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      Remapping Wetness Perception in Upper Limb Amputees

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          Abstract

          Recent research has made remarkable strides in restoring sensory feedback for prosthetic users, including tactile, proprioceptive, and thermal feedback. Herein, a sensory modality that has been largely neglected is explored: the ability to perceive wetness. Providing moisture‐related information to prosthesis users can increase their overall sensory palette toward a more natural sensory experience. A rapid decrease in skin temperature is found to trigger the illusion of contact with something wet. Two body parts were tested, the upper arm and the lateral abdomen, in a group of non amputated participants, and it was found that a wetness sensation can be elicited and maintained for at least 10 s in 86% and 93% of participants, respectively. It is then demonstrated how to mediate the wetness sensation in real‐time using a thermal wearable device that mimics the thermal properties of the skin. Finally, two upper limb amputee individuals used their prosthetic arm, sensorized with the device, to discriminate between three levels of moisture; their detection accuracy was similar to one they had with their intact hands. The current study is a stepping stone for future prostheses aimed at restoring the richness of sensory experience in upper limb amputees.

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          Most cited references18

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          A neural interface provides long-term stable natural touch perception.

          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.
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            Biomimetic Intraneural Sensory Feedback Enhances Sensation Naturalness, Tactile Sensitivity, and Manual Dexterity in a Bidirectional Prosthesis

            Peripheral intraneural stimulation can provide tactile information to amputees. However, efforts are still necessary to identify encoding strategy eliciting percepts that are felt as both natural and effective for prosthesis control. Here we compared the naturalness and efficacy of different encoding strategies to deliver neural stimulation to trans-radial amputees implanted with intraneural electrodes. Biomimetic frequency modulation was perceived as more natural, while amplitude modulation enabled better performance in tasks requiring fine identification of the applied force. Notably, the optimal combination of naturalness and sensitivity of the tactile feedback can be achieved with "hybrid" encoding strategies based on simultaneous biomimetic frequency and amplitude neuromodulation. These strategies improved the gross manual dexterity of the subjects during functional task while maintaining high levels of manual accuracy. They also improved prosthesis embodiment, reducing abnormal phantom limb perceptions ("telescoping effect"). Hybrid strategies are able to provide highly sensitive and natural percepts and should be preferred. VIDEO ABSTRACT.
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              Intraneural stimulation elicits discrimination of textural features by artificial fingertip in intact and amputee humans

              Restoration of touch after hand amputation is a desirable feature of ideal prostheses. Here, we show that texture discrimination can be artificially provided in human subjects by implementing a neuromorphic real-time mechano-neuro-transduction (MNT), which emulates to some extent the firing dynamics of SA1 cutaneous afferents. The MNT process was used to modulate the temporal pattern of electrical spikes delivered to the human median nerve via percutaneous microstimulation in four intact subjects and via implanted intrafascicular stimulation in one transradial amputee. Both approaches allowed the subjects to reliably discriminate spatial coarseness of surfaces as confirmed also by a hybrid neural model of the median nerve. Moreover, MNT-evoked EEG activity showed physiologically plausible responses that were superimposable in time and topography to the ones elicited by a natural mechanical tactile stimulation. These findings can open up novel opportunities for sensory restoration in the next generation of neuro-prosthetic hands. DOI: http://dx.doi.org/10.7554/eLife.09148.001
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                Author and article information

                Contributors
                (View ORCID Profile)
                Journal
                Advanced Intelligent Systems
                Advanced Intelligent Systems
                Wiley
                2640-4567
                2640-4567
                January 18 2024
                Affiliations
                [1 ] Bertarelli Foundation Chair in Translational Neural Engineering Neuro‐X Institute École Polytechnique Fédérale de Lausanne Lausanne 1015 Switzerland
                [2 ] Laboratory for Behavioral Neurology and Imaging of Cognition Department of Fundamental Neuroscience University of Geneva Geneva 1202 Switzerland
                [3 ] The BioRobotics Institute, Health Interdisciplinary Center Department of Excellent in Robotics and AI Scuola Superiore Sant’Anna Pisa 56127 Italy
                [4 ] Foundation Bertarelli Chair in Neuroprosthetic Technology Neuro‐X Institute École Polytechnique Fédérale de Lausanne Lausanne 1015 Switzerland
                [5 ] Centro Protesi INAIL Vigorso di Budrio 40054 Italy
                [6 ] THERMOSENSELAB Skin Sensing Research Group School of Health Sciences The University of Southampton Southampton SO16 6YD UK
                Article
                10.1002/aisy.202300512
                2bbeed12-eedb-4a92-ad8b-bd8e779329c4
                © 2024

                http://creativecommons.org/licenses/by/4.0/

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