TARGETED HYPER-REINNERVATION TO IMPROVE MYOELECTRIC PROSTHESIS CONTROL

这个子项目是利用由NIH/NCRR资助的中心拨款提供的资源的许多研究子项目之一。子项目和调查员(PI)可能从另一个NIH来源获得了主要资金，因此可能会出现在其他CRISE条目中。列出的机构是针对中心的，而不一定是针对调查员的机构。肩关节脱位和经胸截肢患者的假体控制明显比远端截肢患者的假体控制困难得多。截肢者在协调肩部、肘部、腕部和手部假体的不同功能方面有很大的困难。在随后移动不同的关节之前，用户必须将一个关节锁定在空间中的特定位置。对于截肢者来说，这些设备的使用很少变得直观。周围神经仍然携带着来自大脑的信息，尽管上肢截肢后没有任何功能。我们的策略是使用周围神经手术和肌瓣手术的标准技术，通过外科手术将截肢的手臂神经残端与原本没有功能的胸部和上臂残存肌肉连接起来。接受这些新型神经转移的肌肉段随后充当周围神经系统电信号的生物放大器。在患者自愿控制下引发的肌肉收缩可以通过表面肌电电极检测到，并可以用来发出肌电假体的信号。这种手术创造了一个有用的脑机接口，流畅、直观，并首次允许同时控制多个假体关节。

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. The control of prostheses for patients with shoulder disarticulations and transhumeral amputations is significantly more difficult than that of prostheses for more distal amputations. Amputees have significant difficulties coordinating the separate functions of prosthetic shoulder, elbow, wrist, and hand components. The user must lock one joint at a particular position in space before subsequently moving a different joint. Use of the devices seldom becomes intuitive for the amputee. Peripheral nerves still carry information from the brain, despite having no function after the amputation of the upper extremity. Our strategy is to surgically link the amputated nerve stumps of the arm to otherwise functionless residual muscles of the chest and upper arm using standard techniques of peripheral nerve surgery and muscle flap surgery. Muscle segments which receive these novel nerve transfers then act as bio-amplifiers of the electric signals of the peripheral nervous system. The muscle contractions elicited under voluntary control of the patient are detectable by surface EMG electrodes, and can be used to signal a myoelectric prosthesis. This surgery creates a useful brain-machine interface which is smooth, intuitive, and for the first time allows the simultaneous control of multiple prosthesis joints.