Doctor of Philosophy, Case Western Reserve University, 2020, Biomedical Engineering

Over one million individuals in the United States have a lower-limb amputation. Though locomotion is a sensorimotor process, no commercially available prostheses offer somatosensory feedback, and amputees continue to face locomotor challenges. Recent studies have demonstrated that electrically stimulating the residual nerves of amputees can elicit somatosensory percepts referred to the missing limb. Though peripheral nerve stimulation (PNS) takes advantage of the existing neural pathways that carry sensory information from the amputated limb to the brain, neural stimulation does not activate these afferent fibers in the same manner as physically-applied tactile stimuli. We hypothesized that these differences in neural activation may cause PNS-evoked sensation to be perceived differently than natural touch with respect to temporal synchrony and multisensory integration. In Aim 1, we found that the processing time and temporal sensitivity were not different between PNS-evoked and natural somatosensation. The similarity in visuotactile synchrony provided further evidence that PNS-evoked sensations are processed in broadly the same way as natural touch. In Aim 2, we established that much like natural somatosensation, vision and postural manipulations could reinforce PNS-evoked somatosensation. This multisensory integration had not been previously demonstrated and it is important for sensory neuroprostheses, which will be used in diverse environments with various sensory resources. The findings from Aims 1-2 demonstrated that PNS-evoked and natural somatosensation have similar properties, but did not guarantee that the body would utilize the sensory information accordingly. In Aim 3, we showed that amputees utilized PNS-evoked plantar sensation while performing a challenging locomotor task, revealing a significant and immediate benefit of somatosensory feedback to amputees. The use of a sensory-enabled prosthesis did not change the amputees' locomotor strategies, (open full item for complete abstract)

Committee: Ronald Triolo (Advisor); Dustin Tyler (Committee Chair); Bolu Ajiboye (Committee Member); Cenk Cavusoglu (Committee Member) Subjects: Biomedical Engineering