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Dong C, Carnicer-Lombarte A, Bonafè F, Huang B, Middya S, Jin A, Tao X, Han S, Bance M, Barone DG, Fraboni B, Malliaras GG. Electrochemically actuated microelectrodes for minimally invasive peripheral nerve interfaces. NATURE MATERIALS 2024; 23:969-976. [PMID: 38671159 PMCID: PMC11230894 DOI: 10.1038/s41563-024-01886-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 03/31/2024] [Indexed: 04/28/2024]
Abstract
Electrode arrays that interface with peripheral nerves are used in the diagnosis and treatment of neurological disorders; however, they require complex placement surgeries that carry a high risk of nerve injury. Here we leverage recent advances in soft robotic actuators and flexible electronics to develop highly conformable nerve cuffs that combine electrochemically driven conducting-polymer-based soft actuators with low-impedance microelectrodes. Driven with applied voltages as small as a few hundreds of millivolts, these cuffs allow active grasping or wrapping around delicate nerves. We validate this technology using in vivo rat models, showing that the cuffs form and maintain a self-closing and reliable bioelectronic interface with the sciatic nerve of rats without the use of surgical sutures or glues. This seamless integration of soft electrochemical actuators with neurotechnology offers a path towards minimally invasive intraoperative monitoring of nerve activity and high-quality bioelectronic interfaces.
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Affiliation(s)
- Chaoqun Dong
- Electrical Engineering Division, Department of Engineering, University of Cambridge, Cambridge, UK
| | | | - Filippo Bonafè
- Electrical Engineering Division, Department of Engineering, University of Cambridge, Cambridge, UK
- Department of Physics and Astronomy, University of Bologna, Bologna, Italy
| | - Botian Huang
- Electrical Engineering Division, Department of Engineering, University of Cambridge, Cambridge, UK
- Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK
| | - Sagnik Middya
- Electrical Engineering Division, Department of Engineering, University of Cambridge, Cambridge, UK
| | - Amy Jin
- Electrical Engineering Division, Department of Engineering, University of Cambridge, Cambridge, UK
| | - Xudong Tao
- Electrical Engineering Division, Department of Engineering, University of Cambridge, Cambridge, UK
| | - Sanggil Han
- Electrical Engineering Division, Department of Engineering, University of Cambridge, Cambridge, UK
- Department of Nano-Bioengineering, Incheon National University, Incheon, Republic of Korea
| | - Manohar Bance
- Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK
| | - Damiano G Barone
- Electrical Engineering Division, Department of Engineering, University of Cambridge, Cambridge, UK
- Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK
| | - Beatrice Fraboni
- Department of Physics and Astronomy, University of Bologna, Bologna, Italy
| | - George G Malliaras
- Electrical Engineering Division, Department of Engineering, University of Cambridge, Cambridge, UK.
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2
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Jiang Z, Tran BH, Jolfaei MA, Abbasi BBA, Spinks GM. Crack-Resistant and Tissue-Like Artificial Muscles with Low Temperature Activation and High Power Density. ADVANCED MATERIALS (DEERFIELD BEACH, FLA.) 2024; 36:e2402278. [PMID: 38657958 DOI: 10.1002/adma.202402278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Revised: 04/11/2024] [Indexed: 04/26/2024]
Abstract
Constructing soft robotics with safe human-machine interactions requires low-modulus, high-power-density artificial muscles that are sensitive to gentle stimuli. In addition, the ability to resist crack propagation during long-term actuation cycles is essential for a long service life. Herein, a material design is proposed to combine all these desirable attributes in a single artificial muscle platform. The design involves the molecular engineering of a liquid crystalline network with crystallizable segments and an ethylene glycol flexible spacer. A high degree of crystallinity can be afforded by utilizing aza-Michael chemistry to produce a low covalent crosslinking density, resulting in crack-insensitivity with a high fracture energy of 33 720 J m-2 and a high fatigue threshold of 2250 J m-2. Such crack-resistant artificial muscle with tissue-matched modulus of 0.7 MPa can generate a high power density of 450 W kg-1 at a low temperature of 40 °C. Notably, because of the presence of crystalline domains in the actuated state, no crack propagation is observed after 500 heating-cooling actuation cycles under a static load of 220 kPa. This study points to a pathway for the creation of artificial muscles merging seemingly disparate, but desirable properties, broadening their application potential in smart devices.
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Affiliation(s)
- Zhen Jiang
- School of Mechanical, Materials, Mechatronic and Biomedical Engineering, University of Wollongong, Wollongong, NSW, 2522, Australia
| | - Bach H Tran
- School of Mechanical, Materials, Mechatronic and Biomedical Engineering, University of Wollongong, Wollongong, NSW, 2522, Australia
| | - Maryam Adavoudi Jolfaei
- School of Mechanical, Materials, Mechatronic and Biomedical Engineering, University of Wollongong, Wollongong, NSW, 2522, Australia
| | - Burhan Bin Asghar Abbasi
- School of Mechanical, Materials, Mechatronic and Biomedical Engineering, University of Wollongong, Wollongong, NSW, 2522, Australia
| | - Geoffrey M Spinks
- School of Mechanical, Materials, Mechatronic and Biomedical Engineering, University of Wollongong, Wollongong, NSW, 2522, Australia
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3
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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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4
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Kundu A, Patrick E, Currlin S, Madler R, Delgado F, Fahmy A, Verplancke R, Ballini M, Braeken D, de Beeck MO, Maghari N, Otto KJ, Bashirullah R. Using Compound Neural Action Potentials for Functional Validation of a High-Density Intraneural Interface: A Preliminary Study. MICROMACHINES 2024; 15:280. [PMID: 38399008 PMCID: PMC10891740 DOI: 10.3390/mi15020280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Revised: 02/14/2024] [Accepted: 02/15/2024] [Indexed: 02/25/2024]
Abstract
Compound nerve action potentials (CNAPs) were used as a metric to assess the stimulation performance of a novel high-density, transverse, intrafascicular electrode in rat models. We show characteristic CNAPs recorded from distally implanted cuff electrodes. Evaluation of the CNAPs as a function of stimulus current and calculation of recruitment plots were used to obtain a qualitative approximation of the neural interface's placement and orientation inside the nerve. This method avoids elaborate surgeries required for the implantation of EMG electrodes and thus minimizes surgical complications and may accelerate the healing process of the implanted subject.
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Affiliation(s)
- Aritra Kundu
- Department of Bioengineering, Imperial College London, SW7 2AZ London, UK
- Department of Electrical and Computer Engineering, University of Florida, Gainesville, FL 32611, USA; (E.P.); (N.M.)
| | - Erin Patrick
- Department of Electrical and Computer Engineering, University of Florida, Gainesville, FL 32611, USA; (E.P.); (N.M.)
| | - Seth Currlin
- Department of Biomedical Engineering, University of Florida, Gainesville, FL 32611, USA (K.J.O.)
| | - Ryan Madler
- Department of Electrical and Computer Engineering, University of Florida, Gainesville, FL 32611, USA; (E.P.); (N.M.)
| | - Francisco Delgado
- Department of Biomedical Engineering, University of Florida, Gainesville, FL 32611, USA (K.J.O.)
| | - Ahmed Fahmy
- Department of Electrical and Computer Engineering, University of Florida, Gainesville, FL 32611, USA; (E.P.); (N.M.)
| | - Rik Verplancke
- Centre for Microsystems Technology (CMST), IMEC and Ghent University, 9052 Zwijnaarde, Belgium (M.O.d.B.)
| | | | | | - Maaike Op de Beeck
- Centre for Microsystems Technology (CMST), IMEC and Ghent University, 9052 Zwijnaarde, Belgium (M.O.d.B.)
- IMEC, Kapeldreef 75, 3001 Leuven, Belgium;
| | - Nima Maghari
- Department of Electrical and Computer Engineering, University of Florida, Gainesville, FL 32611, USA; (E.P.); (N.M.)
| | - Kevin J. Otto
- Department of Biomedical Engineering, University of Florida, Gainesville, FL 32611, USA (K.J.O.)
| | - Rizwan Bashirullah
- Department of Electrical and Computer Engineering, University of Florida, Gainesville, FL 32611, USA; (E.P.); (N.M.)
- Galvani Bioelectronics, South San Francisco, CA 94080, USA
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5
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Thota AK, Jung R. Accelerating neurotechnology development using an Agile methodology. Front Neurosci 2024; 18:1328540. [PMID: 38435056 PMCID: PMC10904481 DOI: 10.3389/fnins.2024.1328540] [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: 10/26/2023] [Accepted: 01/18/2024] [Indexed: 03/05/2024] Open
Abstract
Novel bioelectronic medical devices that target neural control of visceral organs (e.g., liver, gut, spleen) or inflammatory reflex pathways are innovative class III medical devices like implantable cardiac pacemakers that are lifesaving and life-sustaining medical devices. Bringing innovative neurotechnologies early into the market and the hands of treatment providers would benefit a large population of patients inflicted with autonomic and chronic immune disorders. Medical device manufacturers and software developers widely use the Waterfall methodology to implement design controls through verification and validation. In the Waterfall methodology, after identifying user needs, a functional unit is fabricated following the verification loop (design, build, and verify) and then validated against user needs. Considerable time can lapse in building, verifying, and validating the product because this methodology has limitations for adjusting to unanticipated changes. The time lost in device development can cause significant delays in final production, increase costs, and may even result in the abandonment of the device development. Software developers have successfully implemented an Agile methodology that overcomes these limitations in developing medical software. However, Agile methodology is not routinely used to develop medical devices with implantable hardware because of the increased regulatory burden of the need to conduct animal and human studies. Here, we provide the pros and cons of the Waterfall methodology and make a case for adopting the Agile methodology in developing medical devices with physical components. We utilize a peripheral nerve interface as an example device to illustrate the use of the Agile approach to develop neurotechnologies.
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Affiliation(s)
- Anil Kumar Thota
- Adaptive Neural Systems Group, The Institute for Integrative and Innovative Research, University of Arkansas, Fayetteville, AR, United States
| | - Ranu Jung
- Adaptive Neural Systems Group, The Institute for Integrative and Innovative Research, University of Arkansas, Fayetteville, AR, United States
- Biomedical Engineering Department, University of Arkansas, Fayetteville, AR, United States
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6
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Tian Y, Vaskov AK, Adidharma W, Cederna PS, Kemp SW. Merging Humans and Neuroprosthetics through Regenerative Peripheral Nerve Interfaces. Semin Plast Surg 2024; 38:10-18. [PMID: 38495064 PMCID: PMC10942838 DOI: 10.1055/s-0044-1779028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/19/2024]
Abstract
Limb amputations can be devastating and significantly affect an individual's independence, leading to functional and psychosocial challenges in nearly 2 million people in the United States alone. Over the past decade, robotic devices driven by neural signals such as neuroprostheses have shown great potential to restore the lost function of limbs, allowing amputees to regain movement and sensation. However, current neuroprosthetic interfaces have challenges in both signal quality and long-term stability. To overcome these limitations and work toward creating bionic limbs, the Neuromuscular Laboratory at University of Michigan Plastic Surgery has developed the Regenerative Peripheral Nerve Interface (RPNI). This surgical construct embeds a transected peripheral nerve into a free muscle graft, effectively amplifying small peripheral nerve signals to provide enhanced control signals for a neuroprosthetic limb. Furthermore, the RPNI has the potential to provide sensory feedback to the user and facilitate neuroprosthesis embodiment. This review focuses on the animal studies and clinical trials of the RPNI to recapitulate the promising trajectory toward neurobionics where the boundary between an artificial device and the human body becomes indistinct. This paper also sheds light on the prospects of the improvement and dissemination of the RPNI technology.
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Affiliation(s)
- Yucheng Tian
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, Michigan
| | - Alex K. Vaskov
- Section of Plastic Surgery, Department of Surgery, University of Michigan, Ann Arbor, Michigan
| | - Widya Adidharma
- Section of Plastic Surgery, Department of Surgery, University of Michigan, Ann Arbor, Michigan
| | - Paul S. Cederna
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, Michigan
- Section of Plastic Surgery, Department of Surgery, University of Michigan, Ann Arbor, Michigan
| | - Stephen W.P. Kemp
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, Michigan
- Section of Plastic Surgery, Department of Surgery, University of Michigan, Ann Arbor, Michigan
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7
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Ionescu ON, Franti E, Carbunaru V, Moldovan C, Dinulescu S, Ion M, Dragomir DC, Mihailescu CM, Lascar I, Oproiu AM, Neagu TP, Costea R, Dascalu M, Teleanu MD, Ionescu G, Teleanu R. System of Implantable Electrodes for Neural Signal Acquisition and Stimulation for Wirelessly Connected Forearm Prosthesis. BIOSENSORS 2024; 14:31. [PMID: 38248408 PMCID: PMC10813559 DOI: 10.3390/bios14010031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Revised: 12/31/2023] [Accepted: 01/02/2024] [Indexed: 01/23/2024]
Abstract
There is great interest in the development of prosthetic limbs capable of complex activities that are wirelessly connected to the patient's neural system. Although some progress has been achieved in this area, one of the main problems encountered is the selective acquisition of nerve impulses and the closing of the automation loop through the selective stimulation of the sensitive branches of the patient. Large-scale research and development have achieved so-called "cuff electrodes"; however, they present a big disadvantage: they are not selective. In this article, we present the progress made in the development of an implantable system of plug neural microelectrodes that relate to the biological nerve tissue and can be used for the selective acquisition of neuronal signals and for the stimulation of specific nerve fascicles. The developed plug electrodes are also advantageous due to their small thickness, as they do not trigger nerve inflammation. In addition, the results of the conducted tests on a sous scrofa subject are presented.
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Affiliation(s)
- Octavian Narcis Ionescu
- Faculty of Mechanical and Electrical Engineering, Petroleum and Gas University from Ploiesti, 100680 Ploiesti, Romania; (O.N.I.); (G.I.)
- National Institute for Research and Development for Microtechnology Bucharest, 077190 Bucharest, Romania; (C.M.); (S.D.); (M.I.); (D.C.D.); (C.M.M.)
| | - Eduard Franti
- National Institute for Research and Development for Microtechnology Bucharest, 077190 Bucharest, Romania; (C.M.); (S.D.); (M.I.); (D.C.D.); (C.M.M.)
- ICIA, Centre of New Electronic Architectures, 061071 Bucharest, Romania;
| | - Vlad Carbunaru
- Emergency Clinic Hospital Bucharest, 014461 Bucharest, Romania; (V.C.); (I.L.); (A.M.O.); (T.P.N.)
- University of Medicine and Pharmacy UMF Carol Davila, 050474 Bucharest, Romania; (M.D.T.); (R.T.)
| | - Carmen Moldovan
- National Institute for Research and Development for Microtechnology Bucharest, 077190 Bucharest, Romania; (C.M.); (S.D.); (M.I.); (D.C.D.); (C.M.M.)
| | - Silviu Dinulescu
- National Institute for Research and Development for Microtechnology Bucharest, 077190 Bucharest, Romania; (C.M.); (S.D.); (M.I.); (D.C.D.); (C.M.M.)
| | - Marian Ion
- National Institute for Research and Development for Microtechnology Bucharest, 077190 Bucharest, Romania; (C.M.); (S.D.); (M.I.); (D.C.D.); (C.M.M.)
| | - David Catalin Dragomir
- National Institute for Research and Development for Microtechnology Bucharest, 077190 Bucharest, Romania; (C.M.); (S.D.); (M.I.); (D.C.D.); (C.M.M.)
| | - Carmen Marinela Mihailescu
- National Institute for Research and Development for Microtechnology Bucharest, 077190 Bucharest, Romania; (C.M.); (S.D.); (M.I.); (D.C.D.); (C.M.M.)
| | - Ioan Lascar
- Emergency Clinic Hospital Bucharest, 014461 Bucharest, Romania; (V.C.); (I.L.); (A.M.O.); (T.P.N.)
- University of Medicine and Pharmacy UMF Carol Davila, 050474 Bucharest, Romania; (M.D.T.); (R.T.)
| | - Ana Maria Oproiu
- Emergency Clinic Hospital Bucharest, 014461 Bucharest, Romania; (V.C.); (I.L.); (A.M.O.); (T.P.N.)
- University of Medicine and Pharmacy UMF Carol Davila, 050474 Bucharest, Romania; (M.D.T.); (R.T.)
| | - Tiberiu Paul Neagu
- Emergency Clinic Hospital Bucharest, 014461 Bucharest, Romania; (V.C.); (I.L.); (A.M.O.); (T.P.N.)
- University of Medicine and Pharmacy UMF Carol Davila, 050474 Bucharest, Romania; (M.D.T.); (R.T.)
| | - Ruxandra Costea
- Faculty of Veterinary Medicine, University of Agricultural Sciences and Veterinary Medicine of Bucharest, 011464 Bucharest, Romania;
| | - Monica Dascalu
- ICIA, Centre of New Electronic Architectures, 061071 Bucharest, Romania;
- Faculty of Electronics, Telecommunications and Information Technology, National University of Science and Technology Politehnica of Bucharest, 060042 Bucharest, Romania
| | - Mihai Daniel Teleanu
- University of Medicine and Pharmacy UMF Carol Davila, 050474 Bucharest, Romania; (M.D.T.); (R.T.)
| | - Gabriela Ionescu
- Faculty of Mechanical and Electrical Engineering, Petroleum and Gas University from Ploiesti, 100680 Ploiesti, Romania; (O.N.I.); (G.I.)
| | - Raluca Teleanu
- University of Medicine and Pharmacy UMF Carol Davila, 050474 Bucharest, Romania; (M.D.T.); (R.T.)
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8
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Thomas RL, Howes R, McMenemy L, Hindle P, Wordsworth M, Staruch R. Delivery of UK military upper limb prosthetics: current concepts and future directions. BMJ Mil Health 2023:e002485. [PMID: 37879645 DOI: 10.1136/military-2023-002485] [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: 06/25/2023] [Accepted: 09/24/2023] [Indexed: 10/27/2023]
Abstract
Upper limb prosthetics have a challenging task. A natural upper limb combines strength, coordination and dexterity to accomplish daily activities such as eating, writing, working and social interaction. Artificially replicating these functions requires a prosthetic with composite, synchronous motor function while maintaining sensory feedback and skeletal stability. Achieving these functions requires interfaces between biology and machine across nerve, muscle, bone and skin. This leads to issues related to infection, foreign material encapsulation and implant stability, and electrical signal transduction and interpretation. Over the last 20 years the advent of technologies such as osseointegration, targeted muscle reinnervation, implantable myoelectric sensors, peripheral nerve interfaces and pattern recognition technology has sought to address these problems.Due to many advances in prehospital care, truncated timelines to damage control surgery and improved combat personal protective equipment, the numbers of amputees have increased with more patients surviving injury. From October 2001 to March 2019 there were 333 amputees from Afghanistan and Iraq compared with 457 fatalities over a similar period. Over a third of these were significant multiple amputees. With a functional, robust upper limb prosthetic which mirrors or exceeds normal function, injured service personnel could be returned to an active combat role. This has benefits for their physical and mental health, improves employability prospects and allows Defence to retain some of its most highly motivated and skilled people who represent significant financial investment.
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Affiliation(s)
| | - R Howes
- Burns, Plastic and Reconstructive Surgery, Salisbury NHS Foundation Trust, Salisbury, UK
| | - L McMenemy
- Academic Department of Military Surgery and Trauma (ADMST), Royal Centre for Defence Medicine, Birmingham, UK
- Centre for Blast Injury Studies, Imperial College London, London, UK
| | - P Hindle
- Trauma and Orthopaedic Surgery, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - M Wordsworth
- Academic Department of Military Surgery and Trauma, Royal Centre for Defence Medicine, Birmingham, UK
| | - R Staruch
- Department of Plastic Surgery, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
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9
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Tommasini G, De Simone M, Santillo S, Dufil G, Iencharelli M, Mantione D, Stavrinidou E, Tino A, Tortiglione C. In vivo neuromodulation of animal behavior with organic semiconducting oligomers. SCIENCE ADVANCES 2023; 9:eadi5488. [PMID: 37851802 PMCID: PMC10584338 DOI: 10.1126/sciadv.adi5488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Accepted: 09/08/2023] [Indexed: 10/20/2023]
Abstract
Modulating neural activity with electrical or chemical stimulus can be used for fundamental and applied research. Typically, neuronal stimulation is performed with intracellular and extracellular electrodes that deliver brief electrical pulses to neurons. However, alternative wireless methodologies based on functional materials may allow clinical translation of technologies to modulate neuronal function. Here, we show that the organic semiconducting oligomer 4-[2-{2,5-bis(2,3-dihydrothieno[3,4-b][1,4]dioxin-5-yl)thiophen-3-yl}ethoxy]butane-1-sulfonate (ETE-S) induces precise behaviors in the small invertebrate Hydra, which were dissected through pharmacological and electrophysiological approaches. ETE-S-induced behavioral response relies on the presence of head neurons and calcium ions and is prevented by drugs targeting ionotropic channels and muscle contraction. Moreover, ETE-S affects Hydra's electrical activity enhancing the contraction burst frequency. The unexpected neuromodulatory function played by this conjugated oligomer on a simple nerve net opens intriguing research possibilities on fundamental chemical and physical phenomena behind organic bioelectronic interfaces for neuromodulation and on alternative methods that could catalyze a wide expansion of this rising technology for clinical applications.
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Affiliation(s)
- Giuseppina Tommasini
- Istituto di Scienze Applicate e Sistemi Intelligenti “E. Caianiello”, Consiglio Nazionale delle Ricerche, Via Campi Flegrei 34, 80078 Pozzuoli, Italy
| | - Mariarosaria De Simone
- Istituto di Scienze Applicate e Sistemi Intelligenti “E. Caianiello”, Consiglio Nazionale delle Ricerche, Via Campi Flegrei 34, 80078 Pozzuoli, Italy
| | - Silvia Santillo
- Istituto di Scienze Applicate e Sistemi Intelligenti “E. Caianiello”, Consiglio Nazionale delle Ricerche, Via Campi Flegrei 34, 80078 Pozzuoli, Italy
| | - Gwennaël Dufil
- Laboratory of Organic Electronics, Department of Science and Technology, Linköping University, SE-60174 Norrkoping, Sweden
| | - Marika Iencharelli
- Istituto di Scienze Applicate e Sistemi Intelligenti “E. Caianiello”, Consiglio Nazionale delle Ricerche, Via Campi Flegrei 34, 80078 Pozzuoli, Italy
| | - Daniele Mantione
- POLYMAT University of the Basque Country UPV/EHU, 20018 Donostia-San Sebastián, Spain; IKERBASQUE, Basque Foundation for Science, 48009, Bilbao, Spain
| | - Eleni Stavrinidou
- Laboratory of Organic Electronics, Department of Science and Technology, Linköping University, SE-60174 Norrkoping, Sweden
| | - Angela Tino
- Istituto di Scienze Applicate e Sistemi Intelligenti “E. Caianiello”, Consiglio Nazionale delle Ricerche, Via Campi Flegrei 34, 80078 Pozzuoli, Italy
| | - Claudia Tortiglione
- Istituto di Scienze Applicate e Sistemi Intelligenti “E. Caianiello”, Consiglio Nazionale delle Ricerche, Via Campi Flegrei 34, 80078 Pozzuoli, Italy
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10
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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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11
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Barroso FO, Torricelli D, Moreno JC. Neurorobotics and neuroprostheses: Towards a new anatomy. Anat Rec (Hoboken) 2023; 306:706-709. [PMID: 36715240 DOI: 10.1002/ar.25157] [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: 08/15/2022] [Revised: 11/07/2022] [Accepted: 12/20/2022] [Indexed: 01/31/2023]
Abstract
The idea of this Special Issue arose from the technological advances in bionic, robotic, and neural rehabilitation systems and the common need to comprehend in detail how human anatomical structures can be replicated or controlled. Motor control theories, among others, include the generalized control program theory, the equilibrium point hypothesis, or the optimal control approach in which neural commands to the muscles are a result of the central nervous system solving an optimization problem for a specific cost function. No matter the alternative interpretation selected to replicate biological control of human movements, artificial "anatomies" should consider not only motor capabilities from the central nervous system but integrate bioinspired mechanical features (such as compliance) in artificial limbs. The development of wearable robotics and neuroprosthetic systems for human movement compensation and control is naturally inspired by human anatomy and biology. Cutting-edge technological advances in the field of biomedical and neural engineering are bringing us more and more close to a new artificial anatomy with which humans could augment their motor capabilities or replace them after they are compromised. Either augmentative/assistive or rehabilitation technologies in the near future will require engineering solutions based on novel approaches to create usable neurorobotic and neuroprosthetic systems for the most relevant societal needs.
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Affiliation(s)
| | - Diego Torricelli
- Neural Rehabilitation Group, Cajal Institute, CSIC, Madrid, Spain
| | - Juan C Moreno
- Neural Rehabilitation Group, Cajal Institute, CSIC, Madrid, Spain
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12
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Pogarasteanu ME, Moga M, Barbilian A, Avram G, Dascalu M, Franti E, Gheorghiu N, Moldovan C, Rusu E, Adam R, Orban C. The Role of Fascial Tissue Layer in Electric Signal Transmission from the Forearm Musculature to the Cutaneous Layer as a Possibility for Increased Signal Strength in Myoelectric Forearm Exoprosthesis Development. Bioengineering (Basel) 2023; 10:bioengineering10030319. [PMID: 36978710 PMCID: PMC10044912 DOI: 10.3390/bioengineering10030319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 02/13/2023] [Accepted: 02/28/2023] [Indexed: 03/06/2023] Open
Abstract
Myoelectric exoprostheses serve to aid in the everyday activities of patients with forearm or hand amputations. While electrical signals are known key factors controlling exoprosthesis, little is known about how we can improve their transmission strength from the forearm muscles as to obtain better sEMG. The purpose of this study is to evaluate the role of the forearm fascial layer in transmitting myoelectrical current. We examined the sEMG signals in three individual muscles, each from six healthy forearms (Group 1) and six amputation stumps (Group 2), along with their complete biometric characteristics. Following the tests, one patient underwent a circumferential osteoneuromuscular stump revision surgery (CONM) that also involved partial removal of fascia and subcutaneous fat in the amputation stump, with re-testing after complete healing. In group 1, we obtained a stronger sEMG signal than in Group 2. In the CONM case, after surgery, the patient’s data suggest that the removal of fascia, alongside the fibrotic and subcutaneous fat tissue, generates a stronger sEMG signal. Therefore, a reduction in the fascial layer, especially if accompanied by a reduction of the subcutaneous fat layer may prove significant for improving the strength of sEMG signals used in the control of modern exoprosthetics.
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Affiliation(s)
- Mark-Edward Pogarasteanu
- Faculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, 8 Eroii Sanitari Boulevard, 050474 Bucharest, Romania
- Department of Orthopaedics and Trauma Surgery, “Dr. Carol Davila” Central Military Emergency University Hospital, 010242 Bucharest, Romania
| | - Marius Moga
- Faculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, 8 Eroii Sanitari Boulevard, 050474 Bucharest, Romania
- Department of Orthopaedics and Trauma Surgery, “Dr. Carol Davila” Central Military Emergency University Hospital, 010242 Bucharest, Romania
| | - Adrian Barbilian
- Faculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, 8 Eroii Sanitari Boulevard, 050474 Bucharest, Romania
- Department of Orthopaedics and Trauma Surgery, “Dr. Carol Davila” Central Military Emergency University Hospital, 010242 Bucharest, Romania
| | - George Avram
- Department of Orthopaedics and Trauma Surgery, “Dr. Carol Davila” Central Military Emergency University Hospital, 010242 Bucharest, Romania
| | - Monica Dascalu
- Faculty of Electronics, Telecommunications and Information Technology, University Politehnica of Bucharest, 313 Splaiul Independentei, 060042 Bucharest, Romania
- Center for New Electronic Architecture, Romanian Academy Center for Artificial Intelligence, 13 September Blulevard, 050711 Bucharest, Romania
| | - Eduard Franti
- Faculty of Electronics, Telecommunications and Information Technology, University Politehnica of Bucharest, 313 Splaiul Independentei, 060042 Bucharest, Romania
- Center for New Electronic Architecture, Romanian Academy Center for Artificial Intelligence, 13 September Blulevard, 050711 Bucharest, Romania
- Microsystems in Biomedical and Environmental Applications Laboratory, National Institute for Research and Development in Microtechnology, 126A Erou Iancu Nicolae Street, 077190 Bucharest, Romania
| | - Nicolae Gheorghiu
- Faculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, 8 Eroii Sanitari Boulevard, 050474 Bucharest, Romania
- Department of Orthopedics and Traumatology, Elias Emergency University Hospital, 011461 Bucharest, Romania
| | - Cosmin Moldovan
- Department of Medical-Clinical Disciplines, Faculty of Medicine, “Titu Maiorescu” University of Bucharest, 031593 Bucharest, Romania
- Department of General Surgery, Witting Clinical Hospital, 010243 Bucharest, Romania
- Correspondence: (C.M.); (R.A.); Tel.: +40-7-2350-4207 (C.M.); +40-7-4003-8744 (R.A.)
| | - Elena Rusu
- Department of Preclinic Disciplines, Faculty of Medicine, “Titu Maiorescu” University of Bucharest, 031593 Bucharest, Romania
| | - Razvan Adam
- Department of Orthopedics and Traumatology, Elias Emergency University Hospital, 011461 Bucharest, Romania
- Department of First Aid and Disaster Medicine, Faculty of Medicine, “Titu Maiorescu” University of Bucharest, 040051 Bucharest, Romania
- Correspondence: (C.M.); (R.A.); Tel.: +40-7-2350-4207 (C.M.); +40-7-4003-8744 (R.A.)
| | - Carmen Orban
- Department of Anesthesia and Intensive Care, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania
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13
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Mialland A, Atallah I, Bonvilain A. Toward a robust swallowing detection for an implantable active artificial larynx: a survey. Med Biol Eng Comput 2023; 61:1299-1327. [PMID: 36792845 DOI: 10.1007/s11517-023-02772-8] [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: 02/17/2022] [Accepted: 01/04/2023] [Indexed: 02/17/2023]
Abstract
Total laryngectomy consists in the removal of the larynx and is intended as a curative treatment for laryngeal cancer, but it leaves the patient with no possibility to breathe, talk, and swallow normally anymore. A tracheostomy is created to restore breathing through the throat, but the aero-digestive tracts are permanently separated and the air no longer passes through the nasal tracts, which allowed filtration, warming, humidification, olfaction, and acceleration of the air for better tissue oxygenation. As for phonation restoration, various techniques allow the patient to talk again. The main one consists of a tracheo-esophageal valve prosthesis that makes the air passes from the esophagus to the pharynx, and makes the air vibrate to allow speech through articulation. Finally, swallowing is possible through the original tract as it is now isolated from the trachea. Yet, many methods exist to detect and assess a swallowing, but none is intended as a definitive restoration technique of the natural airway, which would permanently close the tracheostomy and avoid its adverse effects. In addition, these methods are non-invasive and lack detection accuracy. The feasibility of an effective early detection of swallowing would allow to further develop an implantable active artificial larynx and therefore restore the aero-digestive tracts. A previous attempt has been made on an artificial larynx implanted in 2012, but no active detection was included and the system was completely mechanic. This led to residues in the airway because of the imperfect sealing of the mechanism. An active swallowing detection coupled with indwelling measurements would thus likely add a significant reliability on such a system as it would allow to actively close an artificial larynx. So, after a brief explanation of the swallowing mechanism, this survey intends to first provide a detailed consideration of the anatomical region involved in swallowing, with a detection perspective. Second, the swallowing mechanism following total laryngectomy surgery is detailed. Third, the current non-invasive swallowing detection technique and their limitations are discussed. Finally, the previous points are explored with regard to the inherent requirements for the feasibility of an effective swallowing detection for an artificial larynx. Graphical Abstract.
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Affiliation(s)
- Adrien Mialland
- Institute of Engineering and Management Univ. Grenoble Alpes, Univ. Grenoble Alpes, CNRS, Grenoble INP, Gipsa-lab, 38000, Grenoble, France.
| | - Ihab Atallah
- Institute of Engineering and Management Univ. Grenoble Alpes, Otorhinolaryngology, CHU Grenoble Alpes, 38700, La Tronche, France
| | - Agnès Bonvilain
- Institute of Engineering and Management Univ. Grenoble Alpes, Univ. Grenoble Alpes, CNRS, Grenoble INP, Gipsa-lab, 38000, Grenoble, France
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14
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Nazari V, Zheng YP. Controlling Upper Limb Prostheses Using Sonomyography (SMG): A Review. SENSORS (BASEL, SWITZERLAND) 2023; 23:1885. [PMID: 36850483 PMCID: PMC9959820 DOI: 10.3390/s23041885] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 02/01/2023] [Accepted: 02/06/2023] [Indexed: 06/18/2023]
Abstract
This paper presents a critical review and comparison of the results of recently published studies in the fields of human-machine interface and the use of sonomyography (SMG) for the control of upper limb prothesis. For this review paper, a combination of the keywords "Human Machine Interface", "Sonomyography", "Ultrasound", "Upper Limb Prosthesis", "Artificial Intelligence", and "Non-Invasive Sensors" was used to search for articles on Google Scholar and PubMed. Sixty-one articles were found, of which fifty-nine were used in this review. For a comparison of the different ultrasound modes, feature extraction methods, and machine learning algorithms, 16 articles were used. Various modes of ultrasound devices for prosthetic control, various machine learning algorithms for classifying different hand gestures, and various feature extraction methods for increasing the accuracy of artificial intelligence used in their controlling systems are reviewed in this article. The results of the review article show that ultrasound sensing has the potential to be used as a viable human-machine interface in order to control bionic hands with multiple degrees of freedom. Moreover, different hand gestures can be classified by different machine learning algorithms trained with extracted features from collected data with an accuracy of around 95%.
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Affiliation(s)
- Vaheh Nazari
- Department of Biomedical Engineering, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Yong-Ping Zheng
- Department of Biomedical Engineering, The Hong Kong Polytechnic University, Hong Kong SAR, China
- Research Institute for Smart Ageing, The Hong Kong Polytechnic University, Hong Kong SAR, China
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15
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Bruni G, Marinelli A, Bucchieri A, Boccardo N, Caserta G, Di Domenico D, Barresi G, Florio A, Canepa M, Tessari F, Laffranchi M, De Michieli L. Object stiffness recognition and vibratory feedback without ad-hoc sensing on the Hannes prosthesis: A machine learning approach. Front Neurosci 2023; 17:1078846. [PMID: 36875662 PMCID: PMC9978002 DOI: 10.3389/fnins.2023.1078846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Accepted: 01/24/2023] [Indexed: 02/18/2023] Open
Abstract
Introduction In recent years, hand prostheses achieved relevant improvements in term of both motor and functional recovery. However, the rate of devices abandonment, also due to their poor embodiment, is still high. The embodiment defines the integration of an external object - in this case a prosthetic device - into the body scheme of an individual. One of the limiting factors causing lack of embodiment is the absence of a direct interaction between user and environment. Many studies focused on the extraction of tactile information via custom electronic skin technologies coupled with dedicated haptic feedback, though increasing the complexity of the prosthetic system. Contrary wise, this paper stems from the authors' preliminary works on multi-body prosthetic hand modeling and the identification of possible intrinsic information to assess object stiffness during interaction. Methods Based on these initial findings, this work presents the design, implementation and clinical validation of a novel real-time stiffness detection strategy, without ad-hoc sensing, based on a Non-linear Logistic Regression (NLR) classifier. This exploits the minimum grasp information available from an under-sensorized and under-actuated myoelectric prosthetic hand, Hannes. The NLR algorithm takes as input motor-side current, encoder position, and reference position of the hand and provides as output a classification of the grasped object (no-object, rigid object, and soft object). This information is then transmitted to the user via vibratory feedback to close the loop between user control and prosthesis interaction. This implementation was validated through a user study conducted both on able bodied subjects and amputees. Results The classifier achieved excellent performance in terms of F1Score (94.93%). Further, the able-bodied subjects and amputees were able to successfully detect the objects' stiffness with a F1Score of 94.08% and 86.41%, respectively, by using our proposed feedback strategy. This strategy allowed amputees to quickly recognize the objects' stiffness (response time of 2.82 s), indicating high intuitiveness, and it was overall appreciated as demonstrated by the questionnaire. Furthermore, an embodiment improvement was also obtained as highlighted by the proprioceptive drift toward the prosthesis (0.7 cm).
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Affiliation(s)
- Giulia Bruni
- Rehab Technologies, Istituto Italiano di Tecnologia, Genoa, Italy
| | - Andrea Marinelli
- Rehab Technologies, Istituto Italiano di Tecnologia, Genoa, Italy.,Department of Informatics, Bioengineering, Robotics System Engineering (DIBRIS), University of Genova, Genoa, Italy
| | - Anna Bucchieri
- Rehab Technologies, Istituto Italiano di Tecnologia, Genoa, Italy.,Department of Electronics, Information and Bioengineering (NearLab), Politecnico of Milan, Milan, Italy
| | - Nicolò Boccardo
- Rehab Technologies, Istituto Italiano di Tecnologia, Genoa, Italy.,The Open University Affiliated Research Centre at Istituto Italiano di Tecnologia (ARC@IIT), Genoa, Italy
| | - Giulia Caserta
- Rehab Technologies, Istituto Italiano di Tecnologia, Genoa, Italy
| | - Dario Di Domenico
- Rehab Technologies, Istituto Italiano di Tecnologia, Genoa, Italy.,Department of Electronics and Telecommunications, Politecnico of Torino, Turin, Italy
| | - Giacinto Barresi
- Rehab Technologies, Istituto Italiano di Tecnologia, Genoa, Italy
| | - Astrid Florio
- Rehab Technologies, Istituto Italiano di Tecnologia, Genoa, Italy
| | - Michele Canepa
- Rehab Technologies, Istituto Italiano di Tecnologia, Genoa, Italy.,The Open University Affiliated Research Centre at Istituto Italiano di Tecnologia (ARC@IIT), Genoa, Italy
| | - Federico Tessari
- Newman Laboratory, Massachusetts Institute of Technology, Boston, MA, United States
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16
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Steins H, Mierzejewski M, Brauns L, Stumpf A, Kohler A, Heusel G, Corna A, Herrmann T, Jones PD, Zeck G, von Metzen R, Stieglitz T. A flexible protruding microelectrode array for neural interfacing in bioelectronic medicine. MICROSYSTEMS & NANOENGINEERING 2022; 8:131. [PMID: 36568135 PMCID: PMC9772315 DOI: 10.1038/s41378-022-00466-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Revised: 06/23/2022] [Accepted: 07/07/2022] [Indexed: 05/31/2023]
Abstract
Recording neural signals from delicate autonomic nerves is a challenging task that requires the development of a low-invasive neural interface with highly selective, micrometer-sized electrodes. This paper reports on the development of a three-dimensional (3D) protruding thin-film microelectrode array (MEA), which is intended to be used for recording low-amplitude neural signals from pelvic nervous structures by penetrating the nerves transversely to reduce the distance to the axons. Cylindrical gold pillars (Ø 20 or 50 µm, ~60 µm height) were fabricated on a micromachined polyimide substrate in an electroplating process. Their sidewalls were insulated with parylene C, and their tips were optionally modified by wet etching and/or the application of a titanium nitride (TiN) coating. The microelectrodes modified by these combined techniques exhibited low impedances (~7 kΩ at 1 kHz for Ø 50 µm microelectrode with the exposed surface area of ~5000 µm²) and low intrinsic noise levels. Their functionalities were evaluated in an ex vivo pilot study with mouse retinae, in which spontaneous neuronal spikes were recorded with amplitudes of up to 66 µV. This novel process strategy for fabricating flexible, 3D neural interfaces with low-impedance microelectrodes has the potential to selectively record neural signals from not only delicate structures such as retinal cells but also autonomic nerves with improved signal quality to study neural circuits and develop stimulation strategies in bioelectronic medicine, e.g., for the control of vital digestive functions.
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Affiliation(s)
- Helen Steins
- NMI Natural and Medical Sciences Institute at the University of Tübingen, Reutlingen, Germany
- Laboratory for Biomedical Microtechnology, Department of Microsystems Engineering, University of Freiburg, Freiburg, Germany
| | - Michael Mierzejewski
- NMI Natural and Medical Sciences Institute at the University of Tübingen, Reutlingen, Germany
| | - Lisa Brauns
- NMI Natural and Medical Sciences Institute at the University of Tübingen, Reutlingen, Germany
| | - Angelika Stumpf
- NMI Natural and Medical Sciences Institute at the University of Tübingen, Reutlingen, Germany
| | - Alina Kohler
- NMI Natural and Medical Sciences Institute at the University of Tübingen, Reutlingen, Germany
| | - Gerhard Heusel
- NMI Natural and Medical Sciences Institute at the University of Tübingen, Reutlingen, Germany
| | - Andrea Corna
- NMI Natural and Medical Sciences Institute at the University of Tübingen, Reutlingen, Germany
- Institute of Biomedical Electronics, TU Wien, Vienna, Austria
| | - Thoralf Herrmann
- NMI Natural and Medical Sciences Institute at the University of Tübingen, Reutlingen, Germany
| | - Peter D. Jones
- NMI Natural and Medical Sciences Institute at the University of Tübingen, Reutlingen, Germany
| | - Günther Zeck
- NMI Natural and Medical Sciences Institute at the University of Tübingen, Reutlingen, Germany
- Institute of Biomedical Electronics, TU Wien, Vienna, Austria
| | - Rene von Metzen
- NMI Natural and Medical Sciences Institute at the University of Tübingen, Reutlingen, Germany
| | - Thomas 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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17
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Muacevic A, Adler JR, Landge S, Pundkar A, Chandanwale R. Unusual Solitary Neurofibroma of Common Peroneal Nerve in a Child. Cureus 2022; 14:e33039. [PMID: 36721607 PMCID: PMC9881391 DOI: 10.7759/cureus.33039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Accepted: 12/28/2022] [Indexed: 12/29/2022] Open
Abstract
Neurofibroma (NF) is a tumour of peripheral nerves, which would be seldom seen in the limbs, particularly in children's limbs. Soft, skin-coloured papules or small sub-mucosal nodules appear as these lesions. Neurofibroma is classified into three types: localized, diffuse, and plexiform. The vast majority of nerve injury is sporadic and localized, with an incredibly low risk of tumour formation. Neurofibromatosis can present as multiple skin lesions along with bone deformities in which a full investigation is critical where an undiscovered widespread illness may arise. This case study describes a neurofibroma on the common peroneal nerve of the left lower limb in a 6-year-old child who visited our hospital with chief complaints of pain and swelling around the left proximal leg.
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18
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Frossard L, Conforto S, Aszmann OC. Editorial: Bionics limb prostheses: Advances in clinical and prosthetic care. FRONTIERS IN REHABILITATION SCIENCES 2022; 3:950481. [PMID: 36189016 PMCID: PMC9397676 DOI: 10.3389/fresc.2022.950481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/22/2022] [Accepted: 07/18/2022] [Indexed: 11/17/2022]
Affiliation(s)
- Laurent Frossard
- Griffith Centre of Biomedical and Rehabilitation Engineering, Menzies Health Institute Queensland, Griffith University, Gold Coast, QLD, Australia
- Correspondence: Laurent Frossard
| | | | - Oskar C. Aszmann
- Bionic Laboratory of Extremity Reconstruction and Department of Plastic & Reconstructive Surgery, Medical University of Vienna, Vienna, Austria
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19
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Akouissi O, Lacour SP, Micera S, DeSimone A. A finite element model of the mechanical interactions between peripheral nerves and intrafascicular implants. J Neural Eng 2022; 19. [PMID: 35861557 DOI: 10.1088/1741-2552/ac7d0e] [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: 07/28/2021] [Accepted: 06/29/2022] [Indexed: 11/11/2022]
Abstract
Objective.Intrafascicular peripheral nerve implants are key components in the development of bidirectional neuroprostheses such as touch-enabled bionic limbs for amputees. However, the durability of such interfaces is hindered by the immune response following the implantation. Among the causes linked to such reaction, the mechanical mismatch between host nerve and implant is thought to play a decisive role, especially in chronic settings.Approach.Here we focus on modeling mechanical stresses induced on the peripheral nerve by the implant's micromotion using finite element analysis. Through multiple parametric sweeps, we analyze the role of the implant's material, geometry (aspect-ratio and shape), and surface coating, deriving a set of parameters for the design of better-integrated implants.Main results.Our results indicate that peripheral nerve implants should be designed and manufactured with smooth edges, using materials at most three orders of magnitude stiffer than the nerve, and with innovative geometries to redistribute micromotion-associated loads to less delicate parts of the nerve such as the epineurium.Significance.Overall, our model is a useful tool for the peripheral nerve implant designer that is mindful of the importance of implant mechanics for long term applications.
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Affiliation(s)
- Outman Akouissi
- Bertarelli Foundation Chair in Neuroprosthetic Technology, Laboratory for Soft Bioelectronic Interfaces, Neuro-X Institute, Ecole Polytechnique Fédérale de Lausanne (EPFL), Geneva, 1202, Switzerland.,Bertarelli Foundation Chair in Translational Neuroengineering, Translational Neural Engineering Laboratory, Neuro-X Institute, Ecole Polytechnique Fédérale de Lausanne (EPFL), Geneva, 1202, Switzerland
| | - Stéphanie P Lacour
- Bertarelli Foundation Chair in Neuroprosthetic Technology, Laboratory for Soft Bioelectronic Interfaces, Neuro-X Institute, Ecole Polytechnique Fédérale de Lausanne (EPFL), Geneva, 1202, Switzerland
| | - Silvestro Micera
- Bertarelli Foundation Chair in Translational Neuroengineering, Translational Neural Engineering Laboratory, Neuro-X Institute, Ecole Polytechnique Fédérale de Lausanne (EPFL), Geneva, 1202, Switzerland.,The Biorobotics Institute and Department of Excellence in Robotics & AI, Health Science Interdisciplinary Center, Scuola Superiore Sant'Anna, Pisa, Italy
| | - Antonio DeSimone
- The Biorobotics Institute and Department of Excellence in Robotics & AI, Health Science Interdisciplinary Center, Scuola Superiore Sant'Anna, Pisa, Italy.,SISSA-International School for Advanced Studies, 34136 Trieste, Italy
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20
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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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21
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Becerra-Fajardo L, Krob MO, Minguillon J, Rodrigues C, Welsch C, Tudela-Pi M, Comerma A, Oliveira Barroso F, Schneider A, Ivorra A. Floating EMG sensors and stimulators wirelessly powered and operated by volume conduction for networked neuroprosthetics. J Neuroeng Rehabil 2022; 19:57. [PMID: 35672857 PMCID: PMC9171952 DOI: 10.1186/s12984-022-01033-3] [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: 02/14/2022] [Accepted: 05/19/2022] [Indexed: 11/10/2022] Open
Abstract
Background Implantable neuroprostheses consisting of a central electronic unit wired to electrodes benefit thousands of patients worldwide. However, they present limitations that restrict their use. Those limitations, which are more adverse in motor neuroprostheses, mostly arise from their bulkiness and the need to perform complex surgical implantation procedures. Alternatively, it has been proposed the development of distributed networks of intramuscular wireless microsensors and microstimulators that communicate with external systems for analyzing neuromuscular activity and performing stimulation or controlling external devices. This paradigm requires the development of miniaturized implants that can be wirelessly powered and operated by an external system. To accomplish this, we propose a wireless power transfer (WPT) and communications approach based on volume conduction of innocuous high frequency (HF) current bursts. The currents are applied through external textile electrodes and are collected by the wireless devices through two electrodes for powering and bidirectional digital communications. As these devices do not require bulky components for obtaining power, they may have a flexible threadlike conformation, facilitating deep implantation by injection. Methods We report the design and evaluation of advanced prototypes based on the above approach. The system consists of an external unit, floating semi-implantable devices for sensing and stimulation, and a bidirectional communications protocol. The devices are intended for their future use in acute human trials to demonstrate the distributed paradigm. The technology is assayed in vitro using an agar phantom, and in vivo in hindlimbs of anesthetized rabbits. Results The semi-implantable devices were able to power and bidirectionally communicate with the external unit. Using 13 commands modulated in innocuous 3 MHz HF current bursts, the external unit configured the sensing and stimulation parameters, and controlled their execution. Raw EMG was successfully acquired by the wireless devices at 1 ksps. Conclusions The demonstrated approach overcomes key limitations of existing neuroprostheses, paving the way to the development of distributed flexible threadlike sensors and stimulators. To the best of our knowledge, these devices are the first based on WPT by volume conduction that can work as EMG sensors and as electrical stimulators in a network of wireless devices. Supplementary Information The online version contains supplementary material available at 10.1186/s12984-022-01033-3.
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22
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Battraw MA, Fitzgerald J, Joiner WM, James MA, Bagley AM, Schofield JS. A review of upper limb pediatric prostheses and perspectives on future advancements. Prosthet Orthot Int 2022; 46:267-273. [PMID: 35085179 DOI: 10.1097/pxr.0000000000000094] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Accepted: 12/08/2021] [Indexed: 02/03/2023]
Abstract
Many complex factors affect whether a child with a congenital upper limb deficiency will wear a prosthetic limb. Ultimately, for a child to wear and use their prosthesis, it must facilitate the effective performance of daily tasks and promote healthy social interactions. Although numerous pediatric devices are available, most provide a single open-close grasp (if a grasping function is available at all) and often offer nonanthropomorphic appearances, falling short of meeting these criteria. In this narrative review, we provide a critical assessment of the state of upper limb prostheses for children. We summarize literature using quality of life measures and categorize driving factors affecting prosthesis use into two main groupings: psychosocial and physical functioning. We define psychosocial functioning as factors related to social inclusion/exclusion, emotional function, independence, and school functioning. Physical functioning is defined as factors associated with the physical use of a prosthesis. The reviewed literature suggests that psychosocial domains of quality of life may be influenced by a congenital limb deficiency, and currently available prostheses provide little benefit in the physical functioning domains. Finally, we discuss technological advancements in adult prostheses that have yet to be leveraged for pediatric devices, including describing recently developed adult electric hands that may improve physical functioning through multiple grasping configurations and provide more hand-like cosmesis. We outline actions necessary to translate similar technologies for children and discuss further strategies to begin removing barriers to pediatric device adoption.
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Affiliation(s)
- Marcus A Battraw
- Department of Mechanical and Aerospace Engineering, University of California, Davis, CA
| | - Justin Fitzgerald
- Departments of Neurobiology, Physiology and Behavior, Neurology, University of California, Davis, CA
| | - Wilsaan M Joiner
- Departments of Neurobiology, Physiology and Behavior, Neurology, University of California, Davis, CA
| | - Michelle A James
- Shriners Hospital for Children, Northern California, Sacramento, CA
| | - Anita M Bagley
- Shriners Hospital for Children, Northern California, Sacramento, CA
| | - Jonathon S Schofield
- Department of Mechanical and Aerospace Engineering, University of California, Davis, CA
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23
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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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24
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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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25
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Koppaka S, Hess-Dunning A, Tyler DJ. Biomechanical characterization of isolated epineurial and perineurial membranes of rabbit sciatic nerve. J Biomech 2022; 136:111058. [DOI: 10.1016/j.jbiomech.2022.111058] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Revised: 01/31/2022] [Accepted: 03/21/2022] [Indexed: 01/31/2023]
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26
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Tringides CM, Mooney DJ. Materials for Implantable Surface Electrode Arrays: Current Status and Future Directions. ADVANCED MATERIALS (DEERFIELD BEACH, FLA.) 2022; 34:e2107207. [PMID: 34716730 DOI: 10.1002/adma.202107207] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Revised: 10/26/2021] [Indexed: 06/13/2023]
Abstract
Surface electrode arrays are mainly fabricated from rigid or elastic materials, and precisely manipulated ductile metal films, which offer limited stretchability. However, the living tissues to which they are applied are nonlinear viscoelastic materials, which can undergo significant mechanical deformation in dynamic biological environments. Further, the same arrays and compositions are often repurposed for vastly different tissues rather than optimizing the materials and mechanical properties of the implant for the target application. By first characterizing the desired biological environment, and then designing a technology for a particular organ, surface electrode arrays may be more conformable, and offer better interfaces to tissues while causing less damage. Here, the various materials used in each component of a surface electrode array are first reviewed, and then electrically active implants in three specific biological systems, the nervous system, the muscular system, and skin, are described. Finally, the fabrication of next-generation surface arrays that overcome current limitations is discussed.
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Affiliation(s)
- Christina M Tringides
- Harvard Program in Biophysics, Harvard University, Cambridge, MA, 02138, USA
- Harvard-MIT Division in Health Sciences and Technology, Massachusetts Institute of Technology, Cambridge, MA, 02139, USA
- Wyss Institute for Biologically Inspired Engineering, Harvard University, Cambridge, MA, 02138, USA
| | - David J Mooney
- Wyss Institute for Biologically Inspired Engineering, Harvard University, Cambridge, MA, 02138, USA
- John A. Paulson School of Engineering and Applied Sciences, Harvard University, Cambridge, MA, 02138, USA
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27
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Kiang L, Woodington B, Carnicer-Lombarte A, Malliaras G, Barone DG. Spinal cord bioelectronic interfaces: opportunities in neural recording and clinical challenges. J Neural Eng 2022; 19. [PMID: 35320780 DOI: 10.1088/1741-2552/ac605f] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Accepted: 03/23/2022] [Indexed: 11/11/2022]
Abstract
Bioelectronic stimulation of the spinal cord has demonstrated significant progress in restoration of motor function in spinal cord injury (SCI). The proximal, uninjured spinal cord presents a viable target for the recording and generation of control signals to drive targeted stimulation. Signals have been directly recorded from the spinal cord in behaving animals and correlated with limb kinematics. Advances in flexible materials, electrode impedance and signal analysis will allow SCR to be used in next-generation neuroprosthetics. In this review, we summarize the technological advances enabling progress in SCR and describe systematically the clinical challenges facing spinal cord bioelectronic interfaces and potential solutions, from device manufacture, surgical implantation to chronic effects of foreign body reaction and stress-strain mismatches between electrodes and neural tissue. Finally, we establish our vision of bi-directional closed-loop spinal cord bioelectronic bypass interfaces that enable the communication of disrupted sensory signals and restoration of motor function in SCI.
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Affiliation(s)
- Lei Kiang
- Orthopaedic Surgery, Singapore General Hospital, Outram Road, Singapore, Singapore, 169608, SINGAPORE
| | - Ben Woodington
- Department of Engineering, University of Cambridge, Electrical Engineering Division, 9 JJ Thomson Ave, Cambridge, Cambridge, CB2 1TN, UNITED KINGDOM OF GREAT BRITAIN AND NORTHERN IRELAND
| | - Alejandro Carnicer-Lombarte
- Clinical Neurosciences, University of Cambridge, Bioelectronics Laboratory, Cambridge, CB2 0PY, UNITED KINGDOM OF GREAT BRITAIN AND NORTHERN IRELAND
| | - George Malliaras
- University of Cambridge, University of Cambridge, Cambridge, CB2 1TN, UNITED KINGDOM OF GREAT BRITAIN AND NORTHERN IRELAND
| | - Damiano G Barone
- Department of Engineering, University of Cambridge, Electrical Engineering Division, 9 JJ Thomson Ave, Cambridge, Cambridge, Cambridgeshire, CB2 1TN, UNITED KINGDOM OF GREAT BRITAIN AND NORTHERN IRELAND
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28
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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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29
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Marasco PD, Hebert JS, Sensinger JW, Beckler DT, Thumser ZC, Shehata AW, Williams HE, Wilson KR. Neurorobotic fusion of prosthetic touch, kinesthesia, and movement in bionic upper limbs promotes intrinsic brain behaviors. Sci Robot 2021; 6:eabf3368. [PMID: 34516746 DOI: 10.1126/scirobotics.abf3368] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
[Figure: see text].
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Affiliation(s)
- Paul D Marasco
- Laboratory for Bionic Integration, Department of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, 9500 Euclid Avenue, ND20, Cleveland, OH 44195, USA.,Advanced Platform Technology Center, Louis Stokes Cleveland Department of Veterans Affairs Medical Center, 10701 East Boulevard 151 W/APT, Cleveland, OH 44106, USA
| | - Jacqueline S Hebert
- Division of Physical Medicine and Rehabilitation, Department of Medicine, University of Alberta, Edmonton, Alberta T6G 2E1, Canada.,Glenrose Rehabilitation Hospital, Alberta Health Services, 10230-111 Avenue, Edmonton, Alberta T5G 0B7, Canada
| | - Jonathon W Sensinger
- Institute of Biomedical Engineering, University of New Brunswick, 25 Dineen Drive, Fredericton, New Brunswick E3B 5A3, Canada
| | - Dylan T Beckler
- Laboratory for Bionic Integration, Department of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, 9500 Euclid Avenue, ND20, Cleveland, OH 44195, USA
| | - Zachary C Thumser
- Laboratory for Bionic Integration, Department of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, 9500 Euclid Avenue, ND20, Cleveland, OH 44195, USA.,Research Service, Louis Stokes Cleveland Department of Veterans Affairs Medical Center, 10701 East Boulevard, Research 151, Cleveland, OH 44106, USA
| | - Ahmed W Shehata
- Division of Physical Medicine and Rehabilitation, Department of Medicine, University of Alberta, Edmonton, Alberta T6G 2E1, Canada
| | - Heather E Williams
- Department of Biomedical Engineering, University of Alberta, Edmonton, Alberta T6G 2E1, Canada
| | - Kathleen R Wilson
- Institute of Biomedical Engineering, University of New Brunswick, 25 Dineen Drive, Fredericton, New Brunswick E3B 5A3, Canada
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30
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Ganesh Kumar N, Kung TA, Cederna PS. Regenerative Peripheral Nerve Interfaces for Advanced Control of Upper Extremity Prosthetic Devices. Hand Clin 2021; 37:425-433. [PMID: 34253315 DOI: 10.1016/j.hcl.2021.04.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
The quest to find the ideal prosthetic device interface that enables intuitive control has motivated several recent innovations. Although current prosthetic device control strategies have advanced the field of neuroprosthetic control, they are limited in their ability to generate reliable, stable, and specific signals to replicate the complex movements of the upper extremity. The regenerative peripheral nerve interface (RPNI) is a promising solution to enhance prosthetic device control. This article describes the development of RPNIs and summarizes its successful use in the control of advanced prosthetic devices in patients with upper extremity amputations.
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Affiliation(s)
- Nishant Ganesh Kumar
- Section of Plastic Surgery, Department of Surgery, University of Michigan, 2130 Taubman Center, 1500 East Medical Center Drive, Ann Arbor, MI 48109-0340, USA
| | - Theodore A Kung
- Section of Plastic Surgery, Department of Surgery, University of Michigan, 2130 Taubman Center, 1500 East Medical Center Drive, Ann Arbor, MI 48109-0340, USA
| | - Paul S Cederna
- Section of Plastic Surgery, Department of Surgery, University of Michigan, 2130 Taubman Center, 1500 East Medical Center Drive, Ann Arbor, MI 48109-0340, USA; Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, USA.
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31
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Karczewski AM, Dingle AM, Poore SO. The Need to Work Arm in Arm: Calling for Collaboration in Delivering Neuroprosthetic Limb Replacements. Front Neurorobot 2021; 15:711028. [PMID: 34366820 PMCID: PMC8334559 DOI: 10.3389/fnbot.2021.711028] [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: 05/17/2021] [Accepted: 06/22/2021] [Indexed: 11/21/2022] Open
Abstract
Over the last few decades there has been a push to enhance the use of advanced prosthetics within the fields of biomedical engineering, neuroscience, and surgery. Through the development of peripheral neural interfaces and invasive electrodes, an individual's own nervous system can be used to control a prosthesis. With novel improvements in neural recording and signal decoding, this intimate communication has paved the way for bidirectional and intuitive control of prostheses. While various collaborations between engineers and surgeons have led to considerable success with motor control and pain management, it has been significantly more challenging to restore sensation. Many of the existing peripheral neural interfaces have demonstrated success in one of these modalities; however, none are currently able to fully restore limb function. Though this is in part due to the complexity of the human somatosensory system and stability of bioelectronics, the fragmentary and as-yet uncoordinated nature of the neuroprosthetic industry further complicates this advancement. In this review, we provide a comprehensive overview of the current field of neuroprosthetics and explore potential strategies to address its unique challenges. These include exploration of electrodes, surgical techniques, control methods, and prosthetic technology. Additionally, we propose a new approach to optimizing prosthetic limb function and facilitating clinical application by capitalizing on available resources. It is incumbent upon academia and industry to encourage collaboration and utilization of different peripheral neural interfaces in combination with each other to create versatile limbs that not only improve function but quality of life. Despite the rapidly evolving technology, if the field continues to work in divided "silos," we will delay achieving the critical, valuable outcome: creating a prosthetic limb that is right for the patient and positively affects their life.
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Affiliation(s)
| | - Aaron M. Dingle
- Division of Plastic Surgery, Department of Surgery, University of Wisconsin–Madison, Madison, WI, United States
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32
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Raspopovic S, Valle G, Petrini FM. Sensory feedback for limb prostheses in amputees. NATURE MATERIALS 2021; 20:925-939. [PMID: 33859381 DOI: 10.1038/s41563-021-00966-9] [Citation(s) in RCA: 80] [Impact Index Per Article: 26.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Accepted: 02/22/2021] [Indexed: 06/12/2023]
Abstract
Commercial prosthetic devices currently do not provide natural sensory information on the interaction with objects or movements. The subsequent disadvantages include unphysiological walking with a prosthetic leg and difficulty in controlling the force exerted with a prosthetic hand, thus creating health issues. Restoring natural sensory feedback from the prosthesis to amputees is an unmet clinical need. An optimal device should be able to elicit natural sensations of touch or proprioception, by delivering the complex signals to the nervous system that would be produced by skin, muscles and joints receptors. This Review covers the various neurotechnological approaches that have been proposed for the development of the optimal sensory feedback restoration device for arm and leg amputees.
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Affiliation(s)
- Stanisa Raspopovic
- Laboratory for Neuroengineering, Department of Health Sciences and Technology, Institute for Robotics and Intelligent Systems, ETH Zürich, Zurich, Switzerland.
| | - Giacomo Valle
- Laboratory for Neuroengineering, Department of Health Sciences and Technology, Institute for Robotics and Intelligent Systems, ETH Zürich, Zurich, Switzerland
| | - Francesco Maria Petrini
- Laboratory for Neuroengineering, Department of Health Sciences and Technology, Institute for Robotics and Intelligent Systems, ETH Zürich, Zurich, Switzerland
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33
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Gori M, Vadalà G, Giannitelli SM, Denaro V, Di Pino G. Biomedical and Tissue Engineering Strategies to Control Foreign Body Reaction to Invasive Neural Electrodes. Front Bioeng Biotechnol 2021; 9:659033. [PMID: 34113605 PMCID: PMC8185207 DOI: 10.3389/fbioe.2021.659033] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Accepted: 04/27/2021] [Indexed: 12/21/2022] Open
Abstract
Neural-interfaced prostheses aim to restore sensorimotor limb functions in amputees. They rely on bidirectional neural interfaces, which represent the communication bridge between nervous system and neuroprosthetic device by controlling its movements and evoking sensory feedback. Compared to extraneural electrodes (i.e., epineural and perineural implants), intraneural electrodes, implanted within peripheral nerves, have higher selectivity and specificity of neural signal recording and nerve stimulation. However, being implanted in the nerve, their main limitation is represented by the significant inflammatory response that the body mounts around the probe, known as Foreign Body Reaction (FBR), which may hinder their rapid clinical translation. Furthermore, the mechanical mismatch between the consistency of the device and the surrounding neural tissue may contribute to exacerbate the inflammatory state. The FBR is a non-specific reaction of the host immune system to a foreign material. It is characterized by an early inflammatory phase eventually leading to the formation of a fibrotic capsule around intraneural interfaces, which increases the electrical impedance over time and reduces the chronic interface biocompatibility and functionality. Thus, the future in the reduction and control of the FBR relies on innovative biomedical strategies for the fabrication of next-generation neural interfaces, such as the development of more suitable designs of the device with smaller size, appropriate stiffness and novel conductive and biomimetic coatings for improving their long-term stability and performance. Here, we present and critically discuss the latest biomedical approaches from material chemistry and tissue engineering for controlling and mitigating the FBR in chronic neural implants.
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Affiliation(s)
- Manuele Gori
- Laboratory for Regenerative Orthopaedics, Department of Orthopaedic Surgery and Traumatology, Università Campus Bio-Medico di Roma, Rome, Italy
- Institute of Biochemistry and Cell Biology (IBBC) - National Research Council (CNR), Rome, Italy
| | - Gianluca Vadalà
- Laboratory for Regenerative Orthopaedics, Department of Orthopaedic Surgery and Traumatology, Università Campus Bio-Medico di Roma, Rome, Italy
| | - Sara Maria Giannitelli
- Laboratory of Tissue Engineering, Department of Engineering, Università Campus Bio-Medico di Roma, Rome, Italy
| | - Vincenzo Denaro
- Laboratory for Regenerative Orthopaedics, Department of Orthopaedic Surgery and Traumatology, Università Campus Bio-Medico di Roma, Rome, Italy
| | - Giovanni Di Pino
- NeXT: Neurophysiology and Neuroengineering of Human-Technology Interaction Research Unit, Università Campus Bio-Medico di Roma, Rome, Italy
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34
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Zhou X, Du J, Qing L, Mee T, Xu X, Wang Z, Xu C, Jia X. Identification of sensory and motor nerve fascicles by immunofluorescence staining after peripheral nerve injury. J Transl Med 2021; 19:207. [PMID: 33985539 PMCID: PMC8117274 DOI: 10.1186/s12967-021-02871-w] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Accepted: 05/03/2021] [Indexed: 11/25/2022] Open
Abstract
Background Inappropriate matching of motor and sensory fibers after nerve repair or nerve grafting can lead to failure of nerve recovery. Identification of motor and sensory fibers is important for the development of new approaches that facilitate neural regeneration and the next generation of nerve signal-controlled neuro-prosthetic limbs with sensory feedback technology. Only a few methods have been reported to differentiate sensory and motor nerve fascicles, and the reliability of these techniques is unknown. Immunofluorescence staining is one of the most commonly used methods to distinguish sensory and motor nerve fibers, however, its accuracy remains unknown. Methods In this study, we aim to determine the efficacy of popular immunofluorescence markers for motor and sensory nerve fibers. We harvested the facial (primarily motor fascicles) and sural (primarily sensory fascicles) nerves in rats, and examined the immunofluorescent staining expressions of motor markers (choline acetyltransferase (ChAT), tyrosine kinase (TrkA)), and sensory markers [neurofilament protein 200 kDa (NF-200), calcitonin gene-related peptide (CGRP) and Transient receptor potential vanillic acid subtype 1 (TRPV1)]. Three methods, including the average area percentage, the mean gray value, and the axon count, were used to quantify the positive expression of nerve markers in the immunofluorescence images. Results Our results suggest the mean gray value method is the most reliable method. The mean gray value of immunofluorescence in ChAT (63.0 ± 0.76%) and TRKA (47.6 ± 0.43%) on the motor fascicles was significantly higher than that on the sensory fascicles (ChAT: 49.2 ± 0.72%, P < 0.001; and TRKA: 29.1 ± 0.85%, P < 0.001). Additionally, the mean gray values of TRPV1 (51.5 ± 0.83%), NF-200 (61.5 ± 0.62%) and CGRP (37.7 ± 1.22%) on the motor fascicles were significantly lower than that on the sensory fascicles respectively (71.9 ± 2.32%, 69.3 ± 0.46%, and 54.3 ± 1.04%) (P < 0.001). The most accurate cutpoint occurred using CHAT/CRCP ratio, where a value of 0.855 had 100% sensitivity and 100% specificity to identify motor and sensory nerve with an area under the ROC curve of 1.000 (P < 0.001). Conclusions A combination of ChAT and CGRP is suggested to distinguish motor and sensory nerve fibers.
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Affiliation(s)
- Xijie Zhou
- Department of Orthopaedics, The Second Affiliated Hospital and Yuying Children'S Hospital of Wenzhou Medical University, Wenzhou, 325027, China.,Department of Neurosurgery, University of Maryland School of Medicine, 10 South Pine Street, MSTF Building 823, Baltimore, MD, 21201, USA
| | - Jian Du
- Department of Neurosurgery, University of Maryland School of Medicine, 10 South Pine Street, MSTF Building 823, Baltimore, MD, 21201, USA
| | - Liming Qing
- Department of Neurosurgery, University of Maryland School of Medicine, 10 South Pine Street, MSTF Building 823, Baltimore, MD, 21201, USA
| | - Thomas Mee
- Department of Neurosurgery, University of Maryland School of Medicine, 10 South Pine Street, MSTF Building 823, Baltimore, MD, 21201, USA
| | - Xiang Xu
- Department of Neurosurgery, University of Maryland School of Medicine, 10 South Pine Street, MSTF Building 823, Baltimore, MD, 21201, USA
| | - Zhuoran Wang
- Department of Neurosurgery, University of Maryland School of Medicine, 10 South Pine Street, MSTF Building 823, Baltimore, MD, 21201, USA
| | - Cynthia Xu
- Department of Neurosurgery, University of Maryland School of Medicine, 10 South Pine Street, MSTF Building 823, Baltimore, MD, 21201, USA
| | - Xiaofeng Jia
- Department of Neurosurgery, University of Maryland School of Medicine, 10 South Pine Street, MSTF Building 823, Baltimore, MD, 21201, USA. .,Department of Orthopaedics, University of Maryland School of Medicine, Baltimore, MD, 21201, USA. .,Department of Anatomy and Neurobiology, University of Maryland School of Medicine, Baltimore, MD, 21201, USA. .,Department of Biomedical Engineering, The Johns Hopkins University School of Medicine, Baltimore, MD, 21205, USA. .,Department of Anesthesiology and Critical Care Medicine, The Johns Hopkins University School of Medicine, Baltimore, MD, 21205, USA.
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Cracchiolo M, Ottaviani MM, Panarese A, Strauss I, Vallone F, Mazzoni A, Micera S. Bioelectronic medicine for the autonomic nervous system: clinical applications and perspectives. J Neural Eng 2021; 18. [PMID: 33592597 DOI: 10.1088/1741-2552/abe6b9] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Accepted: 02/16/2021] [Indexed: 12/11/2022]
Abstract
Bioelectronic medicine (BM) is an emerging new approach for developing novel neuromodulation therapies for pathologies that have been previously treated with pharmacological approaches. In this review, we will focus on the neuromodulation of autonomic nervous system (ANS) activity with implantable devices, a field of BM that has already demonstrated the ability to treat a variety of conditions, from inflammation to metabolic and cognitive disorders. Recent discoveries about immune responses to ANS stimulation are the laying foundation for a new field holding great potential for medical advancement and therapies and involving an increasing number of research groups around the world, with funding from international public agencies and private investors. Here, we summarize the current achievements and future perspectives for clinical applications of neural decoding and stimulation of the ANS. First, we present the main clinical results achieved so far by different BM approaches and discuss the challenges encountered in fully exploiting the potential of neuromodulatory strategies. Then, we present current preclinical studies aimed at overcoming the present limitations by looking for optimal anatomical targets, developing novel neural interface technology, and conceiving more efficient signal processing strategies. Finally, we explore the prospects for translating these advancements into clinical practice.
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Affiliation(s)
- Marina Cracchiolo
- The BioRobotics Institute and Department of Excellence in Robotics & AI, The BioRobotics Institute, Scuola Superiore Sant'Anna, Pisa, Italy
| | - Matteo Maria Ottaviani
- The BioRobotics Institute and Department of Excellence in Robotics & AI, The BioRobotics Institute, Scuola Superiore Sant'Anna, Pisa, Italy
| | - Alessandro Panarese
- The BioRobotics Institute and Department of Excellence in Robotics & AI, The BioRobotics Institute, Scuola Superiore Sant'Anna, Pisa, Italy
| | - Ivo Strauss
- The BioRobotics Institute and Department of Excellence in Robotics & AI, The BioRobotics Institute, Scuola Superiore Sant'Anna, Pisa, Italy
| | - Fabio Vallone
- The BioRobotics Institute and Department of Excellence in Robotics & AI, The BioRobotics Institute, Scuola Superiore Sant'Anna, Pisa, Italy
| | - Alberto Mazzoni
- The BioRobotics Institute and Department of Excellence in Robotics & AI, The BioRobotics Institute, Scuola Superiore Sant'Anna, Pisa, Italy
| | - Silvestro Micera
- The BioRobotics Institute and Department of Excellence in Robotics & AI, The BioRobotics Institute, Scuola Superiore Sant'Anna, Pisa, Italy.,Bertarelli Foundation Chair in Translational NeuroEngineering, Centre for Neuroprosthetics and Institute of Bioengineering, École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland
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Converging Robotic Technologies in Targeted Neural Rehabilitation: A Review of Emerging Solutions and Challenges. SENSORS 2021; 21:s21062084. [PMID: 33809721 PMCID: PMC8002299 DOI: 10.3390/s21062084] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Revised: 03/05/2021] [Accepted: 03/11/2021] [Indexed: 11/17/2022]
Abstract
Recent advances in the field of neural rehabilitation, facilitated through technological innovation and improved neurophysiological knowledge of impaired motor control, have opened up new research directions. Such advances increase the relevance of existing interventions, as well as allow novel methodologies and technological synergies. New approaches attempt to partially overcome long-term disability caused by spinal cord injury, using either invasive bridging technologies or noninvasive human-machine interfaces. Muscular dystrophies benefit from electromyography and novel sensors that shed light on underlying neuromotor mechanisms in people with Duchenne. Novel wearable robotics devices are being tailored to specific patient populations, such as traumatic brain injury, stroke, and amputated individuals. In addition, developments in robot-assisted rehabilitation may enhance motor learning and generate movement repetitions by decoding the brain activity of patients during therapy. This is further facilitated by artificial intelligence algorithms coupled with faster electronics. The practical impact of integrating such technologies with neural rehabilitation treatment can be substantial. They can potentially empower nontechnically trained individuals-namely, family members and professional carers-to alter the programming of neural rehabilitation robotic setups, to actively get involved and intervene promptly at the point of care. This narrative review considers existing and emerging neural rehabilitation technologies through the perspective of replacing or restoring functions, enhancing, or improving natural neural output, as well as promoting or recruiting dormant neuroplasticity. Upon conclusion, we discuss the future directions for neural rehabilitation research, diagnosis, and treatment based on the discussed technologies and their major roadblocks. This future may eventually become possible through technological evolution and convergence of mutually beneficial technologies to create hybrid solutions.
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Abstract
Historical evidence suggests that prostheses have been used since ancient Egyptian times. Prostheses were usually utilized for function and cosmetic appearances. Nowadays, with the advancement of technology, prostheses such as artificial hands can not only improve functional, but have psychological advantages as well and, therefore, can significantly enhance an individual’s standard of living. Combined with advanced science, a prosthesis is not only a simple mechanical device, but also an aesthetic, engineering and medical marvel. Prosthetic limbs are the best tools to help amputees reintegrate into society. In this article, we discuss the background and advancement of prosthetic hands with their working principles and possible future implications. We also leave with an open question to the readers whether prosthetic hands could ever mimic and replace our biological hands.
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Grushko S, Spurný T, Černý M. Control Methods for Transradial Prostheses Based on Remnant Muscle Activity and Its Relationship with Proprioceptive Feedback. SENSORS (BASEL, SWITZERLAND) 2020; 20:E4883. [PMID: 32872291 PMCID: PMC7506660 DOI: 10.3390/s20174883] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 08/24/2020] [Accepted: 08/25/2020] [Indexed: 02/07/2023]
Abstract
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.
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Affiliation(s)
- Stefan Grushko
- Department of Robotics, VSB-Technical University of Ostrava, 70800 Ostrava, Czech Republic; (T.S.); (M.Č.)
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Ng KKW, Olausson C, Vickery RM, Birznieks I. Temporal patterns in electrical nerve stimulation: Burst gap code shapes tactile frequency perception. PLoS One 2020; 15:e0237440. [PMID: 32790784 PMCID: PMC7425972 DOI: 10.1371/journal.pone.0237440] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2019] [Accepted: 07/27/2020] [Indexed: 12/25/2022] Open
Abstract
We have previously described a novel temporal encoding mechanism in the somatosensory system, where mechanical pulses grouped into periodic bursts create a perceived tactile frequency based on the duration of the silent gap between bursts, rather than the mean rate or the periodicity. This coding strategy may offer new opportunities for transmitting information to the brain using various sensory neural prostheses and haptic interfaces. However, it was not known whether the same coding mechanisms apply when using electrical stimulation, which recruits a different spectrum of afferents. Here, we demonstrate that the predictions of the burst gap coding model for frequency perception apply to burst stimuli delivered with electrical pulses, re-emphasising the importance of the temporal structure of spike patterns in neural processing and perception of tactile stimuli. Reciprocally, the electrical stimulation data confirm that the results observed with mechanical stimulation do indeed depend on neural processing mechanisms in the central nervous system, and are not due to skin mechanical factors and resulting patterns of afferent activation.
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Affiliation(s)
- Kevin K. W. Ng
- School of Medical Sciences, UNSW Sydney, Sydney, Australia
- Neuroscience Research Australia, Sydney, Australia
- * E-mail:
| | - Christoffer Olausson
- Neuroscience Research Australia, Sydney, Australia
- Faculty of Medicine and Health Sciences, Linköping University, Linköping, Sweden
| | - Richard M. Vickery
- School of Medical Sciences, UNSW Sydney, Sydney, Australia
- Neuroscience Research Australia, Sydney, Australia
| | - Ingvars Birznieks
- School of Medical Sciences, UNSW Sydney, Sydney, Australia
- Neuroscience Research Australia, Sydney, Australia
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