Brain activation in a myoelectric prosthetic hand: the role of the brain in the rehabilitation of amputees.
BACKGROUND
Historically, rehabilitation of amputees has focused on developing prostheses, adjusting them to fit the limb, and then submitting the patient to extensive "training" programs. The objective of this study was to investigate whether stimuli from the sensorimotor cortex, observed through functional magnetic resonance imaging, comprises a neuronal network that permits the control of a myoelectric prosthetic hand.


METHODS
A comprehensive review of the subject was conducted, and a specific case is presented to illustrate the hypothesis. In a self-controlled designed study, a 13-year-old girl with congenital amputation of the right hand was tested to verify if the brain can control fine motor movement of a myoelectric prosthetic hand. Functional magnetic resonance images were conducted to assess whether there was a relationship between brain activation and control of the prosthesis. Functional magnetic resonance imaging data were collected to investigate brain activation during the actual opening and closing of the existent hand and during the contraction of the remaining stump muscles used for opening and closing the myoelectric prosthetic hand.


RESULTS
Similar activation was found in the brain hemispheres that control the myoelectric and existing hands. When the patient moved the prosthetic hand, activation was observed in the brain's sensorimotor and visual cortexes and the cerebellum. These data suggest that the patient was controlling and also perceiving that the artificial hand was performing movements.


CONCLUSIONS
This study suggests that it may be possible to control speed, force, and modulation of a myoelectric prosthesis through impulses emitted by specific brain areas.


CONCLUSIONS
Further research in brain control and improvement of myoelectric prosthesis will lead to a more holistic approach in the development of a man-machine complex.
da Paz
Aloysio Campos
AC
SARAH Network of Rehabilitation Hospitals, Brazil. aloysio@sarah.br
Braga
Lucia Willadino
LW
D000293:Adolescent; D000671:Amputation, Surgical / Q000534:rehabilitation*; D001921:Brain / Q000502:physiology*; D005260:Female; D007839:Functional Laterality; D006225:Hand / Q000601:surgery*; D006801:Humans; D008279:Magnetic Resonance Imaging; D019919:Prosthesis Implantation / Q000379:methods*; D012189:Retrospective Studies; D012984:Software