Gozzi Noemi, Chee Lauren, Odermatt Ingrid, Kikkert Sanne, Preatoni Greta, Valle Giacomo, Pfender Nikolai, Beuschlein Felix, Wenderoth Nicole, Zipser Carl, Raspopovic Stanisa
Neuroengineering Laboratory, Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland.
Neural Control of Movement Lab, Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland.
Nat Commun. 2024 Dec 30;15(1):10840. doi: 10.1038/s41467-024-55152-7.
Peripheral neuropathy (PN), the most common complication of diabetes, leads to sensory loss and associated health issues as pain and increased fall risk. However, present treatments do not counteract sensory loss, but only partially manage its consequences. Electrical neural stimulation holds promise to restore sensations, but its efficacy and benefits in PN damaged nerves are yet unknown. We designed a wearable sensory neuroprosthesis (NeuroStep) providing targeted neurostimulation of the undamaged nerve portion and assessed its functionality in 14 PN participants. Our system partially restored lost sensations in all participants through a purposely calibrated neurostimulation, despite PN nerves being less sensitive than healthy nerves (N = 22). Participants improved cadence and functional gait and reported a decrease of neuropathic pain after one day. Restored sensations activated cortical patterns resembling naturally located foot sensations. NeuroStep restores real-time intuitive sensations in PN participants, holding potential to enhance functional and health outcomes while advancing effective non-invasive neuromodulation.
周围神经病变（PN）是糖尿病最常见的并发症，会导致感觉丧失以及诸如疼痛和跌倒风险增加等相关健康问题。然而，目前的治疗方法并不能对抗感觉丧失，而只是部分地控制其后果。电神经刺激有望恢复感觉，但其在PN受损神经中的疗效和益处尚不清楚。我们设计了一种可穿戴的感觉神经假体（NeuroStep），对未受损的神经部分进行靶向神经刺激，并在14名PN参与者中评估了其功能。尽管PN神经比健康神经敏感性低（N = 22），但我们的系统通过特意校准的神经刺激在所有参与者中部分恢复了丧失的感觉。参与者的步频和功能性步态得到改善，并在一天后报告神经性疼痛有所减轻。恢复的感觉激活了类似于自然足部感觉位置的皮层模式。NeuroStep可恢复PN参与者的实时直观感觉，在推进有效的非侵入性神经调节的同时，具有改善功能和健康结果的潜力。
