A direct spinal cord-computer interface enables the control of the paralysed hand in spinal cord injury.

The paralysis of the muscles controlling the hand dramatically limits the quality of life of individuals living with spinal cord injury (SCI). Here, with a non-invasive neural interface, we demonstrate that eight motor complete SCI individuals (C5-C6) are still able to task-modulate in real-time the activity of populations of spinal motor neurons with residual neural pathways. In all SCI participants tested, we identified groups of motor units under voluntary control that encoded various hand movements. The motor unit discharges were mapped into more than 10 degrees of freedom, ranging from grasping to individual hand-digit flexion and extension. We then mapped the neural dynamics into a real-time controlled virtual hand. The SCI participants were able to match the cue hand posture by proportionally controlling four degrees of freedom (opening and closing the hand and index flexion/extension). These results demonstrate that wearable muscle sensors provide access to spared motor neurons that are fully under voluntary control in complete cervical SCI individuals. This non-invasive neural interface allows the investigation of motor neuron changes after the injury and has the potential to promote movement restoration when integrated with assistive devices.

A Generalized Framework for the Study of Spinal Motor Neurons Controlling the Human Hand During Dynamic Movements.

The human hand possesses a large number of degrees of freedom. Hand dexterity is encoded by the discharge times of spinal motor units (MUs). Most of our knowledge on the neural control of movement is based on the discharge times of MUs during isometric contractions. Here we designed a noninvasive framework to study spinal motor neurons during dynamic hand movements with the aim to understand the neural control of MUs during sinusoidal hand digit flexion and extension at different rates of force development. The framework included 320 high-density surface EMG electrodes placed on the forearm muscles, with markerless 3D hand kinematics extracted with deep learning, and a realistic virtual hand that displayed the motor tasks. The movements included flexion and extension of individual hand digits at two different speeds (0.5 Hz and 1.5 Hz) for 40 seconds. We found on average 4.7±1.7 MUs across participants and tasks. Most MUs showed a biphasic pattern closely mirroring the flexion and extension kinematics. Indeed, a factor analysis method (non-negative matrix factorization) was able to learn the two components (flexion/extension) with high accuracy at the individual MU level ( R=0.87±0.12). Although most MUs were highly correlated with either flexion or extension movements, there was a smaller proportion of MUs that was not task-modulated and controlled by a different neural module (7.1% of all MUs with ). This work shows a noninvasive visually guided framework to study motor neurons controlling the movement of the hand in human participants during dynamic hand digit movements.

Accurate Continuous Prediction of 14 Degrees of Freedom of the Hand from Myoelectrical Signals through Convolutive Deep Learning.

Natural control of assistive devices requires continuous positional encoding and decoding of the user's volition. Human movement is encoded by recruitment and rate coding of spinal motor units. Surface electromyography provides some information on the neural code of movement and is usually decoded into finger joint angles. However, the current approaches to mapping the electrical signal into joint angles are unsatisfactory. There are no methods that allow precise estimation of joint angles during natural hand movements within the large numbers of degrees of freedom of the hand. We propose a framework to train a neural network from digital cameras and high-density surface electromyography from the extrinsic (forearm and wrist) hand muscles. Furthermore, we show that our 3D convolutional neural network optimally predicted 14 functional flexion/extension joints of the hand. We found in our experiments (4 subjects; mean age of 26±2.12 years) that our model can predict individual sinusoidal finger movement at different speeds (0.5 and 1.5 Hz), as well as two and three finger pinching, and hand opening and closing, covering 14 degrees of freedom of the hand. Our deep learning method shows a mean absolute error of 2.78±0.28 degrees with a mean correlation coefficient between predicted and expected joint angles of 0.94, 95% confidence interval (CI) [0.81, 0.98] with simulated real-time inference times lower than 30 milliseconds. These results demonstrate that our approach is capable of predicting the user's volition similar to digital cameras through a non-invasive wearable neural interface. Clinical relevance- This method establishes a viable interface that can be used for both immersive virtual reality medical simulations environments and assistive devices such as exoskeleton and prosthetics.