Abstract
PURPOSE OF REVIEW: When an individual loses a limb, he/she loses touch with the world and with the people around him/her. Somatosensation is critical to the feeling of connection and control of one's own body. Decades of attempts to replace lost somatosensation by sensory substitutions have been ineffective outside of the laboratory. This review discusses important recent results demonstrating chronic somatosensory restoration through direct peripheral nerve stimulation. RECENT FINDINGS: Stimulation of peripheral nerves results in somatosensory perception on the phantom limb. Sensations are localized to several independent and functionally relevant locations, such as the fingertips, thenar eminence, ulnar border and dorsal surface. Patterns in stimulation intensity change the perception experience by the user, opening new dimensions on neuromodulation. SUMMARY: Neural interfaces with sophisticated stimulation paradigms create a user's perception of his/her hand to touch and manipulate objects. The pattern of intensity and frequency of stimulation is critical to the quality and intensity of perceived sensation. Restoring feeling has allowed the individuals to, 'feel [my] hand for the first time since the accident,' and 'feel [my] wife touch my hand'. Individuals using a prosthetic hand with sensation can pull cherries and grapes from the stem, open water bottles and move objects without destroying these objects - all while audio and visually deprived. After regaining sensation, phantom pain is eliminated in individuals that had frequent, sometimes debilitating, pain following limb loss. With over 5 subject-years of experience, this work is leading the evolution of a new era in prostheses. Somatosensory prosthetics as a standard procedure to augment and restore somatosensation are now within our reach.