Updates in Targeted Sensory Reinnervation for Upper Limb Amputation

Hebert, Jacqueline S.; Elzinga, Kate; Chan, K. Ming; Olson, Jaret; Morhart, Michael

doi:10.1007/s40137-013-0045-7

Cited by 30 publications

(23 citation statements)

References 50 publications

(57 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The goals were to (i) discover whether movement illusions could be elicited in the missing limb; (ii) investigate functional use of the illusions and the impact on agency and internal dynamic model; and (iii) demonstrate clinical implementation. For the percept mapping, we recruited 6 upper limb amputee participants that had undergone targeted reinnervation(24–26). (Fig.…”

Section: Methodsmentioning

confidence: 99%

Illusory movement perception improves motor control for prosthetic hands

et al. 2018

Self Cite

View full text Add to dashboard Cite

To effortlessly complete an intentional movement, the brain needs feedback from the body regarding the movement’s progress. This largely non-conscious kinesthetic sense helps the brain to learn relationships between motor commands and outcomes to correct movement errors. Prosthetic systems for restoring function have predominantly focused on controlling motorized joint movement. Without the kinesthetic sense, however, these devices do not become intuitively controllable. Here we report a method for endowing human amputees with a kinesthetic perception of dexterous robotic hands. Vibrating the muscles used for prosthetic control via a neural-machine interface produced the illusory perception of complex grip movements. Within minutes, three amputees integrated this kinesthetic feedback and improved movement control. Combining intent, kinesthesia, and vision instilled participants with a sense of agency over the robotic movements. This feedback approach for closed-loop control opens a pathway to seamless integration of minds and machines.

show abstract

Section: Methodsmentioning

confidence: 99%

Illusory movement perception improves motor control for prosthetic hands

et al. 2018

Self Cite

View full text Add to dashboard Cite

show abstract

“…The advantages of TR technique, as stated by Hebert et al ( 2014a , b ), are as follows: (i) A long-term stable interface is possible, (ii) after rerouting of the nerves, there is no additional surgical procedure, (iii) the body is free of implanted interfaces, (iv) electrical stimulation evokes sensation to the reinnervated skin patch, and (v) there is no paresthesia or tingling. A series of results for patients who have undergone TR are; (i) non-invasive stimulation at the innervated site resulting in a generation of perceived sensory information (a cutaneous sensation) in the median nerve of the hand, (ii) effective detection of touch, pain, temperature, and proprioception to some extent, and (iii) stable reinnervated area for the detection of graded forces.…”

Section: Targeted Reinnervation (Tr)mentioning

confidence: 99%

Selectivity and Longevity of Peripheral-Nerve and Machine Interfaces: A Review

2017

View full text Add to dashboard Cite

For those individuals with upper-extremity amputation, a daily normal living activity is no longer possible or it requires additional effort and time. With the aim of restoring their sensory and motor functions, theoretical and technological investigations have been carried out in the field of neuroprosthetic systems. For transmission of sensory feedback, several interfacing modalities including indirect (non-invasive), direct-to-peripheral-nerve (invasive), and cortical stimulation have been applied. Peripheral nerve interfaces demonstrate an edge over the cortical interfaces due to the sensitivity in attaining cortical brain signals. The peripheral nerve interfaces are highly dependent on interface designs and are required to be biocompatible with the nerves to achieve prolonged stability and longevity. Another criterion is the selection of nerves that allows minimal invasiveness and damages as well as high selectivity for a large number of nerve fascicles. In this paper, we review the nerve-machine interface modalities noted above with more focus on peripheral nerve interfaces, which are responsible for provision of sensory feedback. The invasive interfaces for recording and stimulation of electro-neurographic signals include intra-fascicular, regenerative-type interfaces that provide multiple contact channels to a group of axons inside the nerve and the extra-neural-cuff-type interfaces that enable interaction with many axons around the periphery of the nerve. Section Current Prosthetic Technology summarizes the advancements made to date in the field of neuroprosthetics toward the achievement of a bidirectional nerve-machine interface with more focus on sensory feedback. In the Discussion section, the authors propose a hybrid interface technique for achieving better selectivity and long-term stability using the available nerve interfacing techniques.

show abstract

“…These include sensory substitution with cutaneous electrical stimulation [63], vibration on the skin surface [65][66][67][68], skin stretch [69,70] and tendon vibration [71,72] for proprioception, and targeted sensory reinnervation [12,73,74]. In laboratory settings, these have been successful, but none have been sufficiently robust or effective in everyday use for widespread adoption in commercially available prosthetics.…”

Section: Neural Interfaces Are Needed To Restore Somatosensationmentioning

confidence: 99%

Neural interfaces for somatosensory feedback

Tyler

2015

Current Opinion in Neurology

View full text Add to dashboard Cite

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.

show abstract

Updates in Targeted Sensory Reinnervation for Upper Limb Amputation

Cited by 30 publications

References 50 publications

Illusory movement perception improves motor control for prosthetic hands

Illusory movement perception improves motor control for prosthetic hands

Selectivity and Longevity of Peripheral-Nerve and Machine Interfaces: A Review

Neural interfaces for somatosensory feedback

Contact Info

Product

Resources

About