Peripheral Nerve Stimulation for Tactile and Proprioceptive Feedback with Phantom Limb Pain Suppression in Amputees

Soghoyan, Gurgen; Biktimirov, Artur; Matvienko, Yu. G.; Chekh, Ilya; Sintsov, Mikhail; Lebedev, Mikhail

doi:10.2139/ssrn.4227970

Cited by 4 publications

(6 citation statements)

References 40 publications

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“…The use of PNS as a tool for PLP suppression is still in need of additional validation (9). We demonstrated the efficiency of such stimulation in our previous study (8) and we added the case of S12 here. Remarkably, in S13 an additional decrease in PLP level was observed when simultaneous PNS and SCS were included in his treatment program.…”

Section: Discussionmentioning

confidence: 74%

“…Somatosensory substitution systems were previously developed for amputees using vibratory motors and haptics devices attached to the residual limbs (23). Alternatively, PNS-based systems provide feedback of direct phantom limb sensations that enable object size detection and increased prosthetic embodiment (8). Little is known about the progression in time of these discriminative abilities.…”

Section: Discussionmentioning

confidence: 99%

“…For the reported stimulation intensity equal to 5, patients were asked to fill a PerceptMapper questionnaire (47). where they marked the perception location on a drawing of a hand shown on a computer display and described the sensation in terms of painfulness and naturalness (8). When the application form was filled, we switched to the next trial where another electrode pair was selected and tested.…”

Section: Pnsmentioning

confidence: 99%

“…Several approaches have been proposed for improving neuroprosthetic feedback and treating PLP. Peripheral nerve stimulation (PNS) (7) could be used to both implement prosthetic sensations and suppress PLP (8). In addition to PNS, spinal cord stimulation (SCS) is applicable to treat PLP and other types of neuropathic pain (7, 9).…”

Section: Introductionmentioning

confidence: 99%

“…Notwithstanding the progress made in the development of sensorized prostheses for the amputees (15)(16)(17) (8), more research is needed for improving the practicality of such systems. Examples of practical sensorized prostheses include neurostimulation-based solutions for enabling sensations of object size and texture (16,18).…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Restoration of Natural Somatic Sensations to the Amputees: Finding the Right Combination of Neurostimulation Methods

Soghoyan

Biktimirov

Piliugin

et al. 2023

Preprint

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Limb amputation results in such devastating consequences as loss of motor and sensory functions and phantom limb pain (PLP). Here we explored peripheral nerve stimulation (PNS), spinal cord stimulation (SCS) and transcutaneous electrical nerve stimulation (TENS) as the approaches to enable tactile and proprioceptive sensations in amputees, and suppress PLP. We investigated the efficacy of these approaches for sensory discrimination tasks, namely determining object size and softness using a bionic prosthesis of the hand. Two transhumeral amputees were implanted for four weeks with stimulating electrodes placed in the medial nerve and/or epidurally over the spinal cord. Both PNS and SCS mapped to the sensation in different parts of the phantom hand, which was confirmed by both subjective reports and electroencephalographic (EEG) recordings of cortical responses to stimulation. Surprisingly, PNS provided more naturalistic sensations compared to SNS. Moreover, these sensations were felt as emerging from the prosthetic hand when the participants performed sensorimotor tasks where they determined the size and softness of objects being grasped. As they practiced in these tasks, the prosthetic sensations became more natural. While the participants could perform some of the tasks, for example tactile surface exploration, using auditory feedback, PNS and/or SCS have a benefit of better approximating the sensations lost to the amputation while suppressing PLP.

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Section: Discussionmentioning

confidence: 74%

Section: Discussionmentioning

confidence: 99%

Section: Pnsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Restoration of Natural Somatic Sensations to the Amputees: Finding the Right Combination of Neurostimulation Methods

Soghoyan

Biktimirov

Piliugin

et al. 2023

Preprint

Self Cite

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Modulations in high-density EEG during the suppression of phantom-limb pain with neurostimulation in upper-limb amputees

Kleeva

Soghoyan

Biktimirov

et al. 2023

Preprint

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Phantom limb pain (PLP) is a distressing and persistent sensation that occurs after the amputation of a limb. While medication-based treatments have limitations and adverse effects, neurostimulation is a promising alternative approach whose mechanism of action needs research, including electroencephalographic (EEG) recordings for the assessment of cortical manifestation of PLP relieving effects. Here we collected and analyzed high-density EEG data in three patients (P01, P02, and P03). Peripheral nerve stimulation (PNS) suppressed PLP in P01, but was ineffective in P02. By contrast, transcutaneous electrical nerve stimulation (TENS) was effective in P02. In P03, spinal cord stimulation (SCS) was used to suppress PLP. Changes in EEG oscillatory components we analyzed using spatio-spectral decomposition (SSD) and Petrosian fractal dimension (FD). With these methods, changes EEG spatio-spectral components were found in the theta, alpha, and beta bands in all patients, with these effects being specific to each individual. These changes in EEG patterns were found for both the periods when PLP level was stationary and the periods when PLP was gradually changing after neurostimulation was turned on or off. One consistent effect was an increase in EEG fractal dimension on the side contralateral to the amputation when PLP was present, while effective stimulation resulted in a decrease in fractal dimension. Overall, our findings align with the proposed roles of brain rhythms in thalamocortical dysrhythmia, which is has been linked to neuropathic pain. The individual differences in the observed effects could be related to the specifics of treatment in each patient and the unique spectral characteristics in each of them. These findings pave way to the closed-loop systems for PLP management where neurostimulation parameters are adjusted based on EEG-derived markers.

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Unraveling Sensory Restoration: Decoding Complex Behavioral Data through Peripheral Nerve Stimulation Analysis

Piliugin,

Soghoyan,

Biktimirov

et al. 2024

2024 12th International Winter Conference on Brain-Computer Interface (BCI)

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Peripheral Nerve Stimulation for Tactile and Proprioceptive Feedback with Phantom Limb Pain Suppression in Amputees

Cited by 4 publications

References 40 publications

Restoration of Natural Somatic Sensations to the Amputees: Finding the Right Combination of Neurostimulation Methods

Restoration of Natural Somatic Sensations to the Amputees: Finding the Right Combination of Neurostimulation Methods

Modulations in high-density EEG during the suppression of phantom-limb pain with neurostimulation in upper-limb amputees

Unraveling Sensory Restoration: Decoding Complex Behavioral Data through Peripheral Nerve Stimulation Analysis

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