Muscle graft volume for regenerative peripheral nerve interfaces as optimized by electrical signal capacity for neuroprosthetic control.

Hu, Y. (Yaxi) (2015) Muscle graft volume for regenerative peripheral nerve interfaces as optimized by electrical signal capacity for neuroprosthetic control. thesis, Medicine.

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Abstract

Introduction: Upper limb loss affects over 540.000 individuals in the United States alone and has devastating functional and psychological consequences. Prosthetic limbs remain the standard therapy for amputees, however, the optimal interface between patient and prosthesis for high-fidelity control is still lacking. The Regenerative Peripheral Nerve Interface (RPNI) consists of a freely transferred muscle graft reinnervated by a residual nerve within the amputated limb. The muscle serves as a biological amplifier of signals which provide volitional control for neuroprostheses. Our purpose was to evaluate the effect on viability and signaling capacity of the RPNI when a muscle mass up to 8x greater than standard mass was implanted. Material and Methods: F344 rats were assigned to 1 of 5 groups (n=6 per group). 24 RPNIs were created using a semimembranosus allograft of approximately 150 mg (RPNI 150), 300 mg (RPNI 300), 600 mg (RPNI 600), or 1200 mg (RPNI 1200). Each RPNI graft was neurotized with the transected peroneal nerve. In the negative control group, the nerve was transected and no muscle graft was implanted. After 3 months recovery, RPNI compound muscle action potential (CMAP), force and histology were analyzed. Results: When dissected, all RPNIs appeared well vascularized with observable neurotization. RPNI 150 and RPNI 300 significantly retained greater tissue volume than the RPNI 600 and 1200 (p < .05). CMAP electrical signaling was significantly greater for the RPNI 150 than for RPNI 1200 (p = .02). Histology revealed small but healthy skeletal muscle fibers for RPNI 150 and 300 while the RPNI 600 and RPNI 1200 disclosed central areas lacking regenerating muscle fibers. No evidence of neuromas was found in RPNIs. Conclusions: Small RPNIs with implanted muscle mass of ~150-300 milligrams outperformed large RPNIs in terms of tissue viability, signaling capacity and force production in a rat model.

Item Type:	Thesis (Thesis)
Supervisor name:	Werker, Prof. Dr. P.M.N.
Supervisor name:	Cederna, P.S. MD and Urbanchek, M.G. PhD and University of Michigan Health System, Department of Surgery and Ann Arbor, Michigan
Faculty:	Medical Sciences
Date Deposited:	25 Jun 2020 10:58
Last Modified:	25 Jun 2020 10:58
URI:	https://umcg.studenttheses.ub.rug.nl/id/eprint/1852

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