141 Motor and Somatosensory Applications for Nerve Cuff Electrodes in Clinical Neuroprosthesis and Neurorehabilitation

Neurosurgery(2024)

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摘要
INTRODUCTION: Surgically implanted neuroprosthetics aim to restore motor and somatosensory function by delivering controlled electrical impulses to paralyzed nerves. Recently, nerve cuff electrodes (NCEs) have been increasingly studied and may eventually offer the potential to recover somatomotor function in patients with neurologic injury. METHODS: The PubMed, Google Scholar, and Web of Science databases were searched to identify relevant articles published between 2012 – 2022 describing use of neuroprosthetic NCEs for clinical somatomotor rehabilitation. Data from all relevant articles retrieved were collected and summarized. RESULTS: NCE-neural interfaces can restore both upper and lower extremity motor function in spinal cord injury patients and may provide a treatment modality superior to that of muscle-based electrodes. The search yielded 137 studies, and of those reviewed, 18 were original research articles that used peripheral nerve stimulation to elicit motor actions and/or somatosensory perceptions through NCEs. 10 studies looked at restoring motor function in patients with spinal cord injuries or stroke-related paralysis and 7 studies looked at somatosensory applications of NCEs in patients with amputations. Currently, sensory NCE interfacing can restore and improve multiple aspects of sensation in amputees. While there is room for further study in various applications, technological improvements and wider clinical adoption, NCEs have been demonstrated to provide a clinically acceptable option in reducing intraoperative duration and morbidity, while preserving long-term functional stability, threshold charge maintenance, and acceptable mechanical failure rates. CONCLUSIONS: NCEs appear to be a promising avenue for future research in the field of neuroprosthetics. As the translational avenue continues to mature and more clinical studies become avaiable, the utility of NCEs will be better understood.
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