Enhancing Sensorimotor Integration Using a Neural Enabled Prosthetic Hand System

项目摘要 有大量且不断增长的截肢者，他们的需求目前没有得到充分满足。 假手技术，导致生活质量下降。拟议工作的长期目标是 基于假手技术可以为残肢提供与任务相关的感觉， 将提高他们在感觉运动任务中的熟练程度，因此允许他们参与一个 扩大就业和休闲活动的范围。 设计了自适应神经系统神经激活假手（ANS-NEPH）系统， 由我们的实验室与工业和临床合作伙伴合作开发，为截肢者提供与任务相关的 感觉该系统使用来自装有仪器的假手上的传感器的信号来引发感觉 通过经由植入外周神经中的细线纵向神经束内电极（LIFE）递送刺激， 残肢的神经一个商业上证明的神经刺激技术，从科帕卡巴纳有限公司是重新- 被设计成与具有LIFE的外周神经中的神经结构连接。 在拟议的项目中，我们将继续进行纵向首次人体临床试验，以评估临床安全性 将招募4名受试者参与本长期研究。每例受试者将 通过外科手术安装植入组件，安装系统的外部组件， 参与一系列旨在评估我们方法长期可行性的广泛实验，并使用 作为他们主要的假手 这项工作的主要成果将是一个神经使能假体的临床可行性演示 用于家庭日常使用（约两年）或在工作场所无线使用的手持系统- 可控植入式刺激技术。对于经桡动脉截肢者，实时感觉可能会改善 感觉运动能力;日常使用可能增强使用者对假体的体现。 此外，刺激传入纤维还可以降低幻肢痛的严重程度和发生率。 该系统将成为下一代桡动脉截肢者的假手技术， 形成了为其他上肢截肢者提供感觉的系统开发的基础 （经肱骨，肩关节离断）。最后，植入式系统的部署和长期使用， 能够刺激离散的小群体传入纤维，这可能为将来使用这种方法铺平道路。 激活周围神经的技术，可能会影响新陈代谢过程，增强免疫系统 功能，调节胃肠道活动，或治疗各种医疗条件。

PROJECT SUMMARY There is a large and growing population of amputees whose needs are not being fully met by current prosthetic hand technology, which results in reduced quality of life. The long-term goal of the proposed work is based on the notion that prosthetic hand technology that can provide task-related sensations to the residual limb of an amputee will increase their proficiency in sensorimotor tasks and therefore allow them to participate in a greater range of employment and leisure activities. The Adaptive Neural Systems neural-enabled prosthetic hand (ANS-NEPH) system was designed and developed by our lab in collaboration with industrial and clinical partners to provide amputees with task-relevant sensations. The system uses signals derived from sensors on an instrumented prosthetic hand to elicit sensations by delivering stimulation via fine-wire longitudinal intrafascicular electrodes (LIFEs) implanted in peripheral nerves of the residual limb. A commercially proven neural stimulation technology from Cochlear Ltd. was re- engineered to interface with neural structures in the peripheral nerves with LIFEs. In the proposed project, we will continue a longitudinal first-in-human clinical trial to evaluate clinical safety and device functionality Four subjects will be enrolled to participate in this long-term study. Each subject will have the implanted components surgically installed, be fitted with the external components of the system, participate in an extensive series of experiments designed to assess long-term viability of our approach, and use it on a daily basis as their primary prosthetic hand. The primary outcome of this work will be a demonstration of clinical feasibility of a neural-enabled prosthetic hand system for daily use at home (for approximately two years) or at the workplace that uses wirelessly- controlled implantable stimulation technology. For transradial amputees, real-time sensation is likely to improve sensorimotor capabilities; everyday use is likely to enhance embodiment of the prosthesis by the user. Furthermore, stimulation of afferent fibers may also reduce the severity and incidence of phantom limb pain. This system will constitute the next generation of prosthetic hand technology for transradial amputees and will form the foundation for systems to be developed that can provide sensation to other upper limb amputees (transhumeral, shoulder disarticulation). Finally, the deployment and chronic use of an implantable system that enables stimulation of discrete sets of small groups of afferent fibers may pave the way for future uses of this technology to activate peripheral nerves that may influence metabolic processes, enhance immune system function, regulate gastrointestinal activity, or treat a variety of medical conditions.