瑞士苏黎世联邦理工学院Stanisa Raspopovic研究团队发现，腿部截肢者恢复神经感觉反馈，可改善其行走速度、代谢值和幻肢疼痛。 2019年9月出版的《自然—医学》发表了这项成果。

为了确定恢复感觉反馈是否解决截肢带来的生理心理问题，研究人员对两名经股动脉截肢者进行了研究，在剩余的胫神经中植入了4个神经内刺激电极。对使用配备有足部和膝部传感器组成的神经假体装置的参与者进行评估。这些传感器驱动神经刺激，引起膝盖运动和脚底接触地面的感觉。研究者发现，与无刺激试验相比，在拥有神经感觉反馈时，两名参与者的步行速度和自我报告的信心增加，而精神和身体疲劳减少。此外，拥有神经感觉反馈的参与者幻肢痛的感觉也减少。这些验证案例的结果为更大规模研究拥有神经反馈的假体的临床效用提供了理论基础。

据介绍，对于膝盖以上截肢者来说，传统的腿部假肢不能传达运动或与地面接触的感觉信息，从而降低了使用者的信心和步行速度，同时使得使用者身心俱疲。缺乏从剩余的肢体到大脑的生理反馈也会导致截肢者产生幻肢痛。

附：英文原文

Title: Sensory feedback restoration in leg amputees improves walking speed, metabolic cost and phantom pain

Author: Francesco Maria Petrini, Marko Bumbasirevic, Giacomo Valle, Vladimir Ilic, Pavle Mijovi, Paul vanara, Federica Barberi, Natalija Katic, Dario Bortolotti, David Andreu, Knut Lechler, Aleksandar Lesic, Sanja Mazic, Bogdan Mijovi, David Guiraud, Thomas Stieglitz, Asgeir Alexandersson, Silvestro Micera, Stanisa Raspopovic

Issue&Volume: Volume 25 Issue 9

Abstract: Conventional leg prostheses do not convey sensory information about motion or interaction with the ground to above-knee amputees, thereby reducing confidence and walking speed in the users that is associated with high mental and physical fatigue14. The lack of physiological feedback from the remaining extremity to the brain also contributes to the generation of phantom limb pain from the missing leg5,6. To determine whether neural sensory feedback restoration addresses these issues, we conducted a study with two transfemoral amputees, implanted with four intraneural stimulation electrodes7 in the remaining tibial nerve (ClinicalTrials.gov identifier NCT03350061). Participants were evaluated while using a neuroprosthetic device consisting of a prosthetic leg equipped with foot and knee sensors. These sensors drive neural stimulation, which elicits sensations of knee motion and the sole of the foot touching the ground. We found that walking speed and self-reported confidence increased while mental and physical fatigue decreased for both participants during neural sensory feedback compared to the no stimulation trials. Furthermore, participants exhibited reduced phantom limb pain with neural sensory feedback. The results from these proof-of-concept cases provide the rationale for larger population studies investigating the clinical utility of neuroprostheses that restore sensory feedback. A new prosthetic leg that can transmit sensory signals via implanted electrodes is shown to restore meaningful sensory feedback that improves walking performance and lowers phantom limb pain during use in two human lower-limb amputees.

DOI: 10.1038/s41591-019-0567-3

Source: https://www.nature.com/articles/s41591-019-0567-3