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Becerra-Fajardo L, Minguillon J, Krob MO, Rodrigues C, González-Sánchez M, Megía-García Á, Galán CR, Henares FG, Comerma A, Del-Ama AJ, Gil-Agudo A, Grandas F, Schneider-Ickert A, Barroso FO, Ivorra A. First-in-human demonstration of floating EMG sensors and stimulators wirelessly powered and operated by volume conduction. J Neuroeng Rehabil 2024; 21:4. [PMID: 38172975 PMCID: PMC10765656 DOI: 10.1186/s12984-023-01295-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Accepted: 12/12/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND Recently we reported the design and evaluation of floating semi-implantable devices that receive power from and bidirectionally communicate with an external system using coupling by volume conduction. The approach, of which the semi-implantable devices are proof-of-concept prototypes, may overcome some limitations presented by existing neuroprostheses, especially those related to implant size and deployment, as the implants avoid bulky components and can be developed as threadlike devices. Here, it is reported the first-in-human acute demonstration of these devices for electromyography (EMG) sensing and electrical stimulation. METHODS A proof-of-concept device, consisting of implantable thin-film electrodes and a nonimplantable miniature electronic circuit connected to them, was deployed in the upper or lower limb of six healthy participants. Two external electrodes were strapped around the limb and were connected to the external system which delivered high frequency current bursts. Within these bursts, 13 commands were modulated to communicate with the implant. RESULTS Four devices were deployed in the biceps brachii and the gastrocnemius medialis muscles, and the external system was able to power and communicate with them. Limitations regarding insertion and communication speed are reported. Sensing and stimulation parameters were configured from the external system. In one participant, electrical stimulation and EMG acquisition assays were performed, demonstrating the feasibility of the approach to power and communicate with the floating device. CONCLUSIONS This is the first-in-human demonstration of EMG sensors and electrical stimulators powered and operated by volume conduction. These proof-of-concept devices can be miniaturized using current microelectronic technologies, enabling fully implantable networked neuroprosthetics.
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Affiliation(s)
- Laura Becerra-Fajardo
- Department of Information and Communications Technologies, Universitat Pompeu Fabra, Barcelona, 08018, Spain
| | - Jesus Minguillon
- Department of Information and Communications Technologies, Universitat Pompeu Fabra, Barcelona, 08018, Spain
- Research Centre for Information and Communications Technologies, University of Granada, Granada, 18014, Spain
- Department of Signal Theory, Telematics and Communications, University of Granada, Granada, 18014, Spain
| | - Marc Oliver Krob
- Fraunhofer Institute for Biomedical Engineering IBMT, 66280, Sulzbach, Germany
| | - Camila Rodrigues
- Neural Rehabilitation Group, Cajal Institute, Spanish National Research Council (CSIC), Madrid, 28002, Spain
- Systems Engineering and Automation Department, Carlos III University of Madrid, Madrid, 28903, Spain
| | - Miguel González-Sánchez
- Movement Disorders Unit, Department of Neurology, Hospital General Universitario Gregorio Marañón, Madrid, 28007, Spain
| | - Álvaro Megía-García
- Biomechanics and Assistive Technology Unit, National Hospital for Paraplegics. Unit of Neurorehabilitation, Biomechanics and Sensory-Motor Function (HNP-SESCAM), Unit associated to the CSIC, Toledo, Spain
| | - Carolina Redondo Galán
- Biomechanics and Assistive Technology Unit, National Hospital for Paraplegics. Unit of Neurorehabilitation, Biomechanics and Sensory-Motor Function (HNP-SESCAM), Unit associated to the CSIC, Toledo, Spain
| | - Francisco Gutiérrez Henares
- Biomechanics and Assistive Technology Unit, National Hospital for Paraplegics. Unit of Neurorehabilitation, Biomechanics and Sensory-Motor Function (HNP-SESCAM), Unit associated to the CSIC, Toledo, Spain
| | - Albert Comerma
- Department of Information and Communications Technologies, Universitat Pompeu Fabra, Barcelona, 08018, Spain
| | - Antonio J Del-Ama
- School of Science and Technology, Department of Applied Mathematics, Materials Science and Engineering and Electronic Technology, Rey Juan Carlos University, Móstoles, 28933, Spain
| | - Angel Gil-Agudo
- Biomechanics and Assistive Technology Unit, National Hospital for Paraplegics. Unit of Neurorehabilitation, Biomechanics and Sensory-Motor Function (HNP-SESCAM), Unit associated to the CSIC, Toledo, Spain
- CSIC's Associated RDI Unit 'Unidad De Neurorehabilitación, Biomecánica Y Función Sensitivo-Motora', Madrid, Spain
| | - Francisco Grandas
- Movement Disorders Unit, Department of Neurology, Hospital General Universitario Gregorio Marañón, Madrid, 28007, Spain
| | | | - Filipe Oliveira Barroso
- Neural Rehabilitation Group, Cajal Institute, Spanish National Research Council (CSIC), Madrid, 28002, Spain
- CSIC's Associated RDI Unit 'Unidad De Neurorehabilitación, Biomecánica Y Función Sensitivo-Motora', Madrid, Spain
| | - Antoni Ivorra
- Department of Information and Communications Technologies, Universitat Pompeu Fabra, Barcelona, 08018, Spain.
- Serra Húnter Fellow Programme, Universitat Pompeu Fabra, Barcelona, 08018, Spain.
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Boyer M, Bouyer L, Roy JS, Campeau-Lecours A. Reducing Noise, Artifacts and Interference in Single-Channel EMG Signals: A Review. Sensors (Basel) 2023; 23:2927. [PMID: 36991639 PMCID: PMC10059683 DOI: 10.3390/s23062927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 02/22/2023] [Accepted: 03/01/2023] [Indexed: 06/19/2023]
Abstract
Electromyography (EMG) is gaining importance in many research and clinical applications, including muscle fatigue detection, control of robotic mechanisms and prostheses, clinical diagnosis of neuromuscular diseases and quantification of force. However, EMG signals can be contaminated by various types of noise, interference and artifacts, leading to potential data misinterpretation. Even assuming best practices, the acquired signal may still contain contaminants. The aim of this paper is to review methods employed to reduce the contamination of single channel EMG signals. Specifically, we focus on methods which enable a full reconstruction of the EMG signal without loss of information. This includes subtraction methods used in the time domain, denoising methods performed after the signal decomposition and hybrid approaches that combine multiple methods. Finally, this paper provides a discussion on the suitability of the individual methods based on the type of contaminant(s) present in the signal and the specific requirements of the application.
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Affiliation(s)
- Marianne Boyer
- Department of Mechanical Engineering, Université Laval, Québec, QC G1V 0A6, Canada
- Centre for Interdisciplinary Research in Rehabilitation and Social Integration, CIUSSS de la Capitale-Nationale, Québec, QC G1M 2S8, Canada
| | - Laurent Bouyer
- Centre for Interdisciplinary Research in Rehabilitation and Social Integration, CIUSSS de la Capitale-Nationale, Québec, QC G1M 2S8, Canada
- Department of Rehabilitation, Université Laval, Québec, QC G1 V0A, Canada
| | - Jean-Sébastien Roy
- Centre for Interdisciplinary Research in Rehabilitation and Social Integration, CIUSSS de la Capitale-Nationale, Québec, QC G1M 2S8, Canada
- Department of Rehabilitation, Université Laval, Québec, QC G1 V0A, Canada
| | - Alexandre Campeau-Lecours
- Department of Mechanical Engineering, Université Laval, Québec, QC G1V 0A6, Canada
- Centre for Interdisciplinary Research in Rehabilitation and Social Integration, CIUSSS de la Capitale-Nationale, Québec, QC G1M 2S8, Canada
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Siu R, Brown EH, Mesbah S, Gonnelli F, Pisolkar T, Edgerton VR, Ovechkin AV, Gerasimenko YP. Novel Noninvasive Spinal Neuromodulation Strategy Facilitates Recovery of Stepping after Motor Complete Paraplegia. J Clin Med 2022; 11:3670. [PMID: 35806954 PMCID: PMC9267673 DOI: 10.3390/jcm11133670] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 06/03/2022] [Accepted: 06/16/2022] [Indexed: 02/04/2023] Open
Abstract
It has been suggested that neuroplasticity-promoting neuromodulation can restore sensory-motor pathways after spinal cord injury (SCI), reactivating the dormant locomotor neuronal circuitry. We introduce a neuro-rehabilitative approach that leverages locomotor training with multi-segmental spinal cord transcutaneous electrical stimulation (scTS). We hypothesized that scTS neuromodulates spinal networks, complementing the neuroplastic effects of locomotor training, result in a functional progression toward recovery of locomotion. We conducted a case-study to test this approach on a 27-year-old male classified as AIS A with chronic SCI. The training regimen included task-driven non-weight-bearing training (1 month) followed by weight-bearing training (2 months). Training was paired with multi-level continuous and phase-dependent scTS targeting function-specific motor pools. Results suggest a convergence of cross-lesional networks, improving kinematics during voluntary non-weight-bearing locomotor-like stepping. After weight-bearing training, coordination during stepping improved, suggesting an important role of afferent feedback in further improvement of voluntary control and reorganization of the sensory-motor brain-spinal connectome.
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Taylor C, McHugh C, Mockler D, Minogue C, Reilly RB, Fleming N. Transcutaneous spinal cord stimulation and motor responses in individuals with spinal cord injury: A methodological review. PLoS One 2021; 16:e0260166. [PMID: 34793572 PMCID: PMC8601579 DOI: 10.1371/journal.pone.0260166] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Accepted: 11/03/2021] [Indexed: 11/18/2022] Open
Abstract
Background Transcutaneous spinal cord stimulation (tSCS) is a non-invasive modality in which electrodes can stimulate spinal circuitries and facilitate a motor response. This review aimed to evaluate the methodology of studies using tSCS to generate motor activity in persons with spinal cord injury (SCI) and to appraise the quality of included trials. Methods A systematic search for studies published until May 2021 was made of the following databases: EMBASE, Medline (Ovid) and Web of Science. Two reviewers independently screened the studies, extracted the data, and evaluated the quality of included trials. The electrical characteristics of stimulation were summarised to allow for comparison across studies. In addition, the surface electromyography (EMG) recording methods were evaluated. Results A total of 3753 articles were initially screened, of which 25 met the criteria for inclusion. Studies were divided into those using tSCS for neurophysiological investigations of reflex responses (n = 9) and therapeutic investigations of motor recovery (n = 16). The overall quality of evidence was deemed to be poor-to-fair (10.5 ± 4.9) based on the Downs and Black Quality Checklist criteria. The electrical characteristics were collated to establish the dosage range across stimulation trials. The methods employed by included studies relating to stimulation parameters and outcome measurement varied extensively, although some trends are beginning to appear in relation to electrode configuration and EMG outcomes. Conclusion This review outlines the parameters currently employed for tSCS of the cervicothoracic and thoracolumbar regions to produce motor responses. However, to establish standardised procedures for neurophysiological assessments and therapeutic investigations of tSCS, further high-quality investigations are required, ideally utilizing consistent electrophysiological recording methods, and reporting common characteristics of the electrical stimulation administered.
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Affiliation(s)
- Clare Taylor
- Department of Anatomy, School of Medicine, Trinity College, The University of Dublin, Dublin, Ireland
- * E-mail:
| | - Conor McHugh
- Department of Anatomy, School of Medicine, Trinity College, The University of Dublin, Dublin, Ireland
| | - David Mockler
- John Stearne Medical Library, Trinity Centre for Health Sciences, School of Medicine, St. James’s Hospital, Dublin, Ireland
| | - Conor Minogue
- Department of Anatomy, School of Medicine, Trinity College, The University of Dublin, Dublin, Ireland
| | - Richard B. Reilly
- Trinity Centre for Biomedical Engineering, Trinity College, The University of Dublin, Dublin, Ireland
- School of Engineering, Trinity College, The University of Dublin, Dublin, Ireland
- School of Medicine, Trinity College, The University of Dublin, Dublin, Ireland
| | - Neil Fleming
- Department of Anatomy, School of Medicine, Trinity College, The University of Dublin, Dublin, Ireland
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