Division of Signal Processing and Biomedical Engineering, Department of Signals and Systems, Chalmers University of Technology, SE-412 96 Gothenburg, Sweden. Center of Orthopaedic Osseointegration and Center of Advanced Reconstruction of Extremities, Department of Orthopaedics, Sahlgrenska University Hospital, University of Gothenburg, SE-431 80 Mölndal, Sweden.
Division of Signal Processing and Biomedical Engineering, Department of Signals and Systems, Chalmers University of Technology, SE-412 96 Gothenburg, Sweden.
Sci Transl Med. 2014 Oct 8;6(257):257re6. doi: 10.1126/scitranslmed.3008933.
A major challenge since the invention of implantable devices has been a reliable and long-term stable transcutaneous communication. In the case of prosthetic limbs, existing neuromuscular interfaces have been unable to address this challenge and provide direct and intuitive neural control. Although prosthetic hardware and decoding algorithms are readily available, there is still a lack of appropriate and stable physiological signals for controlling the devices. We developed a percutaneous osseointegrated (bone-anchored) interface that allows for permanent and unlimited bidirectional communication with the human body. With this interface, an artificial limb can be chronically driven by implanted electrodes in the peripheral nerves and muscles of an amputee, outside of controlled environments and during activities of daily living, thus reducing disability and improving quality of life. We demonstrate in one subject, for more than 1 year, that implanted electrodes provide a more precise and reliable control than surface electrodes, regardless of limb position and environmental conditions, and with less effort. Furthermore, long-term stable myoelectric pattern recognition and appropriate sensory feedback elicited via neurostimulation was demonstrated. The opportunity to chronically record and stimulate the neuromuscular system allows for the implementation of intuitive control and naturally perceived sensory feedback, as well as opportunities for the prediction of complex limb motions and better understanding of sensory perception. The permanent bidirectional interface presented here is a critical step toward more natural limb replacement, by combining stable attachment with permanent and reliable human-machine communication.
自可植入设备发明以来，一个主要挑战一直是可靠且长期稳定的经皮（transcutaneous）通信。在假肢的情况下，现有的神经肌肉接口一直无法应对这一挑战，无法提供直接和直观的神经控制。尽管假肢硬件和解码算法已经很成熟，但仍然缺乏适当和稳定的生理信号来控制这些设备。我们开发了一种经皮骨整合（osseointegrated）（骨锚定）接口，允许与人体进行永久性和无限的双向通信。通过这个接口，假肢可以通过植入截肢者外周神经和肌肉中的电极进行慢性驱动，无需在受控环境中，也无需在日常生活活动中进行，从而减少残疾并提高生活质量。我们在一名受试者中证明，超过 1 年的时间里，植入电极提供了比表面电极更精确和可靠的控制，无论肢体位置和环境条件如何，而且所需的努力也更少。此外，还证明了通过神经刺激诱发的长期稳定肌电模式识别和适当的感觉反馈。长期稳定的肌电模式识别和通过神经刺激诱发的适当感觉反馈为直观控制和自然感知的感觉反馈提供了机会，也为预测复杂的肢体运动和更好地理解感觉感知提供了机会。这里提出的永久性双向接口是实现更自然的肢体替代的关键一步，它将稳定的附着与永久性和可靠的人机通信结合在一起。
