title: Providing a sense of touch to prosthetic hands.
abstract: Each year, approximately 185,000 Americans suffer the devastating loss of a limb. The effects of upper limb amputations are profound because a person's hands are tools for everyday functioning, expressive communication, and other uniquely human attributes. Despite the advancements in prosthetic technology, current upper limb prostheses are still limited in terms of complex motor control and sensory feedback. Sensory feedback is critical to restoring full functionality to amputated patients because it would relieve the cognitive burden of relying solely on visual input to monitor motor commands and provide tremendous psychological benefits. This article reviews the latest innovations in sensory feedback and argues in favor of peripheral nerve interfaces. First, the authors examine the structure of the peripheral nerve and its importance in the development of a sensory interface. Second, the authors discuss advancements in targeted muscle reinnervation and direct neural stimulation by means of intraneural electrodes. The authors then explore the future of prosthetic sensory feedback using innovative technologies for neural signaling, specifically, the sensory regenerative peripheral nerve interface and optogenetics. These breakthroughs pave the way for the development of a prosthetic limb with the ability to feel.
authors.affiliation: Ann Arbor, Mich.; Cambridge, Mass.; and Charlottesville, Va. From the Department of Surgery, Section of Plastic and Reconstructive Surgery, University of Michigan Health System; the Department of Mechanical Engineering, University of Michigan; the Charles Stark Draper Laboratory; and the Department of Systems and Information Engineering, University of Virginia.
authors.forename: Bao Tram
authors.initials: BT
authors.lastname: Nghiem
authors.forename: Ian C
authors.initials: IC
authors.lastname: Sando
authors.forename: R Brent
authors.initials: RB
authors.lastname: Gillespie
authors.forename: Bryan L
authors.initials: BL
authors.lastname: McLaughlin
authors.forename: Gregory J
authors.initials: GJ
authors.lastname: Gerling
authors.forename: Nicholas B
authors.initials: NB
authors.lastname: Langhals
authors.forename: Melanie G
authors.initials: MG
authors.lastname: Urbanchek
authors.forename: Paul S
authors.initials: PS
authors.lastname: Cederna
mesh_terms: D000673:Amputation, Traumatic / Q000534:rehabilitation* / Q000601:surgery; D001186:Artificial Limbs; D062207:Brain-Computer Interfaces; D056228:Feedback, Sensory / Q000502:physiology*; D005260:Female; D005544:Forecasting; D006225:Hand / Q000294:innervation / Q000601:surgery*; D006801:Humans; D008297:Male; D011474:Prosthesis Design; D017755:Prosthesis Fitting; D011597:Psychomotor Performance / Q000502:physiology; D012684:Sensory Thresholds / Q000502:physiology*; D014110:Touch / Q000502:physiology; D055698:Touch Perception / Q000502:physiology; D016896:Treatment Outcome