title: A neural interface provides long-term stable natural touch perception.
abstract: Touch perception on the fingers and hand is essential for fine motor control, contributes to our sense of self, allows for effective communication, and aids in our fundamental perception of the world. Despite increasingly sophisticated mechatronics, prosthetic devices still do not directly convey sensation back to their wearers. We show that implanted peripheral nerve interfaces in two human subjects with upper limb amputation provided stable, natural touch sensation in their hands for more than 1 year. Electrical stimulation using implanted peripheral nerve cuff electrodes that did not penetrate the nerve produced touch perceptions at many locations on the phantom hand with repeatable, stable responses in the two subjects for 16 and 24 months. Patterned stimulation intensity produced a sensation that the subjects described as natural and without "tingling," or paresthesia. Different patterns produced different types of sensory perception at the same location on the phantom hand. The two subjects reported tactile perceptions they described as natural tapping, constant pressure, light moving touch, and vibration. Changing average stimulation intensity controlled the size of the percept area; changing stimulation frequency controlled sensation strength. Artificial touch sensation improved the subjects' ability to control grasping strength of the prosthesis and enabled them to better manipulate delicate objects. Thus, electrical stimulation through peripheral nerve electrodes produced long-term sensory restoration after limb loss.
authors.affiliation: Louis Stokes Veterans Affairs Medical Center, Cleveland, OH 44106, USA. Case Western Reserve University, Cleveland, OH 44106, USA.
authors.forename: Daniel W
authors.initials: DW
authors.lastname: Tan
authors.affiliation: Louis Stokes Veterans Affairs Medical Center, Cleveland, OH 44106, USA. Case Western Reserve University, Cleveland, OH 44106, USA.
authors.forename: Matthew A
authors.initials: MA
authors.lastname: Schiefer
authors.affiliation: Louis Stokes Veterans Affairs Medical Center, Cleveland, OH 44106, USA. Case Western Reserve University, Cleveland, OH 44106, USA. MetroHealth Medical Center, Cleveland, OH 44109, USA.
authors.forename: Michael W
authors.initials: MW
authors.lastname: Keith
authors.affiliation: Louis Stokes Veterans Affairs Medical Center, Cleveland, OH 44106, USA. Case Western Reserve University, Cleveland, OH 44106, USA. University Hospitals Rainbow Babies & Children's Hospital, Cleveland, OH 44106, USA.
authors.forename: James Robert
authors.initials: JR
authors.lastname: Anderson
authors.affiliation: MetroHealth Medical Center, Cleveland, OH 44109, USA.
authors.forename: Joyce
authors.initials: J
authors.lastname: Tyler
authors.affiliation: Louis Stokes Veterans Affairs Medical Center, Cleveland, OH 44106, USA. Case Western Reserve University, Cleveland, OH 44106, USA. MetroHealth Medical Center, Cleveland, OH 44109, USA. dustin.tyler@case.edu.
authors.forename: Dustin J
authors.initials: DJ
authors.lastname: Tyler
mesh_terms: D000674:Amputees; D001186:Artificial Limbs; D004558:Electric Stimulation / Q000009:adverse effects / Q000379:methods; D004567:Electrodes, Implanted; D056228:Feedback, Sensory; D006225:Hand / Q000294:innervation / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009048:Motor Skills / Q000502:physiology; D010292:Paresthesia / Q000503:physiopathology; D010525:Peripheral Nerves / Q000502:physiology; D010591:Phantom Limb / Q000503:physiopathology; D011312:Pressure; D012677:Sensation; D055698:Touch Perception; D057170:Translational Research, Biomedical