Feasibility of Tracking Multiple Implanted Magnets With a Myokinetic Control Interface: Simulation and Experimental Evidence Based on the Point Dipole Model

To What Extent Implanting Single vs Pairs of Magnets Per Muscle Affect the Localization Accuracy of the Myokinetic Control Interface? Evidence From a Simulated Environment

OBJECTIVE

We recently proposed a new concept of human-machine interface to control hand prostheses which we dubbed the myokinetic control interface. Such interface detects muscle displacement during contraction by localizing permanent magnets implanted in the residual muscles. So far, we evaluated the feasibility of implanting one magnet per muscle and monitoring its displacement relative to its initial position. However, multiple magnets could actually be implanted in each muscle, as using their relative distance as a measure of muscle contraction could improve the system robustness against environmental disturbances.

METHODS

Here, we simulated the implant of pairs of magnets in each muscle and we compared the localization accuracy of such system with the one magnet per muscle approach, considering first a planar and then an anatomically appropriate configuration. Such comparison was also performed when simulating different grades of mechanical disturbances applied to the system (i.e., shift of the sensor grid).

RESULTS

We found that implanting one magnet per muscle always led to lower localization errors under ideal conditions (i.e., no external disturbances). Differently, when mechanical disturbances were applied, magnet pairs outperformed the single magnet approach, confirming that differential measurements are able to reject common mode disturbances.

CONCLUSION

We identified important factors affecting the choice of the number of magnets to implant in a muscle.

SIGNIFICANCE

Our results provide important guidelines for the design of disturbance rejection strategies and for the development of the myokinetic control interface, as well as for a whole range of biomedical applications involving magnetic tracking.

Clinical implementation of a bionic hand controlled with kineticomyographic signals

Sensing the proper signal could be a vital piece of the solution to the much evading attributes of prosthetic hands, such as robustness to noise, ease of connectivity, and intuitive movement. Towards this end, magnetics tags have been recently suggested as an alternative sensing mechanism to the more common EMG signals. Such sensing technology, however, is inherently invasive and hence only in simulation stages of magnet localization to date. Here, for the first time, we report on the clinical implementation of implanted magnetic tags for an amputee's prosthetic hand from both the medical and engineering perspectives. Specifically, the proposed approach introduces a flexor-extensor tendon transfer surgical procedure to implant the tags, artificial neural networks to extract human intention directly from the implanted magnet's magnetic fields -in short KineticoMyoGraphy (KMG) signals- rather than localizing them, and a game strategy to examine the proposed algorithms and rehabilitate the patient with his new prosthetic hand. The bionic hand's ability is then tested following the patient's intended gesture type and grade. The statistical results confirm the possible utility of surgically implanted magnetic tags as an accurate sensing interface for recognizing the intended gesture and degree of movement between an amputee and his bionic hand.

The myokinetic stimulation interface: activation of proprioceptive neural responses with remotely actuated magnets implanted in rodent forelimb muscles

OBJECTIVE

Proprioception is the sense of one's position, orientation, and movement in space, and it is of fundamental importance for motor control. When proprioception is impaired or absent, motor execution becomes error-prone, leading to poorly coordinated movements. The kinaesthetic illusion, which creates perceptions of limb movement in humans through non-invasively applying vibrations to muscles or tendons, provides an avenue for studying and restoring the sense of joint movement (kinaesthesia). This technique, however, leaves ambiguity between proprioceptive percepts that arise from muscles versus those that arise from skin receptors. Here we propose the concept of a stimulation system to activate kinaesthesia through the untethered application of localized vibration through implanted magnets.

APPROACH

In this proof-of-concept study, we use two simplified 1-DoF systems to show the feasibility of eliciting muscle-sensory responses in an animal model across multiple frequencies, including those that activate the kinaesthetic illusion (70 - 115 Hz). Furthermore, we generalized the concept by developing a 5-DoF prototype system capable of generating directional, frequency-selective vibrations with desired displacement profiles.

MAIN RESULTS

In-vivo tests with the 1-DoF systems demonstrated the feasibility to elicit muscle sensory neural responses in the median nerve of an animal model. Instead, in-vitro tests with the 5-DoF prototype demonstrated high accuracy in producing directional and frequency selective vibrations along different magnet axes.

SIGNIFICANCE

These results provide evidence for a new technique that interacts with the native neuro-muscular anatomy to study proprioception and eventually pave the way towards the development of advanced limb prostheses or assistive devices for the sensory impaired.

An innovative eye-tracker: Main features and demonstrative tests

We present a set of results obtained with an innovative eye-tracker based on magnetic dipole localization by means of an array of magnetoresistive sensors. The system tracks both head and eye movements with a high rate (100-200 Sa/s) and in real time. A simple setup is arranged to simulate head and eye motions and to test the tracker performance under realistic conditions. Multimedia material is provided to substantiate and exemplify the results. A comparison with other available technologies for eye-tracking is drawn, discussing advantages (e.g., precision) and disadvantages (e.g., invasivity) of the diverse approaches, with the presented method standing out for low cost, robustness, and relatively low invasivity.

Optimal Spatial Sensor Design for Magnetic Tracking in a Myokinetic Control Interface

BACKGROUND AND OBJECTIVES

Magnetic tracking involves the use of magnetic sensors to localize one or more magnetic objectives, in those applications in which a free line-of-sight between them and the operator is hampered. We applied this concept to prosthetic hands, which could be controlled by tracking permanent magnets implanted in the forearm muscles of amputees (the myokinetic control interface). Concerning the system design, the definition of a sensor distribution which maximizes the information, while minimizing the computational cost of localization, is still an open problem. We present a simple yet effective strategy to define an optimal sensor set for tracking multiple magnets, which we called the Peaks method.

METHODS

We simulated a proximal amputation using a 3D CAD model of a human forearm, and the implantation of 11 magnets in the residual muscles. The Peaks method was applied to select a subset of sensors from an initial grid of 480 elements. The approach involves setting an appropriate threshold to select those sensors associated with the peaks in the magnetic flux density and its gradient distributions. Selected sensors were used to track the magnets during muscle contraction. For validating our strategy, an alternative method based on state-of-the-art solutions was implemented. We finally proposed a calibration phase to customize the sensor distribution on the specific patient's anatomy.

RESULTS

80 sensors were selected with the Peaks method, and 101 with the alternative one. A localization accuracy below 0.22 mm and 1.86° for position and orientation, respectively, was always achieved. Unlike alternative methods from the literature, neither iterative or analytical solution, nor a-priori knowledge on the magnet positions or trajectories were required, and yet the outcomes achieved with the two strategies proved statistically comparable. The calibration phase proved useful to adapt the sensors to the patient's stump and to increase the signal-to-noise ratio against intrinsic noise.

CONCLUSIONS

We demonstrated an efficient and general solution for solving the design optimization problem (i.e. identifying an optimal sensor set) and reducing the computational cost of localization. The optimal sensor distribution mirrors the field shape traced by the magnets on the sensing surface, being an intuitive and fast way of achieving the same results of more complex and application-specific methods. Several applications in the (bio)medical field involving magnetic tracking will benefit from the outcomes of this work.

Feasibility of generating 90 Hz vibrations in remote implanted magnets

Limb amputation not only reduces the motor abilities of an individual, but also destroys afferent channels that convey essential sensory information to the brain. Significant efforts have been made in the area of upper limb prosthetics to restore sensory feedback, through the stimulation of residual sensory elements. Most of the past research focused on the replacement of tactile functions. On the other hand, the difficulties in eliciting proprioceptive sensations using either haptic or (neural) electrical stimulation, has limited researchers to rely on sensory substitution. Here we propose the myokinetic stimulation interface, that aims at restoring natural proprioceptive sensations by exploiting the so-called tendon illusion, elicited through the vibration of magnets implanted inside residual muscles. We present a prototype which exploits 12 electromagnetic coils to vibrate up to four magnets implanted in a forearm mockup. The results demonstrated that it is possible to generate highly directional and frequency-selective vibrations. The system proved capable of activating a single magnet, out of many. Hence, this interface constitutes a promising approach to restore naturally perceived proprioception after an amputation. Indeed, by implanting several magnets in independent muscles, it would be possible to restore proprioceptive sensations perceived as coming from single digits.

Towards Tracking of Deep Brain Stimulation Electrodes Using an Integrated Magnetometer

This paper presents a tracking system using magnetometers, possibly integrable in a deep brain stimulation (DBS) electrode. DBS is a treatment for movement disorders where the position of the implant is of prime importance. Positioning challenges during the surgery could be addressed thanks to a magnetic tracking. The system proposed in this paper, complementary to existing procedures, has been designed to bridge preoperative clinical imaging with DBS surgery, allowing the surgeon to increase his/her control on the implantation trajectory. Here the magnetic source required for tracking consists of three coils, and is experimentally mapped. This mapping has been performed with an in-house three-dimensional magnetic camera. The system demonstrates how magnetometers integrated directly at the tip of a DBS electrode, might improve treatment by monitoring the position during and after the surgery. The three-dimensional operation without line of sight has been demonstrated using a reference obtained with magnetic resonance imaging (MRI) of a simplified brain model. We observed experimentally a mean absolute error of 1.35 mm and an Euclidean error of 3.07 mm. Several areas of improvement to target errors below 1 mm are also discussed.

Localization accuracy of multiple magnets in a myokinetic control interface

Magnetic localizers have been widely investigated in the biomedical field, especially for intra-body applications, because they don't require a free line-of-sight between the implanted magnets and the magnetic field sensors. However, while researchers have focused on narrow and specific aspects of the localization problem, no one has comprehensively searched for general design rules for accurately localizing multiple magnetic objectives. In this study, we sought to systematically analyse the effects of remanent magnetization, number of sensors, and geometrical configuration (i.e. distance among magnets-L_inter-MM-and between magnets and sensors-L_MM-sensor) on the accuracy of the localizer in order to unveil the basic principles of the localization problem. Specifically, through simulations validated with a physical system, we observed that the accuracy of the localization was mainly affected by a specific angle ([Formula: see text] = tan^-1(L_inter-MM / L_MM-sensor)), descriptive of the system geometry. In particular, while tracking nine magnets, errors below ~ 1 mm (10% of the length of the simulated trajectory) and around 9° were obtained if θ ≥  ~ 31°. The latter proved a general rule across all tested conditions, also when the number of magnets was doubled. Our results are interesting for a whole range of biomedical engineering applications exploiting multiple-magnets tracking, such as human-machine interfaces, capsule endoscopy, ventriculostomy interventions, and endovascular catheter navigation.

The Myokinetic Control Interface: How Many Magnets Can be Implanted in an Amputated Forearm? Evidence From a Simulated Environment

We recently introduced the concept of a new human-machine interface (the myokinetic control interface) to control hand prostheses. The interface tracks muscle contractions via permanent magnets implanted in the muscles and magnetic field sensors hosted in the prosthetic socket. Previously we showed the feasibility of localizing several magnets in non-realistic workspaces. Here, aided by a 3D CAD model of the forearm, we computed the localization accuracy simulated for three different below-elbow amputation levels, following general guidelines identified in early work. To this aim we first identified the number of magnets that could fit and be tracked in a proximal (T1), middle (T2) and distal (T3) representative amputation, starting from 18, 20 and 23 eligible muscles, respectively. Then we ran a localization algorithm to estimate the poses of the magnets based on the sensor readings. A sensor selection strategy (from an initial grid of 840 sensors) was also implemented to optimize the computational cost of the localization process. Results showed that the localizer was able to accurately track up to 11 (T1), 13 (T2) and 19 (T3) magnetic markers (MMs) with an array of 154, 205 and 260 sensors, respectively. Localization errors lower than 7% the trajectory travelled by the magnets during muscle contraction were always achieved. This work not only answers the question: "how many magnets could be implanted in a forearm and successfully tracked with a the myokinetic control approach?", but also provides interesting insights for a wide range of bioengineering applications exploiting magnetic tracking.

A Multi-Node Magnetic Positioning System with a Distributed Data Acquisition Architecture

We present a short-range magnetic positioning system that can track in real-time both the position and attitude (i.e., the orientation of the principal axes of an object in space) of up to six moving nodes. Moving nodes are small solenoids coupled with a capacitor (resonant circuit) and supplied with an oscillating voltage. Active moving nodes are detected by measuring the voltage that they induce on a three-dimensional matrix of passive coils. Data on each receiving coil are acquired simultaneously by a distributed data-acquisition architecture. Then, they are sent to a computer that calculates the position and attitude of each moving node. The entire process is run in real-time: the system can perform 62 position and attitude measurements per second when tracking six nodes simultaneously and up to 124 measurements per second when tracking one node only. Different active nodes are identified using a frequency-division multiple access technique. The position and angular resolution of the system have been experimentally estimated by tracking active nodes along a reference trajectory traced by a robotic arm. The factors limiting the viability of upscaling the system with more than six active nodes are discussed.

Control Methods for Transradial Prostheses Based on Remnant Muscle Activity and Its Relationship with Proprioceptive Feedback

The loss of a hand can significantly affect one's work and social life. For many patients, an artificial limb can improve their mobility and ability to manage everyday activities, as well as provide the means to remain independent. This paper provides an extensive review of available biosensing methods to implement the control system for transradial prostheses based on the measured activity in remnant muscles. Covered techniques include electromyography, magnetomyography, electrical impedance tomography, capacitance sensing, near-infrared spectroscopy, sonomyography, optical myography, force myography, phonomyography, myokinetic control, and modern approaches to cineplasty. The paper also covers combinations of these approaches, which, in many cases, achieve better accuracy while mitigating the weaknesses of individual methods. The work is focused on the practical applicability of the approaches, and analyses present challenges associated with each technique along with their relationship with proprioceptive feedback, which is an important factor for intuitive control over the prosthetic device, especially for high dexterity prosthetic hands.

Technological Advances in Prosthesis Design and Rehabilitation Following Upper Extremity Limb Loss

PURPOSE OF REVIEW

The complexity of the human extremity, particularly the upper extremity and the hand, allows us to interact with the world. Prosthetists have struggled to recreate the intuitive motor control, light touch sensation, and proprioception of the innate limb in a manner that reflects the complexity of its native form and function. Nevertheless, recent advances in prosthesis technology, surgical innovations, and enhanced rehabilitation appear promising for patients with limb loss who hope to return to their pre-injury level of function. The purpose of this review is to illustrate recent technological advances that are moving us one step closer to the goal of multi-functional, self-identifiable, durable, and intuitive prostheses.

RECENT FINDINGS

Surgical advances such as targeted muscle reinnervation, regenerative peripheral nerve interfaces, agonist-antagonist myoneural interfaces, and targeted sensory reinnervation; development of technology designed to restore sensation, such as implanted sensors and haptic devices; and evolution of osseointegrated (bone-anchored) prostheses show great promise. Augmented and virtual reality platforms have the potential to enhance prosthesis design, pre-prosthetic training, incorporation, and use. Emerging technologies move surgeons, rehabilitation physicians, therapists, and prosthetists closer to the goal of creating highly functional prostheses with elevated sensory and motor control. Collaboration between medical teams, scientists, and industry stakeholders will be required to keep pace with patients who require durable, high-functioning prostheses.