Upper limb prostheses are increasingly resembling the limbs they seek to replace in both form and functionality, including the design and development of multifingered hands and wrists. Hence, it becomes necessary to control large numbers of degrees of freedom (DOFs), required for individuated finger movements, preferably using noninvasive signals. While existing control paradigms are typically used to drive a single-DOF hook-based configurations, dexterous tasks such as individual finger movements would require more elaborate control schemes. We show that it is possible to decode individual flexion and extension movements of each finger (ten movements) with greater than 90% accuracy in a transradial amputee using only noninvasive surface myoelectric signals. Further, comparison of decoding accuracy from a transradial amputee and able-bodied subjects shows no statistically significant difference ( p < 0.05) between these subjects. These results are encouraging for the development of real-time control strategies based on the surface myoelectric signal to control dexterous prosthetic hands.

Background and Objectives The restoration of touch to fingers and fingertips is critical to achieving dexterous neuroprosthetic control for individuals with sensorimotor dysfunction. However, localized fingertip sensations have not been evoked via intracortical microstimulation (ICMS). Methods Using a novel intraoperative mapping approach, we implanted electrode arrays in the finger areas of left and right somatosensory cortex and delivered ICMS over a 2-year period in a human participant with spinal cord injury. Results Stimulation evoked tactile sensations in 8 fingers, including fingertips, spanning both hands. Evoked percepts followed expected somatotopic arrangements. The subject was able to reliably identify up to 7 finger-specific sites spanning both hands in a finger discrimination task. The size of the evoked percepts was on average 33% larger than a finger pad, as assessed via manual markings of a hand image. The size of the evoked percepts increased modestly with increased stimulation intensity, growing 21% as pulse amplitude increased from 20 to 80 µA. Detection thresholds were estimated on a subset of electrodes, with estimates of 9.2 to 35 µA observed, roughly consistent with prior studies. Discussion These results suggest that ICMS can enable the delivery of consistent and localized fingertip sensations during object manipulation by neuroprostheses for individuals with somatosensory deficits. ClinicalTrials.gov Identifier NCT03161067.

Advances in intelligent robotic systems and brain-machine interfaces (BMI) have helped restore functionality and independence to individuals living with sensorimotor deficits; however, tasks requiring bimanual coordination and fine manipulation continue to remain unsolved given the technical complexity of controlling multiple degrees of freedom (DOF) across multiple limbs in a coordinated way through a user input. To address this challenge, we implemented a collaborative shared control strategy to manipulate and coordinate two Modular Prosthetic Limbs (MPL) for performing a bimanual self-feeding task. A human participant with microelectrode arrays in sensorimotor brain regions provided commands to both MPLs to perform the self-feeding task, which included bimanual cutting. Motor commands were decoded from bilateral neural signals to control up to two DOFs on each MPL at a time. The shared control strategy enabled the participant to map his four-DOF control inputs, two per hand, to as many as 12 DOFs for specifying robot end effector position and orientation. Using neurally-driven shared control, the participant successfully and simultaneously controlled movements of both robotic limbs to cut and eat food in a complex bimanual self-feeding task. This demonstration of bimanual robotic system control via a BMI in collaboration with intelligent robot behavior has major implications for restoring complex movement behaviors for those living with sensorimotor deficits.

In recent years, there has been a growing demand for miniaturization, low power consumption, quick treatments, and non-invasive clinical strategies in the healthcare industry. To meet these demands, healthcare professionals are seeking new technological paradigms that can improve diagnostic accuracy while ensuring patient compliance. Neuromorphic engineering, which uses neural models in hardware and software to replicate brain-like behaviors, can help usher in a new era of medicine by delivering low power, low latency, small footprint, and high bandwidth solutions. This paper provides an overview of recent neuromorphic advancements in medicine, including medical imaging and cancer diagnosis, processing of biosignals for diagnosis, and biomedical interfaces, such as motor, cognitive, and perception prostheses. For each section, we provide examples of how brain-inspired models can successfully compete with conventional artificial intelligence algorithms, demonstrating the potential of neuromorphic engineering to meet demands and improve patient outcomes. Lastly, we discuss current struggles in fitting neuromorphic hardware with non-neuromorphic technologies and propose potential solutions for future bottlenecks in hardware compatibility.

Background: Brain-computer interfaces (BCIs) can restore communication for movement- and/or speech-impaired individuals by enabling neural control of computer typing applications. Single command click detectors provide a basic yet highly functional capability. Methods: We sought to test the performance and long-term stability of click decoding using a chronically implanted high density electrocorticographic (ECoG) BCI with coverage of the sensorimotor cortex in a human clinical trial participant (ClinicalTrials.gov, NCT03567213) with amyotrophic lateral sclerosis. We trained the participant’s click detector using a small amount of training data (<44 min across 4 days) collected up to 21 days prior to BCI use, and then tested it over a period of 90 days without any retraining or updating. Results: Using a click detector to navigate a switch scanning speller interface, the study participant can maintain a median spelling rate of 10.2 characters per min. Though a transient reduction in signal power modulation can interrupt usage of a fixed model, a new click detector can achieve comparable performance despite being trained with even less data (<15 min, within 1 day). Conclusions: These results demonstrate that a click detector can be trained with a small ECoG dataset while retaining robust performance for extended periods, providing functional text-based communication to BCI users.

The restoration of cutaneous sensation to fingers and fingertips is critical to achieving dexterous prosthesis control for individuals with sensorimotor dysfunction. However, localized and reproducible fingertip sensations in humans have not been reported via intracortical microstimulation (ICMS) in humans. Here, we show that ICMS in a human participant was capable of eliciting percepts in 7 fingers spanning both hands, including 6 fingertip regions (i.e., 3 on each hand). Median percept size was estimated to include 1.40 finger or palmar segments (e.g., one segment being a fingertip or the section of upper palm below a finger). This was corroborated with a more sensitive manual marking technique where median percept size corresponded to roughly 120% of a fingertip segment. Percepts showed high intra-day consistency, including high performance (99%) on a blinded finger discrimination task. Across days, there was more variability in percepts, with 75.8% of trials containing the modal finger or palm region for the stimulated electrode. These results suggest that ICMS can enable the delivery of localized fingertip sensations during object manipulation by neuroprostheses.