Prosthetic arm controlled by brain successfully

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Last updated: Thursday 9 October 2014 at 12am PST
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A prosthetic arm connected directly to the bone, nerves and muscles has been found to be a success.
This is the first time that a robotic prosthesis has been connected in such a manner, and this discovery
will open up exciting opportunities for patients in the future.

The patient can control his prosthetic arm with less effort and more precision due to the direct connection between the

implant and the patient's nerves and muscles.

Image credit: Ortiz-Catalan et al., Sci. Trans. Med., 2014.

The arm, controlled with implanted neuromuscular interfaces, was given to an arm amputee patient in
January 2013, and an article about its long-term stability and effectiveness has now been published in the
journalScience Translational Medicine.
Leading author Max Ortiz-Catalan, a research scientist at Chalmers University of Technology in
Gothenburg, Sweden, says their work goes beyond the laboratory to allow the patient to face real-world
challenges.
The patient in question had his arm amputated 10 years ago. Prior to being given the new arm, his
prosthetic arm was controlled using electrodes placed over the skin.
This typical form of control system can be unreliable, limiting how useful prosthetics can be. As a result,
many patients reject them as a form of rehabilitation.

'A union between body and machine'

The new implant system uses a titanium implant connected directly into the bone of the arm, as part of a
process called osseointegration. This creates a long-term stable fusion between the patient and their
implant, which Dr. Ortiz-Catalan explains in detail:

"The artificial arm is directly attached to the skeleton, thus providing mechanical stability. Then the
human's biological control system, that is nerves and muscles, is also interfaced to the machine's
control system via neuromuscular electrodes. This creates an intimate union between the body and
the machine; between biology and mechatronics."
Connecting electrodes directly to the nerves and muscles means that patients can control their prosthesis
more easily and with greater precision, enabling them to handle smaller and more delicate items.
Due to the close proximity between the electrodes and the nerves controlling the device, activity
from other muscles is prevented from interfering with the device, allowing the patient to move the
arm into any position without having to worry about losing control of it.
The osseointegration technology was pioneered by Associate Prof. Rickard Brnemark and his
colleagues at Sahlgrenska University Hospital in Gothenburg, Sweden. Prof. Brnemark led the
implantation surgery and worked closely with Dr. Ortiz-Catalan and Prof. Bo Hkansson, of the Chalmers
University of Technology, for the rest of the project.

Could this be the 'missing link'?

The patient who received the new prosthetic system has been able to use it successfully when facing the
physical demands of his day-to-day life. The patient works as a truck driver and has had no problems with
routine activities such as clamping his trailer load or operating machinery.
He is equally able to perform actions requiring a little more delicacy, such as unpacking eggs or
tying up the laces on his children's skates - actions that other prosthetic devices may not have
been able to perform comfortably. The team now intends to treat further patients with this new
ground-breaking technology over the next few months.
The next step for this research is to achieve long-term sensation for the patient via the prosthesis. This
new form of implant is a bidirectional interface; not only can the prosthetic arm receive signals from the
brain, but also the brain can receive signals coming in the opposite direction.
"Reliable communication between the prosthesis and the body has been the missing link for the clinical
implementation of neural control and sensory feedback, and this is now in place," says Dr. Ortiz-Catalan,
adding:

"Intuitive sensory feedback and control are crucial for interacting with the environment, for example
to reliably hold an object despite disturbances or uncertainty. Today, no patient walks around with a
prosthesis that provides such information, but we are working towards changing that in the very
short term."
Dr. Ortiz-Catalan sees the technology as an important step toward a more natural control of artificial
limbs. "It is the missing link for allowing sophisticated neural interfaces to control sophisticated
prostheses," he says. "So far, this has only been possible in short experiments within controlled
environments."