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Neural prostheses
Author(s) -
Prochazka Arthur,
Mushahwar Vivian K.,
McCreery Douglas B.
Publication year - 2001
Publication title -
the journal of physiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.802
H-Index - 240
eISSN - 1469-7793
pISSN - 0022-3751
DOI - 10.1111/j.1469-7793.2001.0099b.x
Subject(s) - spasticity , medicine , neural prosthesis , spinal cord injury , spinal cord , neuroprosthetics , microstimulation , rehabilitation , reflex , physical medicine and rehabilitation , neuroscience , stimulation , anesthesia , physical therapy , psychology , biomedical engineering , psychiatry
Assuming that neural regeneration after spinal cord injury (SCI) will eventually become a clinical reality, functional recovery will probably remain incomplete. Assistive devices will therefore continue to play an important role in rehabilitation. Neural prostheses (NPs) are assistive devices that restore functions lost as a result of neural damage. NPs electrically stimulate nerves and are either external or implanted devices. Surface stimulators for muscle exercise are now commonplace in rehabilitation clinics and many homes. Regarding implantable NPs, since 1963 over 40 000 have been implanted to restore hearing, bladder control and respiration. Epidural spinal cord stimulators and deep brain stimulators are routinely implanted to control pain, spasticity, tremor and rigidity. Implantable NPs have also been developed to restore limb movements using electrodes tunnelled under the skin to muscles and nerves. Spinal cord microstimulation (SCμstim) is under study as an alternative way of restoring movement and bladder control. Improvement in bladder and bowel function is a high priority for many SCI people. Sacral root stimulation to elicit bladder contraction is the current NP approach, but this usually requires dorsal rhizotomies to reduce reflex contractions of the external urethral sphincter. It is possible that the spinal centres coordinating the bladder‐sphincter synergy could be activated with SCμstim. Given the large and growing number of NPs in use or development, it is surprising how little is known about their long‐term interactions with the nervous system. Physiological research will play an important role in elucidating the mechanisms underlying these interactions.