Stimulation Stability and Selectivity of Chronically Implanted Multicontact Nerve Cuff Electrodes in the Human Upper Extremity

Polasek, Katharine H.; Hoyen, Harry A.; Keith, Michael W.; Kirsch, Robert F.; Tyler, Dustin J.

doi:10.1109/tnsre.2009.2032603

Cited by 121 publications

(88 citation statements)

References 32 publications

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“…In the mid-forearm, 8-contact FINEs were implanted around the median and ulnar nerves and a 4-contact CWRU spiral electrode was implanted around the radial nerve. Cuff leads were routed subcutaneously to percutaneous leads [22,24,25] in the upper arm ( figure 1(A)). The intraluminal size of the FINEs was 10 mm × 1.5 mm.…”

Section: Surgical Implantationmentioning

confidence: 99%

Stability and selectivity of a chronic, multi-contact cuff electrode for sensory stimulation in human amputees

et al. 2015

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Objective-Stability and selectivity are important when restoring long-term, functional sensory feedback in individuals with limb-loss. Our objective is to demonstrate a chronic, clinical neural stimulation system for providing selective sensory response in two upper-limb amputees.Approach-Multi-contact cuff electrodes were implanted in the median, ulnar, and radial nerves of the upper-limb.Main results-Nerve stimulation produced a selective sensory response on 19 of 20 contacts and 16 of 16 contacts in subjects 1 and 2, respectively. Stimulation elicited multiple, distinct percept areas on the phantom and residual limb. Consistent threshold, impedance, and percept areas have demonstrated that the neural interface is stable for the duration of this on-going, chronic study.Significance-We have achieved selective nerve response from multi-contact cuff electrodes by demonstrating characteristic percept areas and thresholds for each contact. Selective sensory response remains consistent in two upper-limb amputees for 1 and 2 years, the longest multicontact sensory feedback system to date. Our approach demonstrates selectivity and stability can be achieved through an extraneural interface, which can provide sensory feedback to amputees.

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Section: Surgical Implantationmentioning

confidence: 99%

Stability and selectivity of a chronic, multi-contact cuff electrode for sensory stimulation in human amputees

et al. 2015

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“…Extraneural electrodes surround a peripheral nerve, but do not insert elements within the nerve, causing the least disturbance to the neural tissue. Circular, self-sizing electrodes, such as the spiral [86] and helical electrode [87], have been stable in clinical applications for decades [88][89][90]. A circular configuration has the minimum surface area to interact with the neural tissue.…”

Section: Physical Interactionmentioning

confidence: 99%

Neural interfaces for somatosensory feedback

Tyler

2015

Current Opinion in Neurology

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Purpose of review-When an individual loses a limb, he/she loses touch with the world and with the people around him/her. Somatosensation is critical to the feeling of connection and control of one's own body. Decades of attempts to replace lost somatosensation by sensory substitutions have been ineffective outside of the laboratory. This review discusses important recent results demonstrating chronic somatosensory restoration through direct peripheral nerve stimulation.Recent findings-Stimulation of peripheral nerves results in somatosensory perception on the phantom limb. Sensations are localized to several independent and functionally relevant locations, such as the fingertips, thenar eminence, ulnar border and dorsal surface. Patterns in stimulation intensity change the perception experience by the user, opening new dimensions on neuromodulation.Summary-Neural interfaces with sophisticated stimulation paradigms create a user's perception of his/her hand to touch and manipulate objects. The pattern of intensity and frequency of stimulation is critical to the quality and intensity of perceived sensation. Restoring feeling has allowed the individuals to, 'feel [my] hand for the first time since the accident,' and 'feel [my] wife touch my hand'. Individuals using a prosthetic hand with sensation can pull cherries and grapes from the stem, open water bottles and move objects without destroying these objects -all while audio and visually deprived. After regaining sensation, phantom pain is eliminated in individuals that had frequent, sometimes debilitating, pain following limb loss. With over 5 subject-years of experience, this work is leading the evolution of a new era in prostheses. Somatosensory prosthetics as a standard procedure to augment and restore somatosensation are now within our reach.

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“…Forschung im Hinblick auf komplexere Implantate und die Verwendung von Nervenelektroden [7] wird weiterhin betrieben, die Zulassung eines neuen Systems als Medizinprodukt ist jedoch gegenwärtig nicht absehbar. Ein Grund für das Scheitern des Unternehmens war, dass die Zahl der Patienten, für die das System infrage kamen, -entgegen anfänglichen Schätzungen -doch zu gering war.…”

Section: Greifenunclassified

Neuroprothetik und Neuromodulation

Stieglitz

2010

Bundesgesundheitsbl.

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Stimulation of the nervous system with the aid of electrical active implants has changed the therapy of neurological diseases and rehabilitation of lost functions and has expanded clinical practice within the last few years. Alleviation of effects of neurodegenerative diseases, therapy of psychiatric diseases, the functional restoration of hearing as well as other applications have been transferred successfully into clinical practice. Other approaches are still under development in preclinical and clinical trials. The restoration of sight by implantable electronic systems that interface with the retina in the eye is an example how technological progress promotes novel medical devices. The idea of using the electrical signal of the brain to control technical devices and (neural) prostheses is driving current research in the field of brain-computer interfaces. The benefit for the patient always has to be balanced with the risks and side effects of those implants in comparison to medicinal and surgical treatments. How these and other developments become established in practice depends finally on their acceptance by the patients and the reimbursement of their costs.

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Stimulation Stability and Selectivity of Chronically Implanted Multicontact Nerve Cuff Electrodes in the Human Upper Extremity

Cited by 121 publications

References 32 publications

Stability and selectivity of a chronic, multi-contact cuff electrode for sensory stimulation in human amputees

Stability and selectivity of a chronic, multi-contact cuff electrode for sensory stimulation in human amputees

Neural interfaces for somatosensory feedback

Neuroprothetik und Neuromodulation

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