A High Definition Noninvasive Neuromuscular Electrical Stimulation System for Cortical Control of Combinatorial Rotary Hand Movements in a Human With Tetraplegia
A High Definition Noninvasive Neuromuscular Electrical Stimulation System for Cortical Control of Combinatorial Rotary Hand Movements in a Human With Tetraplegia
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DOI：
10.1109/tbme.2018.2864104
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发表时间：
2019-04-01
影响因子：
4.6
通讯作者：
Sharma, Gaurav
中科院分区：
文献类型：
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作者：
Annetta, Nicholas V.;Friend, Jeffrey;Sharma, Gaurav
目的：脊髓损伤（spinal cord injury，SCI）导致的瘫痪可对多个手臂和手部运动功能产生破坏性影响。旋转的手运动，如旋后和旋前，通常会受到上肢瘫痪的影响，并且对于许多日常生活活动是必不可少的。在这项概念验证研究中，我们利用神经旁路系统（NBS）从运动皮层解码运动意图，以控制通过刺激手臂肌肉引起的组合旋转手部运动，有效地绕过了研究参与者的SCI。我们描述的NBS系统架构和设计，使此功能。研究方法：NBS由三个主要功能组件组成：1）植入的皮质内微电极阵列，2）使用计算机进行神经数据处理，3）无创神经肌肉电刺激（NMES）系统。结果如下：我们解决以前的NBS的局限性，并确认NBS的增强能力，使，在实时，组合手旋转电机功能在功能相关的对象操作任务。结论：这种增强的能力是通过从参与者的运动皮层准确解码多个运动意图，交织NMES模式以联合收割机手部运动，以及在NMES模式之间动态切换以调整运动期间手部位置的变化来实现的。重要性：这些结果对SCI、中风和其他感觉运动功能障碍患者实现复杂的旋转手功能和其他功能相关运动具有重要意义。
Objective: Paralysis resulting from spinal cord injury (SCI) can have a devastating effect on multiple arm and hand motor functions. Rotary hand movements, such as supination and pronation, are commonly impaired by upper extremity paralysis, and are essential for many activities of daily living. In this proof-of-concept study, we utilize a neural bypass system (NBS) to decode motor intention from motor cortex to control combinatorial rotary hand movements elicited through stimulation of the arm muscles, effectively bypassing the SCI of the study participant. We describe the NBS system architecture and design that enabled this functionality. Methods: The NBS consists of three main functional components: 1) implanted intracortical microelectrode array, 2) neural data processing using a computer, and, 3) a noninvasive neuromuscular electrical stimulation (NMES) system. Results: We address previous limitations of the NBS, and confirm the enhanced capability of the NBS to enable, in real-time, combinatorial hand rotary motor functions during a functionally relevant object manipulation task. Conclusion: This enhanced capability was enabled by accurate decoding of multiple movement intentions from the participant's motor cortex, interleaving NMES patterns to combine hand movements, and dynamically switching between NMES patterns to adjust for hand position changes during movement. Significance: These results have implications for enabling complex rotary hand functions in sequence with other functionally relevant movements for patients suffering from SCI, stroke, and other sensorimotor dysfunctions.