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P190: NEurocontrolled BIdirectional Artificial upper limb and hand prosthesiS (NEBIAS)
Abstracts of Poster Presentations / Clinical Neurophysiology 125, Supplement 1 (2014) S1–S339
Figure 2. Operant conditioning paradigm shown during swing phase to improve tibialis anterior (flexor)–gastrocnemius (extensor) coordination. MRCP: movement related cortical potential; MN: α-motoneuron; IN: Ia-inhibitory interneuron; EMG: electromyogram; DRG: dorsal root ganglion.
ical variables of the targets are perturbed in a systematic manner. Here, Held and colleagues [6,7] have found aftereffects only with sensorimotor integration, which may then lead to motor adaptation [8]. In principal accordance, we found that only stroke subjects who showed aftereffects during systematic perturbation of the “EMG to NMES mapping” parameters (in Bayesian framework) at random catch-trials during the locomotor exploration activity, showed post-intervention changes in the EMG pattern during volitional (no NMES) treadmill walking. References: [1] Yeom and Chang, J Neurosci Meth 2010; 193(1): 118-125. [2] Dutta et al, Proceedings of 17th Conference of IFESS 2012; Banff, Canada 2012. [3] Dutta et al, Conf Proc IEEE Eng Med Biol Soc 2011; 2011: 3696-3699 [4] Feng-Chen and Wolpaw, Proc Natl Acad Sci U S A 1996;93(17):92069211. [5] Wang et al, Eur J Neurosci 2006;23(1):141-150. [6] Held and Gottlieb, Percept Mot Skills 1958, 8, 83-86. [7] Held and Freedman, Science 1963, 142, 455-462. [8] Shadmehr et al, Annu Rev Neurosci 2010;33:89-108.
P189 Does an intraneural interface short-term implant for robotic hand control modulate sensorimotor cortical integration? An EEG-TMS co-registration study on a human amputee A. Guerra 1 , F. Ferreri 1,2 , D. Ponzo 1,2 , L. Vollero 3 , G. Di Pino 1,4 , S. Petrichella 3 , A. Benvenuto 4 , M. Tombini 1 , L. Rossini 4,5 , L. Denaro 6 , S. Micera 7,8 , G. Iannello 3 , E. Guglielmelli 4 , V. Denaro 9 , P.M. Rossini 10,5 1 University Campus Bio-Medico, Neurology, Roma, Italy; 2 Kuopio University Hospital, University of Eastern Finland, Department of Clinical Neurophysiology, Kuopio, Italy; 3 University Campus Biomedico, Computer Science and Bioinformatics Laboratory, Roma, Italy; 4 University Campus Bio-Medico, Biomedical Robotics and Biomicrosystems Laboratory, Centre for Integrated Research, Roma, Italy; 5 IRCCS S. Raffaele-Pisana, Neuroscience, Roma, Italy; 6 Catholic University, Department of Neurosurgery, Roma, Italy; 7 Scuola Superiore Sant’Anna, Advanced Robotics Technology and Systems Laboratory, Pisa, Italy; 8 Swiss Federal Institute of Technology, Institute for Automation, Zurich, Italy; 9 University Campus Bio-Medico, Department of Orthopaedics, Roma, Italy; 10 Catholic University, Institute of Neurology, Roma, Italy Purpose: Following limb amputation central and peripheral nervous system relays partially maintain their functions and can be exploited for interfacing prostheses. Aim of this study is to investigate, for the first time by means of an EEG-TMS co-registration study, whether and how direct bidirectional connection between brain and hand prosthesis impacts on sensorimotor cortical topography. Methods: Within an experimental protocol for robotic hand control, a 26 years-old, left-hand amputated male was selected to have implanted four intrafascicular electrodes (tf-LIFEs-4) in the median and ulnar nerves of the stump for 4 weeks. Before tf-LIFE-4s implant (T0) and after the training period, once electrodes have been removed (T1), experimental subject’s
S99
cortico-cortical excitability, connectivity and plasticity were directly tested via a neuronavigated EEG-TMS experiment. Results: The statistical analysis clearly demonstrated a significant modulation (with t-test p<0.0001) of EEG activity between 30 and 100 ms post-stimulus for the stimulation of the right hemisphere. When looking at the individual latencies in that time range, a global amplitude modulation was present in most of the TMS-evoked potentials; particularly, the GEE analysis showed significant differences between T0 and T1 condition at 30 ms (p<0.0404), 46 ms (p<0.0001) and 60 ms (p<0.007) latencies. Finally, also a clear local decrement in N46 amplitude over C4 was evident. No differences between conditions were observed for the stimulation of the left hemisphere. Conclusions: The results of this study confirm the hypothesis that bidirectional neural interface could redirect cortical areas -deprived of their original input/output functions- toward restorative neuroplasticity. This reorganization strongly involves bi-hemispheric networks and intracortical and transcortical modulation of GABAergic inhibition.
P190 NEurocontrolled BIdirectional Artificial upper limb and hand prosthesiS (NEBIAS) S. Micera 1 , S. Raspospovic 2 , M. Capogrosso 2 , J. Carpaneto 2 , G. Granata 1 , C.M. Oddo 2 , C. Cipriani 2 , T. Stieglitz 3 , M. Schuettler 3 , X. Navarro 4 , L. Raffo 5 , M. Barbaro 5 , P.M. Rossini 1,6 1 Catholic University of the Sacred Heart, Department of Geriatrics, Neurosciences & Orthopedics, Institute of Neurology, Rome, Italy; 2 Scuola Superiore Sant’Anna, The BioRobotics Institute, pisa, Italy; 3 University of Freiburg, Laboratory for Biomedical Microtechnology, Freiburg, Germany; 4 Universidat Autonoma de Barcelona, Barcelona, Spain; 5 University of Cagliari, Cagliari, Italy; 6 San Raffaele Pisana, Rome, Italy Question: The hand is a powerful tool and its loss causes severe physical and often mental debilitation. Surveys on using artificial hands reveal that 30 to 50% amputees do not use their prosthetic hand regularly, due to its low functionality. The fundamental issue is therefore to improve the voluntarily-controlled dexterity to allow amputee to perform tasks that are necessary for activities of daily living and that cannot yet be done with the state-of-the-art artificial limbs. Starting from previous encouraging results, the NEBIAS (“NEurocontrolled BIdirectional Artificial upper limb and hand prosthesiS”) proposal aims at developing and clinically evaluating (in selected amputees) a neuro-controlled upper limb prosthesis intuitively controlled and felt by the amputee as the natural one. Methods: The goal of the project will be achieved by combining microtechnology and material science and will allow, on one side, recording of the motor-related signals governing the actions of the amputated hand/arm for the motion control of a mechanical prosthesis, and on the other providing sensory feedback from tactile and kinesthetic sensors through neuromorphic stimulation of the adequate afferent pathway within the residual limb. Results: The system will be implanted in one or more upper limb amputees enrolled for the study. The patients will undergo a complete clinical and functional neuroimaging study to verify the safety of the prosthetic system and its role in modifying cortical reorganizations following limb amputation and lack of sensory feedback. A clinical follow-up evaluation will be also performed 2 months after the electrode removal. Conclusions: NEBIAS is a highly innovative, interdisciplinary project, combining forefront research from information technologies, smart bio-sensors, control theory, cognitive neuroscience, material sciences, electric design, measurements and robotics to solve a major social problem: the development of a prosthetic hand displaying all the basic features of a real human hand. The successful realisation of this highly visionary project requires crossing the boundaries of distinct scientific fields, merging forefront expertise of the consortium to improve quality of life of amputees.
Figure 2. Operant conditioning paradigm shown during swing phase to improve tibialis anterior (flexor)–gastrocnemius (extensor) coordination. MRCP: movement related cortical potential; MN: α-motoneuron; IN: Ia-inhibitory interneuron; EMG: electromyogram; DRG: dorsal root ganglion.
ical variables of the targets are perturbed in a systematic manner. Here, Held and colleagues [6,7] have found aftereffects only with sensorimotor integration, which may then lead to motor adaptation [8]. In principal accordance, we found that only stroke subjects who showed aftereffects during systematic perturbation of the “EMG to NMES mapping” parameters (in Bayesian framework) at random catch-trials during the locomotor exploration activity, showed post-intervention changes in the EMG pattern during volitional (no NMES) treadmill walking. References: [1] Yeom and Chang, J Neurosci Meth 2010; 193(1): 118-125. [2] Dutta et al, Proceedings of 17th Conference of IFESS 2012; Banff, Canada 2012. [3] Dutta et al, Conf Proc IEEE Eng Med Biol Soc 2011; 2011: 3696-3699 [4] Feng-Chen and Wolpaw, Proc Natl Acad Sci U S A 1996;93(17):92069211. [5] Wang et al, Eur J Neurosci 2006;23(1):141-150. [6] Held and Gottlieb, Percept Mot Skills 1958, 8, 83-86. [7] Held and Freedman, Science 1963, 142, 455-462. [8] Shadmehr et al, Annu Rev Neurosci 2010;33:89-108.
P189 Does an intraneural interface short-term implant for robotic hand control modulate sensorimotor cortical integration? An EEG-TMS co-registration study on a human amputee A. Guerra 1 , F. Ferreri 1,2 , D. Ponzo 1,2 , L. Vollero 3 , G. Di Pino 1,4 , S. Petrichella 3 , A. Benvenuto 4 , M. Tombini 1 , L. Rossini 4,5 , L. Denaro 6 , S. Micera 7,8 , G. Iannello 3 , E. Guglielmelli 4 , V. Denaro 9 , P.M. Rossini 10,5 1 University Campus Bio-Medico, Neurology, Roma, Italy; 2 Kuopio University Hospital, University of Eastern Finland, Department of Clinical Neurophysiology, Kuopio, Italy; 3 University Campus Biomedico, Computer Science and Bioinformatics Laboratory, Roma, Italy; 4 University Campus Bio-Medico, Biomedical Robotics and Biomicrosystems Laboratory, Centre for Integrated Research, Roma, Italy; 5 IRCCS S. Raffaele-Pisana, Neuroscience, Roma, Italy; 6 Catholic University, Department of Neurosurgery, Roma, Italy; 7 Scuola Superiore Sant’Anna, Advanced Robotics Technology and Systems Laboratory, Pisa, Italy; 8 Swiss Federal Institute of Technology, Institute for Automation, Zurich, Italy; 9 University Campus Bio-Medico, Department of Orthopaedics, Roma, Italy; 10 Catholic University, Institute of Neurology, Roma, Italy Purpose: Following limb amputation central and peripheral nervous system relays partially maintain their functions and can be exploited for interfacing prostheses. Aim of this study is to investigate, for the first time by means of an EEG-TMS co-registration study, whether and how direct bidirectional connection between brain and hand prosthesis impacts on sensorimotor cortical topography. Methods: Within an experimental protocol for robotic hand control, a 26 years-old, left-hand amputated male was selected to have implanted four intrafascicular electrodes (tf-LIFEs-4) in the median and ulnar nerves of the stump for 4 weeks. Before tf-LIFE-4s implant (T0) and after the training period, once electrodes have been removed (T1), experimental subject’s
S99
cortico-cortical excitability, connectivity and plasticity were directly tested via a neuronavigated EEG-TMS experiment. Results: The statistical analysis clearly demonstrated a significant modulation (with t-test p<0.0001) of EEG activity between 30 and 100 ms post-stimulus for the stimulation of the right hemisphere. When looking at the individual latencies in that time range, a global amplitude modulation was present in most of the TMS-evoked potentials; particularly, the GEE analysis showed significant differences between T0 and T1 condition at 30 ms (p<0.0404), 46 ms (p<0.0001) and 60 ms (p<0.007) latencies. Finally, also a clear local decrement in N46 amplitude over C4 was evident. No differences between conditions were observed for the stimulation of the left hemisphere. Conclusions: The results of this study confirm the hypothesis that bidirectional neural interface could redirect cortical areas -deprived of their original input/output functions- toward restorative neuroplasticity. This reorganization strongly involves bi-hemispheric networks and intracortical and transcortical modulation of GABAergic inhibition.
P190 NEurocontrolled BIdirectional Artificial upper limb and hand prosthesiS (NEBIAS) S. Micera 1 , S. Raspospovic 2 , M. Capogrosso 2 , J. Carpaneto 2 , G. Granata 1 , C.M. Oddo 2 , C. Cipriani 2 , T. Stieglitz 3 , M. Schuettler 3 , X. Navarro 4 , L. Raffo 5 , M. Barbaro 5 , P.M. Rossini 1,6 1 Catholic University of the Sacred Heart, Department of Geriatrics, Neurosciences & Orthopedics, Institute of Neurology, Rome, Italy; 2 Scuola Superiore Sant’Anna, The BioRobotics Institute, pisa, Italy; 3 University of Freiburg, Laboratory for Biomedical Microtechnology, Freiburg, Germany; 4 Universidat Autonoma de Barcelona, Barcelona, Spain; 5 University of Cagliari, Cagliari, Italy; 6 San Raffaele Pisana, Rome, Italy Question: The hand is a powerful tool and its loss causes severe physical and often mental debilitation. Surveys on using artificial hands reveal that 30 to 50% amputees do not use their prosthetic hand regularly, due to its low functionality. The fundamental issue is therefore to improve the voluntarily-controlled dexterity to allow amputee to perform tasks that are necessary for activities of daily living and that cannot yet be done with the state-of-the-art artificial limbs. Starting from previous encouraging results, the NEBIAS (“NEurocontrolled BIdirectional Artificial upper limb and hand prosthesiS”) proposal aims at developing and clinically evaluating (in selected amputees) a neuro-controlled upper limb prosthesis intuitively controlled and felt by the amputee as the natural one. Methods: The goal of the project will be achieved by combining microtechnology and material science and will allow, on one side, recording of the motor-related signals governing the actions of the amputated hand/arm for the motion control of a mechanical prosthesis, and on the other providing sensory feedback from tactile and kinesthetic sensors through neuromorphic stimulation of the adequate afferent pathway within the residual limb. Results: The system will be implanted in one or more upper limb amputees enrolled for the study. The patients will undergo a complete clinical and functional neuroimaging study to verify the safety of the prosthetic system and its role in modifying cortical reorganizations following limb amputation and lack of sensory feedback. A clinical follow-up evaluation will be also performed 2 months after the electrode removal. Conclusions: NEBIAS is a highly innovative, interdisciplinary project, combining forefront research from information technologies, smart bio-sensors, control theory, cognitive neuroscience, material sciences, electric design, measurements and robotics to solve a major social problem: the development of a prosthetic hand displaying all the basic features of a real human hand. The successful realisation of this highly visionary project requires crossing the boundaries of distinct scientific fields, merging forefront expertise of the consortium to improve quality of life of amputees.