Quantification of human upper extremity nerves and fascicular anatomy

Brill, Natalie; Tyler, Dustin J.

doi:10.1002/mus.25534

Cited by 54 publications

(56 citation statements)

References 58 publications

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“…Lastly, axonal degeneration may have occurred after amputation [40][41][42], and may have had a greater effect in subject 2. During the implantation surgery of subject 2, who was 8 years post amputation, it was noted that the median and ulnar peripheral nerves were smaller than expected from histological studies [26].…”

Section: Va Author Manuscriptmentioning

confidence: 99%

“…Then, extraneural stimulation along the rectangular circumference would selectively stimulate each fascicle. However, human cadaver histological studies have found that peripheral nerves are naturally elongated in shape [26]. Thus, the FINE is a cuff that maintains the natural shape of the nerve.…”

Section: Va Author Manuscriptmentioning

confidence: 99%

“…The spiral cuff was 4 mm in diameter. Peripheral nerve studies in human cadavers [26] guided the sizes of available cuffs, from which the surgeons selected during the implant. The advantages of the FINE over the spiral electrode are the higher number of stimulating contacts and a design that achieves fascicle-selective stimulation [16].…”

Section: Surgical Implantationmentioning

confidence: 99%

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Stability and selectivity of a chronic, multi-contact cuff electrode for sensory stimulation in human amputees

et al. 2015

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Objective-Stability and selectivity are important when restoring long-term, functional sensory feedback in individuals with limb-loss. Our objective is to demonstrate a chronic, clinical neural stimulation system for providing selective sensory response in two upper-limb amputees.Approach-Multi-contact cuff electrodes were implanted in the median, ulnar, and radial nerves of the upper-limb.Main results-Nerve stimulation produced a selective sensory response on 19 of 20 contacts and 16 of 16 contacts in subjects 1 and 2, respectively. Stimulation elicited multiple, distinct percept areas on the phantom and residual limb. Consistent threshold, impedance, and percept areas have demonstrated that the neural interface is stable for the duration of this on-going, chronic study.Significance-We have achieved selective nerve response from multi-contact cuff electrodes by demonstrating characteristic percept areas and thresholds for each contact. Selective sensory response remains consistent in two upper-limb amputees for 1 and 2 years, the longest multicontact sensory feedback system to date. Our approach demonstrates selectivity and stability can be achieved through an extraneural interface, which can provide sensory feedback to amputees.

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Section: Va Author Manuscriptmentioning

confidence: 99%

Section: Va Author Manuscriptmentioning

confidence: 99%

Section: Surgical Implantationmentioning

confidence: 99%

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Stability and selectivity of a chronic, multi-contact cuff electrode for sensory stimulation in human amputees

et al. 2015

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“…In unimpaired nerves, although there are differences in structure and composition, this variability is not comparable to that of damaged nerves . Differences in nerve size along the limb in unimpaired nerves are predominately a result of less drastic changes, such as proximodistal branching . Our results provide evidence to support the influence of branching on morphometric variability because nerve CSA and diameter were consistently larger proximally than distally.…”

Section: Discussionmentioning

confidence: 49%

Influence of limb position on assessment of nerve mechanical properties by using shear wave ultrasound elastography

2020

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Introduction: Evaluation of nerve mechanical properties has the potential to improve assessment of nerve impairment. Shear wave velocity, as measured by using shear wave (SW) ultrasound elastography, is a promising indicator of nerve mechanical properties such as stiffness. However, elucidation of external factors that influence SW velocity, particularly nerve tension, is required for accurate interpretations.Methods: Median and ulnar nerve SW velocities were measured at proximal and distal locations with limb positions that indirectly altered nerve tension.Results: Shear wave velocity was greater at proximal and distal locations for limb positions that induced greater tension in the median (mean increase proximal 89.3%, distal 64%) and ulnar (mean increase proximal 91.1%, distal 37.4%) nerves.Discussion: Due to the influence of nerve tension when SW ultrasound elastography is used, careful consideration must be given to limb positioning. K E Y W O R D S mechanical properties, nerve cross-sectional area, neuromuscular ultrasound, peripheral nerve, shear wave ultrasound elastography, tension

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“…• The largest nerve model we have used in this work has a diameter of 500 μm, and contains fascicles with a diameter of 156.67 μm. These numbers are smaller than the known physiological ranges for human limb peripheral nerves where stimulation is typically studied [27,28]. Also, fiber packing ratios are generally lower than physiological values.…”

Section: Plos Computational Biologymentioning

confidence: 82%

Modelling the effects of ephaptic coupling on selectivity and response patterns during artificial stimulation of peripheral nerves

Capllonch-Juan

Sepúlveda

2020

PLoS Comput Biol

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Artificial electrical stimulation of peripheral nerves for sensory feedback restoration can greatly benefit from computational models for simulation-based neural implant design in order to reduce the trial-and-error approach usually taken, thus potentially significantly reducing research and development costs and time. To this end, we built a computational model of a peripheral nerve trunk in which the interstitial space between the fibers and the tissues was modelled using a resistor network, thus enabling distance-dependent ephaptic coupling between myelinated axons and between fascicles as well. We used the model to simulate a) the stimulation of a nerve trunk model with a cuff electrode, and b) the propagation of action potentials along the axons. Results were used to investigate the effect of ephaptic interactions on recruitment and selectivity stemming from artificial (i.e., neural implant) stimulation and on the relative timing between action potentials during propagation. Ephaptic coupling was found to increase the number of fibers that are activated by artificial stimulation, thus reducing the artificial currents required for axonal recruitment, and it was found to reduce and shift the range of optimal stimulation amplitudes for maximum inter-fascicular selectivity. During propagation, while fibers of similar diameters tended to lock their action potentials and reduce their conduction velocities, as expected from previous knowledge on bundles of identical axons, the presence of many other fibers of different diameters was found to make their interactions weaker and unstable.

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Quantification of human upper extremity nerves and fascicular anatomy

Cited by 54 publications

References 58 publications

Stability and selectivity of a chronic, multi-contact cuff electrode for sensory stimulation in human amputees

Stability and selectivity of a chronic, multi-contact cuff electrode for sensory stimulation in human amputees

Influence of limb position on assessment of nerve mechanical properties by using shear wave ultrasound elastography

Modelling the effects of ephaptic coupling on selectivity and response patterns during artificial stimulation of peripheral nerves

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