Using Utah slanted electrode arrays for treatment of peripheral nerve neuropathy and for closed-loop control of prosthetic limbs

Peripheral nerve implants oer the potential to treat pathologies associated with a compromised ability to transmit information about one's environment to their central nervous system. The transmitted information may cause an unwanted central response, such as pain, or the information may not be able to be endogenously generated, as is the case when an amputation eliminates the signal-producing sensory receptor organs in skin and muscle. Previous reports have indicated that using varying stimulation settings with these neural interfaces can either excite action potentials within a nerve or block them. The use of intrafascicular Utah Slanted Electrode Arrays (USEAs) adds the ability to selectively aect bers within a nerve while leaving others unaected. However, there have been few demonstrations of functional benets for USEA-mediated therapies in humans, and the tools needed to make these assessments have not been well-described. In order to ll these gaps in human subject research, I examine the use of USEAs for clinically treating patients suering from chronic pain and for treating amputees who desire greater sensory feedback from their prosthetic limbs. This work provides three key demonstrations that support the clinical adoption of ecacious USEA stimulation for patients with chronic pain and amputations: First, I will show that delivering kilohertz high frequency alternating current through USEA electrodes reduces pain symptoms in a patient suering from a chronic pain pathology. Second, I will show that closed-loop tasks are possible to perform by human amputees in virtual reality environments, which can reduce the cost of examining the functional benets of receiving sensory feedback from prosthetic devices. I will also provide examples that demonstrate the pros and cons of using virtual prosthetic hands in place of physical ones for closed-loop assessment tasks. Third, I will show how a human amputee controlled a sensorized prosthetic hand with improved functionality when USEA-mediated sensory feedback was delivered to his residual nervous system.