Nature BME: Skin-mechanical interface for neurosurgery feedback

Skin sensation plays an important role in human cognition, emotion, development and behavior.
As a versatile medium of external perception, communication and protection, the skin uses special subjects (contact, pressure, shearing, pain, vibration, and temperature) to create a complex collection of different signals that are subtly integrated by the peripheral nervous system.
the resulting incoming feedback provides a sense of touch that is essential for balance, motion and posture control, grip and object manipulation.
current amputations have discarded the skin's sensational organs.
standard care prosthesis system focuses on restoring mechanical parts of the limb, with little nerve control and skin feedback.
result, the patient's feeling experience and motor function are significantly reduced;
increasing evidence that neurosurgery's sense feedback has a positive impact on confidence, mobility and functionality, while also reducing mental and physical fatigue.
, a skin-mechanical interface (CMI) for neurosurgery feedback was designed.
in CMI, muscles are surgically connected to natural or regenerative flaps for a graded feeling of contact or pressure.
after functional electrical stimulation, muscle activation imposes a controlled strain or vibration on the skin proportional to the external sensation measured by the prosthesis sensor.
mechanical deformation of the skin is converted into incoming signals through free nerve endings and four low-threshold mechanical receptors (LTMRs) in the skin, namely the Meisner small body, the Pacini small body, the Rufini small body and the Merkel cells.
different startup modes activate these slow adaptation (SA) and fast adaptation (RA) subjects, creating a series of sensations.
Since incoming signals are generated by naturally occurring mechanical receptors that encode static contact, compression, and vibration, and are transmitted through their inherent neural axons, mapped to the ionopathic sensory region.
neurodynamic properties of CMI were evaluated in this paper.
assumes that muscle stimulation can be regulated to produce graded haptics and different vibration patterns.
array of stimulus parameters can activate both SA and RA subjects independently.
cmIs is constructed by wrapping the EDL flaps dominated by the fibula around the belt-ti flaps of the inner hind limbs.
, electrostigation stimulates the nerves of muscle grafts to assess nerve re-dominance and induce flap contractions.
in weeks 2 and 4, the average rate of spontaneous beam contraction in muscle grafts decreased from 3 to 0 during a 90-second recording interval, indicating nerve re-dominance of muscle grafts.
, the minimum threshold for muscle activation was observed to decrease over time, which confirmed nerve re-dominance.
the CMI is driven by simulating various stimulus parameters of static exposure to assess its ability to produce hierarchical incomings, which represent the forces of contact at ever-increasing amplitudes.
with the increase of indentation, the amplitude of the neuroelectrological map (ENG) shows a gradual change.
the incoming reaction showed significant grading, with a strong signal-to-noise ratio at a stimulus magnitude higher than 2 mA, and no desensitization under repeated stimulation.
12 mA stimulates the flap to produce a strong and maximum contraction.
in order to verify that the incoming nerve is mechanically driven rather than directly electrically activated, the muscles are separated from the skin and electrically stimulated.
the incoming from the flap is not recorded even at the highest current strength.
to induce muscle stimulation frequencies between 0.5 Hz and 80 Hz and record incoming reactions from CMI.
vibrations above 80 Hz cannot be activated due to the electrochemical coupling, damping and fatigue of the muscles.
incoming reaction to CMI follows a stimulus frequency between 0.5 Hz and 80 Hz.
even with a threshold of 0.75, there is no statistical similarity in the consistency analysis between incoming fibers.
sensitivity of CMI to high-frequency vibration is consistent with the anatomical function of CMI.
histological analysis shows that CMI, as a composite tissue with an expected structure, has been re-neural domination and blood transport reconstruction, and can transmit neural signals through natural mechanical transmitters present in the cortical layer.
in short, CMI is a composite tissue that reconstructs and transmits physiologically incoming sensations.
combination of surgical techniques accepted from the field of reconstructive, orthopaedic and neurosurgery for the construction of CMI contributes to clinical transformation.
the previous method, CMIs activate the population on a biologically natural time scale and configuration by reconstructing the lost end organs with natural mechanical conveyor.
recombination of end-of-life organ tissue can be applied to a series of clinical problems in the fields of neuromuscular diseases, organ transplantation and malignant tumors.
with the application of neuroresusced techniques in limb defect therapy, CMI provides patients with a more realistic sensory experience of nerve repair through the recombination of nerve ending organ tissue.
S. Srinivasan, S., M. Herr, H. A cutaneous mechanoneural interface for neuroprosthetic feedback. Nat Biomed Eng (2021). MedSci Original Source: MedSci Original Copyright Notice: All text, images and audio and video materials on this website that indicate "Source: Mets Medicine" or "Source: MedSci Original" are owned by Mets Medicine and are not authorized to be reproduced by any media, website or individual, and are authorized to be reproduced with the words "Source: Mets Medicine".
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