Residual function in peripheral nerve stumps of amputees: Implications for neural control of artificial limbs Article

Dhillon, GS, Lawrence, SM, Hutchinson, DT et al. (2004). Residual function in peripheral nerve stumps of amputees: Implications for neural control of artificial limbs . JOURNAL OF HAND SURGERY-AMERICAN VOLUME, 29(4), 605-615. 10.1016/j.jhsa.2004.02.006

cited authors

  • Dhillon, GS; Lawrence, SM; Hutchinson, DT; Horch, KW

authors

abstract

  • Purpose It is not known whether motor and sensory pathways associated with a missing or denervated limb remain functionally intact over periods of many months or years after amputation or chronic peripheral nerve transection injury. We examined the extent to which activity on chronically severed motor nerve fibers could be controlled by human amputees and whether distally referred tactile and proprioceptive sensations could be induced by stimulation of sensory axons in the nerve stumps. Methods Amputees undergoing elective stump procedures were invited to participate in this study. Longitudinal intrafascicular electrodes were threaded percutaneously and implanted in severed nerves of human amputees. The electrodes were interfaced to an amplifier and stimulator system controlled by a laptop computer. Electrophysiologic tests were conducted for 2 consecutive days after recovery from the surgery. Results It was possible to record volitional motor nerve activity uniquely associated with missing limb movements. Electrical stimulation through the implanted electrodes elicited discrete, unitary, graded sensations of touch, joint movement, and position, referring to the missing limb. Conclusions These findings indicate that both central and peripheral motor and somatosensory pathways retain significant residual connectivity and function for many years after limb amputation. This implies that peripheral nerve interfaces could be used to provide amputees with prosthetic limbs that have more natural feel and control than is possible with current myoelectric and body-powered control systems. Copyright © 2004 by the American Society for Surgery of the Hand.

publication date

  • July 1, 2004

published in

Digital Object Identifier (DOI)

start page

  • 605

end page

  • 615

volume

  • 29

issue

  • 4