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Licensed Unlicensed Requires Authentication Published by De Gruyter October 5, 2012

Development of a neurotechnological system for relieving phantom limb pain using transverse intrafascicular electrodes (TIME)

  • Thomas Stieglitz EMAIL logo , Tim Boretius , Xavier Navarro , Jordi Badia , David Guiraud , Jean-Louis Divoux , Silvestro Micera , Paolo Maria Rossini , Ken Yoshida , Kristian R. Harreby , Aritra Kundu and Winnie Jensen

Abstract

Phantom limb pain (PLP) is a chronic condition that develops in the majority of amputees. The underlying mechanisms are not completely understood, and thus, no treatment is fully effective. Based on recent studies, we hypothesize that electrical stimulation of afferent nerves might alleviate PLP by giving sensory input to the patient if nerve fibers can be activated selectively. The critical component in this scheme is the implantable electrode structure. We present a review of a novel electrode concept to distribute highly selective electrode contacts over the complete cross section of a peripheral nerve to create a distributed activation of small nerve fiber ensembles at the fascicular level, the transverse intrafascicular multichannel nerve electrode (TIME). The acute and chronic implantations in a small animal model exhibited a good surface and structural biocompatibility as well as excellent selectivity. Implantation studies on large animal models that are closer to human nerve size and anatomical complexity have also been conducted. They proved implant stability and the ability to selectively activate nerve fascicles in a limited proximity to the implant. These encouraging results have opened the way forward for human clinical trials in amputees to investigate the effect of selective electrical stimulation on PLP.


Corresponding author: Thomas Stieglitz, Laboratory for Biomedical Microtechnology, IMTEK-Department of Microsystems Engineering and Bernstein Center Freiburg, University of Freiburg, Georges-Koehler-Allee 102, D-79110 Freiburg, Germany, Phone: +49 761 203 7471, Fax: +49 761 203 7472

The authors acknowledge the valuable contributions of researchers working in the TIME project: B. Geng (AAU/IUPUI); M. Kurstjens (AAU); A. Pascual-Font and E. Udina (UAB); N. Bourquin, J. F. Charmeux, J. Barbaras, and G. Souquet (MXM); D. Andreu and G. Cathébras (LIRMM); J. Carpaneto, S. Raspopovic, M. Capogrosso, S. Bossi, P. N. Sergi, A. Ghionzoli, and A. Cutrone (SSSA); and E. Guglielmelli, A. Benvenuto, D. Accoto, G. Di Pino, and M. Tombini (UCBM). This work has been funded by the European Union under grant CP-FP-INFSO 224012/TIME (for further information: www.project-time.edu).

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Received: 2012-4-24
Accepted: 2012-9-3
Published Online: 2012-10-5
Published in Print: 2012-12-01

©2012 by Walter de Gruyter Berlin Boston

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