To study the impact of brachial plexus MR neurography (MRN) in diagnostic thinking and therapeutic management patients with suspected plexopathy.MRN examinations adult plexuses over a period 18 months were reviewed. Relevant data collection included-patient demographics, clinical history, pre-imaging impression, treatment plan, post-imaging diagnosis, surgical notes electrodiagnostic (ED) results. Impact imaging on diagnosis classified as no change, mild change or substantial change.Final...

Objective. Electrical stimulation is a blunt tool for evoking neural activity. Neurons are naturally activated asynchronously and non-uniformly, whereas drives simultaneous activity within population of cells. These differences in activation pattern can result unintended side effects, including muddled sensory percepts undesirable muscle contractions. effects be mitigated by the placement electrodes close approximation to nerve fibers careful selection interface's location. This work...

Abstract Objective . While prosthetic hands with independently actuated digits have become commercially available, state-of-the-art human-machine interfaces (HMI) only permit control over a limited set of grasp patterns, which does not enable amputees to experience sufficient improvement in their daily activities make an active prosthesis useful. Approach Here we present technology platform combining fully-integrated bioelectronics, implantable intrafascicular microelectrodes and deep...

Objective: Deep learning-based neural decoders have emerged as the prominent approach to enable dexterous and intuitive control of neuroprosthetic hands. Yet few studies materialized use deep learning in clinical settings due its high computational requirements. Methods: Recent advancements edge computing devices bring potential alleviate this problem. Here we present implementation a hand with embedded control. The decoder is designed based on recurrent network (RNN) architecture deployed...

<italic xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">Objective:</i> The next generation prosthetic hand that moves and feels like a real requires robust neural interconnection between the human minds machines. xmlns:xlink="http://www.w3.org/1999/xlink">Methods:</i> Here we present neuroprosthetic system to demonstrate principle by employing an artificial intelligence (AI) agent translate amputee's movement intent through peripheral nerve...

Background: The scratch collapse test is a recently described provocative for diagnosis of peripheral nerve compression. Methods: was studied prospectively in 24 consecutive patients with common peroneal compression neuropathy. confirmed by history, physical examination, and electrodiagnostic testing. Provocative testing the Tinel's sign performed. Results: showed sensitivity 0.77 specificity 0.99, while 0.65 respectively. Conclusion: sensitive specific that compares favorably to existing...

Background: Long-gap peripheral nerve defects arising from tumor, trauma, or birth-related injuries requiring reconstruction are currently treated using autografts and allografts. Autografts associated with limited supply donor-site morbidity. Allografts require administration of transient immunosuppressants, which has substantial risks. To overcome these limitations, we investigated the use detergent-free decellularized grafts to reconstruct long-gap in a rodent model compared it existing...

Background: Migraine headaches have not historically been considered a compression neuropathy. Recent studies suggest that some migraines are successfully treated by targeted peripheral nerve decompression. Other neuropathies previously associated with one another. The goal of this study is to evaluate whether an association exists between and carpal tunnel syndrome (CTS), the most common Methods: Data from 25,880 respondents cross-sectional 2010 National Health Interview Survey were used...

Previous literature shows that deep learning is an effective tool to decode the motor intent from neural signals obtained different parts of nervous system. However, networks are often computationally complex and not feasible work in real-time. Here we investigate approaches' advantages disadvantages enhance learning-based decoding paradigm's efficiency inform its future implementation Our data recorded amputee's residual peripheral nerves. While primary analysis offline, nerve cut using a...

The rat model has had limited utility for the study of long nerve gaps because small size animal. authors sought to develop a simple, effective reconstruction gap defects.Fifteen rats sciatic transection followed by reconstruction. Positive control received 1-cm isograft. Negative 3.5-cm hollow silicone conduit, and experimental 4-cm isograft; these were implanted in looped configuration accommodate length. Nerves harvested at 6 weeks (1-cm grafts) 12 (3.5-cm conduits histologic...

Neural interfaces are designed to decode motor intent and evoke sensory precepts in amputees. In peripheral nerves, recording movement is challenging because axons only a small fraction compared fibers heterogeneously mixed particularly at proximal levels. We previously reported that pain myelinated regenerating through Y-shaped nerve guide with sealed ends, can be modulated by luminar release of growth factor (NGF) neurotrophin-3 (NT-3), respectively. Here, we evaluate the differential...

Regenerative peripheral nerve interfaces have been proposed as viable alternatives for the natural control and feel of robotic prosthetic limbs. We developed a Multi-electrode Interface (REMI) that guides re-growing axons through an electrode array deployed in lumen guide. While acute studies shown use REMI rat sciatic nerve, quality chronic signal recording has not reported. Here we show implantation this interface is stable with high recordings up to 120 days failures mainly attributable...

Complex suture prostheses that deliver sensory and position feedback require a more sophisticated integration with the human user. Here micro-size active implantable system provides many-degree-of-freedom neural in both stimulation motor control is shown, as one potential human-use solution DARPA's HAPTIX program. Various electrical mechanical challenge solutions meeting /motor performance well ISO 14708 FDA-acceptable use an aspirin-size implementation are discussed.

A high-resolution neurostimulator is the essential component of many bidirectional neural interfaces. In practice, effective resolution fully integrated designs often hindered by transistor mismatch, especially in submicrometer CMOS processes. this article, we present a new circuit technique called redundant crossfire (RXF) to address challenge. It derived from our sensing (RS) framework, which aims at engineering information redundancy into system architecture enhance its resolution. RXF...

Division of the superior transverse scapular ligament for decompression suprascapular nerve entrapment can be curative. However, difficult to locate, and large incisions are often required. This study was designed determine topographic coordinates permit reproducible surgical localization reduce incision size. In 20 cadavers, identified through a approach. Measurements were obtained from external landmarks. The located 1.3 +/- 0.3 cm (+/- SD) posterior border clavicle 2.9 0.8...

Abstract To minimize confusion in description of the clinical examination patient with migraine/headaches and implement peripheral nerve concepts into surgical approach to treating migraines, historical origin phrase “trigger point” is explored. The symptoms migraine/headache are due stimulation cranial/peripheral being interpreted as meningeal innervation. Use “extraction trigger points” discouraged favor either neurolysis a compressed or resection neuroma, depending upon pathology.

Background: Acute osteomyelitis of the hand is common in pediatric population. Treatment with intravenous antibiotics expensive and associated catheter-site infection thrombosis. The purpose this study to investigate efficacy managing children oral antibiotics. Methods: A retrospective review cases acute at a single institution over 4.5-year period was performed. Demographic clinical data were reviewed, treatment courses outcomes analyzed. Results: In total, 21 patients included study. Of...

During contact, phasic and tonic responses provide feedback that is used for task performance perceptual processes. These disparate temporal dynamics are carried in peripheral nerves, produce overlapping signals cortex. Using longitudinal intrafascicular electrodes inserted into the median nerve of a nonhuman primate, we delivered composite stimulation consisting onset release bursts to capture rapidly adapting sustained stochastic ongoing response slowly receptors. To measure stimulation’s...

Sporadic inclusion body myositis (sIBM) is a rare and slowly progressive skeletal muscle disease that can cause hand dysfunction, which major source of disability. Tendon transfers have been reliably used to improve function in other neuromuscular settings. Given sIBM patients often present with flexion impairments mostly functioning extensors, we investigated the potential opportunity for tendon transfer surgery dysfunction patients.We conducted scoping review studies transfers, extracted...