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Multisensory bionic limb to achieve prosthesis embodiment and reduce distorted phantom limb perceptions
  1. Giulio Rognini1,2,3,
  2. Francesco Maria Petrini1,4,
  3. Stanisa Raspopovic5,
  4. Giacomo Valle1,4,6,
  5. Giuseppe Granata7,
  6. Ivo Strauss1,4,6,
  7. Marco Solcà1,2,
  8. Javier Bello-Ruiz1,2,
  9. Bruno Herbelin1,2,
  10. Robin Mange1,2,
  11. Edoardo D’Anna1,4,
  12. Riccardo Di Iorio7,
  13. Giovanni Di Pino8,9,
  14. David Andreu10,
  15. David Guiraud10,
  16. Thomas Stieglitz11,
  17. Paolo Maria Rossini7,12,
  18. Andrea Serino1,2,
  19. Silvestro Micera1,4,6,
  20. Olaf Blanke1,2,13
  1. 1 Center for Neuroprosthetics, Ecole Polytechnique Fédérale de Lausanne, Lausanne, Switzerland
  2. 2 Laboratory of Cognitive Neuroscience, Brain Mind Institute, Ecole Polytechnique Fédérale de Lausanne, Lausanne, Switzerland
  3. 3 Laboratory of Robotic Systems, School of Engineering, Ecole Polytechnique Fédérale de Lausanne, Laboratory of Robotic Systems, Switzerland
  4. 4 Translational Neural Engineering Laboratory, Institute of Bioengineering, School of Engineering, Ecole Polytechnique Fédérale de Lausanne, Lausanne, Switzerland
  5. 5 ETH Zürich, Department of Health Sciences and Technology, Institute for Robotics and Intelligent Systems, TAN E 2, Zürich, Switzerland
  6. 6 The BioRobotics Institute, Scuola Superiore Sant’Anna, Pisa, Italy
  7. 7 Area of Neurosciences, Policlinic A Gemelli foundation, Catholic University of the Sacred Heart, Rome, Italy
  8. 8 Neurophysiology and Neuroengineering of Human-Technology Interaction, Campus Bio-Medico University, Rome, Italy
  9. 9 Institute of Neurology, Campus Bio-Medico University, Rome, Italy
  10. 10 NRIA Camin Team, University of Montpellier – LIRMM 860 Rue Saint Priest, Montpellier, France
  11. 11 Laboratory for Biomedical Microtechnology, Department of Microsystems Engineering–IMTEK, University of Freiburg, Freiburg, Germany
  12. 12 IRCCS San Raffaele Pisana, Rome, Italy
  13. 13 Department of Neurology, University Hospital of Geneva, Geneva, Switzerland
  1. Correspondence to Professor Silvestro Micera, Center for Neuroprosthetics, Ecole Polytechnique Fédérale de Lausanne, Lausanne CH-1015, Switzerland; silvestro.micera{at}epfl.ch

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Introduction

A major goal of neuroprosthetics is to design artificial limbs that are experienced (‘embodied’) like real limbs. However, despite important technological advances, this goal has not been reached and prosthesis embodiment is still very limited. Differently from our physical body, current bionic limbs do not provide the continuous multisensory feedback required for a limb to be experienced as one’s own. Here, we present a novel neuroprosthetic approach that combines peripheral neurotactile stimulation—inducing tactile sensation on the missing limb—and immersive digital technology—providing visual illumination of the prosthetic hand. We tested whether coherent multisensory visuo-tactile neural stimulation (VTNS)1 induced higher prosthesis embodiment and reduced the distorted perception of the phantom limb (telescoping, ie, the phantom limb is perceived as shorter than the intact limb).

Methods

Patient 1 and patient 2 are transradial left forearm chronic amputees, who suffered upper limb telescoping. Patients were implanted with transverse intrafascicular multichannel electrodes (TIMEs), which induced the sensation of a vibration in a circumscribed skin region of the finger 2 via medial nerve stimulation in patient 1 (online supplementary figure 1A) and in a skin region of finger 5 via ulnar nerve stimulation in patient 2 (online supplementary figure 1B and material 1). Neurotactile stimulation2 was coupled with automatised visual illumination of a skin region on the patient’s prosthetic hand that corresponded to the somatotopic location of touch sensations experienced on the phantom hand (VTNS; online supplementary video 1, online supplementary figure 1, online supplementary material 1). VTNS was administered in two conditions, either with synchronous visual and neurotactile stimulation or in a control condition of asynchronous stimulation (1.5–2.5s delay).

Supplementary data

[jnnp-2018-318570-supp1.pdf]

Supplementary video

[jnnp-2018-318570-supp1.mp4]

Prosthesis embodiment was measured via a questionnaire, whereas changes in phantom limb perception were tested via a body landmark task where patients indicated the perceived position of different parts of the phantom limb …

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