Svientek Shelby R, Ursu Dan C, Cederna Paul S, Kemp Stephen W P
Department of Surgery, Division of Plastic Surgery, University of Michigan, Ann Arbor;
Department of Surgery, Division of Plastic Surgery, University of Michigan, Ann Arbor.
J Vis Exp. 2020 Feb 25(156). doi: 10.3791/60841.
Recent advances in neuroprosthetics have enabled those living with extremity loss to reproduce many functions native to the absent extremity, and this is often accomplished through integration with the peripheral nervous system. Unfortunately, methods currently employed are often associated with significant tissue damage which prevents prolonged use. Additionally, these devices often lack any meaningful degree of sensory feedback as their complex construction dampens any vibrations or other sensations a user may have previously depended on when using more simple prosthetics. The composite regenerative peripheral nerve interface (C-RPNI) was developed as a stable, biologic construct with the ability to amplify efferent motor nerve signals while providing simultaneous afferent sensory feedback. The C-RPNI consists of a segment of free dermal and muscle graft secured around a target mixed sensorimotor nerve, with preferential motor nerve reinnervation of the muscle graft and sensory nerve reinnervation of the dermal graft. In rats, this construct has demonstrated the generation of compound muscle action potentials (CMAPs), amplifying the target nerve's signal from the micro- to milli-volt level, with signal to noise ratios averaging approximately 30-50. Stimulation of the dermal component of the construct generates compound sensory nerve action potentials (CSNAPs) at the proximal nerve. As such, this construct has promising future utility towards the realization of the ideal, intuitive prosthetic.
神经假肢领域的最新进展使肢体缺失者能够重现缺失肢体的许多固有功能，这通常是通过与周围神经系统整合来实现的。不幸的是，目前采用的方法往往会造成严重的组织损伤，从而妨碍长期使用。此外，这些装置通常缺乏任何有意义程度的感觉反馈，因为其复杂的构造会减弱使用者在使用更简单假肢时可能曾依赖的任何振动或其他感觉。复合再生周围神经接口（C-RPNI）被开发为一种稳定的生物构造，能够放大传出运动神经信号，同时提供传入感觉反馈。C-RPNI由一段游离的皮肤和肌肉移植物组成，固定在目标混合感觉运动神经周围，肌肉移植物优先接受运动神经再支配，皮肤移植物接受感觉神经再支配。在大鼠身上，这种构造已证明能产生复合肌肉动作电位（CMAP），将目标神经的信号从微伏级放大到毫伏级，信噪比平均约为30-50。刺激该构造的皮肤部分会在近端神经产生复合感觉神经动作电位（CSNAP）。因此，这种构造在实现理想的、直观的假肢方面具有广阔的应用前景。
