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1.
Artículo en Inglés | MEDLINE | ID: mdl-38739519

RESUMEN

Intuitive regression control of prostheses relies on training algorithms to correlate biological recordings to motor intent. The quality of the training dataset is critical to run-time regression performance, but accurately labeling intended hand kinematics after hand amputation is challenging. In this study, we quantified the accuracy and precision of labeling hand kinematics using two common training paradigms: 1) mimic training, where participants mimic predetermined motions of a prosthesis, and 2) mirror training, where participants mirror their contralateral intact hand during synchronized bilateral movements. We first explored this question in healthy non-amputee individuals where the ground-truth kinematics could be readily determined using motion capture. Kinematic data showed that mimic training fails to account for biomechanical coupling and temporal changes in hand posture. Additionally, mirror training exhibited significantly higher accuracy and precision in labeling hand kinematics. These findings suggest that the mirror training approach generates a more faithful, albeit more complex, dataset. Accordingly, mirror training resulted in significantly better offline regression performance when using a large amount of training data and a non-linear neural network. Next, we explored these different training paradigms online, with a cohort of unilateral transradial amputees actively controlling a prosthesis in real-time to complete a functional task. Overall, we found that mirror training resulted in significantly faster task completion speeds and similar subjective workload. These results demonstrate that mirror training can potentially provide more dexterous control through the utilization of task-specific, user-selected training data. Consequently, these findings serve as a valuable guide for the next generation of myoelectric and neuroprostheses leveraging machine learning to provide more dexterous and intuitive control.


Asunto(s)
Algoritmos , Miembros Artificiales , Electromiografía , Mano , Humanos , Electromiografía/métodos , Fenómenos Biomecánicos , Masculino , Femenino , Adulto , Mano/fisiología , Reproducibilidad de los Resultados , Amputados/rehabilitación , Redes Neurales de la Computación , Diseño de Prótesis , Movimiento/fisiología , Adulto Joven , Voluntarios Sanos , Dinámicas no Lineales
2.
J Neurosci Methods ; 396: 109934, 2023 08 01.
Artículo en Inglés | MEDLINE | ID: mdl-37524248

RESUMEN

BACKGROUND: The study of chronic pain and its treatments requires a robust animal model with objective and quantifiable metrics. Porcine neuropathic pain models have been assessed with peripheral pain recordings and behavioral responses, but thus far central nervous system electrophysiology has not been investigated. This work aimed to record non-invasive, somatosensory-evoked potentials (SEPs) via electroencephalography in order to quantitatively assess chronic neuropathic pain induced in a porcine model. NEW METHOD: Peripheral neuritis trauma (PNT) was induced unilaterally in the common peroneal nerve of domestic farm pigs, with the contralateral leg serving as the control for each animal. SEPs were generated by stimulation of the peripheral nerves distal to the PNT and were recorded non-invasively using transcranial electroencephalography (EEG). The P30 wave of the SEP was analyzed for latency changes. RESULTS: P30 SEPs were successfully recorded with non-invasive EEG. PNT resulted in significantly longer P30 SEP latencies (p < 0.01 [n = 8]) with a median latency increase of 14.3 [IQR 5.0 - 17.5] ms. Histological results confirmed perineural inflammatory response and nerve damage around the PNT nerves. COMPARISON WITH EXISTING METHOD(S): Control P30 SEPs were similar in latency and amplitude to those previously recorded invasively in healthy pigs. Non-invasive recordings have numerous advantages over invasive measures. CONCLUSIONS: P30 SEP latency can serve as a quantifiable neurological measure that reflects central nervous system processing in a porcine model of chronic pain. Advancing the development of a porcine chronic pain model will facilitate the translation of experimental therapies into human clinical trials.


Asunto(s)
Dolor Crónico , Neuralgia , Humanos , Porcinos , Animales , Potenciales Evocados Somatosensoriales/fisiología , Electroencefalografía , Sistema Nervioso Central , Neuralgia/diagnóstico , Estimulación Eléctrica , Nervio Mediano
3.
Annu Int Conf IEEE Eng Med Biol Soc ; 2021: 6171-6174, 2021 11.
Artículo en Inglés | MEDLINE | ID: mdl-34892525

RESUMEN

Upper-limb prosthetic control is often challenging and non-intuitive, leading to up to 50% of prostheses users abandoning their prostheses. Convolutional neural networks (CNN) and recurrent long short-term memory (LSTM) networks have shown promise in extracting high-degree-of-freedom motor intent from myoelectric signals, thereby providing more intuitive and dexterous prosthetic control. An important next consideration for these algorithms is if performance remains stable over multiple days. Here we introduce a new LSTM network and compare its performance to previously established state-of-the-art algorithms-a CNN and a modified Kalman filter (MKF)-in offline analyses using 76 days of intramuscular recordings from one amputee participant collected over 425 calendar days. Specifically, we assessed the robustness of each algorithm over time by training on data from the first (one, five, ten, 30, or 60) days and then testing on myoelectric signals on the last 16 days. Results indicate that training on additional datasets from prior days generally decreases the Root Mean Squared Error (RMSE) of intended and unintended movements for all algorithms. Across all algorithms trained with 60 days of data, the lowest RMSE for unintended movements was achieved with the LSTM. The LSTM also showed less across-day variance in RMSE of unintended movements relative to the other algorithms. Altogether this work suggests that the LSTM algorithm introduced here can provide more intuitive and dexterous control for prosthetic users, and that training on multiple days of data improves overall performance on subsequent days, at least for offline analyses.


Asunto(s)
Amputados , Miembros Artificiales , Algoritmos , Humanos , Redes Neurales de la Computación , Extremidad Superior
4.
Annu Int Conf IEEE Eng Med Biol Soc ; 2021: 6608-6612, 2021 11.
Artículo en Inglés | MEDLINE | ID: mdl-34892623

RESUMEN

Commercial prosthetic hands are frequently abandoned due to unintuitive control methods and a lack of sensory feedback from the prosthesis. Advanced neuromyoelectric prostheses can restore intuitive control and sensory feedback to prosthesis users and potentially reduce abandonment. However, not all advanced prosthetic systems are deployable for home use on portable systems with limited computational power. In this work, we use a commercially available portable neural interface processor (the Ripple Neuro Nomad), and a multi-degree-of-freedom bionic arm (the DEKA LUKE Arm) to create a closed-loop neuromyoelectric prosthesis. The system restores intuitive, independent, continuous control over the arm's six-degrees-of-freedom and provides sensory feedback for up to 288 neural and six vibrotactile channels. Additionally, the large storage capacity of the system enables high-resolution logging of EMG, hand positions, prosthesis sensors, and stimulation parameters. We developed two GUIs enabling wireless, real-time adjustments to motor control and feedback parameters: one with nearly full control over motor control and feedback parameters for investigators, and one with restricted capabilities enabling end-user safety. We verified the system's closed-loop function through a fragile egg task with vibrotactile sensory feedback. We tested the neural stimulation with an amplifier capable of eliciting transcutaneous percepts. This neuromyoelectric prosthetic system will be used for an extended take-home trial that could provide strong clinical justification for advanced, closed-loop prostheses.Clinical Relevance- This work establishes an advanced, intuitive, sensorized prosthesis that can be used in home and clinical settings.


Asunto(s)
Miembros Artificiales , Biónica , Brazo , Electromiografía , Diseño de Prótesis
5.
J Neuroeng Rehabil ; 18(1): 45, 2021 02 25.
Artículo en Inglés | MEDLINE | ID: mdl-33632237

RESUMEN

BACKGROUND: Advanced prostheses can restore function and improve quality of life for individuals with amputations. Unfortunately, most commercial control strategies do not fully utilize the rich control information from residual nerves and musculature. Continuous decoders can provide more intuitive prosthesis control using multi-channel neural or electromyographic recordings. Three components influence continuous decoder performance: the data used to train the algorithm, the algorithm, and smoothing filters on the algorithm's output. Individual groups often focus on a single decoder, so very few studies compare different decoders using otherwise similar experimental conditions. METHODS: We completed a two-phase, head-to-head comparison of 12 continuous decoders using activities of daily living. In phase one, we compared two training types and a smoothing filter with three algorithms (modified Kalman filter, multi-layer perceptron, and convolutional neural network) in a clothespin relocation task. We compared training types that included only individual digit and wrist movements vs. combination movements (e.g., simultaneous grasp and wrist flexion). We also compared raw vs. nonlinearly smoothed algorithm outputs. In phase two, we compared the three algorithms in fragile egg, zipping, pouring, and folding tasks using the combination training and smoothing found beneficial in phase one. In both phases, we collected objective, performance-based (e.g., success rate), and subjective, user-focused (e.g., preference) measures. RESULTS: Phase one showed that combination training improved prosthesis control accuracy and speed, and that the nonlinear smoothing improved accuracy but generally reduced speed. Phase one importantly showed simultaneous movements were used in the task, and that the modified Kalman filter and multi-layer perceptron predicted more simultaneous movements than the convolutional neural network. In phase two, user-focused metrics favored the convolutional neural network and modified Kalman filter, whereas performance-based metrics were generally similar among all algorithms. CONCLUSIONS: These results confirm that state-of-the-art algorithms, whether linear or nonlinear in nature, functionally benefit from training on more complex data and from output smoothing. These studies will be used to select a decoder for a long-term take-home trial with implanted neuromyoelectric devices. Overall, clinical considerations may favor the mKF as it is similar in performance, faster to train, and computationally less expensive than neural networks.


Asunto(s)
Actividades Cotidianas , Miembros Artificiales , Aprendizaje Automático , Procesamiento de Señales Asistido por Computador , Brazo/fisiología , Biónica/métodos , Electromiografía , Humanos , Masculino , Movimiento/fisiología , Calidad de Vida , Adulto Joven
6.
J Neuroeng Rehabil ; 18(1): 12, 2021 01 21.
Artículo en Inglés | MEDLINE | ID: mdl-33478534

RESUMEN

BACKGROUND: Electrical stimulation of residual afferent nerve fibers can evoke sensations from a missing limb after amputation, and bionic arms endowed with artificial sensory feedback have been shown to confer functional and psychological benefits. Here we explore the extent to which artificial sensations can be discriminated based on location, quality, and intensity. METHODS: We implanted Utah Slanted Electrode Arrays (USEAs) in the arm nerves of three transradial amputees and delivered electrical stimulation via different electrodes and frequencies to produce sensations on the missing hand with various locations, qualities, and intensities. Participants performed blind discrimination trials to discriminate among these artificial sensations. RESULTS: Participants successfully discriminated cutaneous and proprioceptive sensations ranging in location, quality and intensity. Performance was significantly greater than chance for all discrimination tasks, including discrimination among up to ten different cutaneous location-intensity combinations (15/30 successes, p < 0.0001) and seven different proprioceptive location-intensity combinations (21/40 successes, p < 0.0001). Variations in the site of stimulation within the nerve, via electrode selection, enabled discrimination among up to five locations and qualities (35/35 successes, p < 0.0001). Variations in the stimulation frequency enabled discrimination among four different intensities at the same location (13/20 successes, p < 0.0005). One participant also discriminated among individual stimulation of two different USEA electrodes, simultaneous stimulation on both electrodes, and interleaved stimulation on both electrodes (20/24 successes, p < 0.0001). CONCLUSION: Electrode location, stimulation frequency, and stimulation pattern can be modulated to evoke functionally discriminable sensations with a range of locations, qualities, and intensities. This rich source of artificial sensory feedback may enhance functional performance and embodiment of bionic arms endowed with a sense of touch.


Asunto(s)
Miembros Artificiales , Estimulación Eléctrica/instrumentación , Propiocepción/fisiología , Percepción del Tacto/fisiología , Adulto , Amputados , Brazo , Electrodos , Retroalimentación Sensorial/fisiología , Mano , Humanos , Masculino , Persona de Mediana Edad
7.
Annu Int Conf IEEE Eng Med Biol Soc ; 2020: 3297-3301, 2020 07.
Artículo en Inglés | MEDLINE | ID: mdl-33018709

RESUMEN

Intuitive control of prostheses relies on training algorithms to correlate biological recordings to motor intent. The quality of the training dataset is critical to run-time performance, but it is difficult to label hand kinematics accurately after the hand has been amputated. We quantified the accuracy and precision of labeling hand kinematics for two different training approaches: 1) assuming a participant is perfectly mimicking predetermined motions of a prosthesis (mimicked training), and 2) assuming a participant is perfectly mirroring their contralateral hand during identical bilateral movements (mirrored training). We compared these approaches in non-amputee individuals, using an infrared camera to track eight different joint angles of the hands in real-time. Aggregate data revealed that mimicked training does not account for biomechanical coupling or temporal changes in hand posture. Mirrored training was significantly more accurate and precise at labeling hand kinematics. However, when training a modified Kalman filter to estimate motor intent, the mimicked and mirrored training approaches were not significantly different. The results suggest that the mirrored training approach creates a more faithful but more complex dataset. Advanced algorithms, more capable of learning the complex mirrored training dataset, may yield better run-time prosthetic control.


Asunto(s)
Amputados , Miembros Artificiales , Electromiografía , Mano , Humanos , Aprendizaje Automático Supervisado
8.
Annu Int Conf IEEE Eng Med Biol Soc ; 2020: 3893-3896, 2020 07.
Artículo en Inglés | MEDLINE | ID: mdl-33018851

RESUMEN

Electrical stimulation of residual nerves can be used to provide amputees with intuitive sensory feedback. An important aspect of this artificial sensory feedback is the ability to convey the magnitude of tactile stimuli. Using classical psychophysical methods, we quantified the just-noticeable differences for electrocutaneous stimulation pulse frequency in both intact participants and one transradial amputee. For the transradial amputee, we also quantified the just-noticeable difference of intraneural microstimulation pulse frequency via chronically implanted Utah Slanted Electrode Arrays. We demonstrate that intensity discrimination is similar across conditions: intraneural microstimulation of the residual nerves, electrocutaneous stimulation of the reinnervated skin on the residual limb, and electrocutaneous stimulation of intact hands. We also show that intensity discrimination performance is significantly better at lower pulse frequencies than at higher pulse frequencies - a finding that's unique to electrocutaneous and intraneural stimulation and suggests that supplemental sensory cues may be present at lower pulse frequencies. These results can help guide the implementation of artificial sensory feedback for sensorized bionic arms.Clinical Relevance- Intraneural and electrocutaneous artificial sensory feedback are comparable in their ability to convey the magnitude of tactile stimuli via pulse frequency.


Asunto(s)
Amputados , Retroalimentación Sensorial , Mano , Humanos , Tacto , Utah
9.
J Neural Eng ; 17(5): 056042, 2020 10 31.
Artículo en Inglés | MEDLINE | ID: mdl-33045689

RESUMEN

OBJECTIVE: We explore the long-term performance and stability of seven percutaneous Utah Slanted Electrode Arrays (USEAs) and intramuscular recording leads (iEMGs) implanted chronically in the residual arm nerves and muscles of three human participants as a means to permanently restore sensorimotor function after transradial amputations. APPROACH: We quantify the number of functional recording and functional stimulating electrodes over time. We also calculate the signal-to-noise ratio (SNR) of USEA and iEMG recordings and quantify the stimulation current necessary to evoke detectable sensory percepts. Furthermore, we quantify the consistency of the sensory modality, receptive field location, and receptive field size of USEA-evoked percepts. MAIN RESULTS: In the most recent subject, involving USEAs with technical improvements, neural recordings persisted for 502 d (entire implant duration) and the number of functional recording electrodes for one USEA increased over time. However, for six out of seven USEAs across the three participants, the number of functional recording electrodes decreased within the first 2 months after implantation. The SNR of neural recordings and electromyographic recordings stayed relatively consistent over time. Sensory percepts were consistently evoked over the span of 14 months, were not significantly different in size, and highlighted the nerves' fascicular organization. The percentage of percepts with consistent modality or consistent receptive field location between sessions (∼1 month apart) varied between 0%-86.2% and 9.1%-100%, respectively. Stimulation thresholds and electrode impedances increased initially but then remained relatively stable over time. SIGNIFICANCE: This work demonstrates improved performance of USEAs, and provides a basis for comparing the longevity and stability of USEAs to that of other neural interfaces. USEAs provide a rich repertoire of neural recordings and sensory percepts. Although their performance still generally declines over time, functionality can persist long-term. Future work should leverage the results presented here to further improve USEA design or to develop adaptive algorithms that can maintain a high level of performance.


Asunto(s)
Brazo , Miembros Artificiales , Electrodos Implantados , Humanos , Microelectrodos , Músculos , Utah
10.
J Neurosci Methods ; 330: 108462, 2020 01 15.
Artículo en Inglés | MEDLINE | ID: mdl-31711883

RESUMEN

BACKGROUND: Multi-articulate prostheses are capable of performing dexterous hand movements. However, clinically available control strategies fail to provide users with intuitive, independent and proportional control over multiple degrees of freedom (DOFs) in real-time. NEW METHOD: We detail the use of a modified Kalman filter (MKF) to provide intuitive, independent and proportional control over six-DOF prostheses such as the DEKA "LUKE" arm. Input features include neural firing rates recorded from Utah Slanted Electrode Arrays and mean absolute value of intramuscular electromyographic (EMG) recordings. Ad-hoc modifications include thresholds and non-unity gains on the output of a Kalman filter. RESULTS: We demonstrate that both neural and EMG data can be combined effectively. We also highlight that modifications can be optimized to significantly improve performance relative to an unmodified Kalman filter. Thresholds significantly reduced unintended movement and promoted more independent control of the different DOFs. Gains were significantly greater than one and served to ease movement initiation. Optimal modifications can be determined quickly offline and translate to functional improvements online. Using a portable take-home system, participants performed various activities of daily living. COMPARISON WITH EXISTING METHODS: In contrast to pattern recognition, the MKF allows users to continuously modulate their force output, which is critical for fine dexterity. The MKF is also computationally efficient and can be trained in less than five minutes. CONCLUSIONS: The MKF can be used to explore the functional and psychological benefits associated with long-term, at-home control of dexterous prosthetic hands.


Asunto(s)
Brazo/fisiopatología , Miembros Artificiales , Biónica , Electromiografía/métodos , Intención , Actividad Motora/fisiología , Músculo Esquelético/fisiopatología , Actividades Cotidianas , Adulto , Amputados , Electrodos Implantados , Electromiografía/instrumentación , Femenino , Humanos , Masculino , Persona de Mediana Edad , Adulto Joven
11.
Front Robot AI ; 7: 559034, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33501323

RESUMEN

This paper describes a portable, prosthetic control system and the first at-home use of a multi-degree-of-freedom, proportionally controlled bionic arm. The system uses a modified Kalman filter to provide 6 degree-of-freedom, real-time, proportional control. We describe (a) how the system trains motor control algorithms for use with an advanced bionic arm, and (b) the system's ability to record an unprecedented and comprehensive dataset of EMG, hand positions and force sensor values. Intact participants and a transradial amputee used the system to perform activities-of-daily-living, including bi-manual tasks, in the lab and at home. This technology enables at-home dexterous bionic arm use, and provides a high-temporal resolution description of daily use-essential information to determine clinical relevance and improve future research for advanced bionic arms.

12.
IEEE Trans Neural Syst Rehabil Eng ; 27(10): 2070-2076, 2019 10.
Artículo en Inglés | MEDLINE | ID: mdl-31536008

RESUMEN

Bypass sockets allow researchers to perform tests of prosthetic systems from the prosthetic user's perspective. We designed a modular upper-limb bypass socket with 3D-printed components that can be easily modified for use with a variety of terminal devices. Our bypass socket preserves access to forearm musculature and the hand, which are necessary for surface electromyography and to provide substituted sensory feedback. Our bypass socket allows a sufficient range of motion to complete tasks in the frontal working area, as measured on non-amputee participants. We examined the performance of non-amputee participants using the bypass socket on the original and modified Box and Block Tests. Participants moved 11.3 ± 2.7 and 11.7 ± 2.4 blocks in the original and modified Box and Block Tests (mean ± SD), respectively, within the range of reported scores using amputee participants. Range of motion for users wearing the bypass socket meets or exceeds most reported range of motion requirements for activities of daily living. The bypass socket was originally designed with a freely rotating wrist; we found that adding elastic resistance to user wrist rotation while wearing the bypass socket had no significant effect on motor decode performance. We have open-sourced the design files and an assembly manual for the bypass socket. We anticipate that the bypass socket will be a useful tool to evaluate and develop sensorized myoelectric prosthesis technology.


Asunto(s)
Miembros Artificiales , Electromiografía/métodos , Radio (Anatomía) , Amputados , Simulación por Computador , Retroalimentación Sensorial , Femenino , Voluntarios Sanos , Humanos , Masculino , Músculo Esquelético/fisiología , Impresión Tridimensional , Diseño de Prótesis , Muñeca/fisiología
13.
IEEE Trans Neural Syst Rehabil Eng ; 27(5): 876-886, 2019 05.
Artículo en Inglés | MEDLINE | ID: mdl-30951470

RESUMEN

Although recent advances in neuroprostheses offer opportunities for improved and intuitive control of advanced motorized and sensorized robotic arms, practical complications associated with such hardware can impede the research necessary for clinical translation. These hurdles potentially can be reduced with virtual reality environments (VREs) with embedded physics engines using virtual models of physical robotic hands. These software suites offer several advantages over physical prototypes, including high repeatability, reduced human error, elimination of many secondary sensory cues, and others. There are limited demonstrations of closed-loop prostheses in the VRE, and it is unclear whether VRE performance translates to the physical world. Here we describe how two trans-radial amputees with neural and intramuscular implants identified objects and performed activities of daily living with closed-loop control of prostheses in the VRE. Our initial evidence further suggests that capabilities with virtual prostheses may be predictors of physical prosthesis performance, demonstrating the utility of VREs for neuroprosthetic research.


Asunto(s)
Electromiografía/métodos , Prótesis Neurales , Realidad Virtual , Actividades Cotidianas , Amputados , Biorretroalimentación Psicológica , Señales (Psicología) , Electrodos Implantados , Mano/fisiología , Humanos , Diseño de Prótesis , Robótica , Sensación/fisiología , Programas Informáticos
14.
IEEE Trans Biomed Eng ; 66(11): 3192-3203, 2019 11.
Artículo en Inglés | MEDLINE | ID: mdl-30835207

RESUMEN

SIGNIFICANCE: The performance of traditional approaches to decoding movement intent from electromyograms (EMGs) and other biological signals commonly degrade over time. Furthermore, conventional algorithms for training neural network based decoders may not perform well outside the domain of the state transitions observed during training. The work presented in this paper mitigates both these problems, resulting in an approach that has the potential to substantially improve the quality of life of the people with limb loss. OBJECTIVE: This paper presents and evaluates the performance of four decoding methods for volitional movement intent from intramuscular EMG signals. METHODS: The decoders are trained using the dataset aggregation (DAgger) algorithm, in which the training dataset is augmented during each training iteration based on the decoded estimates from previous iterations. Four competing decoding methods, namely polynomial Kalman filters (KFs), multilayer perceptron (MLP) networks, convolutional neural networks (CNN), and long short-term memory (LSTM) networks, were developed. The performances of the four decoding methods were evaluated using EMG datasets recorded from two human volunteers with transradial amputation. Short-term analyses, in which the training and cross-validation data came from the same dataset, and long-term analyses, in which the training and testing were done in different datasets, were performed. RESULTS: Short-term analyses of the decoders demonstrated that CNN and MLP decoders performed significantly better than KF and LSTM decoders, showing an improvement of up to 60% in the normalized mean-square decoding error in cross-validation tests. Long-term analyses indicated that the CNN, MLP, and LSTM decoders performed significantly better than a KF-based decoder at most analyzed cases of temporal separations (0-150 days) between the acquisition of the training and testing datasets. CONCLUSION: The short-term and long-term performances of MLP- and CNN-based decoders trained with DAgger demonstrated their potential to provide more accurate and naturalistic control of prosthetic hands than alternate approaches.


Asunto(s)
Algoritmos , Miembros Artificiales , Aprendizaje Profundo , Electromiografía/métodos , Procesamiento de Señales Asistido por Computador , Amputados , Ingeniería Biomédica , Humanos , Intención , Movimiento/fisiología
15.
Neuromodulation ; 22(5): 597-606, 2019 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-30117624

RESUMEN

OBJECTIVES: Kilohertz high-frequency alternating current (KHFAC) electrical nerve stimulation produces a reversible nerve block in peripheral nerves in human patients with chronic pain pathologies. Although this stimulation methodology has been verified with nonselective extrafascicular electrodes, the effectiveness of producing a selective nerve block with more-selective intrafascicular electrodes has not been well documented. The objective of this study was to examine whether intrafascicular electrodes can block painful stimuli while preserving conduction of other neural activity within the implanted nerve. MATERIALS AND METHODS: We analyzed the effects of various stimulation waveforms delivered through Utah Slanted Electrode Arrays (USEAs) implanted in the median nerve of a male human subject with a left brachial plexus injury. We compared KHFAC stimulation with a sham control. RESULTS: KHFAC stimulation through USEA electrodes produced a reduction in pain sensitivity in the palmar aspect of the left middle finger. KHFAC had limited effects on the patient's ability to feel tactile probing in the same area or move the digits of his left hand. Other tested stimulation parameters either increased or showed no reduction in pain. CONCLUSIONS: KHFAC stimulation in peripheral nerves through intrafascicular electrodes demonstrated a selective reduction in pain sensitivity while preserving other nerve functions. This treatment may benefit patient populations who have chronic pain originating from peripheral nerves, but who do not want to block whole-nerve function in order to preserve sensory and motor function reliant on the implanted nerve. Furthermore, KHFAC may benefit patients who respond negatively to other forms of peripheral nerve stimulation therapy.


Asunto(s)
Plexo Braquial/lesiones , Plexo Braquial/fisiología , Electrodos Implantados , Hiperalgesia/terapia , Nervio Mediano/fisiología , Estimulación Eléctrica Transcutánea del Nervio/métodos , Anciano , Humanos , Hiperalgesia/diagnóstico por imagen , Hiperalgesia/fisiopatología , Masculino , Nervios Periféricos/fisiología , Estimulación Eléctrica Transcutánea del Nervio/instrumentación
16.
Annu Int Conf IEEE Eng Med Biol Soc ; 2018: 3782-3787, 2018 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-30441190

RESUMEN

Working towards improved neuromyoelectric control of dexterous prosthetic hands, we explored how differences in training paradigms affect the subsequent online performance of two different motor-decode algorithms. Participants included two intact subjects and one participant who had undergone a recent transradial amputation after complex regional pain syndrome (CRPS) and multi-year disuse of the affected hand. During algorithm training sessions, participants actively mimicked hand movements appearing on a computer monitor. We varied both the duration of the hold-time (0.1 s or 5 s) at the end-point of each of six different digit and wrist movements, and the order in which the training movements were presented (random or sequential). We quantified the impact of these variations on two different motordecode algorithms, both having proportional, six-degree-offreedom (DOF) control: a modified Kalman filter (MKF) previously reported by this group, and a new approach - a convolutional neural network (CNN). Results showed that increasing the hold-time in the training set improved run-time performance. By contrast, presenting training movements in either random or sequential order had a variable and relatively modest effect on performance. The relative performance of the two decode algorithms varied according to the performance metric. This work represents the first-ever amputee use of a CNN for real-time, proportional six-DOF control of a prosthetic hand. Also novel was the testing of implanted high-channelcount devices for neuromyoelectric control shortly after amputation, following CRPS and long-term hand disuse. This work identifies key factors in the training of decode algorithms that improve their subsequent run-time performance.


Asunto(s)
Amputados , Síndromes de Dolor Regional Complejo , Algoritmos , Mano , Humanos
17.
Front Hum Neurosci ; 12: 352, 2018.
Artículo en Inglés | MEDLINE | ID: mdl-30319374

RESUMEN

We quantified prosthesis embodiment and phantom pain reduction associated with motor control and sensory feedback from a prosthetic hand in one human with a long-term transradial amputation. Microelectrode arrays were implanted in the residual median and ulnar arm nerves and intramuscular electromyography recording leads were implanted in residual limb muscles to enable sensory feedback and motor control. Objective measures (proprioceptive drift) and subjective measures (survey answers) were used to assess prosthesis embodiment. For both measures, there was a significant level of embodiment of the physical prosthetic limb after open-loop motor control of the prosthesis (i.e., without sensory feedback), open-loop sensation from the prosthesis (i.e., without motor control), and closed-loop control of the prosthesis (i.e., motor control with sensory feedback). There was also a statistically significant reduction in reported phantom pain after experimental sessions that included open-loop nerve microstimulation, open-loop prosthesis motor control, or closed-loop prosthesis motor control. The closed-loop condition provided no additional significant improvements in phantom pain reduction or prosthesis embodiment relative to the open-loop sensory condition or the open-loop motor condition. This study represents the first long-term (14-month), systematic report of phantom pain reduction and prosthesis embodiment in a human amputee across a variety of prosthesis use cases.

18.
J Neuroeng Rehabil ; 14(1): 121, 2017 Nov 25.
Artículo en Inglés | MEDLINE | ID: mdl-29178940

RESUMEN

BACKGROUND: Despite advances in sophisticated robotic hands, intuitive control of and sensory feedback from these prostheses has been limited to only 3-degrees-of-freedom (DOF) with 2 sensory percepts in closed-loop control. A Utah Slanted Electrode Array (USEA) has been used in the past to provide up to 81 sensory percepts for human amputees. Here, we report on the advanced capabilities of multiple USEAs implanted in the residual peripheral arm nerves of human amputees for restoring control of 5 DOF and sensation of up to 131 proprioceptive and cutaneous hand sensory percepts. We also demonstrate that USEA-restored sensory percepts provide a useful source of feedback during closed-loop virtual prosthetic hand control. METHODS: Two 100-channel USEAs were implanted for 4-5 weeks, one each in the median and ulnar arm nerves of two human subjects with prior long-duration upper-arm amputations. Intended finger and wrist positions were decoded from neuronal firing patterns via a modified Kalman filter, allowing subjects to control many movements of a virtual prosthetic hand. Additionally, USEA microstimulation was used to evoke numerous sensory percepts spanning the phantom hand. Closed-loop control was achieved by stimulating via an electrode of the ulnar-nerve USEA while recording and decoding movement via the median-nerve USEA. RESULTS: Subjects controlled up to 12 degrees-of-freedom during informal, 'freeform' online movement decode sessions, and experienced up to 131 USEA-evoked proprioceptive and cutaneous sensations spanning the phantom hand. Independent control was achieved for a 5-DOF real-time decode that included flexion/extension of the thumb, index, middle, and ring fingers, and the wrist. Proportional control was achieved for a 4-DOF real-time decode. One subject used a USEA-evoked hand sensation as feedback to complete a 1-DOF closed-loop virtual-hand movement task. There were no observed long-term functional deficits due to the USEA implants. CONCLUSIONS: Implantation of high-channel-count USEAs enables multi-degree-of-freedom control of virtual prosthetic hand movement and restoration of a rich selection of both proprioceptive and cutaneous sensory percepts spanning the hand during the short 4-5 week post-implant period. Future USEA use in longer-term implants and in closed-loop may enable restoration of many of the capabilities of an intact hand while contributing to a meaningful embodiment of the prosthesis.


Asunto(s)
Miembros Artificiales , Terapia por Estimulación Eléctrica/métodos , Electrodos Implantados , Diseño de Prótesis/instrumentación , Adulto , Amputados , Brazo , Retroalimentación Sensorial , Humanos , Masculino , Persona de Mediana Edad , Propiocepción , Utah
19.
Front Neurosci ; 10: 414, 2016.
Artículo en Inglés | MEDLINE | ID: mdl-27679557

RESUMEN

Asynchronous intrafascicular multi-electrode stimulation (aIFMS) of small independent populations of peripheral nerve motor axons can evoke selective, fatigue-resistant muscle forces. We previously developed a real-time proportional closed-loop control method for aIFMS generation of isometric muscle force and the present work extends and adapts this closed-loop controller to the more demanding task of dynamically controlling joint position in the presence of opposing joint torque. A proportional-integral-velocity controller, with integrator anti-windup strategies, was experimentally validated as a means to evoke motion about the hind-limb ankle joint of an anesthetized feline via aIFMS stimulation of fast-twitch plantar-flexor muscles. The controller was successful in evoking steps in joint position with 2.4% overshoot, 2.3-s rise time, 4.5-s settling time, and near-zero steady-state error. Controlled step responses were consistent across changes in step size, stable against external disturbances, and reliable over time. The controller was able to evoke smooth eccentric motion at joint velocities up to 8 deg./s, as well as sinusoidal trajectories with frequencies up to 0.1 Hz, with time delays less than 1.5 s. These experiments provide important insights toward creating a robust closed-loop aIFMS controller that can evoke precise fatigue-resistant motion in paralyzed individuals, despite the complexities introduced by aIFMS.

20.
Annu Int Conf IEEE Eng Med Biol Soc ; 2016: 3422-3425, 2016 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-28269038

RESUMEN

Signals recorded from the peripheral nervous system (PNS) with high channel count penetrating microelectrode arrays, such as the Utah Slanted Electrode Array (USEA), often have electromyographic (EMG) signals contaminating the neural signal. This common-mode signal source may prevent single neural units from successfully being detected, thus hindering motor decode algorithms. Reducing this EMG contamination may lead to more accurate motor decode performance. A virtual reference (VR), created by a weighted linear combination of signals from a subset of all available channels, can be used to reduce this EMG contamination. Four methods of determining individual channel weights and six different methods of selecting subsets of channels were investigated (24 different VR types in total). The methods of determining individual channel weights were equal weighting, regression-based weighting, and two different proximity-based weightings. The subsets of channels were selected by a radius-based criteria, such that a channel was included if it was within a particular radius of inclusion from the target channel. These six radii of inclusion were 1.5, 2.9, 3.2, 5, 8.4, and 12.8 electrode-distances; the 12.8 electrode radius includes all USEA electrodes. We found that application of a VR improves the detectability of neural events via increasing the SNR, but we found no statistically meaningful difference amongst the VR types we examined. The computational complexity of implementation varies with respect to the method of determining channel weights and the number of channels in a subset, but does not correlate with VR performance. Hence, we examined the computational costs of calculating and applying the VR and based on these criteria, we recommend an equal weighting method of assigning weights with a 3.2 electrode-distance radius of inclusion. Further, we found empirically that application of the recommended VR will require less than 1 ms for 33.3 ms of data from one USEA.


Asunto(s)
Electromiografía/métodos , Nervios Periféricos/fisiología , Procesamiento de Señales Asistido por Computador , Algoritmos , Electromiografía/instrumentación , Humanos , Modelos Lineales , Microelectrodos , Relación Señal-Ruido
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