Irwin Z T, Schroeder K E, Vu P P, Tat D M, Bullard A J, Woo S L, Sando I C, Urbanchek M G, Cederna P S, Chestek C A
Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, USA.
J Neural Eng. 2016 Aug;13(4):046007. doi: 10.1088/1741-2560/13/4/046007. Epub 2016 Jun 1.
Loss of even part of the upper limb is a devastating injury. In order to fully restore natural function when lacking sufficient residual musculature, it is necessary to record directly from peripheral nerves. However, current approaches must make trade-offs between signal quality and longevity which limit their clinical potential. To address this issue, we have developed the regenerative peripheral nerve interface (RPNI) and tested its use in non-human primates.
The RPNI consists of a small, autologous partial muscle graft reinnervated by a transected peripheral nerve branch. After reinnervation, the graft acts as a bioamplifier for descending motor commands in the nerve, enabling long-term recording of high signal-to-noise ratio (SNR), functionally-specific electromyographic (EMG) signals. We implanted nine RPNIs on separate branches of the median and radial nerves in two rhesus macaques who were trained to perform cued finger movements.
No adverse events were noted in either monkey, and we recorded normal EMG with high SNR (>8) from the RPNIs for up to 20 months post-implantation. Using RPNI signals recorded during the behavioral task, we were able to classify each monkey's finger movements as flexion, extension, or rest with >96% accuracy. RPNI signals also enabled functional prosthetic control, allowing the monkeys to perform the same behavioral task equally well with either physical finger movements or RPNI-based movement classifications.
The RPNI signal strength, stability, and longevity demonstrated here represents a promising method for controlling advanced prosthetic limbs and fully restoring natural movement.
上肢哪怕只是部分缺失都是一种极具毁灭性的损伤。为了在缺乏足够残留肌肉组织时充分恢复自然功能,有必要直接从周围神经记录信号。然而,目前的方法必须在信号质量和使用寿命之间做出权衡,这限制了它们的临床潜力。为了解决这个问题,我们开发了再生周围神经接口(RPNI)并在非人类灵长类动物中测试了其用途。
RPNI由一个小的自体部分肌肉移植物组成,该移植物由横断的周围神经分支重新支配。重新支配后,移植物充当神经中下行运动指令的生物放大器,可以长期记录高信噪比(SNR)、功能特异性的肌电图(EMG)信号。我们在两只恒河猴的正中神经和桡神经不同分支上植入了9个RPNI,训练它们进行提示性手指运动。
两只猴子均未出现不良事件,在植入后长达20个月的时间里,我们从RPNI记录到了SNR大于8的正常EMG。利用行为任务期间记录的RPNI信号,我们能够以大于96%的准确率将每只猴子的手指运动分类为屈曲、伸展或休息。RPNI信号还实现了功能性假肢控制,使猴子能够通过实际手指运动或基于RPNI的运动分类同样出色地完成相同的行为任务。
此处展示的RPNI信号强度、稳定性和使用寿命代表了一种控制先进假肢和完全恢复自然运动的有前景的方法。