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CLINICAL TRIAL article

Front. Neurosci.
Sec. Neuroprosthetics
Volume 18 - 2024 | doi: 10.3389/fnins.2024.1466684

Restoration of Natural Somatic Sensations to the Amputees: Finding the Right Combination of Neurostimulation Methods

Provisionally accepted
Gurgen Soghoyan Gurgen Soghoyan 1*Artur Biktimirov Artur Biktimirov 2Nikita S. Piliugin Nikita S. Piliugin 1Yury Matvienko Yury Matvienko 3Alexander Kaplan Alexander Kaplan 1,4Mikhail Y. Sintsov Mikhail Y. Sintsov 3Mikhail A. Lebedev Mikhail A. Lebedev 4,5
  • 1 Skolkovo Institute of Science and Technology, Moscow, Moscow Oblast, Russia
  • 2 Far Eastern Federal University, Vladivostok, Russia
  • 3 Motorica research center, Moscow, Russia
  • 4 Lomonosov Moscow State University, Moscow, Moscow, Russia
  • 5 Institute of Evolutionary Physiology and Biochemistry (RAS), Saint Petersburg, Russia

The final, formatted version of the article will be published soon.

    Limb amputation results in such devastating consequences as loss of motor and sensory functions and phantom limb pain (PLP). Neurostimulation-based approaches have been developed to treat this condition, which provide artificial somatosensory feedback such as peripheral nerve stimulation (PNS), spinal cord stimulation (SCS), and transcutaneous electrical nerve stimulation (TENS). Yet, the effectiveness of different neurostimulation methods has been rarely tested in the same participants. Such tests would help to select the most effective method or a combination of methods and could contribute to the development of multisensory limb prostheses. In this study, two transhumeral amputees were implanted with stimulating electrodes placed in the medial nerve and over the spinal cord epidurally. PNS and SCS were tested in each participant as approaches to enable tactile and proprioceptive sensations and suppress PLP. Both PNS and SCS induced sensation in different parts of the phantom hand, which correlated with cortical responses detected with electroencephalographic (EEG) recordings. The sensations produced by PNS more often felt natural compared to those produced by SCS. Еvoked response potentials (ERPs) were more lateralized and adapted faster for PNS compared to SCS. In the tasks performed with the bionic hand, neurostimulation-induced sensations enabled discrimination of object size. As the participants practiced with neurostimulation, they improved on the object-size discrimination task and their sensations became more natural. А combination of PNS and TENS enabled sensations that utilized both tactile and proprioceptive information. This combination was effective to convey the perception of object softness. In addition to enabling sensations, neurostimulation led to a decrease in PLP. The study is registered as a clinical trial on platform https://clinicaltrials.gov/ #NCT05650931.

    Keywords: neuroprosthetics, Neuromodulation, Sensory restoration, embodiment, peripheral nerve stimulation, Sensory feedback, EEG, Spinal cord stimulation (SCS)

    Received: 18 Jul 2024; Accepted: 18 Oct 2024.

    Copyright: © 2024 Soghoyan, Biktimirov, Piliugin, Matvienko, Kaplan, Sintsov and Lebedev. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Gurgen Soghoyan, Skolkovo Institute of Science and Technology, Moscow, 143026, Moscow Oblast, Russia

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.