Fascicle specific targeting for selective peripheral nerve stimulation
Fascicle specific targeting for selective peripheral nerve stimulation
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DOI：
10.1088/1741-2552/ab4370
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发表时间：
2019-12-01
影响因子：
4
通讯作者：
Keefer, Edward W.
中科院分区：
文献类型：
--
作者：
Overstreet, Cynthia K.;Cheng, Jonathan;Keefer, Edward W.
目标。电刺激是唤起神经活动的钝器。神经元的自然激活是异步和不均匀的，而刺激驱动细胞群内的同时活动。这些激活模式的差异会导致意想不到的副作用，包括混乱的感官知觉和不良的肌肉收缩。这些影响可以通过将电极放置在接近神经纤维的位置和仔细选择神经界面的位置来减轻。这项工作描述了将电极放置在周围神经的特定束内以形成双向神经假体装置的选择性神经接口的好处。的方法。慢性电极针对四个人类受试者的前臂尺神经和正中神经的单个束。在手术植入过程中，从每条神经上剥离神经束，并使用功能测试来确定每条神经中感觉纤维和运动纤维的相对组成。FAST-LIFE阵列由纵向束内阵列和束袖电极组成，植入每个束内。这些电极上电刺激引起的感觉的位置、质量和刺激参数在整个90？植入期180 d。主要的结果。FAST-LIFE阵列能够对单个周围神经束进行选择性和慢性电刺激。刺激在每个神经束中所引起的感觉的质量是可预测的和不同的；受试者报告在刺激感觉肌束时有触觉和皮肤感觉，在刺激运动肌束时有更深层的本体感觉。刺激阈值和强度-持续时间常数在感觉肌束内通常较高。的意义。通过在周围神经束内或周围放置电极，可以创造出高度选择性的、稳定的神经界面。这种方法可以将电极定位到支配特定身体区域或具有特定功能的神经纤维上。束束特异性接口技术在许多神经调节应用中具有广泛的潜力，可以最大限度地发挥电刺激的治疗效果。（临床试验编号NCT02994160.）
Objective. Electrical stimulation is a blunt tool for evoking neural activity. Neurons are naturally activated asynchronously and non-uniformly, whereas stimulation drives simultaneous activity within a population of cells. These differences in activation pattern can result in unintended side effects, including muddled sensory percepts and undesirable muscle contractions. These effects can be mitigated by the placement of electrodes in close approximation to nerve fibers and careful selection of the neural interface's location. This work describes the benefits of placing electrodes within specific fascicles of peripheral nerve to form selective neural interfaces for bidirectional neuroprosthetic devices. Approach. Chronic electrodes were targeted to individual fascicles of the ulnar and median nerves in the forearm of four human subjects. During the surgical implant procedure, fascicles were dissected from each nerve, and functional testing was used to identify the relative composition of sensory and motor fibers within each. FAST-LIFE arrays, composed of longitudinal intrafascicular arrays and fascicular cuff electrodes, were implanted in each fascicle. The location, quality, and stimulation parameters associated with sensations evoked by electrical stimulation on these electrodes were characterized throughout the 90?180 d implant period. Main results. FAST-LIFE arrays enable selective and chronic electrical stimulation of individual peripheral nerve fascicles. The quality of sensations evoked by stimulation in each fascicle is predictable and distinct; subjects reported tactile and cutaneous sensations during stimulation of sensory fascicles and deeper proprioceptive sensations during stimulation of motor fascicles. Stimulation thresholds and strength-duration time constants were typically higher within sensory fascicles. Significance. Highly selective, stable neural interfaces can be created by placing electrodes within and around single fascicles of peripheral nerves. This method enables targeting electrodes to nerve fibers that innervate a specific body region or have specific functions. Fascicle-specific interfacing techniques have broad potential to maximize the therapeutic effects of electrical stimulation in many neuromodulation applications. (Clinical Trial ID NCT02994160.)