Abstract
Our expanding expertise in peripheral nerve regeneration and soft tissue reconstruction is enabling the development of novel innervated tissue constructs that can be combined with artificial interfacing technologies to facilitate control and sensation of limb prostheses. By utilizing the body’s native afferent and efferent signalling pathways, these mechanoneural interfaces have demonstrated the capacity to enhance volitional prosthetic control, refer somatosensory sensation within proprioceptive and cutaneous modalities, and reduce post-amputation pain. This Review discusses the biophysical principles underpinning recent advancements in targeted reinnervation techniques, regenerative peripheral nerve interfaces and agonist–antagonist neuromuscular architectures that can be combined with artificial technologies, including implanted electrodes, magnetic interfacing and osseointegrated structures, for improved integration with upper-extremity and lower-extremity prostheses. Expanding the capacity for bidirectional information transfer between the peripheral nervous system and external assistive devices will increase the potential of prosthetic embodiment and rehabilitation.
Key points
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A mechanoneural interface combines surgically modified soft tissue constructs, such as nerves and muscles, with artificial components to enhance peripheral neural signalling for the reconstruction of bionic limbs
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A more thorough understanding of end organ cross-innervation and regeneration dynamics may inform mechanoneural interface design
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Mechanoneural interfaces afford improved physiological efferent and afferent neural signalling that could sustain prosthetic embodiment
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Mechanoneural interface soft tissue constructs show reduced post-amputation pain and neuroma formation in clinical settings
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Next-generation mechanoneural interfaces suggest additional utility with respect to efferent prosthetic control and prosthetic somatosensation
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Acknowledgements
This work was funded by the K. Lisa Yang Center for Bionics at the Massachusetts Institute of Technology.
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T.S. and G.H. researched data, contributed to content discussion, wrote the manuscript and contributed equally. C.T. researched data, contributed to content discussion and wrote the manuscript. H.H. contributed to content discussion and wrote the manuscript. All authors reviewed and approved the final manuscript.
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H.H. holds patents on AMI and CMI mechanoneural interfacing technologies. The remaining authors declare no competing interests.
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Shu, T., Herrera-Arcos, G., Taylor, C.R. et al. Mechanoneural interfaces for bionic integration. Nat Rev Bioeng (2024). https://doi.org/10.1038/s44222-024-00151-y
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DOI: https://doi.org/10.1038/s44222-024-00151-y