida, 32611, UNITED STATES
| | - Jack W Judy
- NIMET, University of Florida Herbert Wertheim College of Engineering, 1041 Center Dr, Gainesville, Florida, 32611-6550, UNITED STATES
| | - Kevin J Otto
- J. Crayton Pruitt Family Department of Biomedical Engineering, University of Florida, 1064 Center Dr., Gainesville, Florida, 32611-7011, UNITED STATES
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26
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Zamani M, Okreghe C, Demosthenous A. Efficient Approximation of Action Potentials with High-Order Shape Preservation in Unsupervised Spike Sorting. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2022; 2022:4884-4887. [PMID: 36086429 DOI: 10.1109/embc48229.2022.9871487] [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
This paper presents a novel approximation unit added to the conventional spike processing chain which provides an appreciable reduction of complexity of the high-hardware cost feature extractors. The use of the Taylor polynomial is proposed and modelled employing its cascaded derivatives to non-uniformly capture the essential samples in each spike for reliable feature extraction and sorting. Inclusion of the approximation unit can provide 3X compression (i.e. from 66 to 22 samples) to the spike waveforms while preserving their shapes. Detailed spike waveform sequences based on in-vivo measurements have been generated using a customized neural simulator for performance assessment of the approximation unit tested on six published feature extractors. For noise levels σN between 0.05 and 0.3 and groups of 3 spikes in each channel, all the feature extractors provide almost same sorting performance before and after approximation. The overall implementation cost when including the approximation unit and feature extraction shows a large reduction (i.e. up to 8.7X) in the hardware costly and more accurate feature extractors, offering a substantial improvement in feature extraction design.
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27
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Thomas WM, Leber M, Crew J, Warren DJ. Evaluation of Pneumatic Insertion Stability of Utah Slanted Electrode Arrays in Rat Sciatic Nerve. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2022; 2022:5099-5102. [PMID: 36086163 DOI: 10.1109/embc48229.2022.9871237] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
The Utah Electrode Array (UEA) and its variants (e.g., the Utah Slanted Electrode Array, or USEA) have been prominent contributors to advances in the field of neural engineering over the past decade. The most common means of inserting UEA and USEA devices into neural tissue is pneumatic insertion performed by an insertion wand and a pneumatic controller. As design changes from the well-established standards occur to better suit specialized surgical applications, it becomes essential to verify that the alterations do not compromise the structural integrity of the device during insertion. This paper characterizes and demonstrates the reliability of specialized USEAs and insertion wands designed for auditory nerve implants following pneumatic insertion into a rat sciatic nerve. The results show that proposed changes in the USEA form factor and pneumatic insertion ergonomics do not compromise implant stability and device structural viability.
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28
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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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29
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Ahkami B, Mastinu E, Earley EJ, Ortiz-Catalan M. Extra-neural signals from severed nerves enable intrinsic hand movements in transhumeral amputations. Sci Rep 2022; 12:10218. [PMID: 35715459 PMCID: PMC9206000 DOI: 10.1038/s41598-022-13363-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Accepted: 05/24/2022] [Indexed: 11/22/2022] Open
Abstract
Robotic prostheses controlled by myoelectric signals can restore limited but important hand function in individuals with upper limb amputation. The lack of individual finger control highlights the yet insurmountable gap to fully replacing a biological hand. Implanted electrodes around severed nerves have been used to elicit sensations perceived as arising from the missing limb, but using such extra-neural electrodes to record motor signals that allow for the decoding of phantom movements has remained elusive. Here, we showed the feasibility of using signals from non-penetrating neural electrodes to decode intrinsic hand and finger movements in individuals with above-elbow amputations. We found that information recorded with extra-neural electrodes alone was enough to decode phantom hand and individual finger movements, and as expected, the addition of myoelectric signals reduced classification errors both in offline and in real-time decoding.
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Affiliation(s)
- Bahareh Ahkami
- Center for Bionics and Pain Research, Mölndal, Sweden.,Department of Electrical Engineering, Chalmers University of Technology, Gothenburg, Sweden
| | - Enzo Mastinu
- Center for Bionics and Pain Research, Mölndal, Sweden.,Department of Electrical Engineering, Chalmers University of Technology, Gothenburg, Sweden
| | - Eric J Earley
- Center for Bionics and Pain Research, Mölndal, Sweden.,Department of Electrical Engineering, Chalmers University of Technology, Gothenburg, Sweden
| | - Max Ortiz-Catalan
- Center for Bionics and Pain Research, Mölndal, Sweden. .,Department of Electrical Engineering, Chalmers University of Technology, Gothenburg, Sweden. .,Operational Area 3, Sahlgrenska University Hospital, Mölndal, Sweden. .,Department of Orthopaedics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
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30
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Vu PP, Lu CW, Vaskov AK, Gates DH, Gillespie RB, Kemp SW, Patil PG, Chestek CA, Cederna PS, Kung TA. Restoration of Proprioceptive and Cutaneous Sensation Using Regenerative Peripheral Nerve Interfaces in Humans with Upper Limb Amputations. Plast Reconstr Surg 2022; 149:1149e-1154e. [PMID: 35404335 PMCID: PMC9133017 DOI: 10.1097/prs.0000000000009153] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
SUMMARY Without meaningful and intuitive sensory feedback, even the most advanced prosthetic limbs remain insensate and impose an enormous cognitive burden during use. The regenerative peripheral nerve interface can serve as a novel bidirectional motor and sensory neuroprosthetic interface. In previous human studies, regenerative peripheral nerve interfaces demonstrated stable high-amplitude motor electromyography signals with excellent signal-to-noise ratio for prosthetic control. In addition, they can treat and prevent postamputation pain by mitigating neuroma formation. In this study, the authors investigated whether electrical stimulation applied to regenerative peripheral nerve interfaces could produce appreciable proprioceptive and/or tactile sensations in two participants with upper limb amputations. Stimulation of the interfaces resulted in both participants reporting proprioceptive sensations in the phantom hand. Specifically, stimulation of participant 1's median nerve regenerative peripheral nerve interface activated a flexion sensation in the thumb or index finger, whereas stimulation of the ulnar nerve interface evoked a flexion sensation of the ring or small finger. Likewise, stimulation of one of participant 2's ulnar nerve interfaces produced a sensation of flexion at the ring finger distal interphalangeal joint. In addition, stimulation of participant 2's other ulnar nerve interface and the median nerve interface resulted in perceived cutaneous sensations that corresponded to each nerve's respective dermatome. These results suggest that regenerative peripheral nerve interfaces have the potential to restore proprioceptive and cutaneous sensory feedback that could significantly improve prosthesis use and embodiment.
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Affiliation(s)
- Philip P. Vu
- Department of Surgery, Section of Plastic Surgery, University of Michigan, Ann Arbor, MI, USA
| | - Charles W. Lu
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, USA
| | - Alex K. Vaskov
- Robotics Institute, University of Michigan, Ann Arbor, MI, USA
| | - Deanna H. Gates
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, USA
- Robotics Institute, University of Michigan, Ann Arbor, MI, USA
- School of Kinesiology, University of Michigan, Ann Arbor, MI, USA
| | - R. Brent Gillespie
- Department of Mechanical Engineering, University of Michigan, Ann Arbor, MI, USA
- Robotics Institute, University of Michigan, Ann Arbor, MI, USA
| | - Stephen W.P Kemp
- Department of Surgery, Section of Plastic Surgery, University of Michigan, Ann Arbor, MI, USA
| | - Parag G. Patil
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, USA
- Neuroscience Graduate Program, University of Michigan, Ann Arbor, MI, USA
- Department of Neurosurgery, University of Michigan, Ann Arbor, MI, USA
| | - Cynthia A. Chestek
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, USA
- Robotics Institute, University of Michigan, Ann Arbor, MI, USA
- Department of Electrical Engineering and Computer Science, University of Michigan, Ann Arbor, MI, USA
| | - Paul S. Cederna
- Department of Surgery, Section of Plastic Surgery, University of Michigan, Ann Arbor, MI, USA
| | - Theodore A. Kung
- Department of Surgery, Section of Plastic Surgery, University of Michigan, Ann Arbor, MI, USA
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31
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Preliminary Evaluation of the Effect of Mechanotactile Feedback Location on Myoelectric Prosthesis Performance Using a Sensorized Prosthetic Hand. SENSORS 2022; 22:s22103892. [PMID: 35632311 PMCID: PMC9145984 DOI: 10.3390/s22103892] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Revised: 05/13/2022] [Accepted: 05/16/2022] [Indexed: 02/01/2023]
Abstract
A commonly cited reason for the high abandonment rate of myoelectric prostheses is a lack of grip force sensory feedback. Researchers have attempted to restore grip force sensory feedback by stimulating the residual limb’s skin surface in response to the prosthetic hand’s measured grip force. Recent work has focused on restoring natural feedback to the missing digits directly through invasive surgical procedures. However, the functional benefit of utilizing somatotopically matching feedback has not been evaluated. In this paper, we propose an experimental protocol centered on a fragile object grasp and lift task using a sensorized myoelectric prosthesis to evaluate sensory feedback techniques. We formalized a suite of outcome measures related to task success, timing, and strategy. A pilot study (n = 3) evaluating the effect of utilizing a somatotopically accurate feedback stimulation location in able-bodied participants was conducted to evaluate the feasibility of the standardized platform, and to inform future studies on the role of feedback stimulation location in prosthesis use. Large between-participant effect sizes were observed in all outcome measures, indicating that the feedback location likely plays a role in myoelectric prosthesis performance. The success rate decreased, and task timing and task focus metrics increased, when using somatotopically-matched feedback compared to non-somatotopically-matched feedback. These results were used to conduct a power analysis, revealing that a sample size of n = 8 would be sufficient to achieve significance in all outcome measures.
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32
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Devecioğlu İ. Psychophysical Evaluation of Proprioceptive Feedback Through a Probe Sliding on the Forearm Skin of Healthy Humans. Ann Biomed Eng 2022; 50:991-1000. [PMID: 35581510 DOI: 10.1007/s10439-022-02978-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2022] [Accepted: 05/10/2022] [Indexed: 11/01/2022]
Abstract
We have tested the forearm skin of humans as a target organ to deliver proprioceptive feedback via a tactile sensory substitution method. In the proposed method, a contactor probe was actuated by a linear servo motor and moved on the skin in proximo-distal axis depending on the angle of a virtual joint moving on a 180° arc. Twenty healthy subjects were tested to stop the joint at a given target under no-feedback, visual feedback, and tactile (dorsal and volar) feedback conditions. The absolute difference between the target and the response angle was recorded. Tests were repeated 4 times with ~ 1-week intervals. Two joint movement speeds were tested. The subjects performed best with visual feedback, and worst if no feedback was provided. Their performances with tactile feedback were not as good as in the visual feedback condition, but better than in the no-feedback condition. Subjects equally performed with volar and dorsal tactile feedback. The movement speed had no significant effects on tactile feedback. The performance improved with training only in tactile feedback conditions. The proprioceptive information from a motorized prosthesis can be provided through probes moving on the forearm skin, while the efficacy of the feedback may improve with extensive training.
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Affiliation(s)
- İsmail Devecioğlu
- Biomedical Engineering Department, Tekirdağ Namık Kemal University, Silahtaraga Mh. Universite 1. Sk. No: 13, 59860, Çorlu, Tekirdag, Turkey.
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Touch, Texture and Haptic Feedback: A Review on How We Feel the World around Us. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12094686] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Touch is one most of the important aspects of human life. Nearly all interactions, when broken down, involve touch in one form or another. Recent advances in technology, particularly in the field of virtual reality, have led to increasing interest in the research of haptics. However, accurately capturing touch is still one of most difficult engineering challenges currently being faced. Recent advances in technology such as those found in microcontrollers which allow the creation of smaller sensors and feedback devices may provide the solution. Beyond capturing and measuring touch, replicating touch is also another unique challenge due to the complexity and sensitivity of the human skin. The development of flexible, soft-wearable devices, however, has allowed for the creating of feedback systems that conform to the human form factor with minimal loss of accuracy, thus presenting possible solutions and opportunities. Thus, in this review, the researchers aim to showcase the technologies currently being used in haptic feedback, and their strengths and limitations.
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Amin KR, Fildes JE. Bionic Prostheses: The Emerging Alternative to Vascularised Composite Allotransplantation of the Limb. Front Surg 2022; 9:873507. [PMID: 35599802 PMCID: PMC9122218 DOI: 10.3389/fsurg.2022.873507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Accepted: 04/19/2022] [Indexed: 11/15/2022] Open
Abstract
Twenty years have surpassed since the first vascularised composite allotransplantation (VCA) of the upper limb. This is an opportunity to reflect on the position of VCA as the gold standard in limb reconstruction. The paucity of recipients, tentative clinical outcomes, and insufficient scientific progress question whether VCA will remain a viable treatment option for the growing numbers of amputees. Bionic technology is advancing at a rapid pace. The prospect of widely available, affordable, safely applied prostheses with long-standing functional benefit is appealing. Progress in the field stems from the contributions made by engineering, electronic, computing and material science research groups. This review will address the ongoing reservations surrounding VCA whilst acknowledging the future impact of bionic technology as a realistic alternative for limb reconstruction.
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Affiliation(s)
- Kavit R. Amin
- Blond McIndoe Laboratories, Division of Cell Matrix Biology and Regenerative Medicine, School of Biological Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester Academic Health Science Centre, Manchester, United Kingdom
- Department of Plastic Surgery & Burns, Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester, United Kingdom
- Correspondence: Kavit R. Amin ;
| | - James E. Fildes
- The Ex-Vivo Research Centre CIC, Alderley Park, Macclesfield, United Kingdom
- The Healthcare Technologies Institute, School of Chemical Engineering, University of Birmingham, Birmingham, United Kingdom
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Castellini C. Peripheral Nervous System Interfaces: Invasive or Non-invasive? Front Neurorobot 2022; 16:846866. [PMID: 35574233 PMCID: PMC9099407 DOI: 10.3389/fnbot.2022.846866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Accepted: 03/25/2022] [Indexed: 11/13/2022] Open
Affiliation(s)
- Claudio Castellini
- Chair of Medical Robotics, Friedrich-Alexander Universität Erlangen-Nürnberg, Erlangen, Germany
- The Adaptive Bio-Interfaces Group, German Aerospace Center (DLR), Institute of Robotics and Mechatronics, Oberpfaffenhofen, Germany
- *Correspondence: Claudio Castellini
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Luu DK, Nguyen AT, Jiang M, Drealan MW, Xu J, Wu T, Tam WK, Zhao W, Lim BZH, Overstreet CK, Zhao Q, Cheng J, Keefer EW, Yang Z. Artificial Intelligence Enables Real-Time and Intuitive Control of Prostheses via Nerve Interface. IEEE Trans Biomed Eng 2022; 69:3051-3063. [PMID: 35302937 DOI: 10.1109/tbme.2022.3160618] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
OBJECTIVE The next generation prosthetic hand that moves and feels like a real hand requires a robust neural interconnection between the human minds and machines. METHODS Here we present a neuroprosthetic system to demonstrate that principle by employing an artificial intelligence (AI) agent to translate the amputees movement intent through a peripheral nerve interface. The AI agent is designed based on the recurrent neural network (RNN) and could simultaneously decode six degree-of-freedom (DOF) from multichannel nerve data in real-time. The decoder's performance is characterized in motor decoding experiments with three human amputees. RESULTS First, we show the AI agent enables amputees to intuitively control a prosthetic hand with individual finger and wrist movements up to 97-98% accuracy. Second, we demonstrate the AI agent's real-time performance by measuring the reaction time and information throughput in a hand gesture matching task. Third, we investigate the AI agent's long-term uses and show the decoder's robust predictive performance over a 16-month implant duration. Conclusion & significance: Our study demonstrates the potential of AI-enabled nerve technology, underling the next generation of dexterous and intuitive prosthetic hands.
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Jabban L, Dupan S, Zhang D, Ainsworth B, Nazarpour K, Metcalfe BW. Sensory Feedback for Upper-Limb Prostheses: Opportunities and Barriers. IEEE Trans Neural Syst Rehabil Eng 2022; 30:738-747. [PMID: 35290188 DOI: 10.1109/tnsre.2022.3159186] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
The addition of sensory feedback to upper-limb prostheses has been shown to improve control, increase embodiment, and reduce phantom limb pain. However, most commercial prostheses do not incorporate sensory feedback due to several factors. This paper focuses on the major challenges of a lack of deep understanding of user needs, the unavailability of tailored, realistic outcome measures and the segregation between research on control and sensory feedback. The use of methods such as the Person-Based Approach and co-creation can improve the design and testing process. Stronger collaboration between researchers can integrate different prostheses research areas to accelerate the translation process.
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Graczyk EL, Christie BP, He Q, Tyler DJ, Bensmaia SJ. Frequency Shapes the Quality of Tactile Percepts Evoked through Electrical Stimulation of the Nerves. J Neurosci 2022; 42:2052-2064. [PMID: 35074865 PMCID: PMC8916769 DOI: 10.1523/jneurosci.1494-21.2021] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 09/29/2021] [Accepted: 11/22/2021] [Indexed: 11/21/2022] Open
Abstract
Electrical stimulation of the peripheral nerves of human participants provides a unique opportunity to study the neural determinants of perceptual quality using a causal manipulation. A major challenge in the study of neural coding of touch has been to isolate the role of spike timing-at the scale of milliseconds or tens of milliseconds-in shaping the sensory experience. In the present study, we address this question by systematically varying the pulse frequency (PF) of electrical stimulation pulse trains delivered to the peripheral nerves of seven participants with upper and lower extremity limb loss via chronically implanted neural interfaces. We find that increases in PF lead to systematic increases in perceived frequency, up to ∼50 Hz, at which point further changes in PF have little to no impact on sensory quality. Above this transition frequency, ratings of perceived frequency level off, the ability to discriminate changes in PF is abolished, and verbal descriptors selected to characterize the sensation change abruptly. We conclude that sensation quality is shaped by temporal patterns of neural activation, even if these patterns are imposed on a fixed neural population, but this temporal patterning can only be resolved up to ∼50 Hz. These findings highlight the importance of spike timing in shaping the quality of a sensation and will contribute to the development of encoding strategies for conveying touch feedback through bionic hands and feet.SIGNIFICANCE STATEMENT A major challenge in the study of neural coding of touch has been to understand how temporal patterns in neuronal responses shape the sensory experience. We address this question by varying the pulse frequency (PF) of electrical pulse trains delivered through implanted nerve interfaces in seven amputees. We concomitantly vary pulse width to separate the effect of changing PF on sensory quality from its effect on perceived magnitude. We find that increases in PF lead to increases in perceived frequency, a qualitative dimension, up to ∼50 Hz, beyond which changes in PF have little impact on quality. We conclude that temporal patterning in the neuronal response can shape quality and discuss the implications for restoring touch via neural interfaces.
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Affiliation(s)
- Emily L Graczyk
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, Ohio 44106
- Louis Stokes Cleveland Department of Veterans Affairs Medical Center, Cleveland, Ohio 44106
| | - Breanne P Christie
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, Ohio 44106
- Research and Exploratory Development Department, Johns Hopkins University Applied Physics Laboratory, Laurel, Maryland 20723
| | - Qinpu He
- Committee on Computational Neuroscience, University of Chicago, Chicago, Illinois 60637
| | - Dustin J Tyler
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, Ohio 44106
- Louis Stokes Cleveland Department of Veterans Affairs Medical Center, Cleveland, Ohio 44106
| | - Sliman J Bensmaia
- Committee on Computational Neuroscience, University of Chicago, Chicago, Illinois 60637
- Department of Organismal Biology and Anatomy, University of Chicago, Chicago, Illinois 60637
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Mablekos-Alexiou A, Kontogiannopoulos S, Bertos GA, Papadopoulos E. A biomechatronics-based EPP topology for upper-limb prosthesis control: Modeling & benchtop prototype. Biomed Signal Process Control 2022. [DOI: 10.1016/j.bspc.2021.103454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
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40
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Isagulyan ED, Mikhailova VA, Aslakhanova KS, Slavin KV. Prospects of neuromodulation for chronic pain. BRAIN DISORDERS 2022. [DOI: 10.1016/j.dscb.2021.100027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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41
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A Custom Interface for the Joint Operation of Med Associates and Tucker-Davis Technologies Hardware in a Rodent Behavioral Model. J Neurosci Methods 2022; 371:109528. [PMID: 35182605 DOI: 10.1016/j.jneumeth.2022.109528] [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: 10/18/2021] [Revised: 01/28/2022] [Accepted: 02/14/2022] [Indexed: 11/20/2022]
Abstract
BACKGROUND Rodent behavioral models with an electrophysiological component may require the joint operation of hardware from Med Associates, Inc. (St. Albans, VT) and Tucker-Davis Technologies (TDT; Alachua, FL). Although these manufacturers do produce supplemental hardware for interfacing with each other, investing in such hardware may be untenable for research groups with limited funds who wish to use equipment already in their possession. NEW METHOD We designed a printed circuit board (PCB) in KiCad and had it fabricated by Advanced Circuits (Aurora, CO), with components sourced from Digi-Key (Thief River Falls, MN). The PCB provided 8 channels of bidirectional communication for the transmission of signals between Med Asssociates' SG-716B SmartCtrl connection panel and TDT's RZ5D base station. This setup enabled the coordinated operation of programs running separately on each set of hardware. RESULTS The custom-built PCB facilitated the joint operation of Med Associates and TDT hardware in a go/no-go detection task involving rats with electrical implants in their sciatic nerves. COMPARISON WITH EXISTING METHODS Conventional methods for interfacing Med Associates and Tucker-Davis Technologies rely on the purchase of pre-built hardware whose costs can add up to thousands of dollars. The present method offers a viable alternative that is easily implemented and considerably less expensive (below $200). CONCLUSION The present approach provides an inexpensive yet effective alternative to far more costly interfacing solutions offered by Med Associates and Tucker-Davis Technologies.
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Huggins JE, Krusienski D, Vansteensel MJ, Valeriani D, Thelen A, Stavisky S, Norton JJS, Nijholt A, Müller-Putz G, Kosmyna N, Korczowski L, Kapeller C, Herff C, Halder S, Guger C, Grosse-Wentrup M, Gaunt R, Dusang AN, Clisson P, Chavarriaga R, Anderson CW, Allison BZ, Aksenova T, Aarnoutse E. Workshops of the Eighth International Brain-Computer Interface Meeting: BCIs: The Next Frontier. BRAIN-COMPUTER INTERFACES 2022; 9:69-101. [PMID: 36908334 PMCID: PMC9997957 DOI: 10.1080/2326263x.2021.2009654] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Accepted: 11/15/2021] [Indexed: 12/11/2022]
Abstract
The Eighth International Brain-Computer Interface (BCI) Meeting was held June 7-9th, 2021 in a virtual format. The conference continued the BCI Meeting series' interactive nature with 21 workshops covering topics in BCI (also called brain-machine interface) research. As in the past, workshops covered the breadth of topics in BCI. Some workshops provided detailed examinations of specific methods, hardware, or processes. Others focused on specific BCI applications or user groups. Several workshops continued consensus building efforts designed to create BCI standards and increase the ease of comparisons between studies and the potential for meta-analysis and large multi-site clinical trials. Ethical and translational considerations were both the primary topic for some workshops or an important secondary consideration for others. The range of BCI applications continues to expand, with more workshops focusing on approaches that can extend beyond the needs of those with physical impairments. This paper summarizes each workshop, provides background information and references for further study, presents an overview of the discussion topics, and describes the conclusion, challenges, or initiatives that resulted from the interactions and discussion at the workshop.
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Affiliation(s)
- Jane E Huggins
- Department of Physical Medicine and Rehabilitation, Department of Biomedical Engineering, Neuroscience Graduate Program, University of Michigan, Ann Arbor, Michigan, United States 325 East Eisenhower, Room 3017; Ann Arbor, Michigan 48108-5744, 734-936-7177
| | - Dean Krusienski
- Department of Biomedical Engineering, Virginia Commonwealth University, Richmond, VA 23219
| | - Mariska J Vansteensel
- UMC Utrecht Brain Center, Dept of Neurosurgery, University Medical Center Utrecht, The Netherlands
| | | | - Antonia Thelen
- eemagine Medical Imaging Solutions GmbH, Berlin, Germany
| | | | - James J S Norton
- National Center for Adaptive Neurotechnologies, US Department of Veterans Affairs, 113 Holland Ave, Albany, NY 12208
| | - Anton Nijholt
- Faculty EEMCS, University of Twente, Enschede, The Netherlands
| | - Gernot Müller-Putz
- Institute of Neural Engineering, GrazBCI Lab, Graz University of Technology, Stremayrgasse 16/4, 8010 Graz, Austria
| | - Nataliya Kosmyna
- Massachusetts Institute of Technology (MIT), Media Lab, E14-548, Cambridge, MA 02139, Unites States
| | | | | | - Christian Herff
- School of Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | | | - Christoph Guger
- g.tec medical engineering GmbH/Guger Technologies OG, Austria, Sierningstrasse 14, 4521 Schiedlberg, Austria, +43725122240-0
| | - Moritz Grosse-Wentrup
- Research Group Neuroinformatics, Faculty of Computer Science, Vienna Cognitive Science Hub, Data Science @ Uni Vienna University of Vienna
| | - Robert Gaunt
- Rehab Neural Engineering Labs, Department of Physical Medicine and Rehabilitation, Center for the Neural Basis of Cognition, University of Pittsburgh, Pittsburgh, PA, USA, 3520 5th Ave, Suite 300, Pittsburgh, PA 15213, 412-383-1426
| | - Aliceson Nicole Dusang
- Department of Electrical and Computer Engineering, School of Engineering, Brown University, Carney Institute for Brain Science, Brown University, Providence, RI
- Department of Veterans Affairs Medical Center, Center for Neurorestoration and Neurotechnology, Rehabilitation R&D Service, Providence, RI
- Center for Neurotechnology and Neurorecovery, Neurology, Massachusetts General Hospital, Boston, MA
| | | | - Ricardo Chavarriaga
- IEEE Standards Association Industry Connections group on neurotechnologies for brain-machine interface, Center for Artificial Intelligence, School of Engineering, ZHAW-Zurich University of Applied Sciences, Switzerland, Switzerland
| | - Charles W Anderson
- Department of Computer Science, Molecular, Cellular and Integrative Neurosience Program, Colorado State University, Fort Collins, CO 80523
| | - Brendan Z Allison
- Dept. of Cognitive Science, Mail Code 0515, University of California at San Diego, La Jolla, United States, 619-534-9754
| | - Tetiana Aksenova
- University Grenoble Alpes, CEA, LETI, Clinatec, Grenoble 38000, France
| | - Erik Aarnoutse
- UMC Utrecht Brain Center, Department of Neurology & Neurosurgery, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands
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Pasluosta C, Kiele P, Čvančara P, Micera S, Aszmann OC, Stieglitz T. Bidirectional bionic limbs: a perspective bridging technology and physiology. J Neural Eng 2022; 19. [PMID: 35132954 DOI: 10.1088/1741-2552/ac4bff] [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: 07/12/2021] [Accepted: 01/17/2022] [Indexed: 11/11/2022]
Abstract
Precise control of bionic limbs relies on robust decoding of motor commands from nerves or muscles signals and sensory feedback from artificial limbs to the nervous system by interfacing the afferent nerve pathways. Implantable devices for bidirectional communication with bionic limbs have been developed in parallel with research on physiological alterations caused by an amputation. In this perspective article, we question whether increasing our effort on bridging these technologies with a deeper understanding of amputation pathophysiology and human motor control may help to overcome pressing stalls in the next generation of bionic limbs.
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Affiliation(s)
- C Pasluosta
- Laboratory for Biomedical Microtechnology, Department of Microsystems Engineering, University of Freiburg, Freiburg, Germany
| | - P Kiele
- Laboratory for Biomedical Microtechnology, Department of Microsystems Engineering, University of Freiburg, Freiburg, Germany
| | - P Čvančara
- Laboratory for Biomedical Microtechnology, Department of Microsystems Engineering, University of Freiburg, Freiburg, Germany.,BrainLinks-BrainTools, University of Freiburg, Freiburg, Germany
| | - S Micera
- School of Engineering, École Polytechnique Fédérale de Lausanne, Bertarelli Foundation Chair in Translational Neuroengineering, Centre for Neuroprosthetics and Institute of Bioengineering, Lausanne, Switzerland.,The BioRobotics Institute and Department of Excellence in Robotics and Artificial Intelligence, Scuola Superiore Sant'Anna, Pisa, Italy
| | - O C Aszmann
- Clinical Laboratory for Bionic Extremity Reconstruction, Medical University of Vienna; Division of Plastic and Reconstructive Surgery, Department of Surgery, Medical University of Vienna, Vienna, Austria
| | - T Stieglitz
- Laboratory for Biomedical Microtechnology, Department of Microsystems Engineering, University of Freiburg, Freiburg, Germany.,Bernstein Center Freiburg, University of Freiburg, Freiburg, Germany.,BrainLinks-BrainTools, University of Freiburg, Freiburg, Germany
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44
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Valle G, Iberite F, Strauss I, D'Anna E, Granata G, Di Iorio R, Stieglitz T, Raspopovic S, Petrini FM, Rossini PM, Micera S. A Psychometric Platform to Collect Somatosensory Sensations for Neuroprosthetic Use. FRONTIERS IN MEDICAL TECHNOLOGY 2022; 3:619280. [PMID: 35047903 PMCID: PMC8757828 DOI: 10.3389/fmedt.2021.619280] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Accepted: 02/08/2021] [Indexed: 11/13/2022] Open
Abstract
Somatosensory neuroprostheses exploit invasive and non-invasive feedback technologies to restore sensorimotor functions lost to disease or trauma. These devices use electrical stimulation to communicate sensory information to the brain. A sensation characterization procedure is thus necessary to determine the appropriate stimulation parameters and to establish a clear personalized map of the sensations that can be restored. Several questionnaires have been described in the literature to collect the quality, type, location, and intensity of the evoked sensations, but there is still no standard psychometric platform. Here, we propose a new psychometric system containing previously validated questionnaires on evoked sensations, which can be applied to any kind of somatosensory neuroprosthesis. The platform collects stimulation parameters used to elicit sensations and records subjects' percepts in terms of sensation location, type, quality, perceptual threshold, and intensity. It further collects data using standardized assessment questionnaires and scales, performs measurements over time, and collects phantom limb pain syndrome data. The psychometric platform is user-friendly and provides clinicians with all the information needed to assess the sensory feedback. The psychometric platform was validated with three trans-radial amputees. The platform was used to assess intraneural sensory feedback provided through implanted peripheral nerve interfaces. The proposed platform could act as a new standardized assessment toolbox to homogenize the reporting of results obtained with different technologies in the field of somatosensory neuroprosthetics.
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Affiliation(s)
- Giacomo Valle
- The BioRobotics Institute, Scuola Superiore Sant'Anna, Pisa, Italy.,Department of Health Sciences and Technology, Institute for Robotics and Intelligent Systems, ETH Zürich, Zurich, Switzerland
| | | | - Ivo Strauss
- The BioRobotics Institute, Scuola Superiore Sant'Anna, Pisa, Italy
| | - Edoardo D'Anna
- Bertarelli Foundation Chair in Translational Neuroengineering, Centre for Neuroprosthetics, School of Engineering, École Polytechnique Fédérale de Lausanne (EPFL), Institute of Bioengineering, Lausanne, Switzerland
| | - Giuseppe Granata
- Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS)-Policlinic A. Gemelli Foundation, Institute of Neurology, Catholic University of the Sacred Heart, Rome, Italy
| | - Riccardo Di Iorio
- Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS)-Policlinic A. Gemelli Foundation, Institute of Neurology, Catholic University of the Sacred Heart, Rome, Italy
| | - Thomas Stieglitz
- Laboratory for Biomedical Microtechnology, Department of Microsystems Engineering-IMTEK, Bernstein Center, BrainLinks-BrainTools Cluster of Excellence, University of Freiburg, Freiburg, Germany
| | - Stanisa Raspopovic
- Department of Health Sciences and Technology, Institute for Robotics and Intelligent Systems, ETH Zürich, Zurich, Switzerland
| | - Francesco M Petrini
- Department of Health Sciences and Technology, Institute for Robotics and Intelligent Systems, ETH Zürich, Zurich, Switzerland
| | - Paolo M Rossini
- Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS)-Policlinic A. Gemelli Foundation, Institute of Neurology, Catholic University of the Sacred Heart, Rome, Italy
| | - Silvestro Micera
- The BioRobotics Institute, Scuola Superiore Sant'Anna, Pisa, Italy.,Bertarelli Foundation Chair in Translational Neuroengineering, Centre for Neuroprosthetics, School of Engineering, École Polytechnique Fédérale de Lausanne (EPFL), Institute of Bioengineering, Lausanne, Switzerland
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45
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Objective neuromodulation basis for intrafascicular artificial somatosensation through carbon nanotube yarn electrodes. J Neurosci Methods 2022; 369:109481. [PMID: 35032498 DOI: 10.1016/j.jneumeth.2022.109481] [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: 08/17/2021] [Revised: 12/13/2021] [Accepted: 01/10/2022] [Indexed: 11/20/2022]
Abstract
BACKGROUND Intrafascicular electrical stimulation has been extensively adopted to achieve sensory feedback for limb amputees. Axon-like carbon nanotube yarn (CNTy) electrodes with both promising flexibility and spatial selectivity index (SSI) can be fascinating alternatives to generate artificial somatosensation. NEW METHOD Here we systematically disclose objective neuromodulation basis for artificial somatosensation through intrafascicular CNTy electrodes. CNTy electrodes with different exposed lengths were utilized for electrically stimulating tibial nerves in twelve rats. Somatosensory evoked potentials (SEPs) were recorded synchronously using an epidural thirty-channel electrode array. Spatiotemporal characteristics of SEPs were analyzed as current pulse amplitude (PA), pulse width (PW) and pulse frequency (PF) varied. RESULTS The current thresholds at 1Hz exhibit the lowest means when compared with those at 4 and 8Hz for most CNTy electrodes (20/28). For all the electrodes, amplitudes of SEPs and activated areas of perceptive fields increase with PWs and PAs rising, and decrease remarkably with PFs from 1 to 8Hz. Latencies of P1 and N1 of SEP peaks gradually reduced with PWs and PAs advancing. Considering high SSIs, relatively stable current thresholds, wider variation ranges of sensory magnitudes and optimal stability of perceptive fields, the L-200 μm electrodes are preferable for neuromodulation with PFs of 1 - 8Hz, PWs of 100 - 800 μs and PAs of 2 - 64 μA. COMPARISON WITH EXISTING METHODS New-type CNTy electrodes possess both promising flexibility and SSI when compared with other neural interfaces. We systematically explore objective neuromodulation basis for artificial somatosensation through CNTy electrodes for the first time. CONCLUSIONS Significantly higher SSIs, lower current and charge thresholds exist for CNTy electrodes in comparison with other peripheral-nerve interfaces. This study can, for the first time, lay a solid neuromodulation foundation for CNTy electrodes to achieve fine sensory feedback.
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Rekant J, Fisher LE, Boninger M, Gaunt RA, Collinger JL. Amputee, clinician, and regulator perspectives on current and prospective upper extremity prosthetic technologies. Assist Technol 2022:1-13. [PMID: 34982647 DOI: 10.1080/10400435.2021.2020935] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
Existing prosthetic technologies for people with upper limb amputation are being adopted at moderate rates. Once fitted for these devices, many upper limb amputees report not using them regularly or at all. The primary aim of this study was to solicit feedback about prosthetic technology and important device design criteria from amputees, clinicians, and device regulators. We compare these perspectives to identify common or divergent priorities. Twenty-one adults with upper limb loss, 35 clinicians, and 3 regulators completed a survey on existing prosthetic technologies and a conceptual sensorimotor prosthesis driven by implanted myoelectric electrodes with sensory feedback via spinal root stimulation. The survey included questions from the Trinity Amputation and Prosthesis Experience Scale, the Disabilities of the Arm, Shoulder, and Hand, and novel questions about technology acceptance and neuroprosthetic design. User and clinician ratings of satisfaction with existing devices were similar. Amputees were most accepting of the proposed sensorimotor prosthesis (75.5% vs clinicians(68.8%), regulators(67.8%)). Stakeholders valued user-centered outcomes like individualized task goals, improved quality of life, device reliability, and user safety; regulators emphasized these last two. The results of this study provide insight into amputee, clinician, and regulator priorities to inform future upper-limb prosthetic design and clinical trial protocol development.
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Affiliation(s)
- Julie Rekant
- Rehab Neural Engineering Labs, University of Pittsburgh, Pittsburgh, PA, USA.,Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, USA
| | - Lee E Fisher
- Rehab Neural Engineering Labs, University of Pittsburgh, Pittsburgh, PA, USA.,Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, USA.,Department of Physical Medicine and Rehabilitation, University of Pittsburgh, Pittsburgh, PA, USA.,Center for Neural Basis of Cognition, Pittsburgh, PA, USA
| | - Michael Boninger
- Rehab Neural Engineering Labs, University of Pittsburgh, Pittsburgh, PA, USA.,Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, USA.,Department of Physical Medicine and Rehabilitation, University of Pittsburgh, Pittsburgh, PA, USA.,Human Engineering Research Labs, VA Center of Excellence, Department of Veteran Affairs, Pittsburgh, PA, USA
| | - Robert A Gaunt
- Rehab Neural Engineering Labs, University of Pittsburgh, Pittsburgh, PA, USA.,Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, USA.,Department of Physical Medicine and Rehabilitation, University of Pittsburgh, Pittsburgh, PA, USA.,Center for Neural Basis of Cognition, Pittsburgh, PA, USA
| | - Jennifer L Collinger
- Rehab Neural Engineering Labs, University of Pittsburgh, Pittsburgh, PA, USA.,Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, USA.,Department of Physical Medicine and Rehabilitation, University of Pittsburgh, Pittsburgh, PA, USA.,Center for Neural Basis of Cognition, Pittsburgh, PA, USA.,Human Engineering Research Labs, VA Center of Excellence, Department of Veteran Affairs, Pittsburgh, PA, USA
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47
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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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Arauz PG, Chiriboga P, García MG, Kao I, Díaz EA. New technologies applied to canine limb prostheses: A review. Vet World 2021; 14:2793-2802. [PMID: 34903941 PMCID: PMC8654758 DOI: 10.14202/vetworld.2021.2793-2802] [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: 07/14/2021] [Accepted: 09/30/2021] [Indexed: 11/16/2022] Open
Abstract
Although only a few studies have investigated about the development of animal prosthesis, currently, there is an increasing interest in canine limb prosthesis design and its clinical application since they offer an alternative to killing the animal in extreme situations where amputating the limb is the only option. Restoring normal function of amputated canine limbs with the use of a prosthesis is challenging. However, recent advances in surgical procedures and prosthesis design technology appear promising in developing devices that closely recreate normal canine limb function. Surgical advances such as evolution of osseointegration (bone-anchored) prostheses present great promise. Likewise, modern computer-aided design and manufacturing technology, as well as novel motion analysis systems are now providing improved prosthesis designs. Advances in patient-customized prostheses have the potential to reduce the risk of implant failure. The objective of this investigation is to present a general review of the existing literature on modern surgical approaches, design and manufacturing methods, as well as biomechanical analyses so that veterinarians can make more and better-informed decisions on the development and selection of proper canine limb prosthesis. Isolated research efforts have made possible an improvement in stability, comfort, and performance of canine limb prosthesis. However, continued multidisciplinary research collaboration and teamwork among veterinarians, engineers, designers, and industry, with supporting scientific evidence, is required to better understand the development of canine limb prosthesis designs that closely replicate the normal limb function.
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Affiliation(s)
- Paul G Arauz
- Department of Mechanical Engineering, Universidad San Francisco de Quito, Quito, Ecuador
| | - Patricio Chiriboga
- Department of Mechanical Engineering, Universidad San Francisco de Quito, Quito, Ecuador
| | - María-Gabriela García
- Department of Industrial Engineering, Universidad San Francisco de Quito, Quito, Ecuador
| | - Imin Kao
- Department of Mechanical Engineering, Stony Brook University, Stony Brook, United States
| | - Eduardo A Díaz
- Department of Veterinary Medicine, Universidad San Francisco de Quito, Quito, Ecuador
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Chandra NS, McCarron WM, Yan Y, Ruiz LC, Sallinger EG, Birenbaum NK, Burton H, Green L, Moran DW, Ray WZ, MacEwan MR. Sensory Percepts Elicited by Chronic Macro-Sieve Electrode Stimulation of the Rat Sciatic Nerve. Front Neurosci 2021; 15:758427. [PMID: 34690689 PMCID: PMC8530229 DOI: 10.3389/fnins.2021.758427] [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: 08/13/2021] [Accepted: 09/17/2021] [Indexed: 11/30/2022] Open
Abstract
Objective: Intuitive control of conventional prostheses is hampered by their inability to provide the real-time tactile and proprioceptive feedback of natural sensory pathways. The macro-sieve electrode (MSE) is a candidate interface to amputees’ truncated peripheral nerves for introducing sensory feedback from external sensors to facilitate prosthetic control. Its unique geometry enables selective control of the complete nerve cross-section by current steering. Unlike previously studied interfaces that target intact nerve, the MSE’s implantation requires transection and subsequent regeneration of the target nerve. Therefore, a key determinant of the MSE’s suitability for this task is whether it can elicit sensory percepts at low current levels in the face of altered morphology and caliber distribution inherent to axon regeneration. The present in vivo study describes a combined rat sciatic nerve and behavioral model developed to answer this question. Approach: Rats learned a go/no-go detection task using auditory stimuli and then underwent surgery to implant the MSE in the sciatic nerve. After healing, they were trained with monopolar electrical stimuli with one multi-channel and eight single-channel stimulus configurations. Psychometric curves derived by the method of constant stimuli (MCS) were used to calculate 50% detection thresholds and associated psychometric slopes. Thresholds and slopes were calculated at two time points 3 weeks apart. Main Results: For the multi-channel stimulus configuration, the average current required for stimulus detection was 19.37 μA (3.87 nC) per channel. Single-channel thresholds for leads located near the nerve’s center were, on average, half those of leads located near the periphery (54.92 μA vs. 110.71 μA, or 10.98 nC vs. 22.14 nC). Longitudinally, 3 of 5 leads’ thresholds decreased or remained stable over the 3-week span. The remaining two leads’ thresholds increased by 70–74%, possibly due to scarring or device failure. Significance: This work represents an important first step in establishing the MSE’s viability as a sensory feedback interface. It further lays the groundwork for future experiments that will extend this model to the study of other devices, stimulus parameters, and task paradigms.
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Affiliation(s)
- Nikhil S Chandra
- Department of Biomedical Engineering, Washington University in St. Louis, St. Louis, MO, United States
| | - Weston M McCarron
- Department of Neurosurgery, Washington University School of Medicine in St. Louis, St. Louis, MO, United States
| | - Ying Yan
- Department of Neurosurgery, Washington University School of Medicine in St. Louis, St. Louis, MO, United States
| | - Luis C Ruiz
- Department of Biomedical Engineering, Washington University in St. Louis, St. Louis, MO, United States
| | - Eric G Sallinger
- Department of Biology, Washington University in St. Louis, St. Louis, MO, United States
| | - Nathan K Birenbaum
- Department of Biomedical Engineering, Washington University in St. Louis, St. Louis, MO, United States
| | - Harold Burton
- Department of Neuroscience, Washington University School of Medicine in St. Louis, St. Louis, MO, United States
| | - Leonard Green
- Department of Psychological & Brain Sciences, Washington University in St. Louis, St. Louis, MO, United States
| | - Daniel W Moran
- Department of Biomedical Engineering, Washington University in St. Louis, St. Louis, MO, United States
| | - Wilson Z Ray
- Department of Neurosurgery, Washington University School of Medicine in St. Louis, St. Louis, MO, United States
| | - Matthew R MacEwan
- Department of Neurosurgery, Washington University School of Medicine in St. Louis, St. Louis, MO, United States
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50
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Kubiak CA, Svientek SR, Dehdashtian A, Lawera NG, Nadarajan V, Bratley JV, Kung TA, Cederna PS, Kemp SWP. Physiologic signaling and viability of the muscle cuff regenerative peripheral nerve interface (MC-RPNI) for intact peripheral nerves. J Neural Eng 2021; 18. [PMID: 34359056 DOI: 10.1088/1741-2552/ac1b6b] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Accepted: 08/06/2021] [Indexed: 11/11/2022]
Abstract
Background. Robotic exoskeleton devices have become a promising modality for restoration of extremity function in individuals with limb loss or functional weakness. However, there exists no consistent or reliable way to record efferent motor action potentials from intact peripheral nerves to control device movement. Peripheral nerve motor action potentials are similar in amplitude to that of background noise, producing an unfavorable signal-to-noise ratio (SNR) that makes these signals difficult to detect and interpret. To address this issue, we have developed the muscle cuff regenerative peripheral nerve interface (MC-RPNI), a construct consisting of a free skeletal muscle graft wrapped circumferentially around an intact peripheral nerve. Over time, the muscle graft regenerates, and the intact nerve undergoes collateral axonal sprouting to reinnervate the muscle. The MC-RPNI amplifies efferent motor action potentials by several magnitudes, thereby increasing the SNR, allowing for higher fidelity signaling and detection of motor intention. The goal of this study was to characterize the signaling capabilities and viability of the MC-RPNI over time.Methods. Thirty-seven rats were randomly assigned to one of five experimental groups (Groups A-E). For MC-RPNI animals, their contralateral extensor digitorum longus (EDL) muscle was harvested and trimmed to either 8 mm (Group A) or 13 mm (Group B) in length, wrapped circumferentially around the intact ipsilateral common peroneal (CP) nerve, secured, and allowed to heal for 3 months. Additionally, one 8 mm (Group C) and one 13 mm (Group D) length group had an epineurial window created in the CP nerve immediately preceding MC-RPNI creation. Group E consisted of sham surgery animals. At 3 months, electrophysiologic analyses were conducted to determine the signaling capabilities of the MC-RPNI. Additionally, electromyography and isometric force analyses were performed on the CP-innervated EDL to determine the effects of the MC-RPNI on end organ function. Following evaluation, the CP nerve, MC-RPNI, and ipsilateral EDL muscle were harvested for histomorphometric analysis.Results. Study endpoint analysis was performed at 3 months post-surgery. All rats displayed visible muscle contractions in both the MC-RPNI and EDL following proximal CP nerve stimulation. Compound muscle action potentials were recorded from the MC-RPNI following proximal CP nerve stimulation and ranged from 3.67 ± 0.58 mV to 6.04 ± 1.01 mV, providing efferent motor action potential amplification of 10-20 times that of a normal physiologic nerve action potential. Maximum tetanic isometric force (Fo) testing of the distally-innervated EDL muscle in MC-RPNI groups producedFo(2341 ± 114 mN-2832 ± 102 mN) similar to controls (2497 ± 122 mN), thus demonstrating that creation of MC-RPNIs did not adversely impact the function of the distally-innervated EDL muscle. Overall, comparison between all MC-RPNI sub-groups did not reveal any statistically significant differences in signaling capabilities or negative effects on distal-innervated muscle function as compared to the control group.Conclusions. MC-RPNIs have the capability to provide efferent motor action potential amplification from intact nerves without adversely impacting distal muscle function. Neither the size of the muscle graft nor the presence of an epineurial window in the nerve had any significant impact on the ability of the MC-RPNI to amplify efferent motor action potentials from intact nerves. These results support the potential for the MC-RPNI to serve as a biologic nerve interface to control advanced exoskeleton devices.
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Affiliation(s)
- Carrie A Kubiak
- Department of Surgery, Section of Plastic Surgery, The University of Michigan Health System, 1150 W Medical Center Drive, Medical Sciences Research Building II, Rm.A570A, Ann Arbor, MI 48109-5456, United States of America
| | - Shelby R Svientek
- Department of Surgery, Section of Plastic Surgery, The University of Michigan Health System, 1150 W Medical Center Drive, Medical Sciences Research Building II, Rm.A570A, Ann Arbor, MI 48109-5456, United States of America
| | - Amir Dehdashtian
- Department of Surgery, Section of Plastic Surgery, The University of Michigan Health System, 1150 W Medical Center Drive, Medical Sciences Research Building II, Rm.A570A, Ann Arbor, MI 48109-5456, United States of America
| | - Nathan G Lawera
- Department of Surgery, Section of Plastic Surgery, The University of Michigan Health System, 1150 W Medical Center Drive, Medical Sciences Research Building II, Rm.A570A, Ann Arbor, MI 48109-5456, United States of America
| | - Vidhya Nadarajan
- Department of Surgery, Section of Plastic Surgery, The University of Michigan Health System, 1150 W Medical Center Drive, Medical Sciences Research Building II, Rm.A570A, Ann Arbor, MI 48109-5456, United States of America
| | - Jarred V Bratley
- Department of Surgery, Section of Plastic Surgery, The University of Michigan Health System, 1150 W Medical Center Drive, Medical Sciences Research Building II, Rm.A570A, Ann Arbor, MI 48109-5456, United States of America
| | - Theodore A Kung
- Department of Surgery, Section of Plastic Surgery, The University of Michigan Health System, 1150 W Medical Center Drive, Medical Sciences Research Building II, Rm.A570A, Ann Arbor, MI 48109-5456, United States of America
| | - Paul S Cederna
- Department of Surgery, Section of Plastic Surgery, The University of Michigan Health System, 1150 W Medical Center Drive, Medical Sciences Research Building II, Rm.A570A, Ann Arbor, MI 48109-5456, United States of America.,Department of Biomedical Engineering, The University of Michigan, Ann Arbor, MI, United States of America
| | - Stephen W P Kemp
- Department of Surgery, Section of Plastic Surgery, The University of Michigan Health System, 1150 W Medical Center Drive, Medical Sciences Research Building II, Rm.A570A, Ann Arbor, MI 48109-5456, United States of America.,Department of Biomedical Engineering, The University of Michigan, Ann Arbor, MI, United States of America
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