Article

The development of a new generation of hand prostheses that can ideally
approximate the human 'physiological' performance in terms of movement dexterity
and sensory feedback for amputees still poses many open research challenges. The
most promising approaches aim at establishing a direct connection with either the
central or the peripheral human nervous system by means of invasive or
non-invasive neural interfaces. This paper starts from the assumption that a
major contribution to derive functional and technical specifications for such
interfaces, and even for the whole prosthetic system, can stem from in-depth
analysis of the nervous system reorganization following limb amputation.
Neuroplasticity can be modulated by the use of hand prostheses both in the acute
phase and in the long-term. We hereby critically review the literature concerning
neuroplastic phenomena in amputees, in terms of changes at different CNS levels,
particularly for their implications on the development of bidirectional neural
interfaces for cybernetic hand prostheses. Our analysis of the literature
demonstrates that: (1) the level of CNS reorganization could be used as a
parameter of the effectiveness achieved by the prosthetic device and its
interfaces, in restoring the hand physiological functionality, (2) the prosthetic
system could be seen as a neurorehabilitation tool, as it could induce reduction
in aberrant plasticity and promote 'good' plasticity and (3) new generations of
'natural' interfaces can be developed by fully exploiting neuroplastic phenomena
to restore neural connections originally governing the lost limb and linking them
to the prosthetic system.

Langue : ANGLAIS