دورية أكاديمية
أعرض في EDS

Selective neural electrical stimulation restores hand and forearm movements in individuals with complete tetraplegia.

التفاصيل البيبلوغرافية
العنوان: Selective neural electrical stimulation restores hand and forearm movements in individuals with complete tetraplegia.
المؤلفون: Tigra W; INRIA, University of Montpellier, CNRS, Montpellier, France.; MXM group, Sophia-Antipolis, France., Dali M; INRIA, University of Montpellier, CNRS, Montpellier, France., William L; INRIA, University of Montpellier, CNRS, Montpellier, France., Fattal C; La Châtaigneraie Rehabilitation Center, Menucourt, France., Gélis A; Propara Rehabilitation Center, Montpellier, France., Divoux JL; Axonic, MXM Group, Sophia-Antipolis, France., Coulet B; University Hospital of Montpellier, Montpellier, France., Teissier J; Beau Soleil Clinic, Montpellier, France., Guiraud D; INRIA, University of Montpellier, CNRS, Montpellier, France. david.guiraud@inria.fr.; NEURINNOV SAS, Montpellier, France. david.guiraud@inria.fr., Azevedo Coste C; INRIA, University of Montpellier, CNRS, Montpellier, France.
المصدر: Journal of neuroengineering and rehabilitation [J Neuroeng Rehabil] 2020 May 19; Vol. 17 (1), pp. 66. Date of Electronic Publication: 2020 May 19.
نوع المنشور: Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't
اللغة: English
بيانات الدورية: Publisher: BioMed Central Country of Publication: England NLM ID: 101232233 Publication Model: Electronic Cited Medium: Internet ISSN: 1743-0003 (Electronic) Linking ISSN: 17430003 NLM ISO Abbreviation: J Neuroeng Rehabil Subsets: MEDLINE
أسماء مطبوعة: Original Publication: [London] : BioMed Central, 2004-
مواضيع طبية MeSH: Electric Stimulation Therapy/*methods , Median Nerve/*surgery , Quadriplegia/*therapy , Radial Nerve/*surgery , Spinal Cord Injuries/*therapy, Adult ; Electrodes, Implanted ; Forearm/physiopathology ; Hand/physiopathology ; Humans ; Male ; Middle Aged ; Movement/physiology ; Quadriplegia/etiology ; Spinal Cord Injuries/complications ; Young Adult
مستخلص: Background: We hypothesized that a selective neural electrical stimulation of radial and median nerves enables the activation of functional movements in the paralyzed hand of individuals with tetraplegia. Compared to previous approaches for which up to 12 muscles were targeted through individual muscular stimulations, we focused on minimizing the number of implanted electrodes however providing almost all the needed and useful hand movements for subjects with complete tetraplegia.
Methods: We performed acute experiments during scheduled surgeries of the upper limb with eligible subjects. We scanned a set of multicontact neural stimulation cuff electrode configurations, pre-computed through modeling simulations. We reported the obtained isolated and functional movements that were considered useful for the subject (different grasping movements).
Results: In eight subjects, we demonstrated that selective stimulation based on multicontact cuff electrodes and optimized current spreading over the active contacts provided isolated, compound, functional and strong movements; most importantly 3 out of 4 had isolated fingers or thumb flexion, one patient performed a Key Grip, another one the Power and Hook Grips, and the 2 last all the 3 Grips. Several configurations were needed to target different areas within the nerve to obtain all the envisioned movements. We further confirmed that the upper limb nerves have muscle specific fascicles, which makes it possible to activate isolated movements.
Conclusions: The future goal is to provide patients with functional restoration of object grasping and releasing with a minimally invasive solution: only two cuff electrodes above the elbow. Ethics Committee / ANSM clearance prior to the beginning of the study (inclusion period 2016-2018): CPP Sud Méditerranée, #ID-RCB:2014-A01752-45, first acceptance 10th of February 2015, amended 12th of January 2016.
Trial Registration: (www.clinicaltrials.gov): #NCT03721861, Retrospectively registered on 26th of October 2018.
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فهرسة مساهمة: Keywords: Grasping movement; Multicontact cuff electrode; Neural stimulation; Selective stimulation; Tetraplegia
سلسلة جزيئية: ClinicalTrials.gov NCT03721861
تواريخ الأحداث: Date Created: 20200521 Date Completed: 20201020 Latest Revision: 20201020
رمز التحديث: 20231215
مُعرف محوري في PubMed: PMC7236876
DOI: 10.1186/s12984-020-00676-4
PMID: 32429963
قاعدة البيانات: MEDLINE
الوصف
تدمد:1743-0003
DOI:10.1186/s12984-020-00676-4