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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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Roche AD, Bailey ZK, Gonzalez M, Vu PP, Chestek CA, Gates DH, Kemp SWP, Cederna PS, Ortiz-Catalan M, Aszmann OC. Upper limb prostheses: bridging the sensory gap. J Hand Surg Eur Vol 2023; 48:182-190. [PMID: 36649123 PMCID: PMC9996795 DOI: 10.1177/17531934221131756] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Replacing human hand function with prostheses goes far beyond only recreating muscle movement with feedforward motor control. Natural sensory feedback is pivotal for fine dexterous control and finding both engineering and surgical solutions to replace this complex biological function is imperative to achieve prosthetic hand function that matches the human hand. This review outlines the nature of the problems underlying sensory restitution, the engineering methods that attempt to address this deficit and the surgical techniques that have been developed to integrate advanced neural interfaces with biological systems. Currently, there is no single solution to restore sensory feedback. Rather, encouraging animal models and early human studies have demonstrated that some elements of sensation can be restored to improve prosthetic control. However, these techniques are limited to highly specialized institutions and much further work is required to reproduce the results achieved, with the goal of increasing availability of advanced closed loop prostheses that allow sensory feedback to inform more precise feedforward control movements and increase functionality.
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Affiliation(s)
- Aidan D Roche
- College of Medicine, The Queen's Medical Research Institute, Edinburgh, UK.,Department of Plastic Surgery, NHS Lothian, Livingston, UK
| | - Zachary K Bailey
- Department of Bioengineering, Imperial College London, South Kensington Campus, UK
| | | | - Philip P Vu
- 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.,Section of Plastic Surgery, University of Michigan, Ann Arbor, MI, USA.,Department of Electrical Engineering and Computer Science, University of Michigan, Ann Arbor, MI, USA.,Neuroscience Graduate Program, University of Michigan, Ann Arbor, MI, USA
| | - Deanna H Gates
- Robotics Institute, University of Michigan, Ann Arbor, MI, USA.,Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, USA.,School of Kinesiology, University of Michigan, Ann Arbor, MI, USA
| | - Stephen W P Kemp
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, USA.,Section of Plastic Surgery, 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
| | - Max Ortiz-Catalan
- Center for Bionics and Pain Research, Mölndal, Sweden.,Department of Electrical Engineering, Chalmers University of Technology, Sweden.,Operational Area 3, Sahlgrenska University Hospital, Mölndal, Sweden.,Department of Orthopaedics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Sweden
| | - Oskar C Aszmann
- Department of Plastic & Reconstructive Surgery, Medical University of Vienna, Austria.,Clinical Laboratory for Bionic Extremity Reconstruction, Medical University of Vienna, Austria
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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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Watkins RH, Amante M, Wasling HB, Wessberg J, Ackerley R. Slowly-adapting type II afferents contribute to conscious touch sensation in humans: evidence from single unit intraneural microstimulation. J Physiol 2022; 600:2939-2952. [PMID: 35569041 PMCID: PMC9328136 DOI: 10.1113/jp282873] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Accepted: 05/03/2022] [Indexed: 11/08/2022] Open
Abstract
NEW & NOTEWORTHY Slowly-adapting type II mechanoreceptive afferents (SA-II) in glabrous hand skin encode touch force, direction, and velocity, as well as skin stretch/tension. Using single unit intraneural microstimulation, via microneurography in humans, a single mechanoreceptive afferent can be electrically-stimulated, producing a clear percept, yet SA-II stimulation has produced ambiguous results. We show that selective SA-II stimulation produces large pressure sensations, which has implications for their role in perceived touch and generating realistic touch feedback from prosthetics. KEY POINTS Slowly adapting type II mechanoreceptors (SA-IIs) are primary sensory neurons in humans that respond to pressure and stretch applied to the skin. To date, no specific conscious correlate of touch has been linked to SA-II activation Using microneurography and intraneural microstimulation to stimulate single sensory neurons in human subjects, we find a specific sensation linked to the activation of single SA-II afferents. This sensation of touch was reported as gentle pressure and subjects could detect this with a high degree of accuracy. Methods of artificial tactile sensory feedback and computational models of touch should include SA-II s as meaningful contributors to the conscious sensation of touch. ABSTRACT Slowly-adapting type II (SA-II, Ruffini) mechanoreceptive afferents respond well to pressure and stretch, and are regularly encountered in human microneurography studies. Despite an understanding of SA-II response properties, their role in touch perception remains unclear. Specific roles of different myelinated Aβ mechanoreceptive afferents in tactile perception have been revealed using single unit intraneural microstimulation (INMS), via microneurography, recording from and then electrically stimulating individual afferents. This method directly links single afferent artificial activation to perception, where INMS produces specific 'quantal' touch percepts associated with different mechanoreceptive afferent types. However, SA-II afferent stimulation has been ambiguous, producing inconsistent, vague sensations or no clear percept. We physiologically characterized hundreds of individual Aβ mechanoreceptive afferents in the glabrous hand skin and examined the subsequent percepts evoked by trains of low amplitude INMS current pulses (<10 μA). We present 18 SA-II afferents where INMS resulted in a clear, electrically evoked sensation of large (∼36 mm2 ) diffuse pressure, which was projected precisely to their physiologically-defined receptive field in the skin. This sensation was felt as natural, distinctive from other afferents, and showed no indications of multi-afferent stimulation. Stimulus frequency modulated sensation intensity and even brief stimuli (4 pulses, 60 ms) were perceived. These results suggest SA-II afferents contribute to perceived tactile sensations, can signal this rapidly and precisely, and are relevant and important for computational models of touch sensation and artificial prosthetic feedback. Abstract figure legend Using microneurography, recordings were made from single mechanoreceptive afferents in the median nerve of human subjects. After fiber classification, low amplitude (<10 μA) intraneural microstimulation was delivered to evoke sensations of touch. Varied sensations were evoked that could be attributed to selective activation of the recorded afferents. We identify a consistent link between type II slowly adapting mechanoreceptive afferents (SA-IIs) and a specific sensation (light pressure). These sensations matched the afferent properties precisely, indicated sensations were evoked by stimulating single SA-II afferents, and were modified by stimulus train modulations. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Roger Holmes Watkins
- Aix Marseille Univ, CNRS, LNC (Laboratoire de Neurosciences Cognitives - UMR 7291), Marseille, France
| | - Mario Amante
- Department of Physiology, University of Gothenburg, Gothenburg, 40530, Sweden
| | | | - Johan Wessberg
- Department of Physiology, University of Gothenburg, Gothenburg, 40530, Sweden
| | - Rochelle Ackerley
- Aix Marseille Univ, CNRS, LNC (Laboratoire de Neurosciences Cognitives - UMR 7291), Marseille, France
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Medrano RL, Thomas GC, Rouse EJ. Can humans perceive the metabolic benefit provided by augmentative exoskeletons? J Neuroeng Rehabil 2022; 19:26. [PMID: 35219335 PMCID: PMC8881941 DOI: 10.1186/s12984-022-01002-w] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Accepted: 02/15/2022] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND The purpose of augmentative exoskeletons is to help people exceed the limitations of their human bodies, but this cannot be realized unless people choose to use these exciting technologies. Although human walking efficiency has been highly optimized over generations, exoskeletons have been able to consistently improve this efficiency by 10-15%. However, despite these measurable improvements, exoskeletons today remain confined to the laboratory. To achieve widespread adoption, exoskeletons must not only exceed the efficiency of human walking, but also provide a perceivable benefit to their wearers. METHODS In this study, we quantify the perceptual threshold of the metabolic efficiency benefit provided during exoskeleton-assisted locomotion. Ten participants wore bilateral ankle exoskeletons during continuous walking. The assistance provided by the exoskeletons was varied in 2 min intervals while participants provided feedback on their metabolic rate. These data were aggregated and used to estimate the perceptual threshold. RESULTS Participants were able to detect a change in their metabolic rate of 22.7% (SD: 17.0%) with 75% accuracy. This indicates that in the short term and on average, wearers cannot yet reliably perceive the metabolic benefits of today's augmentative exoskeletons. CONCLUSIONS If wearers cannot perceive the benefits provided by these technologies, it will negatively affect their impact, including long-term adoption and product viability. Future exoskeleton researchers and designers can use these methods and results to inform the development of exoskeletons that reach their potential.
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Affiliation(s)
- Roberto Leo Medrano
- Department of Mechanical Engineering, University of Michigan, Ann Arbor, 48109 USA
- Robotics Institute, University of Michigan, 48109 Ann Arbor, USA
| | - Gray Cortright Thomas
- Department of Mechanical Engineering, University of Michigan, Ann Arbor, 48109 USA
- Department of Electrical Engineering and Computer Science, University of Michigan, Ann Arbor, 48109 USA
- Robotics Institute, University of Michigan, 48109 Ann Arbor, USA
| | - Elliott J. Rouse
- Department of Mechanical Engineering, University of Michigan, Ann Arbor, 48109 USA
- Robotics Institute, University of Michigan, 48109 Ann Arbor, USA
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Andreis FR, Metcalfe B, Janjua TAM, Jensen W, Meijs S, dos Santos Nielsen TGN. The Use of the Velocity Selective Recording Technique to Reveal the Excitation Properties of the Ulnar Nerve in Pigs. SENSORS (BASEL, SWITZERLAND) 2021; 22:58. [PMID: 35009601 PMCID: PMC8747393 DOI: 10.3390/s22010058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Revised: 12/02/2021] [Accepted: 12/16/2021] [Indexed: 06/14/2023]
Abstract
Decoding information from the peripheral nervous system via implantable neural interfaces remains a significant challenge, considerably limiting the advancement of neuromodulation and neuroprosthetic devices. The velocity selective recording (VSR) technique has been proposed to improve the classification of neural traffic by combining temporal and spatial information through a multi-electrode cuff (MEC). Therefore, this study investigates the feasibility of using the VSR technique to characterise fibre type based on the electrically evoked compound action potentials (eCAP) propagating along the ulnar nerve of pigs in vivo. A range of electrical stimulation parameters (amplitudes of 50 μA-10 mA and pulse durations of 100 μs, 500 μs, 1000 μs, and 5000 μs) was applied on a cutaneous and a motor branch of the ulnar nerve in nine Danish landrace pigs. Recordings were made with a 14 ring MEC and a delay-and-add algorithm was used to convert the eCAPs into the velocity domain. The results revealed two fibre populations propagating along the cutaneous branch of the ulnar nerve, with mean velocities of 55 m/s and 21 m/s, while only one dominant fibre population was found for the motor branch, with a mean velocity of 63 m/s. Because of its simplicity to provide information on the fibre selectivity and direction of propagation of nerve fibres, VSR can be implemented to advance the performance of the bidirectional control of neural prostheses and bioelectronic medicine applications.
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Affiliation(s)
- Felipe Rettore Andreis
- Center for Neuroplasticity and Pain (CNAP), Department of Health Science and Technology, Aalborg University, 9220 Aalborg, Denmark; (T.A.M.J.); (W.J.); (S.M.); (T.G.N.d.S.N.)
| | - Benjamin Metcalfe
- Center for Biosensors, Bioelectronics and Biodevices (C3Bio), Department of Electronic & Electrical Engineering, University of Bath, Bath BA2 7AY, UK;
| | - Taha Al Muhammadee Janjua
- Center for Neuroplasticity and Pain (CNAP), Department of Health Science and Technology, Aalborg University, 9220 Aalborg, Denmark; (T.A.M.J.); (W.J.); (S.M.); (T.G.N.d.S.N.)
| | - Winnie Jensen
- Center for Neuroplasticity and Pain (CNAP), Department of Health Science and Technology, Aalborg University, 9220 Aalborg, Denmark; (T.A.M.J.); (W.J.); (S.M.); (T.G.N.d.S.N.)
| | - Suzan Meijs
- Center for Neuroplasticity and Pain (CNAP), Department of Health Science and Technology, Aalborg University, 9220 Aalborg, Denmark; (T.A.M.J.); (W.J.); (S.M.); (T.G.N.d.S.N.)
| | - Thomas Gomes Nørgaard dos Santos Nielsen
- Center for Neuroplasticity and Pain (CNAP), Department of Health Science and Technology, Aalborg University, 9220 Aalborg, Denmark; (T.A.M.J.); (W.J.); (S.M.); (T.G.N.d.S.N.)
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Zbinden J, Ortiz-Catalan M. The rubber hand illusion is a fallible method to study ownership of prosthetic limbs. Sci Rep 2021; 11:4423. [PMID: 33627714 PMCID: PMC7904923 DOI: 10.1038/s41598-021-83789-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Accepted: 02/05/2021] [Indexed: 11/25/2022] Open
Abstract
Enabling sensory feedback in limb prostheses can reverse a damaged body image caused by amputation. The rubber hand illusion (RHI) is a popular paradigm to study ownership of artificial limbs and potentially useful to assess sensory feedback strategies. We investigated the RHI as means to induce ownership of a prosthetic hand by providing congruent visual and tactile stimuli. We elicited tactile sensations via electric stimulation of severed afferent nerve fibres in four participants with transhumeral amputation. Contrary to our expectations, they failed to experience the RHI. The sensations we elicited via nerve stimulation resemble tapping as opposed to stroking, as in the original RHI. We therefore investigated the effect of tapping versus stroking in 30 able-bodied subjects. We found that either tactile modality equally induced ownership in two-thirds of the subjects. Failure to induce the RHI in the intact hand of our participants with amputation later confirmed that they form part of the RHI-immune population. Conversely, these participants use neuromusculoskeletal prostheses with neural sensory feedback in their daily lives and reported said prostheses as part of their body. Our findings suggest that people immune to the RHI can nevertheless experience ownership over prosthetic limbs when used in daily life and accentuates a significant limitation of the RHI paradigm.
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Affiliation(s)
- Jan Zbinden
- 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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Page DM, George JA, Wendelken SM, Davis TS, Kluger DT, Hutchinson DT, Clark GA. Discriminability of multiple cutaneous and proprioceptive hand percepts evoked by intraneural stimulation with Utah slanted electrode arrays in human amputees. J Neuroeng Rehabil 2021; 18:12. [PMID: 33478534 PMCID: PMC7819250 DOI: 10.1186/s12984-021-00808-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Accepted: 01/11/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Electrical stimulation of residual afferent nerve fibers can evoke sensations from a missing limb after amputation, and bionic arms endowed with artificial sensory feedback have been shown to confer functional and psychological benefits. Here we explore the extent to which artificial sensations can be discriminated based on location, quality, and intensity. METHODS We implanted Utah Slanted Electrode Arrays (USEAs) in the arm nerves of three transradial amputees and delivered electrical stimulation via different electrodes and frequencies to produce sensations on the missing hand with various locations, qualities, and intensities. Participants performed blind discrimination trials to discriminate among these artificial sensations. RESULTS Participants successfully discriminated cutaneous and proprioceptive sensations ranging in location, quality and intensity. Performance was significantly greater than chance for all discrimination tasks, including discrimination among up to ten different cutaneous location-intensity combinations (15/30 successes, p < 0.0001) and seven different proprioceptive location-intensity combinations (21/40 successes, p < 0.0001). Variations in the site of stimulation within the nerve, via electrode selection, enabled discrimination among up to five locations and qualities (35/35 successes, p < 0.0001). Variations in the stimulation frequency enabled discrimination among four different intensities at the same location (13/20 successes, p < 0.0005). One participant also discriminated among individual stimulation of two different USEA electrodes, simultaneous stimulation on both electrodes, and interleaved stimulation on both electrodes (20/24 successes, p < 0.0001). CONCLUSION Electrode location, stimulation frequency, and stimulation pattern can be modulated to evoke functionally discriminable sensations with a range of locations, qualities, and intensities. This rich source of artificial sensory feedback may enhance functional performance and embodiment of bionic arms endowed with a sense of touch.
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Affiliation(s)
| | - Jacob A George
- Division of Physical Medicine and Rehabilitation, University of Utah, Salt Lake City, UT, 84112, USA.
| | - Suzanne M Wendelken
- Department of Anesthesiology, Maine Medical Center, Portland, ME, 04102, USA
| | - Tyler S Davis
- Department of Neurosurgery, University of Utah, Salt Lake City, UT, 84112, USA
| | | | | | - Gregory A Clark
- Department of Biomedical Engineering, University of Utah, Salt Lake City, UT, 84112, USA
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Chronic Use of a Sensitized Bionic Hand Does Not Remap the Sense of Touch. Cell Rep 2020; 33:108539. [PMID: 33357421 PMCID: PMC9793568 DOI: 10.1016/j.celrep.2020.108539] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 09/23/2020] [Accepted: 11/25/2020] [Indexed: 12/30/2022] Open
Abstract
Electrical stimulation of tactile nerve fibers that innervated an amputated hand results in vivid sensations experienced at a specific location on the phantom hand, a phenomenon that can be leveraged to convey tactile feedback through bionic hands. Ideally, electrically evoked sensations would be experienced on the appropriate part of the hand: touch with the bionic index fingertip, for example, would elicit a sensation experienced on the index fingertip. However, the perceived locations of sensations are determined by the idiosyncratic position of the stimulating electrode in the nerve and thus are difficult to predict or control. This problem could be circumvented if perceived sensations shifted over time to become consistent with the position of the sensor that triggers them. We show that, after long-term use of a neuromusculoskeletal prosthesis that featured a mismatch between the sensor location and the resulting tactile experience, the perceived location of the touch did not change.
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Dupan SSG, McNeill Z, Brunton E, Nazarpour K. Temporal Modulation of Transcutaneous Electrical Nerve Stimulation Influences Sensory Perception. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2020; 2020:3885-3888. [PMID: 33018849 DOI: 10.1109/embc44109.2020.9176472] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
The incorporation of sensory feedback in prosthetics can lead to a range of benefits, such as improved hand control, increased prosthesis embodiment, and the reduction of phantom limb pain. However, the creation of reliable sensory feedback is complicated by the temporal modulation of the nervous system. Sensory fibres in the hand are primed to react to changing conditions, firing when discrete mechanical events occur. In this study, we investigate the minimal possible stimulation needed to distinguish different sensory patterns that can be used to indicate events. We presented a two-alternative forced-choice task of transcutaneous electrical nerve stimuli to 10 participants. The results showed that different stimuli can be distinguished when double pulses have an inter-stimulus-interval of 10 ms. Additionally, providing a pause of at least 350 ms between stimuli increases the discrimination of the perception. These results suggest that humans can distinguish different patterns of transcutaneous electrical nerve stimulation with as little as two stimuli, illustrating the possibility of providing event-related stimulation.
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11
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George JA, Brinton MR, Colgan PC, Colvin GK, Bensmaia SJ, Clark GA. Intensity Discriminability of Electrocutaneous and Intraneural Stimulation Pulse Frequency in Intact Individuals and Amputees. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2020; 2020:3893-3896. [PMID: 33018851 DOI: 10.1109/embc44109.2020.9176720] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Electrical stimulation of residual nerves can be used to provide amputees with intuitive sensory feedback. An important aspect of this artificial sensory feedback is the ability to convey the magnitude of tactile stimuli. Using classical psychophysical methods, we quantified the just-noticeable differences for electrocutaneous stimulation pulse frequency in both intact participants and one transradial amputee. For the transradial amputee, we also quantified the just-noticeable difference of intraneural microstimulation pulse frequency via chronically implanted Utah Slanted Electrode Arrays. We demonstrate that intensity discrimination is similar across conditions: intraneural microstimulation of the residual nerves, electrocutaneous stimulation of the reinnervated skin on the residual limb, and electrocutaneous stimulation of intact hands. We also show that intensity discrimination performance is significantly better at lower pulse frequencies than at higher pulse frequencies - a finding that's unique to electrocutaneous and intraneural stimulation and suggests that supplemental sensory cues may be present at lower pulse frequencies. These results can help guide the implementation of artificial sensory feedback for sensorized bionic arms.Clinical Relevance- Intraneural and electrocutaneous artificial sensory feedback are comparable in their ability to convey the magnitude of tactile stimuli via pulse frequency.
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Mastinu E, Engels LF, Clemente F, Dione M, Sassu P, Aszmann O, Brånemark R, Håkansson B, Controzzi M, Wessberg J, Cipriani C, Ortiz-Catalan M. Neural feedback strategies to improve grasping coordination in neuromusculoskeletal prostheses. Sci Rep 2020; 10:11793. [PMID: 32678121 PMCID: PMC7367346 DOI: 10.1038/s41598-020-67985-5] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Accepted: 06/11/2020] [Indexed: 11/09/2022] Open
Abstract
Conventional prosthetic arms suffer from poor controllability and lack of sensory feedback. Owing to the absence of tactile sensory information, prosthetic users must rely on incidental visual and auditory cues. In this study, we investigated the effect of providing tactile perception on motor coordination during routine grasping and grasping under uncertainty. Three transhumeral amputees were implanted with an osseointegrated percutaneous implant system for direct skeletal attachment and bidirectional communication with implanted neuromuscular electrodes. This neuromusculoskeletal prosthesis is a novel concept of artificial limb replacement that allows to extract control signals from electrodes implanted on viable muscle tissue, and to stimulate severed afferent nerve fibers to provide somatosensory feedback. Subjects received tactile feedback using three biologically inspired stimulation paradigms while performing a pick and lift test. The grasped object was instrumented to record grasping and lifting forces and its weight was either constant or unexpectedly changed in between trials. The results were also compared to the no-feedback control condition. Our findings confirm, in line with the neuroscientific literature, that somatosensory feedback is necessary for motor coordination during grasping. Our results also indicate that feedback is more relevant under uncertainty, and its effectiveness can be influenced by the selected neuromodulation paradigm and arguably also the prior experience of the prosthesis user.
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Affiliation(s)
- Enzo Mastinu
- Center for Bionics and Pain Research, Mölndal, Sweden
- Department of Electrical Engineering, Chalmers University of Technology, Gothenburg, Sweden
| | - Leonard F Engels
- The Biorobotics Institute, Scuola Superiore Sant'Anna, Pisa, Italy
- Department of Excellence in Robotics & AI, Scuola Superiore Sant'Anna, Pisa, Italy
| | - Francesco Clemente
- The Biorobotics Institute, Scuola Superiore Sant'Anna, Pisa, Italy
- Department of Excellence in Robotics & AI, Scuola Superiore Sant'Anna, Pisa, Italy
- Prensilia SRL, Pontedera, Italy
| | - Mariama Dione
- Department of Physiology, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Paolo Sassu
- Department of Hand Surgery, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Oskar Aszmann
- Clinical Laboratory for Bionic Extremity Reconstruction, Division of Plastic and Reconstructive Surgery, Medical University of Vienna, Vienna, Austria
| | - Rickard Brånemark
- Department of Orthopaedics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Center for Extreme Bionics, Biomechatronics Group, MIT Media Lab, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Bo Håkansson
- Department of Electrical Engineering, Chalmers University of Technology, Gothenburg, Sweden
| | - Marco Controzzi
- The Biorobotics Institute, Scuola Superiore Sant'Anna, Pisa, Italy
- Department of Excellence in Robotics & AI, Scuola Superiore Sant'Anna, Pisa, Italy
| | - Johan Wessberg
- Department of Physiology, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Christian Cipriani
- The Biorobotics Institute, Scuola Superiore Sant'Anna, Pisa, Italy
- Department of Excellence in Robotics & AI, Scuola Superiore Sant'Anna, Pisa, Italy
| | - Max Ortiz-Catalan
- Center for Bionics and Pain Research, Mölndal, Sweden.
- Department of Electrical Engineering, Chalmers University of Technology, Gothenburg, Sweden.
- Department of Orthopaedics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
- Operational Area 3, Sahlgrenska University Hospital, Mölndal, Sweden.
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13
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Yildiz KA, Shin AY, Kaufman KR. Interfaces with the peripheral nervous system for the control of a neuroprosthetic limb: a review. J Neuroeng Rehabil 2020; 17:43. [PMID: 32151268 PMCID: PMC7063740 DOI: 10.1186/s12984-020-00667-5] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Accepted: 02/17/2020] [Indexed: 12/22/2022] Open
Abstract
The field of prosthetics has been evolving and advancing over the past decade, as patients with missing extremities are expecting to control their prostheses in as normal a way as possible. Scientists have attempted to satisfy this expectation by designing a connection between the nervous system of the patient and the prosthetic limb, creating the field of neuroprosthetics. In this paper, we broadly review the techniques used to bridge the patient's peripheral nervous system to a prosthetic limb. First, we describe the electrical methods including myoelectric systems, surgical innovations and the role of nerve electrodes. We then describe non-electrical methods used alone or in combination with electrical methods. Design concerns from an engineering point of view are explored, and novel improvements to obtain a more stable interface are described. Finally, a critique of the methods with respect to their long-term impacts is provided. In this review, nerve electrodes are found to be one of the most promising interfaces in the future for intuitive user control. Clinical trials with larger patient populations, and for longer periods of time for certain interfaces, will help to evaluate the clinical application of nerve electrodes.
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Affiliation(s)
- Kadir A Yildiz
- Motion Analysis Laboratory, Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USA
| | - Alexander Y Shin
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USA
| | - Kenton R Kaufman
- Motion Analysis Laboratory, Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USA.
- Motion Analysis Laboratory, W. Hall Wendel, Jr., Musculoskeletal Research, 200 First Street SW, Rochester, MN, 55905, USA.
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14
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Brunton EK, Silveira C, Rosenberg J, Schiefer MA, Riddell J, Nazarpour K. Temporal Modulation of the Response of Sensory Fibers to Paired-Pulse Stimulation. IEEE Trans Neural Syst Rehabil Eng 2019; 27:1676-1683. [DOI: 10.1109/tnsre.2019.2935813] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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15
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Ortiz-Catalan M, Wessberg J, Mastinu E, Naber A, Branemark R. Patterned Stimulation of Peripheral Nerves Produces Natural Sensations With Regards to Location but Not Quality. ACTA ACUST UNITED AC 2019. [DOI: 10.1109/tmrb.2019.2931758] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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