Department of Neurology, University Campus Bio-Medico, Via Alvaro del Portillo 200, 00100 Rome, Italy.
Exp Brain Res. 2011 Apr;210(1):1-11. doi: 10.1007/s00221-011-2571-9. Epub 2011 Mar 10.
Do central and peripheral motor pathways associated with an amputated limb retain at least some functions over periods of years? This problem could be addressed by evaluating the response patterns of nerve signals from peripheral motor fibers during transcranial magnetic stimulation (TMS) of corticospinal tracts. The aim of this study was to record for the first time TMS-related responses from the nerves of a left arm stump of an amputee via intrafascicular longitudinal flexible multi-electrodes (tfLIFE4) implanted for a prosthetic hand control. After tfLIFE4 implant in the stump median and ulnar nerves, TMS impulses of increasing intensity were delivered to the contralateral motor cortex while tfLIFE4 recordings were carried out. Combining TMS of increasing intensity and tfLIFE4 electrodes recordings, motor nerve activity possibly related to the missing limb motor control and selectively triggered by brain stimulation without significant electromyographic contamination was identified. These findings are entirely original and indicate that tfLIFE4 signals are clearly driven from M1 stimulation, therefore witnessing the presence in the stump nerves of viable motor signals from the CNS possibly useful for artificial prosthesis control.
与截肢肢体相关的中枢和外周运动通路在数年的时间内是否至少保留了一些功能？这个问题可以通过评估经颅磁刺激（TMS）皮质脊髓束时外周运动纤维的神经信号的反应模式来解决。本研究的目的是首次通过植入用于假肢手控制的腔内纵向柔性多电极（tfLIFE4）记录截肢者左断臂的 TMS 相关反应。在 tfLIFE4 植入残端正中神经和尺神经后，当进行 tfLIFE4 记录时，给予对侧运动皮层递增强度的 TMS 脉冲。通过递增强度的 TMS 和 tfLIFE4 电极记录的组合，确定了可能与缺失肢体运动控制相关的运动神经活动，并通过大脑刺激选择性触发，而没有明显的肌电图干扰。这些发现是完全原创的，表明 tfLIFE4 信号明显是由 M1 刺激驱动的，因此见证了 CNS 中可能对人工假体控制有用的可行运动信号存在于残端神经中。
