Sensory restoration by epidural stimulation of the lateral spinal cord in upper-limb amputees
Sensory restoration by epidural stimulation of the lateral spinal cord in upper-limb amputees
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DOI：
10.7554/elife.54349
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发表时间：
2020-07-21
期刊：
影响因子：
7.7
通讯作者：
Fisher, Lee E.
中科院分区：
文献类型：
--
作者：
Chandrasekaran, Santosh;Nanivadekar, Ameya C.;Fisher, Lee E.
恢复肢体截肢患者的体感反馈是改善假肢控制的关键。多项研究表明，外周神经刺激和靶向神经再支配可以提供与躯体有关的感觉反馈。虽然有效，但这些技术所需的外科程序仍然是可译性的主要障碍。在这里，我们在四名上肢截肢患者中演示了硬膜外脊髓刺激(SCS)，这是一种治疗疼痛的常见临床技术，它唤起了被认为是从缺失的手臂和手发出的躯体感觉。在长达29天的时间里，无论截肢时间或截肢程度如何，刺激都会在缺失的手中唤起一致位置的感官知觉。被唤起的感觉有时被描述为自然主义的(例如触摸或压力)，但通常是异感。增加刺激幅度会线性地增加感知强度，而不会增加感觉面积。这些结果证明了SCS作为一种恢复截肢后躯体感觉的工具的潜力。
Restoring somatosensory feedback to people with limb amputations is crucial to improve prosthetic control. Multiple studies have demonstrated that peripheral nerve stimulation and targeted reinnervation can provide somatotopically relevant sensory feedback. While effective, the surgical procedures required for these techniques remain a major barrier to translatability. Here, we demonstrate in four people with upper-limb amputation that epidural spinal cord stimulation (SCS), a common clinical technique to treat pain, evoked somatosensory percepts that were perceived as emanating from the missing arm and hand. Over up to 29 days, stimulation evoked sensory percepts in consistent locations in the missing hand regardless of time since amputation or level of amputation. Evoked sensations were occasionally described as naturalistic (e.g. touch or pressure), but were often paresthesias. Increasing stimulus amplitude increased the perceived intensity linearly, without increasing area of the sensations. These results demonstrate the potential of SCS as a tool to restore somatosensation after amputations.