目的:周围神经刺激(PNS)已被证明是选择性激活肌肉并产生精细手部运动的有效方法。然而,连续多关节上肢运动,这对瘫痪康复至关重要,尚未使用PNS进行测试。这里,我们的目的是恢复多个上肢关节运动,通过一个单电极的神经内接口,通过顺序刺激实现连贯的伸手-抓-拉运动任务。
方法:在大鼠上肢的腋下植入横行内多通道电极(TIME),穿过肌肉皮肤,径向,中位数,尺神经.肌内电极植入肱二头肌(BB),肱三头肌(TB),径向腕屈肌(FCR),和伸肌(ECR)肌来记录肌电图(EMG)活动和视频记录用于捕获肘关节的运动学,手腕,和手指关节。将电荷平衡的双相脉冲施加到不同的通道以招募不同的上肢肌肉,同时记录肌电图信号和关节运动学,以评估刺激的有效性。最后,通过在不同通道中产生协调脉冲,采用了序贯刺激方案.
结果:BB,TB,FCR和ECR肌肉被选择性地激活,各种上肢运动,包括肘部屈曲,弯头延伸,手腕屈曲,手腕延伸,手指屈曲,和数字扩展名,可靠地生成。刺激参数的调制效应,包括脉冲宽度,振幅,和频率,对诱导的关节运动进行了研究,并通过顺序刺激引起了伸手-抓-拉运动。
结论:我们的结果证明了连续神经内刺激用于功能性多关节运动恢复的可行性,为瘫痪患者的临床康复提供了新的途径。
Objective.Peripheral nerve stimulation (PNS) has been demonstrated as an effective way to selectively activate muscles and to produce fine hand movements. However, sequential multi-joint upper limb movements, which are critical for paralysis rehabilitation, has not been tested with PNS. Here, we aimed to restore multiple upper limb joint movements through an intraneural interface with a single electrode, achieving coherent reach-grasp-pull movement tasks through sequential stimulation.Approach.A transverse intrafascicular multichannel electrode was implanted under the axilla of the rat\'s upper limb, traversing the musculocutaneous, radial, median, and ulnar nerves. Intramuscular electrodes were implanted into the biceps brachii (BB), triceps brachii (TB), flexor carpi radialis (FCR), and extensor carpi radialis (ECR) muscles to record electromyographic (EMG) activity and video recordings were used to capture the kinematics of elbow, wrist, and digit joints. Charge-balanced biphasic pulses were applied to different channels to recruit distinct upper limb muscles, with concurrent recording of EMG signals and joint kinematics to assess the efficacy of the stimulation. Finally, a sequential stimulation protocol was employed by generating coordinated pulses in different channels.Main results.BB, TB, FCR and ECR muscles were selectively activated and various upper limb movements, including elbow flexion, elbow extension, wrist flexion, wrist extension, digit flexion, and digit extension, were reliably generated. The modulation effects of stimulation parameters, including pulse width, amplitude, and frequency, on induced joint movements were investigated and reach-grasp-pull movement was elicited by sequential stimulation.Significance.Our results demonstrated the feasibility of sequential intraneural stimulation for functional multi-joint movement restoration, providing a new approach for clinical rehabilitation in paralyzed patients.