Cited by 845Neuroscience and Neural EngineeringMuscle activation and electromyography studiesEEG and Brain-Computer Interfaces

The DOI matches its Crossref record; 269 of the 269 references it cites were found in a registry or an index; 19 of the 259 sources its claims cite were checked for support.

A critical review of interfaces with the peripheral nervous system for the control of neuroprostheses and hybrid bionic systems

Open access

Abstract

Considerable scientific and technological efforts have been devoted to develop neuroprostheses and hybrid bionic systems that link the human nervous system with electronic or robotic prostheses, with the main aim of restoring motor and sensory functions in disabled patients.

Overview

AI snapshot

Written from the paper’s full text.

TL;DR

This review surveys peripheral nervous system interfaces for neuroprostheses and hybrid bionic systems, comparing non-invasive, muscle, extraneural, intraneural, and regenerative electrodes. It concludes that no single interface is universally optimal; selection depends on required selectivity, invasiveness, clinical maturity, and application.

Key findings

  • Electrode invasiveness generally tracks selectivity: surface and muscle electrodes are safer and easier but act only on underlying or implanted muscles; cuff and epineurial electrodes interface many axons; intrafascicular, penetrating, and sieve/regenerative electrodes access smaller axon groups but carry greater risk of nerve damage and are mostly research-stage.
  • Clinical PNS neuroprostheses are dominated by stimulation: sacral anterior root stimulators for bladder control reached about 2,000 patients worldwide; phrenic pacing, vagus nerve stimulation (postoperative infection under 3%, device removal 1%), cochlear implants, and pain/continence devices are clinical, while recording interfaces for prosthesis control remain largely research.
  • Penetrating arrays: Utah MEAs with 25 or 100 needles, including slanted lengths from 0.5 to 1.5 mm, recorded single-unit mechanoreceptor responses in only 10–20% of electrodes and evoked graded muscle recruitment with 1–20 µA currents; responses were stable over 36 hours, and in cat sciatic nerve up to 7 months stimulation stabilized in 80% of electrodes but sensory recordings did not.
  • LIFEs implanted in eight amputees for two days allowed voluntary motor signals linked to intended missing-limb movements and elicited graded touch, joint-movement, and position sensations; regenerative sieve electrodes require hole diameters around 40–65 µm, and no human implants have been reported. EMG-based control works for prostheses and exoskeletons but is limited in degrees of freedom, while ENG can provide event and kinematic feedback.

Methods

  • Design: critical narrative review, not a primary experimental study; it covers PNS organization, electrode types, materials and fabrication, and control strategies.
  • Data or sample: synthesizes prior animal and human studies and clinical experience; no systematic search, inclusion criteria, or primary dataset is described.
  • Main analysis: qualitative comparison using tables of advantages/disadvantages and application/status, with discussion of engineering, biological, and clinical tradeoffs.

Limitations

  • Stated: no universal best electrode exists; nerve electrodes may damage nerves; cuff, intraneural, and regenerative designs need more study; regenerative electrodes have no human implants; bioelectronic interfaces are early experimental.
  • Stated: long-term stability, selectivity, and biocompatibility remain unresolved, and many recording approaches are not clinically mature.
  • Evident: as a narrative review from 2005, it lacks a systematic search or meta-analysis and predates later technological and clinical developments.

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.1111/j.1085-9489.2005.10303.x

Cites

269 of 269 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Verification

Claims the paper makes

19 of 259 cited sources checked · 8 supported · 0 flagged · accuracy not yet measured

Show all 113 claims

  • It may state two separate claims as one. 94
  • Probably not a substantial claim. 46
  • The quote only partly states this claim. 1
127 of 127
  • The paper relies on this without support.

    Nerve fibers are recruited by electrical stimulation according to their thickness, so large motor fibers are activated earlier than thinner fibers.

    “nerve fibers are recruited by electrical stimulation according to their thickness, therefore large motor fibers innervating the fast-fatigue and strong motor units are activated earlier than the physiologically first-recruited thinner fibers controlling slow fatigue-resistant motor units”
  • The paper relies on this without support.

    Recruitment of motor units follows an order of size, with slow fatigue-resistant motor units activated first and large fast-fatigue motor units activated only at high levels of tension.

    “Recruitment of motor units follows an order of size, with slow fatigue-resistant motor units activated first and large fast-fatigue motor units activated only at high levels of tension.”
  • The paper relies on this without support.

    Signals are transmitted by axons in series of impulses or action potentials, with intensity mainly coded in impulse frequency along the peripheral axon.

    “Signals are transmitted by the corresponding axons in series of impulses or action potentials, with intensity of the signal mainly coded in impulse frequency along the peripheral axon.”
  • The paper relies on this without support.

    The fascicular architecture changes throughout the length of the nerve, with an increasing number of fascicles of smaller size in distal compared with proximal segments.

    “The fascicular architecture changes throughout the length of the nerve, with an increasing number of fascicles of smaller size in distal with respect to proximal segments.”
  • The paper relies on this without support.

    The perineurium is the main contributor to the tensile strength of the nerve, acts as a diffusion barrier, and maintains the endoneurial fluid pressure.

    “The perineurium is the main contributor to the tensile strength of the nerve, acts as a diffusion barrier, and maintains the endoneurial fluid pressure.”
  • The paper relies on this without support.

    Using multiple wire needles to interface a high number of nerve fibers has practical problems for long-term use.

    “However, the use of multiple wire needles for interfacing a high number of nerve fibers has practical problems for long-term use.”
  • The paper relies on this without support.

    No human implants of regenerative electrodes have been reported.

    “No human implants of regenerative electrodes have been reported.”
  • The paper relies on this without support.

    Cuff electrodes are the type of peripheral nervous system interface electrode most investigated in basic and applied research.

    “Cuff electrodes are the type of PNS interface electrode most investigated in basic and applied research.”
  • The paper relies on this without support.

    The neuromuscular system has non-linear and time-variant characteristics.

    “the non-linear and time-variant characteristics of the neuromuscular system”
  • The paper relies on this without support.

    A traumatic lesion of a peripheral nerve leads to Wallerian degeneration of the distal nerve.

    “A traumatic lesion of a peripheral nerve leads to Wallerian degeneration of the distal nerve”
  • The paper relies on this without support.

    Healing of a peripheral nerve lesion occurs only under favorable conditions involving sprouting of axons from the proximal stump, outgrowth along the distal stump, and reinnervation of target tissues.

    “healing of such a lesion occurs only under favorable conditions involving sprouting of axons from the proximal nerve stump, outgrowth along the distal nerve stump, and reinnervation of target tissues”
  • The paper relies on this without support.

    Recovery from a peripheral nerve lesion is usually delayed and limited if the lesion site is very proximal.

    “Recovery is usually delayed and limited if the lesion site is very proximal.”
  • The paper relies on this without support.

    Muscle atrophy prevents formation of new neuromuscular junctions at a later time when regenerating nerve fibers may reach the muscle.

    “muscle atrophy prevents the formation of new neuromuscular junctions at a later time point when regenerating nerve fibers may reach the muscle”
  • The paper relies on this without support.

    Regenerated nerve fibers have smaller than normal diameter and internodal length.

    “the smaller than normal diameter and internodal length of regenerated fibers”
14 of 14

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

Citations

Cites

Items 201–269 of 269

Flagged first, then by citations

Research works printed but not linked: 18

  1. Brindley GS, 1995, Neuroprostheses., 15
  2. Bronzino JD, 1995, Biomedical Engineering Handbook.
  3. CoganSF LiuY‐P McCaffreyM TwardochUM(1993). Thin film hermetic coatings. Quarterly Progress Report NIH‐NINDS Neural Prosthesis Program No. 5 N44‐NS‐2‐2311.
  4. De Luca CJ, 2002, Surface Electromyography: Detection and Recording.
  5. EdellDJ DevaneyL DurfeeWK GleasonEF GleasonKK HerndonTO ThompsonCV WrightonMS(1993). Bioresistant integrated circuits. Quarterly Progress Report NIH‐NINDS Neural Prosthesis Program No. 9 NO1‐NS‐0‐2399.
  6. Hoffer JA, 2001, Neural Prostheses for Restoration of Sensory and Motor Function., 139
  7. Llinás R, 1973, Brain Unit Activity During Behaviour., 105
  8. Naples GG, 1990, Neural Prostheses: Fundamental Studies, Biophysics and Bioengineering Series., 107
  9. Nishikawa D, 1999, IEEE IROS'99, Kyongju, 1592
  10. PineJ TaiY‐C BuzsakiG BraginA CarpiD(1994). The cultured neuron probe. Quarterly Progress Report NIH‐NINDS Neural Prosthesis Program No. 4 NO1‐NS‐3‐2393.
  11. Popovic DB, 1992, Neural Prostheses Replacing Motor Function After Disease or Disability., 233
  12. Roblee LS, 1990, Neural Prostheses: Fundamental Studies, Biophysics and Bioengineering Series., 26
  13. Santa‐Cruz MC, 2000, IFESS 2000, 436
  14. SinghJ PeckRA LoebGE(2001). Development of BIONs technology for functional electrical stimulation: hermetic packaging. Proceedings of the 23th Annual International Conference of IEEE Eng Med and Bio Soc.
  15. Stein RB, 1992, Neural Prostheses. Replacing Motor Function After Diseases or Disability
  16. StieglitzT HabererW KammerS SchanzeT(2003). A simple model to investigate the stability of flexible micromachined retina stimulators. Proceedings of the 8th Annual International Conference of the International Functional Electrical Stimulation Society pp69–73.
  17. Tatic‐LucicS TaiY‐C WrightJA PineJ DenisonT(1993). Silicon‐micromachined neurochips for in vitro studies of cultured neural networks. Proceedings of the International Conference on Solid State Sensors and Actuators pp943–946.
  18. Tyler DJ, 1994, Interfascicular electrical stimulation for selectively activating axons, IEEE–EMBS Mag, 13, 575

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Metadata

Authors
Navarro, X., Krueger, T. B., Lago, N., Micera, S., Stieglitz, T., & Dario, P.
Affiliations
  • Universitat Autònoma de Barcelona (ES)
  • University of Freiburg (DE)
  • Scuola Superiore Sant'Anna (IT)
Corresponding author
Navarro, Xavier
Venue
Journal of the Peripheral Nervous System
Publisher
Wiley
Published
2005-09
Volume
10
Issue
3
Pages
229-258
ISSN
  • 1085-9489 (ISSN-L)
  • 1529-8027
OpenAlex
W2108068079
Cited by
845
References
259
Citations by year
2026: 18 · 2025: 27 · 2024: 36 · 2023: 32 · 2022: 39 · 2021: 53 · 2020: 49 · 2019: 58 · 2018: 53 · 2017: 49 · 2016: 60 · 2015: 57 · 2014: 58 · 2013: 45 · 2012: 28
FWCI
2.19
Type
journal article
Language
en
Open access
Locations
  • Journal of the Peripheral Nervous System (publishedVersion)
  • PubMed (publishedVersion)
  • Publikationsdatenbank der Fraunhofer-Gesellschaft (Fraunhofer-Gesellschaft) (submittedVersion)
  • Fraunhofer-Publica (Fraunhofer-Gesellschaft) (submittedVersion)
  • CINECA IRIS Institutional Research Information System (Sant'Anna School of Advanced Studies) (submittedVersion)
Funders
European Commission (IST-001917)
Topics
  • Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › Neuroscience and Neural Engineering
  • Physical Sciences › Engineering › Biomedical Engineering › Muscle activation and electromyography studies
  • Life Sciences › Neuroscience › Cognitive Neuroscience › EEG and Brain-Computer Interfaces
Keywords
neural prostheses, peripheral nerve interfaces, peripheral nerve stimulation, neuromuscular stimulation, electromyography, surface electrodes, cuff electrodes, intrafascicular electrodes, electrode design, tissue damage, robotic prostheses
MeSH terms
Animals, Bionics, Electrodes, Electromyography, Humans, User-Computer Interface, Peripheral Nervous System, Prostheses and Implants

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