Scientist and technologist have long sought to advance limb prostheses that connect directly to the peripheral nervous system, enabling a person with amputation to volitionally control synthetic actuators that move, stiffen and power the prosthesis, as well as to experience natural afferent sensations from the prosthesis. Recently, the agonist-antagonist myoneural interface (AMI) was developed, a mechanoneural transduction architecture and neural interface system designed to provide persons with amputation improved muscle-tendon proprioception and neuroprosthetic control. In this paper, we provide an overview of the AMI, including its conceptual framing and pre-clinical science, surgical techniques for its construction, and clinical efficacy related to pain mitigation, phantom limb range of motion, fascicle dynamics, central brain proprioceptive sensorimotor preservation, and prosthetic controllability. Following this broad overview, we end with a discussion of current limitations of the AMI and potential resolutions to such challenges.
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http://dx.doi.org/10.1097/bto.0000000000000552 | DOI Listing |
Neural Regen Res
December 2024
Department of Neural Engineering Center, Shenzhen Institutes of Advanced Technology (SIAT), Chinese Academy of Sciences (CAS), Shenzhen, Guangdong Province, China.
Neural machine interface technology is a pioneering approach that aims to address the complex challenges of neurological dysfunctions and disabilities resulting from conditions such as congenital disorders, traumatic injuries, and neurological diseases. Neural machine interface technology establishes direct connections with the brain or peripheral nervous system to restore impaired motor, sensory, and cognitive functions, significantly improving patients' quality of life. This review analyzes the chronological development and integration of various neural machine interface technologies, including regenerative peripheral nerve interfaces, targeted muscle and sensory reinnervation, agonist-antagonist myoneural interfaces, and brain-machine interfaces.
View Article and Find Full Text PDFBioengineering (Basel)
September 2024
Shenzhen Institute of Advanced Technology of the Chinese Academy of Sciences, Shenzhen 518055, China.
Sci Rep
June 2024
Biomechatronics Group, Massachusetts Institute of Technology, Media Lab, Cambridge, MA, 02139, USA.
JBJS Essent Surg Tech
August 2023
Department of Orthopaedic Surgery, Walter Reed National Military Medical Center, Bethesda, Maryland.
Background: The agonist-antagonist myoneural interface (AMI) technique at the time of transtibial amputation involves the use of agonist-antagonist muscle pairs to restore natural contraction-stretch relationships and to improve proprioceptive feedback when utilizing a prosthetic limb.
Description: Utilizing the standard incision for a long posterior myofasciocutaneous flap, the lateral and medial aspects of the limb are dissected, identifying and preserving the superficial peroneal and saphenous nerve, respectively. The tendons of the tibialis anterior and peroneus longus are transected distally to allow adequate length for the AMI constructs.
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