Considerable scientific and technological efforts have been devoted to develop neuroprostheses and hybrid bionic systems that link the human nervous system with electronic or robotic prostheses, with the main aim of restoring motor and sensory functions in disabled patients. A number of neuroprostheses use interfaces with peripheral nerves or muscles for neuromuscular stimulation and signal recording. Herein, we provide a critical overview of the peripheral interfaces available and trace their use from research to clinical application in controlling artificial and robotic prostheses. The first section reviews the different types of non-invasive and invasive electrodes, which include surface and muscular electrodes that can record EMG signals from and stimulate the underlying or implanted muscles. Extraneural electrodes, such as cuff and epineurial electrodes, provide simultaneous interface with many axons in the nerve, whereas intrafascicular, penetrating, and regenerative electrodes may contact small groups of axons within a nerve fascicle. Biological, technological, and material science issues are also reviewed relative to the problems of electrode design and tissue injury. The last section reviews different strate- gies for the use of information recorded from peripheral interfaces and the current state of control neuroprostheses and hybrid bionic systems.

A critical review of interfaces with the peripheral nervous system for the control of neuroprostheses and hybrid bionic systems

http://www.psy.vanderbilt.edu/courses/hon182/Schwartz_Brain-Controlled_Interfaces.pdf

Brain-Controlled Interfaces: Movement Restoration with Neural Prosthetics

Hand loss is a highly disabling event that markedly affects the quality of life. To achieve a close to natural replacement for the lost hand, the user should be provided with the rich sensations that we naturally perceive when grasping or manipulating an object. Ideal bidirectional hand prostheses should involve both a reliable decoding of the user's intentions and the delivery of nearly "natural" sensory feedback through remnant afferent pathways, simultaneously and in real time. However, current hand prostheses fail to achieve these requirements, particularly because they lack any sensory feedback. We show that by stimulating the median and ulnar nerve fascicles using transversal multichannel intrafascicular electrodes, according to the information provided by the artificial sensors from a hand prosthesis, physiologically appropriate (near-natural) sensory information can be provided to an amputee during the real-time decoding of different grasping tasks to control a dexterous hand prosthesis. This feedback enabled the participant to effectively modulate the grasping force of the prosthesis with no visual or auditory feedback. Three different force levels were distinguished and consistently used by the subject. The results also demonstrate that a high complexity of perception can be obtained, allowing the subject to identify the stiffness and shape of three different objects by exploiting different characteristics of the elicited sensations. This approach could improve the efficacy and "life-like" quality of hand prostheses, resulting in a keystone strategy for the near-natural replacement of missing hands.

/pdf/restoring-natural-sensory-feedback-in-real-time-48ihx8sc2g.pdf

Restoring Natural Sensory Feedback in Real-Time Bidirectional Hand Prostheses

Neural plasticity after peripheral nerve injury and regeneration.

Despite not recording directly from neural cells, the surface electromyogram (EMG) signal contains information on the neural drive to muscles, i.e., the spike trains of motor neurons. Using this property, myoelectric control consists of the recording of EMG signals for extracting control signals to command external devices, such as hand prostheses. In commercial control systems, the intensity of muscle activity is extracted from the EMG and used for single degrees of freedom activation (direct control). Over the past 60 years, academic research has progressed to more sophisticated approaches but, surprisingly, none of these academic achievements has been implemented in commercial systems so far. We provide an overview of both commercial and academic myoelectric control systems and we analyze their performance with respect to the characteristics of the ideal myocontroller. Classic and relatively novel academic methods are described, including techniques for simultaneous and proportional control of multiple degrees of freedom and the use of individual motor neuron spike trains for direct control. The conclusion is that the gap between industry and academia is due to the relatively small functional improvement in daily situations that academic systems offer, despite the promising laboratory results, at the expense of a substantial reduction in robustness. None of the systems so far proposed in the literature fulfills all the important criteria needed for widespread acceptance by the patients, i.e. intuitive, closed-loop, adaptive, and robust real-time ( 200 ms delay) control, minimal number of recording electrodes with low sensitivity to repositioning, minimal training, limited complexity and low consumption. Nonetheless, in recent years, important efforts have been invested in matching these criteria, with relevant steps forwards.

The Extraction of Neural Information from the Surface EMG for the Control of Upper-Limb Prostheses: Emerging Avenues and Challenges

Purpose It is not known whether motor and sensory pathways associated with a missing or denervated limb remain functionally intact over periods of many months or years after amputation or chronic peripheral nerve transection injury. We examined the extent to which activity on chronically severed motor nerve fibers could be controlled by human amputees and whether distally referred tactile and proprioceptive sensations could be induced by stimulation of sensory axons in the nerve stumps. Methods Amputees undergoing elective stump procedures were invited to participate in this study. Longitudinal intrafascicular electrodes were threaded percutaneously and implanted in severed nerves of human amputees. The electrodes were interfaced to an amplifier and stimulator system controlled by a laptop computer. Electrophysiologic tests were conducted for 2 consecutive days after recovery from the surgery. Results It was possible to record volitional motor nerve activity uniquely associated with missing limb movements. Electrical stimulation through the implanted electrodes elicited discrete, unitary, graded sensations of touch, joint movement, and position, referring to the missing limb. Conclusions These findings indicate that both central and peripheral motor and somatosensory pathways retain significant residual connectivity and function for many years after limb amputation. This implies that peripheral nerve interfaces could be used to provide amputees with prosthetic limbs that have more natural feel and control than is possible with current myoelectric and body-powered control systems.

Residual function in peripheral nerve stumps of amputees: implications for neural control of artificial limbs.

Neuroanatomy and neurophysiology extracellular stimulation and recording - theory and models immunology materials for nerve stimulation and recording peripheral nerve and muscle - stimulation and recording electrodes and techniques CNS stimulation and recording electrodes and techniques existing FES systems and signal processing future FES systems/devices/brain-computer interfaces experimentation and device approval.

Neuroprosthetics : Theory and Practice

Much has been studied and written about plastic changes in the CNS of humans triggered by events such as limb amputation. However, little is known about the extent to which the original pathways retain residual function after peripheral amputation. Our earlier, acute study on long-term amputees indicated that central pathways associated with amputated peripheral nerves retain at least some sensory and motor function. The purpose of the present study was to determine if these functional connections would be strengthened or improved with experience and training over several days time. To do this, electrodes were implanted within fascicles of severed nerves of long-term human amputees to evaluate the changes in electrically evoked sensations and volitional motor neuron activity associated with attempted phantom limb movements. Nerve stimulation consistently resulted in discrete, unitary, graded sensations of touch/pressure and joint-position sense. There was no significant change in the values of stimulation parameters required to produce these sensations over time. Similarly, while the amputees were able to improve volitional control of motor neuron activity, the rate and pattern of change was similar to that seen with practice in normal individuals on motor tasks. We conclude that the central plasticity seen after amputation is most likely primarily due to unmasking, rather than replacement, of existing synaptic connections. These results also have implications for neural control of prosthetic limbs.

https://www.physiology.org/doi/pdf/10.1152/jn.00937.2004

Effects of Short-Term Training on Sensory and Motor Function in Severed Nerves of Long-Term Human Amputees

We examined the recording characteristics of two different types of polymer-based longitudinal intrafascicular electrodes (LIFEs) in peripheral nerve: single-stranded (s-polyLIFEs) and multistranded (m-polyLIFEs). Recordings were also made from Pt-Ir wire-based electrodes (PtIrLIFEs) as a control. The electrodes were implanted in either tibial or medial gastrocnemius branches of the rabbit sciatic nerve, and in the sciatic nerve of rats. Recorded neural activity induced by manually elicited afferent neural activity showed that both polyLIFE versions performed comparably to PtIrLIFEs.

Gurpreet S Dhillon

Papers

Residual function in peripheral nerve stumps of amputees: implications for neural control of artificial limbs.

Neuroprosthetics : Theory and Practice

Effects of Short-Term Training on Sensory and Motor Function in Severed Nerves of Long-Term Human Amputees

Acute peripheral nerve recording Characteristics of polymer-based longitudinal intrafascicular electrodes

Fabrication and characteristics of an implantable, polymer-based, intrafascicular electrode.