Restoration of natural somatic sensations to the amputees: finding the right combination of neurostimulation methods
Limb amputation results in such devastating consequences as loss of motor and sensory functions and phantom limb pain (PLP). Neurostimulation-based approaches have been developed to treat this condition, which provide artificial somatosensory feedback such as peripheral nerve stimulation (PNS), spin...
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Frontiers Media S.A.
2024-11-01
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| Series: | Frontiers in Neuroscience |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fnins.2024.1466684/full |
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| author | Gurgen Soghoyan Artur R. Biktimirov Nikita S. Piliugin Yury Matvienko Alexander Y. Kaplan Alexander Y. Kaplan Mikhail Y. Sintsov Mikhail A. Lebedev Mikhail A. Lebedev |
| author_facet | Gurgen Soghoyan Artur R. Biktimirov Nikita S. Piliugin Yury Matvienko Alexander Y. Kaplan Alexander Y. Kaplan Mikhail Y. Sintsov Mikhail A. Lebedev Mikhail A. Lebedev |
| author_sort | Gurgen Soghoyan |
| collection | DOAJ |
| description | Limb amputation results in such devastating consequences as loss of motor and sensory functions and phantom limb pain (PLP). Neurostimulation-based approaches have been developed to treat this condition, which provide artificial somatosensory feedback such as peripheral nerve stimulation (PNS), spinal cord stimulation (SCS), and transcutaneous electrical nerve stimulation (TENS). Yet, the effectiveness of different neurostimulation methods has been rarely tested in the same participants. Meanwhile, such tests would help to select the most effective method or a combination of methods and could contribute to the development of multisensory limb prostheses. In this study, two transhumeral amputees were implanted with stimulating electrodes placed in the medial nerve and over the spinal cord epidurally. PNS and SCS were tested in each participant as approaches to enable tactile and proprioceptive sensations and suppress PLP. Both PNS and SCS induced sensation in different parts of the phantom hand, which correlated with cortical responses detected with electroencephalographic (EEG) recordings. The sensations produced by PNS more often felt natural compared to those produced by SCS. Еvoked response potentials (ERPs) were more lateralized and adapted faster for PNS compared to SCS. In the tasks performed with the bionic hand, neurostimulation-induced sensations enabled discrimination of object size. As the participants practiced with neurostimulation, they improved on the object-size discrimination task and their sensations became more natural. А combination of PNS and TENS enabled sensations that utilized both tactile and proprioceptive information. This combination was effective to convey the perception of object softness. In addition to enabling sensations, neurostimulation led to a decrease in PLP.Clinical trial registrationhttps://clinicaltrials.gov/, identifier, #NCT05650931. |
| format | Article |
| id | doaj-art-ec33baf1ea13433cb7da07bb5b6cc1c0 |
| institution | OA Journals |
| issn | 1662-453X |
| language | English |
| publishDate | 2024-11-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Neuroscience |
| spelling | doaj-art-ec33baf1ea13433cb7da07bb5b6cc1c02025-08-20T01:53:27ZengFrontiers Media S.A.Frontiers in Neuroscience1662-453X2024-11-011810.3389/fnins.2024.14666841466684Restoration of natural somatic sensations to the amputees: finding the right combination of neurostimulation methodsGurgen Soghoyan0Artur R. Biktimirov1Nikita S. Piliugin2Yury Matvienko3Alexander Y. Kaplan4Alexander Y. Kaplan5Mikhail Y. Sintsov6Mikhail A. Lebedev7Mikhail A. Lebedev8Vladimir Zelman Center for Neurobiology and Brain Rehabilitation, Skolkovo Institute of Science and Technology, Moscow, RussiaLaboratory of Experimental and Translational Medicine, School of Biomedicine, Far Eastern Federal University, Vladivostok, RussiaVladimir Zelman Center for Neurobiology and Brain Rehabilitation, Skolkovo Institute of Science and Technology, Moscow, RussiaMotorica Research Center, Moscow, RussiaVladimir Zelman Center for Neurobiology and Brain Rehabilitation, Skolkovo Institute of Science and Technology, Moscow, RussiaFaculty of Mechanics and Mathematics, Lomonosov Moscow State University, Moscow, RussiaMotorica Research Center, Moscow, RussiaFaculty of Mechanics and Mathematics, Lomonosov Moscow State University, Moscow, RussiaI. M. Sechenov Institute of Evolutionary Physiology and Biochemistry, St. Petersburg, RussiaLimb amputation results in such devastating consequences as loss of motor and sensory functions and phantom limb pain (PLP). Neurostimulation-based approaches have been developed to treat this condition, which provide artificial somatosensory feedback such as peripheral nerve stimulation (PNS), spinal cord stimulation (SCS), and transcutaneous electrical nerve stimulation (TENS). Yet, the effectiveness of different neurostimulation methods has been rarely tested in the same participants. Meanwhile, such tests would help to select the most effective method or a combination of methods and could contribute to the development of multisensory limb prostheses. In this study, two transhumeral amputees were implanted with stimulating electrodes placed in the medial nerve and over the spinal cord epidurally. PNS and SCS were tested in each participant as approaches to enable tactile and proprioceptive sensations and suppress PLP. Both PNS and SCS induced sensation in different parts of the phantom hand, which correlated with cortical responses detected with electroencephalographic (EEG) recordings. The sensations produced by PNS more often felt natural compared to those produced by SCS. Еvoked response potentials (ERPs) were more lateralized and adapted faster for PNS compared to SCS. In the tasks performed with the bionic hand, neurostimulation-induced sensations enabled discrimination of object size. As the participants practiced with neurostimulation, they improved on the object-size discrimination task and their sensations became more natural. А combination of PNS and TENS enabled sensations that utilized both tactile and proprioceptive information. This combination was effective to convey the perception of object softness. In addition to enabling sensations, neurostimulation led to a decrease in PLP.Clinical trial registrationhttps://clinicaltrials.gov/, identifier, #NCT05650931.https://www.frontiersin.org/articles/10.3389/fnins.2024.1466684/fullneuroprostheticsneuromodulationsensory restorationembodimentperipheral nerve stimulationsensory feedback |
| spellingShingle | Gurgen Soghoyan Artur R. Biktimirov Nikita S. Piliugin Yury Matvienko Alexander Y. Kaplan Alexander Y. Kaplan Mikhail Y. Sintsov Mikhail A. Lebedev Mikhail A. Lebedev Restoration of natural somatic sensations to the amputees: finding the right combination of neurostimulation methods Frontiers in Neuroscience neuroprosthetics neuromodulation sensory restoration embodiment peripheral nerve stimulation sensory feedback |
| title | Restoration of natural somatic sensations to the amputees: finding the right combination of neurostimulation methods |
| title_full | Restoration of natural somatic sensations to the amputees: finding the right combination of neurostimulation methods |
| title_fullStr | Restoration of natural somatic sensations to the amputees: finding the right combination of neurostimulation methods |
| title_full_unstemmed | Restoration of natural somatic sensations to the amputees: finding the right combination of neurostimulation methods |
| title_short | Restoration of natural somatic sensations to the amputees: finding the right combination of neurostimulation methods |
| title_sort | restoration of natural somatic sensations to the amputees finding the right combination of neurostimulation methods |
| topic | neuroprosthetics neuromodulation sensory restoration embodiment peripheral nerve stimulation sensory feedback |
| url | https://www.frontiersin.org/articles/10.3389/fnins.2024.1466684/full |
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