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两名截肢患者选择性神经内电刺激后的幻肢体感诱发电位。

Phantom somatosensory evoked potentials following selective intraneural electrical stimulation in two amputees.

机构信息

Institute of Neurology, Catholic University of The Sacred Heart, Roma, Italy.

Institute of Neurology, Catholic University of The Sacred Heart, Roma, Italy.

出版信息

Clin Neurophysiol. 2018 Jun;129(6):1117-1120. doi: 10.1016/j.clinph.2018.02.138. Epub 2018 Mar 26.

Abstract

OBJECTIVE

The aim of the paper is to objectively demonstrate that amputees implanted with intraneural interfaces are truly able to feel a sensation in the phantom hand by recording "phantom" somatosensory evoked potentials from the corresponding brain areas.

METHODS

We implanted four transverse intrafascicular multichannel electrodes, available with percutaneous connections to a multichannel electrical stimulator, in the median and ulnar nerves of two left trans-radial amputees. Two channels of the implants that were able to elicit sensations during intraneural nerve stimulation were chosen, in both patients, for recording somatosensory evoked potentials.

RESULTS

We recorded reproducible evoked responses by stimulating the median and the ulnar nerves in both cases. Latencies were in accordance with the arrival of somatosensory information to the primary somatosensory cortex.

CONCLUSION

Our results provide evidence that sensations generated by intraneural stimulation are truly perceived by amputees and located in the phantom hand. Moreover, our results strongly suggest that sensations perceived in different parts of the phantom hand result in different evoked responses.

SIGNIFICANCE

Somatosensory evoked potentials obtained by selective intraneural electrical stimulation in amputee patients are a useful tool to provide an objective demonstration of somatosensory feedback in new generation bidirectional prostheses.

摘要

目的

本文旨在通过记录相应脑区的“幻肢”体感诱发电位,客观证明植入神经内接口的截肢者确实能够在手幻肢中感受到感觉。

方法

我们将四个横向束内多通道电极植入两位左桡骨截断截肢者的正中神经和尺神经中,这些电极带有可与多通道电刺激器连接的经皮连接。在两位患者中,我们都选择了两个能够在神经内刺激时引起感觉的植入物通道,用于记录体感诱发电位。

结果

在两种情况下,我们通过刺激正中神经和尺神经都记录到了可重复的诱发电位。潜伏期与体感信息到达初级体感皮层的时间一致。

结论

我们的结果提供了证据,证明神经内刺激产生的感觉确实被截肢者感知到,并位于手幻肢中。此外,我们的结果强烈表明,在手幻肢的不同部位感知到的感觉会产生不同的诱发电位。

意义

在截肢患者中通过选择性神经内电刺激获得的体感诱发电位是为新一代双向假肢提供体感反馈的客观证明的有用工具。

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