Enhancing Sensorimotor Integration Using a Neural Enabled Prosthetic Hand System

项目总结 目前有大量且不断增长的截肢者的需求得不到充分满足 假手技术，导致生活质量下降。拟议工作的长期目标是 基于能够为残肢提供任务相关感觉的假手技术的概念 将提高截肢者在感觉运动任务中的熟练程度，从而使他们能够参与 就业和休闲活动范围更广。 自适应神经系统神经使能假手(ANS-NEPE)系统被设计并 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 轰动一时。该系统使用仪表式假手上的传感器发出的信号来产生感觉 通过植入外周的细丝纵向束内电极(LIFE)提供刺激 残肢的神经。Cochlear Ltd.的一项经过商业验证的神经刺激技术被重新命名。 被设计成与周围神经中的神经结构对接，与生命。 在拟议的项目中，我们将继续进行纵向首例人类临床试验，以评估临床安全性。 和设备功能四个受试者将参加这项长期研究。每个科目都将 通过外科手术安装植入的部件，安装系统的外部部件， 参与一系列广泛的实验，旨在评估我们方法的长期可行性，并使用 它每天都作为他们的主要假手。 这项工作的主要成果将是展示一种神经使能假体的临床可行性。 在家中(大约两年)或在工作场所无线使用的日常使用的手持系统 受控植入式刺激技术。对于经桡骨截肢者，实时感觉可能会改善 感觉运动能力；日常使用可能会增强用户对假体的体现。 此外，刺激传入纤维也可以降低幻肢疼痛的严重程度和发生率。 该系统将构成下一代经桡骨截肢者的假手技术，并将 为开发能够为其他上肢截肢者提供感觉的系统奠定了基础 (经肩关节脱位)。最后，可植入系统的部署和长期使用 使得能够刺激小群传入纤维的离散集合，可能为未来的使用铺平道路 激活可能影响代谢过程的周围神经，增强免疫系统的技术 功能，调节胃肠活动，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.