title: Double nerve intraneural interface implant on a human amputee for robotic hand control.
abstract: OBJECTIVE
  The principle underlying this project is that, despite nervous reorganization following upper limb amputation, original pathways and CNS relays partially maintain their function and can be exploited for interfacing prostheses. Aim of this study is to evaluate a novel peripheral intraneural multielectrode for multi-movement prosthesis control and for sensory feed-back, while assessing cortical reorganization following the re-acquired stream of data.
  
  
  METHODS
  Four intrafascicular longitudinal flexible multielectrodes (tf-LIFE4) were implanted in the median and ulnar nerves of an amputee; they reliably recorded output signals for 4 weeks. Artificial intelligence classifiers were used off-line to analyse LIFE signals recorded during three distinct hand movements under voluntary order.
  
  
  RESULTS
  Real-time control of motor output was achieved for the three actions. When applied off-line artificial intelligence reached >85% real-time correct classification of trials. Moreover, different types of current stimulation were determined to allow reproducible and localized hand/fingers sensations. Cortical organization was observed via TMS in parallel with partial resolution of symptoms due to the phantom-limb syndrome (PLS).
  
  
  CONCLUSIONS
  tf-LIFE4s recorded output signals in human nerves for 4 weeks, though the efficacy of sensory stimulation decayed after 10 days. Recording from a number of fibres permitted a high percentage of distinct actions to be classified correctly. Reversal of plastic changes and alleviation of PLS represent corollary findings of potential therapeutic benefit.
  
  
  CONCLUSIONS
  This study represents a breakthrough in robotic hand use in amputees.
authors.affiliation: Dept. of Neurology, University Campus Bio-Medico, Rome, Italy. p.rossini@unicampus.it
authors.forename: Paolo M
authors.initials: PM
authors.lastname: Rossini
authors.forename: Silvestro
authors.initials: S
authors.lastname: Micera
authors.forename: Antonella
authors.initials: A
authors.lastname: Benvenuto
authors.forename: Jacopo
authors.initials: J
authors.lastname: Carpaneto
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Cavallo
authors.forename: Luca
authors.initials: L
authors.lastname: Citi
authors.forename: Christian
authors.initials: C
authors.lastname: Cipriani
authors.forename: Luca
authors.initials: L
authors.lastname: Denaro
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Denaro
authors.forename: Giovanni
authors.initials: G
authors.lastname: Di Pino
authors.forename: Florinda
authors.initials: F
authors.lastname: Ferreri
authors.forename: Eugenio
authors.initials: E
authors.lastname: Guglielmelli
authors.forename: Klaus-Peter
authors.initials: KP
authors.lastname: Hoffmann
authors.forename: Stanisa
authors.initials: S
authors.lastname: Raspopovic
authors.forename: Jacopo
authors.initials: J
authors.lastname: Rigosa
authors.forename: Luca
authors.initials: L
authors.lastname: Rossini
authors.forename: Mario
authors.initials: M
authors.lastname: Tombini
authors.forename: Paolo
authors.initials: P
authors.lastname: Dario
mesh_terms: D000328:Adult; D000673:Amputation, Traumatic / Q000150:complications; D000674:Amputees; D001186:Artificial Limbs; D003199:Computer Systems; D004558:Electric Stimulation; D004567:Electrodes, Implanted; D006225:Hand; D006801:Humans; D007389:Internal-External Control; D008297:Male; D008475:Median Nerve / Q000503:physiopathology / Q000601:surgery*; D009068:Movement; D009412:Nerve Fibers; D009473:Neuronal Plasticity; D010591:Phantom Limb / Q000209:etiology / Q000503:physiopathology / Q000601:surgery; D012371:Robotics; D012677:Sensation; D050781:Transcranial Magnetic Stimulation; D014459:Ulnar Nerve / Q000503:physiopathology / Q000601:surgery*