Neural Noise

Neuroprosthetics outlook toward natural limb function

2 min read

  • A 2025 Annals of Neurology review frames the clinical and engineering direction for neuroprosthetics toward natural limb function.1
  • The review aligns with BCI-driven prosthetics and restoration of motor control.1 1

Gardner updates

  • Tian (2025) review in Annals of Neurology frames clinical and engineering direction for neuroprosthetics toward natural limb function. 1

Weekly enrichment (2026-07-20)

  • The review’s full citation is Tian Y, Wallace DM, Cederna PS, Chestek CA, Kemp SWP (University of Michigan), Annals of Neurology 2025;98(5):913-928, published 30 June 2025 (PMID 40586414).2 3
  • It is organized in two sections: peripheral nervous-system interfaces (direct nerve, residual muscle, and reinnervated muscle) for individuals with limb loss, and brain interfaces (EEG, ECoG, and intracortical electrodes) for individuals with paralytic conditions.4 2
  • Surgical advances it highlights include regenerative peripheral nerve interfaces (RPNI) and the composite-RPNI construct to improve control signal quality for prosthetic limbs.2
  • Intracortical arrays are presented as providing both the best dexterous control and an opportunity for sensory feedback via intracortical microstimulation (ICMS) of the sensory cortex, enabling bidirectional BCI.2
  • A key challenge for bidirectional control is ICMS-induced signal artifact on motor-cortex electrodes; Weiss et al. developed an artifact-exclusion method enabling the first clinical bidirectional BCI robotic-arm object transfer, and Flesher et al. later showed improved control while quantifying ICMS and motor signals over 1,500 days.2
  • The review’s central thesis is that next-generation devices should integrate both brain and peripheral-nervous-system signals, leveraging the strengths of each to more closely replicate natural limb function.4 2
  • For context, a Nature Medicine first-in-human “double neural bypass” trial (spanning more than 3 years) in a 42-year-old with complete C4 sensory/C5 motor tetraplegia combined a bidirectional intracortical BCI, deep reinforcement-learning decoding, and transcutaneous spinal cord stimulation to restore hand movement and tactile sensation with persistent recovery.5
  • Parallel reviews on biomimetic somatosensory feedback and on lower-limb bidirectional neuroprostheses reinforce the same direction: closing the sensorimotor loop improves device embodiment, task performance, and intuitiveness of control.6 7

Footnotes

  1. https://news.google.com/rss/articles/CBMiakFVX3lxTE8tSzNxRjRjSFN4bWVhOEI2dFhLRVVSb1hoOXE2YmZrY2twQXd3SHJDT0E0c0p2SE1vaUVheEtTcTlaOWxFUWVCOXUzMlltRkRuUndQdnpULU8ybjczU1k1QnZwdnBqUFJoamc?oc=5 ↩ ↩2 ↩3 ↩4

  2. https://doi.org/10.1002/ana.27287 ↩ ↩2 ↩3 ↩4 ↩5 ↩6

  3. https://europepmc.org/article/med/40586414 ↩

  4. https://onlinelibrary.wiley.com/doi/full/10.1002/ana.27287 ↩ ↩2

  5. https://www.nature.com/articles/s41591-026-04498-0 ↩

  6. https://doi.org/10.3390/biomimetics10030130 ↩

  7. https://doi.org/10.1038/s44385-025-00050-w ↩

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