From the Department of Biomedical Engineering, Department of Surgery, Section of Plastic Surgery, Department of Mechanical Engineering, Robotics Institute, School of Kinesiology, Department of Electrical Engineering and Computer Science, Neuroscience Graduate Program, and Department of Neurosurgery, University of Michigan.
Plast Reconstr Surg. 2022 Jun 1;149(6):1149e-1154e. doi: 10.1097/PRS.0000000000009153. Epub 2022 Apr 11.
Without meaningful and intuitive sensory feedback, even the most advanced prosthetic limbs remain insensate and impose an enormous cognitive burden during use. The regenerative peripheral nerve interface can serve as a novel bidirectional motor and sensory neuroprosthetic interface. In previous human studies, regenerative peripheral nerve interfaces demonstrated stable high-amplitude motor electromyography signals with excellent signal-to-noise ratio for prosthetic control. In addition, they can treat and prevent postamputation pain by mitigating neuroma formation. In this study, the authors investigated whether electrical stimulation applied to regenerative peripheral nerve interfaces could produce appreciable proprioceptive and/or tactile sensations in two participants with upper limb amputations. Stimulation of the interfaces resulted in both participants reporting proprioceptive sensations in the phantom hand. Specifically, stimulation of participant 1's median nerve regenerative peripheral nerve interface activated a flexion sensation in the thumb or index finger, whereas stimulation of the ulnar nerve interface evoked a flexion sensation of the ring or small finger. Likewise, stimulation of one of participant 2's ulnar nerve interfaces produced a sensation of flexion at the ring finger distal interphalangeal joint. In addition, stimulation of participant 2's other ulnar nerve interface and the median nerve interface resulted in perceived cutaneous sensations that corresponded to each nerve's respective dermatome. These results suggest that regenerative peripheral nerve interfaces have the potential to restore proprioceptive and cutaneous sensory feedback that could significantly improve prosthesis use and embodiment.
如果没有有意义和直观的感觉反馈，即使是最先进的假肢仍然没有感觉，并在使用过程中造成巨大的认知负担。再生周围神经接口可以作为一种新型的双向运动和感觉神经假肢接口。在以前的人类研究中，再生周围神经接口表现出稳定的高振幅肌电图信号，具有出色的信噪比，可用于假肢控制。此外，它们还可以通过减轻神经瘤的形成来治疗和预防截肢后疼痛。在这项研究中，作者研究了电刺激应用于再生周围神经接口是否可以在两名上肢截肢患者中产生明显的本体感觉和/或触觉。刺激接口导致两名参与者都报告在幻影手中有本体感觉。具体来说，刺激参与者 1 的正中神经再生周围神经接口会激活拇指或食指的弯曲感，而刺激尺神经接口会引起环指或小指的弯曲感。同样，刺激参与者 2 的尺神经接口之一会产生环指远指间关节的弯曲感。此外，刺激参与者 2 的另一个尺神经接口和正中神经接口会产生与每个神经的相应皮节相对应的皮肤感觉。这些结果表明，再生周围神经接口有可能恢复本体感觉和皮肤感觉反馈，这可以显著改善假肢的使用和体现。
