Chronic nerve health following implantation of femoral nerve cuff electrodes

Autor: Rahila Ansari, Gilles Pinault, Dustin J. Tyler, Max J. Freeberg, Ronald J. Triolo
Rok vydání: 2020
Předmět:
Adult
Male
030506 rehabilitation
Neural Prostheses
Neuroprosthetics
Action Potentials
Electric Stimulation Therapy
Health Informatics
Spinal cord injury
Electromyography
lcsh:RC321-571
03 medical and health sciences
Postoperative Complications
0302 clinical medicine
Femoral nerve
Chronic nerve health
peripheral nerve cuff electrodes
Humans
Paralysis
Medicine
Knee
Muscle Strength
lcsh:Neurosciences. Biological psychiatry. Neuropsychiatry
Spinal Cord Injuries
Paraplegia
medicine.diagnostic_test
business.industry
Research
Electrodiagnosis
Electrodiagnostics and neuromuscular diseases
Rehabilitation
medicine.disease
Biomechanical Phenomena
Electrodes
Implanted
Motor unit
Saphenous nerve
Electrical stimulation
Anesthesia
Cuff
Implant
0305 other medical science
business
Femoral Nerve
030217 neurology & neurosurgery
Zdroj: Journal of NeuroEngineering and Rehabilitation, Vol 17, Iss 1, Pp 1-17 (2020)
Journal of NeuroEngineering and Rehabilitation
ISSN: 1743-0003
Popis: Background Peripheral nerve stimulation with implanted nerve cuff electrodes can restore standing, stepping and other functions to individuals with spinal cord injury (SCI). We performed the first study to evaluate the clinical electrodiagnostic changes due to electrode implantation acutely, chronic presence on the nerve peri- and post-operatively, and long-term delivery of electrical stimulation. Methods A man with bilateral lower extremity paralysis secondary to cervical SCI sustained 5 years prior to enrollment received an implanted standing neuroprosthesis including composite flat interface nerve electrodes (C-FINEs) electrodes implanted around the proximal femoral nerves near the inguinal ligaments. Electromyography quantified neurophysiology preoperatively, intraoperatively, and through 1 year postoperatively. Stimulation charge thresholds, evoked knee extension moments, and weight distribution during standing quantified neuroprosthesis function over the same interval. Results Femoral compound motor unit action potentials increased 31% in amplitude and 34% in area while evoked knee extension moments increased significantly (p Conclusions This is the first human trial reporting acute and chronic neurophysiologic changes due to application of and stimulation through nerve cuff electrodes. Electrodiagnostics indicated preserved nerve health with strengthened responses following stimulated exercise. Temporary electrodiagnostic changes suggest minor nerve irritation only intra- and peri-operatively, not continuing chronically nor impacting function. These outcomes follow implantation of a neuroprosthesis enabling standing and demonstrate the ability to safely implant electrodes on the proximal femoral nerve close to the inguinal ligament. We demonstrate the electrodiagnostic findings that can be expected from implanting nerve cuff electrodes and their time-course for resolution, potentially applicable to prostheses modulating other peripheral nerves and functions. Trial registration ClinicalTrials.govNCT01923662, retrospectively registered August 15, 2013.
Databáze: OpenAIRE
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