Regenerative Peripheral Nerve Interfaces for Improving Activities of Daily Living in People with Upper Limb Amputations

There are millions of people worldwide with debilitating upper limb amputations. While electrical signals from residual muscle can provide some function, every person with amputation is missing muscles, and therefore missing a variety of important functions. Our group has demonstrated a novel method for obtaining signals from independent nerve fascicles in humans, which we call the Regenerative Peripheral Nerve Interface (RPNI). The small muscle grafts degenerate, regenerate, revascularize, and reinnervate utilizing natural biologic processes. Our long-term goal is to make nerve-controlled prostheses widely available, such that multi-articulated hands can be controlled as dexterously and intuitively as an anatomic limb. The objective of the present application, which represents our proposed next step, is to obtain the necessary regulatory approvals to conduct a pilot take- home clinical trial of a portable control system for recording intramuscular signals from RPNIs and residual muscles in 6 participants with upper limb loss. In the UG3 portion of the study, we will address the following aim: Aim 1. Enable advanced prosthetic functionality using a small wearable device to process RPNI signals. In the UH3 portion of the study, we will address the following aims: Aim 2. Determine whether intramuscular EMG with RPNI signals can reliably and intuitively improve activities of daily living. and Aim 3. Compare prosthetic use and function during take-home trials of prosthetic controllers using surface pattern recognition and those using pattern recognition of intramuscular electromyography from residual muscles and RPNIs. We have partnered with industry (Ossur, Synapse Biomedical, Blue Arbor Technologies) to ensure the system we develop will be safe and manufacturable in the future. We believe successful completion of these aims will motivate commercialization and widespread use of RPNIs for prosthetic control. Project Number: 1UG3NS138154-01A1 | Fiscal Year: 2025 | NIH Institute/Center: National Institute of Neurological Disorders and Stroke (NINDS) | Principal Investigator: Deanna Gates (+1 co-PI) | Institution: UNIVERSITY OF MICHIGAN AT ANN ARBOR, ANN ARBOR, MI | Award Amount: $605,832 | Activity Code: UG3 | Study Section: Special Emphasis Panel[ZNS1 SRB-A (10)] View on NIH RePORTER: https://reporter.nih.gov/project-details/11229165