Sensory capacity of reinnervated skin after redirection of amputated upper limb nerves to the chest
Open accessAbstract
Targeted reinnervation is a new neural-machine interface that has been developed to help improve the function of new-generation prosthetic limbs. Targeted reinnervation is a surgical procedure that takes the nerves that once innervated a severed limb and redirects them to proximal muscle and skin sites. The sensory afferents of the redirected nerves reinnervate the skin overlying the transfer site. This creates a sensory expression of the missing limb in the amputee's reinnervated skin. When these individuals are touched on this reinnervated skin they feel as though they are being touched on their missing limb. Targeted reinnervation takes nerves that once served the hand, a skin region of high functional importance, and redirects them to less functionally relevant skin areas adjacent to the amputation site. In an effort to better understand the sensory capacity of the reinnervated target skin following this procedure, we examined grating orientation thresholds and point localization thresholds on two amputees who had undergone the targeted reinnervation surgery. Grating orientation thresholds and point localization thresholds were also measured on the contralateral normal skin of the targeted reinnervation amputees and on analogous sites in able-bodied controls. Grating orientation thresholds for the reinnervated skin of the targeted reinnervation amputees were found to be similar to normal ranges for both the amputees' contralateral skin and also for the control population. Point localization thresholds for these amputees were found to be lower for their reinnervated skin than for their contralateral skin. Reinnervated point localization thresholds values were also lower in comparison to homologous chest sites on the control population. Mechanisms appear to be in place to maximize re-established touch input in targeted reinnervation amputees. It seems that sound sensory function is provided to the denervated skin of the residual limb when connected to afferent pathways once serving highly functionally relevant regions of the brain. This suggests that tactile interface devices could be used to give a physiologically appropriate sense of touch to a prosthetic limb, which would likely help with better functional utilization of the prosthetic device and possibly help to more effectively integrate the device with the user's self-image.
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The sensitivity of the reinnervated skin is comparable to that of intact skin and the elicited sensations are natural.
“However, the sensitivity of the reinnervated skin is comparable to that of intact skin and the elicited sensations are natural (Marasco et al. 2009;Schultz et al., 2009).”
From Biomimetic approaches to bionic touch through a peripheral nerve interface (2015) · cites this paper as Marasco et al. 2009
The Discussion reports grating-orientation thresholds similar to those of intact contralateral skin, supporting comparable tactile sensitivity on the measures tested. The Methods say that touching the reinnervated skin felt as though the missing limb were being touched, but do not establish that the elicited sensations were natural in quality. (LLM, conf=0.81)
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- Authors
- Marasco, P. D., Schultz, A. E., & Kuiken, T. A.
- Affiliations
- Shirley Ryan AbilityLab (US)
- Northwestern University (US)
- Corresponding author
- Marasco, P. D.
- Venue
- Brain
- Publisher
- Oxford University Press (OUP)
- Published
- 2009-04-15
- Volume
- 132
- Issue
- 6
- Pages
- 1441-1448
- ISSN
- 0006-8950 (ISSN-L)
- 1460-2156
- PMC
- PMC2685921
- OpenAlex
- W2109190623
- Cited by
- 113
- References
- 65
- Citations by year
- 2025: 2 · 2024: 4 · 2023: 4 · 2022: 4 · 2021: 5 · 2020: 5 · 2019: 8 · 2018: 7 · 2017: 8 · 2016: 5 · 2015: 9 · 2014: 15 · 2013: 11 · 2012: 9
- FWCI
- 4.15
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- cc-by-nc
- Locations
- Brain (publishedVersion, cc-by-nc)
- Europe PMC (PubMed Central) (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- Funders
- Chicago Community Trust
- National Institutes of Health (5r01hd043137-05, R01-HD)
- Advanced Research Projects Agency
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (R01HD044798, R01-HD-4-3137, N01-HD-53402)
- Topics
- Life Sciences › Neuroscience › Cognitive Neuroscience › Tactile and Sensory Interactions
- Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › Neuroscience and Neural Engineering
- Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Treatment
- Keywords
- sensory reinnervation, upper limb amputation, tactile perception, point localization, residual limb, artificial limbs, neural-machine interface, sensory feedback
- MeSH terms
- Adult, Amputation, Surgical, Amputees, Artificial Limbs, Feasibility Studies, Female, Humans, Male, Middle Aged, Psychomotor Performance, Sensory Thresholds, Skin, Thorax, Touch, Upper Extremity, Young Adult
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