Regenerative Peripheral Nerve Interface for Prostheses Control: Electrode Comparison

Sando, Ian C.; Leach, Michelle K.; Woo, Shoshana L.; Moon, Jana D.; Cederna, Paul S.; Langhals, Nicholas B.; Urbanchek, Melanie G.

doi:10.1055/s-0035-1565248

Cited by 12 publications

(31 citation statements)

References 23 publications

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“…9,18 In the beginning, there were no neuroma formations in laboratory animal studies based on this approach. [28][29][30] Woo et al 18 conducted a pilot clinical study on 16 amputees and demonstrated a decrease in neuroma and phantom pain.…”

Section: Discussionmentioning

confidence: 99%

Update on Upper Limb Neuroma Management

Sayegh

Jaloux

Witters

et al. 2023

Journal of Craniofacial Surgery

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Painful terminal neuromas in the upper limb due to nerve injury are common. Neuroma symptoms include a sharp and burning sensation, cold intolerance, dysesthesia, pain, numbness, and paresthesia. These symptoms could have a negative impact on the functional ability of the patient and quality of life. In addition, Prostheses use might be abandoned by amputees due to neuroma-induced pain. Many clinicians face challenges while managing neuromas. Contemporary “active” methods like regenerative peripheral nerve interface (RPNI), targeted muscle reinnervation (TMR), and processed nerve allograft repair (PNA) are replacing the conventional “passive” approaches such as excision, transposition, and implantation techniques. RPNI involves inducing axonal sprouting by transplanting the free end of a peripheral nerve into a free muscle graft. TMR includes reassigning the role of the peripheral nerve by the transfer of the distal end of a pure sensory or a mixed peripheral nerve to a motor nerve of a nearby muscle segment. To give the peripheral nerve a pathway to re-innervate its target tissue, PNA entails implanting a sterile extracellular matrix prepared from decellularized and regenerated human nerve tissue with preserved epineurium and fascicles. Of these, RPNI and TMR appear to hold a promising treatment for nerve-ending neuromas and prevent their relapse. In contrast, PNA may reduce neuroma pain and allow meaningful nerve repair. The aim of this article is to provide an overview of the newer approaches of TMR, RPNI, and PNA and discuss their implications, surgical techniques, and reported consequences.

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Section: Discussionmentioning

confidence: 99%

Update on Upper Limb Neuroma Management

Sayegh

Jaloux

Witters

et al. 2023

Journal of Craniofacial Surgery

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“…This distinct feature of RPNI surgery to harness discrete motor and sensory signals through reinnervation of multiple individual RPNIs is advantageous when using it as an interface for advanced prosthetic limb rehabilitation. 38–47,86…”

Section: Discussionmentioning

confidence: 99%

Regenerative Peripheral Nerve Interface Surgery: Anatomic and Technical Guide

Leach

Dean

Kumar

et al. 2023

Plastic and Reconstructive Surgery - Global Open

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Summary: Regenerative peripheral nerve interface (RPNI) surgery has been demonstrated to be an effective tool as an interface for neuroprosthetics. Additionally, it has been shown to be a reproducible and reliable strategy for the active treatment and for prevention of neuromas. The purpose of this article is to provide a comprehensive review of RPNI surgery to demonstrate its simplicity and empower reconstructive surgeons to add this to their armamentarium. This article discusses the basic science of neuroma formation and prevention, as well as the theory of RPNI. An anatomic review and discussion of surgical technique for each level of amputation and considerations for other etiologies of traumatic neuromas are included. Lastly, the authors discuss the future of RPNI surgery and compare this with other active techniques for the treatment of neuromas.

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“…Effectively, it is a sieve made of silicon, ceramic or polymer with a large number of fine holes that is placed inside the transected nerve. The increase in growth rate of regeneration of individual or a group of fibers through those holes can activate selective stimulation and make it possible to record action potentials (Micera and Navarro, 2009 ; Sando et al, 2016 ) from individual axons or a small group. In principle, a high number of selective contacts can be achieved by reducing the size of the sieve along with an increased number of fine holes (Lago et al, 2007a ).…”

Section: Invasive Methods Of Sensory Feedbackmentioning

confidence: 99%

Selectivity and Longevity of Peripheral-Nerve and Machine Interfaces: A Review

2017

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For those individuals with upper-extremity amputation, a daily normal living activity is no longer possible or it requires additional effort and time. With the aim of restoring their sensory and motor functions, theoretical and technological investigations have been carried out in the field of neuroprosthetic systems. For transmission of sensory feedback, several interfacing modalities including indirect (non-invasive), direct-to-peripheral-nerve (invasive), and cortical stimulation have been applied. Peripheral nerve interfaces demonstrate an edge over the cortical interfaces due to the sensitivity in attaining cortical brain signals. The peripheral nerve interfaces are highly dependent on interface designs and are required to be biocompatible with the nerves to achieve prolonged stability and longevity. Another criterion is the selection of nerves that allows minimal invasiveness and damages as well as high selectivity for a large number of nerve fascicles. In this paper, we review the nerve-machine interface modalities noted above with more focus on peripheral nerve interfaces, which are responsible for provision of sensory feedback. The invasive interfaces for recording and stimulation of electro-neurographic signals include intra-fascicular, regenerative-type interfaces that provide multiple contact channels to a group of axons inside the nerve and the extra-neural-cuff-type interfaces that enable interaction with many axons around the periphery of the nerve. Section Current Prosthetic Technology summarizes the advancements made to date in the field of neuroprosthetics toward the achievement of a bidirectional nerve-machine interface with more focus on sensory feedback. In the Discussion section, the authors propose a hybrid interface technique for achieving better selectivity and long-term stability using the available nerve interfacing techniques.

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Regenerative Peripheral Nerve Interface for Prostheses Control: Electrode Comparison

Abstract: Epimysial patch electrodes outperform intramuscular hook electrodes during chronic skeletal muscle implantation.

Cited by 12 publications

References 23 publications

Update on Upper Limb Neuroma Management

Update on Upper Limb Neuroma Management

Regenerative Peripheral Nerve Interface Surgery: Anatomic and Technical Guide

Selectivity and Longevity of Peripheral-Nerve and Machine Interfaces: A Review

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