"Long-term stability of stimulating spiral nerve cuff electrodes on human peripheral nerves"
"Long-term stability of stimulating spiral nerve cuff electrodes on human peripheral nerves"
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DOI：
10.1186/s12984-017-0285-3
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发表时间：
2017-07-11
影响因子：
5.1
通讯作者：
Triolo, Ronald J.
中科院分区：
文献类型：
--
作者：
Christie, Breanne P.;Freeberg, Max;Triolo, Ronald J.
背景：电刺激周围神经已被证明能有效恢复肢体和上肢的感觉和运动功能。这种神经刺激可以通过非穿透性螺旋神经袖带电极施加，尽管关于其植入后多年的长期表现的信息很少。方法：自2005年以来，14名颈髓或胸髓损伤或上肢截肢的志愿者被长期植入总共50个螺旋神经袖带电极在10条不同的神经上(平均植入时间6.7+/-3.1年)。结果：在8名仍积极参与研究的受试者中，44/45的螺旋接触仍然有效。在四名参与者的1个月到10.4年的定期研究中，大多数个人接触者的充电阈值随着时间的推移保持稳定。股神经上戴着螺旋袖带的四名参与者都能够产生足够的力矩，在2-4之后的站立过程中保持膝盖锁定。五年了。在积极活动的参与者中，所有四个腓神经袖带产生的背屈力矩都超过了防止脚下坠所需的值，但没有一个胫神经袖带能够满足在正常步行速度下推下时发生的足屈力矩。对两种多接触螺旋神经袖的选择性进行了检测，两种多接触螺旋神经袖对不同运动单位人群的选择性最高可达6.3年。结论：所研究的螺旋神经袖在运动和感觉神经假体植入后2~11年仍具有一定的功能。它们表现出稳定的电荷阈值、临床相关的募集特性和功能肌肉的选择性。非穿透性螺旋神经袖套电极在植入神经假体的人类周围神经上的长期临床应用似乎是一种合适的选择。
Background: Electrical stimulation of the peripheral nerves has been shown to be effective in restoring sensory and motor functions in the lower and upper extremities. This neural stimulation can be applied via non-penetrating spiral nerve cuff electrodes, though minimal information has been published regarding their long-term performance for multiple years after implantation.Methods: Since 2005, 14 human volunteers with cervical or thoracic spinal cord injuries, or upper limb amputation, were chronically implanted with a total of 50 spiral nerve cuff electrodes on 10 different nerves (mean time postimplant 6.7 +/- 3.1 years). The primary outcome measures utilized in this study were muscle recruitment curves, charge thresholds, and percent overlap of recruited motor unit populations.Results: In the eight recipients still actively involved in research studies, 44/45 of the spiral contacts were still functional. In four participants regularly studied over the course of 1 month to 10.4 years, the charge thresholds of the majority of individual contacts remained stable over time. The four participants with spiral cuffs on their femoral nerves were all able to generate sufficient moment to keep the knees locked during standing after 2-4. 5 years. The dorsiflexion moment produced by all four fibular nerve cuffs in the active participants exceeded the value required to prevent foot drop, but no tibial nerve cuffs were able to meet the plantarflexion moment that occurs during push-off at a normal walking speed. The selectivity of two multi-contact spiral cuffs was examined and both were still highly selective for different motor unit populations for up to 6.3 years after implantation.Conclusions: The spiral nerve cuffs examined remain functional in motor and sensory neuroprostheses for 2-11 years after implantation. They exhibit stable charge thresholds, clinically relevant recruitment properties, and functional muscle selectivity. Non-penetrating spiral nerve cuff electrodes appear to be a suitable option for long-term clinical use on human peripheral nerves in implanted neuroprostheses.