Intrafascicular peripheral nerve stimulation produces fine functional hand movements in primates

Badi, Marion; Wurth, Sophie; Scarpato, Ilaria; Roussinova, Evgenia; Losanno, Elena; Bogaard, Andrew; Delacombaz, Maude; Borgognon, Simon; Čvančara, Paul; Fallegger, Florian; Su, David K.; Schmidlin, Eric; Courtine, Grégoire; Bloch, Jocelyne; Lacour, Stéphanie; Rouiller, Eric M.; Capogrosso, Marco; Micera, Silvestro

doi:10.1126/scitranslmed.abg6463

Cited by 41 publications

(55 citation statements)

References 74 publications

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“…The BCFES results presented here expand upon the BCFES accomplishments of others 24–26,28,29 by beginning to investigate the realm of continuous control with FES, using similar technologies as what was previously used in clinical trials. Although our monkey model of temporary paralysis should not be considered equivalent to chronic tetraplegia, one could consider the model to be representative of an ideal case of tetraplegia without typical pathologies, such as spasticity or contractures.…”

Section: Discussionmentioning

confidence: 72%

“…As indicated by most tetraplegic participants of a survey, "brain-computer interface (BCI) control of [FES for hand grasp] would be 'very helpful.'" 23 Those who have translated BMIs to use with FES have successfully shown restoration of function in paralysis with monkeys [24][25][26][27] and people 28,29 . For upper extremity restoration, braincontrolled functional electrical stimulation typically comes in discrete or continuous control forms.…”

Section: Introductionmentioning

confidence: 99%

“…Those who have translated BMIs to use with FES have successfully shown restoration of function in paralysis with monkeys 24–27 and people 28,29 . For upper extremity restoration, brain-controlled functional electrical stimulation typically comes in discrete or continuous control forms.…”

Section: Introductionmentioning

confidence: 99%

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Brain-Controlled Electrical Stimulation Restores Continuous Finger Function

Nason

Mender

Kennedy

et al. 2022

Preprint

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Brain-machine interfaces have shown promise in extracting upper extremity movement intention from the thoughts of nonhuman primates and people with tetraplegia. Attempts to restore a user's own hand and arm function have employed functional electrical stimulation (FES), but most work has restored discrete grasps. Little is known about how well FES can control continuous finger movements. Here, we use a low-power brain-controlled functional electrical stimulation (BCFES) system to restore continuous volitional control of finger positions to a monkey with a temporarily paralyzed hand. In a one-dimensional, continuous, finger-related target acquisition task, the monkey improved his success rate to 83% (1.5s median acquisition time) when using the BCFES system during temporary paralysis from 8.8% (9.5s median acquisition, equivalent to chance) when attempting to use his temporarily paralyzed hand. With two monkeys under general anesthesia, we found FES alone could control the monkeys' fingers to rapidly reach targets in a median 1.1s but caused oscillation about the target. Finally, when attempting to perform a virtual two-finger continuous target acquisition task in brain-control mode following temporary hand paralysis, we found performance could be completely recovered by executing recalibrated feedback-intention training one time following temporary paralysis. These results suggest that BCFES can restore continuous finger function during temporary paralysis using existing low-power technologies and brain-control may not be the limiting performance factor in a BCFES neuroprosthesis.

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Section: Discussionmentioning

confidence: 72%

Section: Introductionmentioning

confidence: 99%

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Brain-Controlled Electrical Stimulation Restores Continuous Finger Function

Nason

Mender

Kennedy

et al. 2022

Preprint

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“…Similar approaches have been published involving the use of other polymers, such as SU-8 [14] or Parylene-C [15]. In comparison, however, the higher reliability achieved following decades of continued development in polyimide electrode technology have made it possible for researchers to conduct more advanced and elaborate studies aiming at evaluating therapies in primate models [16,17] and humans [18][19][20].…”

Section: The Influence Of Microengineering Methods In Medical Technology Researchmentioning

confidence: 96%

Biomedical Microtechnologies Beyond Scholarly Impact

Vomero

Schiavone

2021

Micromachines

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The recent tremendous advances in medical technology at the level of academic research have set high expectations for the clinical outcomes they promise to deliver. To the demise of patient hopes, however, the more disruptive and invasive a new technology is, the bigger the gap is separating the conceptualization of a medical device and its adoption into healthcare systems. When technology breakthroughs are reported in the biomedical scientific literature, news focus typically lies on medical implications rather than engineering progress, as the former are of higher appeal to a general readership. While successful therapy and diagnostics are indeed the ultimate goals, it is of equal importance to expose the engineering thinking needed to achieve such results and, critically, identify the challenges that still lie ahead. Here, we would like to provoke thoughts on the following questions, with particular focus on microfabricated medical devices: should research advancing the maturity and reliability of medical technology benefit from higher accessibility and visibility? How can the scientific community encourage and reward academic work on the overshadowed engineering aspects that will facilitate the evolution of laboratory samples into clinical devices?

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“…Focusing on the restoration of hand function, an ideal BBI should effectively integrate an easy-to-learn, accurate, and stable brain decoding paradigm with a motor restoration module allowing the selective control of the hand. Recently, we demonstrated in a preclinical study in monkeys that peripheral nerve stimulation (PNS) at the intrafascicular level can evoke multiple grasps and hand extension movements with only two nerve implants [14], thus complying with the requirement of movement selectivity. Here, we present a brain decoding module based on the direct linear coupling between intrinsic neural ensemble dynamics and motion commands, which satisfies the characteristics of ease of learning and temporal stability.…”

Section: Introductionmentioning

confidence: 99%

Validation of manifold-based direct control for a brain-to-body neural bypass

Losanno

Badi

Roussinova

et al. 2022

Preprint

Self Cite

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Brain-body interfaces (BBIs) are neuroprostheses that can restore the connection between brain activity and body movements. They have emerged as a radical solution for restoring voluntary hand control in people with upper-limb paralysis. The BBI module decoding motor commands to actuate the limb from brain signals should provide the user with intuitive, accurate, and stable control. Here, we present the design and demonstration in a monkey of a novel brain decoding strategy based on the direct coupling between the activity of intrinsic neural ensembles and output variables, meant to achieve ease of learning and long-term robustness. We identified once an intrinsic low-dimensional space (called manifold) capturing the co-variation patterns of the monkey’s neural activity associated to reach-to-grasp movements. We then tested the animal’s ability to directly control a computer cursor using cortical activation along the manifold axes and demonstrated rapid learning and stable high performance over 16 weeks of experiments. Finally, we showed that this brain decoding strategy can be effectively coupled to peripheral nerve stimulation to trigger hand movements. These results provide evidence that manifold-based direct control has promising characteristics for clinical applications of BBIs.

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Intrafascicular peripheral nerve stimulation produces fine functional hand movements in primates

Abstract: Intrafascicular stimulation evokes precise and functional hand movements in monkeys, suggesting clinical opportunities for people with hand paralysis.

Cited by 41 publications

References 74 publications

Brain-Controlled Electrical Stimulation Restores Continuous Finger Function

Brain-Controlled Electrical Stimulation Restores Continuous Finger Function

Biomedical Microtechnologies Beyond Scholarly Impact

Validation of manifold-based direct control for a brain-to-body neural bypass

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