Selective activation of the human tibial and common peroneal nerves with a flat interface nerve electrode

Abstract

Problem Addressed Electrical stimulation has been shown effective in restoring basic lower extremity motor function in individuals with paralysis. We tested the hypothesis that a Flat Interface Nerve Electrode (FINE) placed around the human tibial or common peroneal nerve above the knee can selectively activate each of the most important muscles these nerves innervate for use in a neuroprosthesis to control ankle motion. Methodology During intraoperative trials involving three subjects, an 8-contact FINE was placed around the tibial and/or common peroneal nerve, proximal to the popliteal fossa. The FINE’s ability to selectively recruit muscles innervated by these nerves was assessed. Data were used to estimate the potential to restore active plantarflexion or dorsiflexion while balancing inversion and eversion using a biomechanical simulation. Results, Significance, and Potential Impact With minimal spillover to non-targets, at least three of the four targets in the tibial nerve, including two of the three muscles constituting the triceps surae were independently and selectively recruited in all subjects. As acceptable levels of spillover increased, recruitment of the target muscles increased. Selective activation of muscles innervated by the peroneal nerve was more challenging. Estimated joint moments suggests that plantarflexion sufficient for propulsion during stance phase of gait and dorsiflexion sufficient to prevent foot drop during swing can be achieved, accompanied by a small but tolerable inversion or eversion moment.

Microstimulation of the lumbar DRG recruits primary afferent neurons in localized regions of lower limb

“…Additionally, these studies, which have all focused on sensory restoration after upper-limb amputation, have demonstrated improvements in control of prosthetic limbs and the ability to manipulate and detect objects with a prosthetic limb without any visual feedback. Epineural electrodes have also been shown to provide selective recruitment of lower-limb muscles during functional neuromuscular stimulation (FNS) of knee extensors and hip flexors (Fisher et al 2009;Schiefer et al 2010) as well as ankle plantar-and dorsiflexors (Schiefer et al 2013). Despite these successes, electrode placements on peripheral nerves require a compromise between the competing interests of recruitment selectivity, limb coverage, and robustness to mechanical stresses.…”

Toward Bioelectronic Medicine—Neuromodulation of Small Peripheral Nerves Using Flexible Neural Clip

“…In addition, the specificity of the sciatic nerve branches (i.e., the common peroneal (CP) nerve primarily innervates the tibialis anterior (TA) muscle that controls ankle dorsiflexion40 while the tibial nerve mainly activates the gastrocnemius (GC) muscle for ankle extension41) make them ideal for showcasing the function of the FNC. We stimulated the CP nerve, tibial nerve, and sural nerve in rats ( Figure 5 a) while recording compound muscle action potentials (CMAPs) from the GC and the TA muscles.…”

Neural interfaces for somatosensory feedback

“…To increase the surface area and proximity to more of the neural tissues while not penetrating the nerve, another class of extraneural electrodes maintains an elongated or rectangular configuration for the nerve. The Flat Interface Nerve Electrode (FINE) [91] has shown fascicular level selectivity for stimulation [91][92][93] and recording capabilities [94]. invasive penetrates the perineurium to place components inside the fascicle.…”