Strategies for neural control of prosthetic limbs: from electrode interfacing to 3D printing

Limb amputation is a major cause of disability in our community, for which motorised prosthetic devices offer a return to function and independence. With the commercialisation and increasing availability of advanced motorised prosthetic technologies, there is a consumer need and clinical drive for intuitive user control. In this context, rapid additive fabrication/prototyping capacities and biofabrication protocols embrace a highly-personalised medicine doctrine that marries specific patient biology and anatomy to high-end prosthetic design, manufacture and functionality. Commercially-available prosthetic models utilise surface electrodes that are limited by their disconnect between mind and device. As such, alternative strategies of mind-prosthetic interfacing have been explored to purposefully drive the prosthetic limb. This review investigates mind to machine interfacing strategies, with a focus on the biological challenges of long-term harnessing of the user's cerebral commands to drive actuation/movement in electronic prostheses. It covers the limitations of skin, peripheral nerve and brain interfacing electrodes, and in particular the challenges of minimising the foreign-body response, as well as a new strategy of grafting muscle onto residual peripheral nerves. In conjunction, this review also investigates the applicability of additive tissue engineering at the nerve-electrode boundary, which has led to pioneering work in neural regeneration and bioelectrode development for applications at the neuroprosthetic interface

Universitas odontológica

Nerve injury secondary to trauma, neurological disease or tumor excision presents a challenge for surgical reconstruction. Current practice for nerve repair involves autologous nerve transplantation, which is associated with significant donor-site morbidity and other complications. Previously artificial nerve conduits made from polycaprolactone, polyglycolic acid and collagen were approved by the FDA (USA) for nerve repair. More recently, there have been significant advances in nerve conduit design that better address the requirements of nerve regrowth. Innovations in materials science, nanotechnology, and biology open the way for the synthesis of new generation nerve repair conduits that address issues currently faced in nerve repair and regeneration. This review discusses recent innovations in this area, including the use of nanotechnology to improve the design of nerve conduits and to enhance nerve regeneration

Enhancing peptide biomaterials for biofabrication

Biofabrication using well-matched cell/materials systems provides unprecedented opportunities for dealing with human health issues where disease or injury overtake the body’s native regenerative abilities. Such opportunities can be enhanced through the development of biomaterials with cues that appropriately influence embedded cells into forming functional tissues and organs. In this context, biomaterials’ reliance on rigid biofabrication techniques needs to support the incorporation of a hierarchical mimicry of local and bulk biological cues that mimic the key functional components of native extracellular matrix. Advances in synthetic self-assembling peptide biomaterials promise to produce reproducible mimics of tissue-specific structures and may go some way in overcoming batch inconsistency issues of naturally sourced materials. Recent work in this area has demonstrated biofabrication with self-assembling peptide biomaterials with unique biofabrication technologies to support structural fidelity upon 3D patterning. The use of synthetic self-assembling peptide biomaterials is a growing field that has demonstrated applicability in dermal, intestinal, muscle, cancer and stem cell tissue engineering.</jats:p

In vivo biocompatibility of porous and non-porous polypyrrole based trilayered actuators

Trilayered polypyrrole (PPy) actuators have high stress density, low modulus and have wide potential biological applications including use in artificial muscles and in limb prosthesis after limb amputation. This article examines the in vivo biocompatibility of actuators in muscle using rabbit models. The actuators were specially designed with pores to encourage tissue in growth; this study also assessed the effect of such pores on the stability of the actuators in vivo. Trilayered PPy actuators were either laser cut with 150 µm pores or left pore-less and implanted into rabbit muscle for 3 days, 2 weeks, 4 weeks and 8 weeks and retrieved subsequently for histological analysis. In a second set of experiments, the cut edges of pores in porous actuator strips were further sealed by PPy after laser cutting to further improve its stability in vivo. Porous actuators with and without PPy sealing of pore edges were implanted intramuscularly for 4 and 8 weeks and assessed with histology. Pore-less actuators incited a mild inflammatory response, becoming progressively walled off by a thin layer of fibrous tissue. Porous actuators showed increased PPy fragmentation and delamination with associated greater foreign body response compared to pore-less actuators. The PPy fragmentation was minimized when the pore edges were sealed off by PPy after laser cutting showing less PPy debris. Laser cutting of the actuators with pores destabilizes the PPy. This can be overcome by sealing the cut edges of the pores with PPy after laser. The findings in this article have implications in future design and manufacturing of PPy actuator for use in vivo