A robot hand testbed designed for enhancing embodiment and functional neurorehabilitation of body schema in subjects with upper limb impairment or loss.

Many upper limb amputees experience an incessant, post-amputation "phantom limb pain" and report that their missing limbs feel paralyzed in an uncomfortable posture. One hypothesis is that efferent commands no longer generate expected afferent signals, such as proprioceptive feedback from changes in limb configuration, and that the mismatch of motor commands and visual feedback is interpreted as pain. Non-invasive therapeutic techniques for treating phantom limb pain, such as mirror visual feedback (MVF), rely on visualizations of postural changes. Advances in neural interfaces for artificial sensory feedback now make it possible to combine MVF with a high-tech "rubber hand" illusion, in which subjects develop a sense of embodiment with a fake hand when subjected to congruent visual and somatosensory feedback. We discuss clinical benefits that could arise from the confluence of known concepts such as MVF and the rubber hand illusion, and new technologies such as neural interfaces for sensory feedback and highly sensorized robot hand testbeds, such as the "BairClaw" presented here. Our multi-articulating, anthropomorphic robot testbed can be used to study proprioceptive and tactile sensory stimuli during physical finger-object interactions. Conceived for artificial grasp, manipulation, and haptic exploration, the BairClaw could also be used for future studies on the neurorehabilitation of somatosensory disorders due to upper limb impairment or loss. A remote actuation system enables the modular control of tendon-driven hands. The artificial proprioception system enables direct measurement of joint angles and tendon tensions while temperature, vibration, and skin deformation are provided by a multimodal tactile sensor. The provision of multimodal sensory feedback that is spatiotemporally consistent with commanded actions could lead to benefits such as reduced phantom limb pain, and increased prosthesis use due to improved functionality and reduced cognitive burden

Phantom sensation: threshold and quality indicators of a tactile illusion of motion

Utilizing a randomized, blind, controlled experiment, and the ascending method of limits, we determined the minimum amplitude of motion at which individuals perceive a tactile illusion called moving phantom sensation, the perceived level of clarity and continuity of motion. Implementing tactile illusions in virtual/augmented reality, sensory substitution systems, and other human–computer interaction technologies results in interfaces with improved resolution, using two vibrating actuators only. The actuators are attached to the skin in different locations to render a moving phantom sensation. The intensity of vibrations increases in one actuator while decreases in the other according to the envelope of the voltage supply signals. This intensity variation creates the illusion of a vibrating point moving between the actuators. We gradually increased the amplitude of motion until the participant reported perceiving the illusion, for eight values of duration of the stimulus from 0.1 to 6.0 s. Participants perceived the illusion at a minimum amplitude of motion of 20%; being 100% the motion from one actuator to the other. The median level of clarity of the perceived illusion at the minimum amplitude of motion was 2 (not so clear). Finally, we found a positive correlation between duration and continuity of motion.Funding for open access charge: Universidad de Málaga/CBUA

Doctor of Philosophy

dissertationHands are so central to the human experience, yet we often take for granted the capacity to maneuver objects, to form a gesture, or to caress a loved-one’s hand. The effects of hand amputation can be severe, including functional disabilities, chronic phantom pain, and a profound sense of loss which can lead to depression and anxiety. In previous studies, peripheral-nerve interfaces, such as the Utah Slanted Electrode Array (USEA), have shown potential for restoring a sense of touch and prosthesis movement control. This dissertation represents a substantial step forward in the use of the USEAs for clinical careâ€"ultimately providing human amputees with widespread hand sensation that is functionally useful and psychologically meaningful. In completion of this ultimate objective, we report on three major advances. First, we performed the first dual-USEA implantations in human amputees; placing one USEA in the residual median nerve and another USEA in the residual ulnar nerve. Chapter 2 of this dissertation shows that USEAs provided full-hand sensory coverage, and that movement of the implant site to the upper arm in the second subject, proximal to nerve branch-points to extrinsic hand muscles, enabled activation of both proprioceptive sensory percepts and cutaneous percepts. Second, in Chapter 3, we report on successful use of USEA-evoked sensory percepts for functional discrimination tasks. We provide a comprehensive report of functional discrimination among USEA-evoked sensory percepts from three human subjects, including discrimination among multiple proprioceptive or cutaneous sensory percepts with different hand locations, sensory qualities, and/or intensities. Finally, in Chapter 4, we report on the psychological value of multiple degree of freedom prosthesis control, multisensor prosthesis sensation, and closed-loop control. This chapter represents the first report of prosthesis embodiment during closed-loop and open-loop prosthesis control by an amputee, as well as the most sophisticated closed-loop prosthesis control reported in literature to-date, including 5-degree-of-freedom motor control and sensory feedback from 4 hand locations. Ultimately, we expect that USEA-evoked hand sensations may be used as part of a take-home prosthesis system which will provide users with both advanced functional capabilities and a meaningful sense of embodiment and limb restoration

Doctor of Philosophy

dissertationToday, we are implanting electrodes into many different parts of the peripheral and central nervous systems for the purpose of restoring function to people with nerve injury or disease. As technology and manufacturing continue to become more advanced, ne

Upper limb prostheses: bridging the sensory gap

Replacing human hand function with prostheses goes far beyond only recreating muscle movement with feedforward motor control. Natural sensory feedback is pivotal for fine dexterous control and finding both engineering and surgical solutions to replace this complex biological function is imperative to achieve prosthetic hand function that matches the human hand. This review outlines the nature of the problems underlying sensory restitution, the engineering methods that attempt to address this deficit and the surgical techniques that have been developed to integrate advanced neural interfaces with biological systems. Currently, there is no single solution to restore sensory feedback. Rather, encouraging animal models and early human studies have demonstrated that some elements of sensation can be restored to improve prosthetic control. However, these techniques are limited to highly specialized institutions and much further work is required to reproduce the results achieved, with the goal of increasing availability of advanced closed loop prostheses that allow sensory feedback to inform more precise feedforward control movements and increase functionality

Towards a Somatosensory Neuroprosthesis: Characterizing Microstimulation of the DRG and Spinal Cord for Sensory Restoration

Restoring sensation is key to making prostheses more functional. While there have been important advances in the design and actuation of prosthetic limbs, these devices lack a means for providing direct sensory feedback. As such, users must infer information about limb state from cues like pressure on the residual limb, resulting in diminished control of prostheses, and reduced adoption and use of these technologies. The dorsal root ganglia (DRG) are an attractive target for a somatosensory neural interface. The DRG are enlargements of the spinal nerve that house the cell bodies of primary sensory neurons and provide access to a heterogenous population of somatosensory fibers. Importantly, the separation of motor and sensory pathways at the spinal roots allows recruitment of sensory afferents without coactivating motor efferents which may otherwise contaminate a myoelectric control interface. This dissertation examines a novel way of interfacing with the DRG and dorsal roots using epineural electrodes, that takes us a step closer towards developing a somatosensory neuroprosthesis. I begin with an animal model to compare the recruitment properties of epineural and penetrating electrodes when stimulating afferents in the lumbar DRG. In the next section, I develop a computational model to explain the mechanism of recruitment of afferents. Finally, I describe a series of experiments in human upper-limb amputees to characterize the modality and utility of sensations evoked when the cervical spinal cord and spinal roots were stimulated

Neuromorphic hardware for somatosensory neuroprostheses

In individuals with sensory-motor impairments, missing limb functions can be restored using neuroprosthetic devices that directly interface with the nervous system. However, restoring the natural tactile experience through electrical neural stimulation requires complex encoding strategies. Indeed, they are presently limited in effectively conveying or restoring tactile sensations by bandwidth constraints. Neuromorphic technology, which mimics the natural behavior of neurons and synapses, holds promise for replicating the encoding of natural touch, potentially informing neurostimulation design. In this perspective, we propose that incorporating neuromorphic technologies into neuroprostheses could be an effective approach for developing more natural human-machine interfaces, potentially leading to advancements in device performance, acceptability, and embeddability. We also highlight ongoing challenges and the required actions to facilitate the future integration of these advanced technologies

Sensory disturbances, but not motor disturbances, induced by sensorimotor conflicts are increased in the presence of acute pain

© 2017 Brun, Gagné, McCabe and Mercier. Incongruence between our motor intention and the sensory feedback of the action (sensorimotor conflict) induces abnormalities in sensory perception in various chronic pain populations, and to a lesser extent in pain-free individuals. The aim of this study was to simultaneously investigate sensory and motor disturbances evoked by sensorimotor conflicts, as well as to assess how they are influenced by the presence of acute pain. It was hypothesized that both sensory and motor disturbances would be increased in presence of pain, which would suggest that pain makes body representations less robust. Thirty healthy participants realized cyclic asymmetric movements of flexion-extension with both upper limbs in a robotized system combined to a 2D virtual environment. The virtual environment provided a visual feedback (VF) about movements that was either congruent or incongruent, while the robotized system precisely measured motor performance (characterized by bilateral amplitude asymmetry and medio-lateral drift). Changes in sensory perception were assessed with a questionnaire after each trial. The effect of pain (induced with capsaicin) was compared to three control conditions (no somatosensory stimulation, tactile distraction and proprioceptive masking). Results showed that while both sensory and motor disturbances were induced by sensorimotor conflicts, only sensory disturbances were enhanced during pain condition comparatively to the three control conditions. This increase did not statistically differ across VF conditions (congruent or incongruent). Interestingly however, the types of sensations evoked by the conflict in the presence of pain (changes in intensity of pain or discomfort, changes in temperature or impression of a missing limb) were different than those evoked by the conflict alone (loss of control, peculiarity and the perception of having an extra limb). Finally, results showed no relationship between the amount of motor and sensory disturbances evoked in a given individual. Contrary to what was hypothesized, acute pain does not appear to make people more sensitive to the conflict itself, but rather impacts on the type and amount of sensory disturbances that they experienced in response to that conflict.Moreover, the results suggest that some sensorimotor integration processes remain intact in presence of acute pain, allowing us to maintain adaptive motor behavior