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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: 1.0] [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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Ditunno JF, Corcoran PJ, Sandel ME. Growing Academic Physiatry: The Comparative Impact of Baruch Grants to Harvard Medical School and Columbia College of Physicians and Surgeons. Part I. PM R 2019; 12:315-321. [PMID: 31856382 DOI: 10.1002/pmrj.12307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2018] [Accepted: 07/07/2019] [Indexed: 11/06/2022]
Affiliation(s)
- John F Ditunno
- Department of Rehabilitation Medicine, Regional Spinal Cord Injury Center of the Delaware Valley, Sidney Kimmel Medical College of Thomas Jefferson University, Philadelphia, PA
| | | | - M Elizabeth Sandel
- Department of Physical Medicine and Rehabilitation, University of California/Davis Health System, Sacramento, CA
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Spearman BS, Desai VH, Mobini S, McDermott MD, Graham JB, Otto KJ, Judy JW, Schmidt CE. Tissue-Engineered Peripheral Nerve Interfaces. ADVANCED FUNCTIONAL MATERIALS 2018; 28:1701713. [PMID: 37829558 PMCID: PMC10569514 DOI: 10.1002/adfm.201701713] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/14/2023]
Abstract
Research on neural interfaces has historically concentrated on development of systems for the brain; however, there is increasing interest in peripheral nerve interfaces (PNIs) that could provide benefit when peripheral nerve function is compromised, such as for amputees. Efforts focus on designing scalable and high-performance sensory and motor peripheral nervous system interfaces. Current PNIs face several design challenges such as undersampling of signals from the thousands of axons, nerve-fiber selectivity, and device-tissue integration. To improve PNIs, several researchers have turned to tissue engineering. Peripheral nerve tissue engineering has focused on designing regeneration scaffolds that mimic normal nerve extracellular matrix composition, provide advanced microarchitecture to stimulate cell migration, and have mechanical properties like the native nerve. By combining PNIs with tissue engineering, the goal is to promote natural axon regeneration into the devices to facilitate close contact with electrodes; in contrast, traditional PNIs rely on insertion or placement of electrodes into or around existing nerves, or do not utilize materials to actively facilitate axon regeneration. This review presents the state-of-the-art of PNIs and nerve tissue engineering, highlights recent approaches to combine neural-interface technology and tissue engineering, and addresses the remaining challenges with foreign-body response.
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Affiliation(s)
- Benjamin S Spearman
- Crayton Pruitt Family Department of Biomedical Engineering, The University of Florida, 1275 Center Dr., BMS Building JG-56, 116131, Gainesville, FL 32611-6131
| | - Vidhi H Desai
- Department of Electrical and Computer Engineering, The University of Florida, 216 Larsen Hall, 116200, Gainesville, FL 32611-6200
- Nanoscience Institute for Medical and Engineering Technology, The University of Florida, 1041 Center Drive, 116621, Gainesville, FL 32611-6621
| | - Sahba Mobini
- Crayton Pruitt Family Department of Biomedical Engineering, The University of Florida, 1275 Center Dr., BMS Building JG-56, 116131, Gainesville, FL 32611-6131
| | - Matthew D McDermott
- Crayton Pruitt Family Department of Biomedical Engineering, The University of Florida, 1275 Center Dr., BMS Building JG-56, 116131, Gainesville, FL 32611-6131
- Weldon School of Biomedical Engineering, Purdue University, 206 S. Martin Jischke Dr., West Lafayette, IN 47907-2032
| | - James B Graham
- Crayton Pruitt Family Department of Biomedical Engineering, The University of Florida, 1275 Center Dr., BMS Building JG-56, 116131, Gainesville, FL 32611-6131
| | - Kevin J Otto
- Crayton Pruitt Family Department of Biomedical Engineering, The University of Florida, 1275 Center Dr., BMS Building JG-56, 116131, Gainesville, FL 32611-6131
- Nanoscience Institute for Medical and Engineering Technology, The University of Florida, 1041 Center Drive, 116621, Gainesville, FL 32611-6621
- Department of Neuroscience, The University of Florida, 1149 Newell Dr., Room L1-100, 100244, Gainesville, FL 32610-0244
- Department of Neurology, The University of Florida, 2000 SW Archer Rd., Third Floor, 100383, Gainesville, FL 32610
| | - Jack W Judy
- Crayton Pruitt Family Department of Biomedical Engineering, The University of Florida, 1275 Center Dr., BMS Building JG-56, 116131, Gainesville, FL 32611-6131
- Department of Electrical and Computer Engineering, The University of Florida, 216 Larsen Hall, 116200, Gainesville, FL 32611-6200
- Nanoscience Institute for Medical and Engineering Technology, The University of Florida, 1041 Center Drive, 116621, Gainesville, FL 32611-6621
| | - Christine E Schmidt
- Crayton Pruitt Family Department of Biomedical Engineering, The University of Florida, 1275 Center Dr., BMS Building JG-56, 116131, Gainesville, FL 32611-6131
- Nanoscience Institute for Medical and Engineering Technology, The University of Florida, 1041 Center Drive, 116621, Gainesville, FL 32611-6621
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Long-term in vivo impedance changes of subretinal microelectrodes implanted in dystrophic P23H rats. Int J Artif Organs 2013; 36:612-9. [PMID: 23918262 DOI: 10.5301/ijao.5000213] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/08/2013] [Indexed: 11/20/2022]
Abstract
Retinal prostheses are being developed to restore vision in blind patients with photoreceptor degeneration. Electrodes arrays were subretinally implanted in transgenic P23H rats with their photoreceptors degenerated. Electrical stability of the implants was evaluated by long-term monitoring of their impedance changes. Electrode impedances were found to increase by two log units over a three weeks period whereas no impedance increase was noted when the implants were located in the vitreous. In case of hemorrhage or major fibrous reactions, the impedance continued to increase steadily. After explantation, it recovered its initial value indicating no deterioration of the implant. Although the glial cell layer at the surface of the subretinal space was slightly larger, no major glial reaction was seen in direct contact to the implant. These results indicate that no functional testing should be considered before at least three weeks post implantation.
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Ortiz-Catalan M, Brånemark R, Håkansson B, Delbeke J. On the viability of implantable electrodes for the natural control of artificial limbs: review and discussion. Biomed Eng Online 2012; 11:33. [PMID: 22715940 PMCID: PMC3438028 DOI: 10.1186/1475-925x-11-33] [Citation(s) in RCA: 74] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2011] [Accepted: 05/14/2012] [Indexed: 01/06/2023] Open
Abstract
The control of robotic prostheses based on pattern recognition algorithms is a widely studied subject that has shown promising results in acute experiments. The long-term implementation of this technology, however, has not yet been achieved due to practical issues that can be mainly attributed to the use of surface electrodes and their highly environmental dependency. This paper describes several implantable electrodes and discusses them as a solution for the natural control of artificial limbs. In this context "natural" is defined as producing control over limb movement analogous to that of an intact physiological system. This includes coordinated and simultaneous movements of different degrees of freedom. It also implies that the input signals must come from nerves or muscles that were originally meant to produce the intended movement and that feedback is perceived as originating in the missing limb without requiring burdensome levels of concentration. After scrutinizing different electrode designs and their clinical implementation, we concluded that the epimysial and cuff electrodes are currently promising candidates to achieving a long-term stable and natural control of robotic prosthetics, provided that communication from the electrodes to the outside of the body is guaranteed.
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Affiliation(s)
- Max Ortiz-Catalan
- Department of Signals and Systems, Biomedical Engineering Division, Chalmers University of Technology, Göteborg, Sweden
- Centre of Orthopaedic Osseointegration, Department of Orthopaedics, Sahlgrenska University Hospital, Göteborg, Sweden
| | - Rickard Brånemark
- Centre of Orthopaedic Osseointegration, Department of Orthopaedics, Sahlgrenska University Hospital, Göteborg, Sweden
| | - Bo Håkansson
- Department of Signals and Systems, Biomedical Engineering Division, Chalmers University of Technology, Göteborg, Sweden
| | - Jean Delbeke
- School of Medicine (MD), Institute of Neuroscience (SSS/IoNS/COSY), Université catholique de Louvain, Brussels, Belgium
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Dhillon GS, Krüger TB, Sandhu JS, Horch KW. Effects of Short-Term Training on Sensory and Motor Function in Severed Nerves of Long-Term Human Amputees. J Neurophysiol 2005; 93:2625-33. [PMID: 15846000 DOI: 10.1152/jn.00937.2004] [Citation(s) in RCA: 101] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Much has been studied and written about plastic changes in the CNS of humans triggered by events such as limb amputation. However, little is known about the extent to which the original pathways retain residual function after peripheral amputation. Our earlier, acute study on long-term amputees indicated that central pathways associated with amputated peripheral nerves retain at least some sensory and motor function. The purpose of the present study was to determine if these functional connections would be strengthened or improved with experience and training over several days time. To do this, electrodes were implanted within fascicles of severed nerves of long-term human amputees to evaluate the changes in electrically evoked sensations and volitional motor neuron activity associated with attempted phantom limb movements. Nerve stimulation consistently resulted in discrete, unitary, graded sensations of touch/pressure and joint-position sense. There was no significant change in the values of stimulation parameters required to produce these sensations over time. Similarly, while the amputees were able to improve volitional control of motor neuron activity, the rate and pattern of change was similar to that seen with practice in normal individuals on motor tasks. We conclude that the central plasticity seen after amputation is most likely primarily due to unmasking, rather than replacement, of existing synaptic connections. These results also have implications for neural control of prosthetic limbs.
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Affiliation(s)
- G S Dhillon
- Department of Bioengineering, University of Utah, Salt Lake City, UT 84112, USA.
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Grill WM, Mortimer JT. Stability of the input-output properties of chronically implanted multiple contact nerve cuff stimulating electrodes. IEEE TRANSACTIONS ON REHABILITATION ENGINEERING : A PUBLICATION OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY 1998; 6:364-73. [PMID: 9865883 DOI: 10.1109/86.736150] [Citation(s) in RCA: 70] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The objective of this investigation was to measure the input-output (I-O) properties of chronically implanted nerve cuff electrodes. Silicone rubber spiral nerve cuff electrodes, containing 12 individual platinum electrode contacts, were implanted on the sciatic nerve of seven adult cats for 28-34 weeks. Measurements of the torque generated at the ankle joint by electrical stimulation of the sciatic nerve were made every 1-2 weeks for the first 6 weeks post-implant and every 3-5 weeks between 6 weeks and 32 weeks post-implant. In three implants the percutaneous lead cable was irreparably damaged by the animal within 4 weeks after implant and further testing was not possible. One additional lead cable was irreparably damaged by the animal at 17 weeks post-implant. The three remaining implants functioned for 28, 31, and 32 weeks. Input-output curves of ankle joint torque as a function of stimulus current amplitude were repeatable within an experimental session, but there were changes in I-O curves between sessions. The degree of variability in I-O properties differed between implants and between different contacts within the same implant. After 8 weeks, the session to session changes in the stimulus amplitude required to generate 50% of the maximum torque (I50) were smaller (15+/-19%, mean +/- s.d.) than the changes in I50 measured between 1 week and 8 weeks post-implant (34+/-42%). Furthermore, the I-O properties were more stable across changes in limb position in the late post-implant period than in acutely implanted cuff electrodes. These results suggest that tissue encapsulation acted to stabilize chronically implanted cuff electrodes. Electrode movement relative to the nerve, de- and regeneration of nerve fibers, and the inability to precisely reproduce limb position in the measurement apparatus all may have contributed to the variability in I-O properties.
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Affiliation(s)
- W M Grill
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH 44106, USA
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Abstract
The purpose of this study was to determine the electrical properties of the encapsulation tissue that surrounds electrodes chronically implanted in the body. Two four-electrode arrays, fabricated from either epoxy or silicone rubber, were implanted in each of six adult cats for 82 to 156 days. In vivo measurements of tissue resistivity using the four-electrode technique indicated that formation of the encapsulation tissue resulted in a significant increase in the resistivity of the tissue around the arrays. In vitro measurements of tissue impedance using a four-electrode cell indicated that the resistivity of the encapsulation tissue was a function of the tissue morphology. The tight layers of fibroblasts and collagen that formed around the silicone rubber arrays had a resistivity of 627 +/- 108 omega-cm (mean +/- SD; n = 6), which was independent of frequency from 10 Hz to 100 kHz, and was significantly larger than the resistivity of the epoxy encapsulation tissue at all frequencies between 20 Hz and 100 kHz. The combination of macrophages, foreign body giant cells, loose collagen, and fibroblasts that formed around the epoxy arrays had a frequency-dependent resistivity that decreased from 454 +/- 123 omega-cm (n = 5) to 193 +/- 98 omega-cm between 10 Hz and 1 kHz, and was independent of frequency between 1 kHz and 100 kHz, with a mean value of 195 +/- 88 omega-cm. The results indicate that the resistivity of the encapsulation tissue is sufficient to alter the shape and magnitude of the electric field generated by chronically implanted electrodes.
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Affiliation(s)
- W M Grill
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH 44106-4912
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Rutten WL, Meier JH. Selectivity of intraneural prosthetic interfaces for muscular control. Med Biol Eng Comput 1991; 29:NS3-7. [PMID: 1813744 DOI: 10.1007/bf02446095] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Intraneural stimulation with multi-electrodes in principle offers the best possibilities to reach selectivity at motor unit level and to improve recruitment order. The selectivity of stimulation in the peroneal nerve of the rat is explored in the paper by calculations and measurements, using a linear 12-electrode array and a newly devised selectivity test method. With analytical models for potential field distributions, areas of excitation can be calculated for arbitrary electrode configurations. It is demonstrated, using tripolar electrode combinations, how selectivity can be further enhanced and recruitment order improved.
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Affiliation(s)
- W L Rutten
- Department of Electrical Engineering, University of Twente, Enschede, The Netherlands
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Rutten WL, van Wier HJ, Put JH. Sensitivity and selectivity of intraneural stimulation using a silicon electrode array. IEEE Trans Biomed Eng 1991; 38:192-8. [PMID: 2066129 DOI: 10.1109/10.76386] [Citation(s) in RCA: 96] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Artificial electrical stimulation of peripheral nerves needs the development of multielectrode devices which stimulate individual fibers or small groups in a selective and sensitive way. To this end, a multielectrode array in silicon technology has been developed, as well as experimental paradigms and model calculations for sensitivity and selectivity measures. The array consists of twelve platinum electrode sites (10 x 50 microns at 50 microns interdistance) on a 45 microns thick tip-shaped silicon substrate and a Si3N4 insulating glass cover layer. The tip is inserted in the peroneal nerve of the rat during acute experiments to stimulate alpha motor fibers of the extensor digitorum longus muscle. Sensitivity calculations and experiments show a cubic dependence of the number of stimulated motor units on current amplitude of the stimulatory pulse (recruitment curves), starting at single motor level. Selectivity was tested by a method based on the refractory properties of neurons. At the lowest stimulus levels (for one motor unit) selectivity is maximal when two electrodes are separated by 200-250 microns, which was estimated also on theoretical grounds. The study provides clues for future designs of two- and three-dimensional devices.
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Affiliation(s)
- W L Rutten
- Department of Biomedical Engineering, Faculty of Electrical Engineering, Twente University, Enschede, The Netherlands
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Naples GG, Mortimer JT, Scheiner A, Sweeney JD. A spiral nerve cuff electrode for peripheral nerve stimulation. IEEE Trans Biomed Eng 1988; 35:905-16. [PMID: 3198136 DOI: 10.1109/10.8670] [Citation(s) in RCA: 215] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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Abstract
The effect of rapid as well as sustained compressive forces applied to the surface of intact and severed peroneal nerves of rabbits was studied. Considerable effort was taken to ensure a quantitative and consistent experimental paradigm. Stimuli were delivered to the sciatic nerve, and the compound action potential was recorded in the peroneal nerve, with compressive forces applied more proximally on the peroneal nerve. It was found that the conduction of action potentials on the larger nerve fibers was more sensitive to compressive force than that of the smaller nerve fibers, although all nerve fibers stopped conducting when sufficient compression was applied to the nerve. The effect on the conduction of action potentials on the nerve fibers appeared to be determined both by Laplace's law (as previously reported by others) and the viscoelastic properties of the entire nerve. Relatively low compressive forces (20 gm applied over approximately 7 sq mm) were found to decrease the neutral conduction of the larger nerve fibers for at least two hours, whereas stagnation of blood circulation was not found to affect measurably the neural conduction of all the nerve fibers for up to two hours.
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Abstract
Implanted nerve cuff and muscle electrodes were used to serially record reflexes after spinal cord transection in cat. Recording of reflexes, in response to both sensory nerve and to mixed motor and sensory nerve stimulation, was accomplished through 2 months after cord section. Serial recording of afferent and efferent nerve volleys was achieved as well. Serial reflex changes that follow cord transection are described. Reflex amplitude to sensory nerve stimulation increased in two phases. The first increase was noted between 1 and 4 days after cord transection; the second increase was recorded between 2 and 4 weeks. These observations suggest that at least two neuronal mechanisms with distinct temporal courses mediate the appearance of spinal hyperreflexia. The animal model described may be useful for further study of the neuronal mechanisms which underlie the hyperreflexia of spinal cord injury.
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