Despite previous studies on the restoration of tactile sensation on the fingers and the hand, there are no examples of use of the routed sensory information to finely control the prosthesis hand in complex grasp and manipulation tasks. Here it is shown that force and slippage sensations can be elicited in an amputee subject by means of biologically-inspired slippage detection and encoding algorithms, supported by a stick-slip model of the performed grasp. A combination of cuff and intraneural electrodes was implanted for eleven weeks in a young woman with hand amputation, and was shown to provide close-to-natural force and slippage sensations, paramount for significantly improving the subject’s manipulative skills with the prosthesis. Evidence is provided about the improvement of the subject’s grasping and manipulation capabilities over time, thanks to neural feedback. The elicited tactile sensations enabled the successful fulfillment of fine grasp and manipulation tasks with increasing complexity. Grasp performance was quantitatively assessed by means of instrumented objects and a purposely developed metrics. Closed-loop control capabilities enabled by the neural feedback were compared to those achieved without feedback. Further, the work investigates whether the described amelioration of motor performance in dexterous tasks had as central neurophysiological correlates changes in motor cortex plasticity and whether such changes were of purely motor origin, or else the effect of a strong and persistent drive of the sensory feedback.

Embodiment is the percept that something not originally belonging to the self becomes part of the body. Feeling embodiment for a prosthesis may counteract amputees' altered image of the body and increase prosthesis acceptability. Prosthesis embodiment has been studied longitudinally in an amputee receiving feedback through intraneural and perineural multichannel electrodes implanted in her stump. Three factors-invasive (vs non-invasive) stimulation, training, and anthropomorphism-have been tested through two multisensory integration tasks: visuo-tactile integration (VTI) and crossing-hand effect in temporal order judgment (TOJ), the former more sensible to an extension of a safe margin around the body and the latter to action-oriented remapping. Results from the amputee participant were compared with the ones from healthy controls. Testing the participant with intraneural stimulation produced an extension of peripersonal space, a sign of prosthesis embodiment. One-month training extended the peripersonal space selectively on the side wearing the prostheses. More and less-anthropomorphic prostheses benefited of intraneural feedback and extended the peripersonal space. However, the worsening of TOJ performance following arm crossing was present only wearing the more trained, despite less anthropomorphic, prosthesis, suggesting that training was critical for our participant to achieve operative tool-like embodiment.

The afferent branch of the autonomic nervous system contributes with interoception to the multimodal sensory correlation continuously needed to update our representation of the body. To test whether the modulation of body representation would have an impact on the efferent branch of the autonomic nervous system, nonspecific skin conductance has been measured in three rubber hand illusion (RHI) experiments, controlled with asynchronous brush-stroking and incongruent fake hand position. Nonspecific skin conductance standard deviation (SCSD) computed along the whole 90 sec of stroking was found to be increased by the illusion and to correlate with all the typical measures of embodiment. Computing SCSD in shorter time windows strongly enhanced the difference between illusion and controls. The highest difference was found in the 10–55 sec window, being the 14–34 sec window as the most informative one. The higher correlations with the validated measures of embodiment (all but the proprioceptive drift) were found for time windows ranging between 35 and 65 sec. The SCSD was no longer significantly higher when the RHI was repeated twice (two trials each iteration), but it was still significantly higher in synchronous stroking even when considering only the second trial. However, after the first iteration of the RHI paradigm, the effect of the embodiment on nonspecific skin conductance response results to be attenuated, suggesting that novelty in presentation of the RHI can contribute to the effect on nonspecific skin conductance response. Results candidate SCSD as a noninvasive, cheap, easy, and objective measure of embodiment, especially sensible to onset and strength of the illusion. Alike the already known enhanced autonomic reaction to a threatening, SCSD does not interfere with the collection of other behavioral measures. Correlations and their dynamics, presence of the effect in the second presentation of the setup but relative low robustness against multiple repetition, suggest that the increased fluctuations of skin conductance caught by SCSD are not just the effect of different presented sensory stimuli but more likely a stronger arousal response to the novelty of the updated perceptual status.

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