{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T16:06:46Z","timestamp":1753891606973,"version":"3.41.2"},"reference-count":28,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,3,18]],"date-time":"2025-03-18T00:00:00Z","timestamp":1742256000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:p>Restoring upper limb function is critical in individuals with central paralysis, and hand control is a priority in patients with neurological impairments. Functional electrical stimulation with implantable electrodes targeting the peripheral nervous system has the potential to selectively recruit hand muscles and generate multiple functional hand movements. However, the implantation of electrodes in the forearm or elbow areas requires multiple incisions for surgery, and elbow joint movements cannot be performed. In this study, we designed and implanted two epineural cuffs on the median and radial nerves in the distal brachial plexus of a single Japanese macaque (<jats:italic>Macaca fuscata<\/jats:italic>) monkey. The cuffs were successfully placed via an axillary approach using a single incision. Electrical stimuli were applied to innervate the contraction patterns of the hand, forearm, and triceps muscles relevant to the median and radial nerves. The evoked potentials of the target muscles electrically stimulated the distal brachial plexus to reliably and selectively innervate the upper limb muscles at the functional group level. Our results demonstrated that the distal brachial plexus can be a useful stimulation site for upper limb muscle contraction and that the axillary approach enables electrode placement to peripheral nerves required for upper limb control.<\/jats:p>","DOI":"10.3389\/fneur.2025.1515986","type":"journal-article","created":{"date-parts":[[2025,3,18]],"date-time":"2025-03-18T05:23:31Z","timestamp":1742275411000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Epineural stimulation on distal brachial plexus for functional restoration of the upper limb in a primate study"],"prefix":"10.3389","volume":"16","author":[{"given":"Tianfang","family":"Yan","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Benjamin C.","family":"Fortune","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lingjun","family":"Liu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yan","family":"Liu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Taro","family":"Kaiju","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takafumi","family":"Suzuki","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masayuki","family":"Hirata","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2025,3,18]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"327","DOI":"10.1146\/annurev.bioeng.6.040803.140103","article-title":"Functional electrical stimulation for neuromuscular applications","volume":"7","author":"Peckham","year":"2005","journal-title":"Annu Rev Biomed Eng"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"1371","DOI":"10.1089\/neu.2004.21.1371","article-title":"Targeting recovery: priorities of the spinal cord-injured population","volume":"21","author":"Anderson","year":"2004","journal-title":"J Neurotrauma"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"244","DOI":"10.1038\/sj.sc.3100980","article-title":"Use of the NESS handmaster to restore handfunction in tetraplegia: clinical experiences in ten patients","volume":"38","author":"Snoek","year":"2000","journal-title":"Spinal Cord"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"749","DOI":"10.1139\/y04-057","article-title":"Therapy of paretic arm in hemiplegic subjects augmented with a neural prosthesis: a cross-over study","volume":"82","author":"Popovic","year":"2004","journal-title":"Can J Physiol Pharmacol"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"1467","DOI":"10.1016\/j.jstrokecerebrovasdis.2017.03.011","article-title":"A randomized controlled study: effectiveness of functional electrical stimulation on wrist and finger flexor spasticity in hemiplegia","volume":"26","author":"Nakipoglu Yuzer","year":"2017","journal-title":"J Stroke Cerebrovasc Dis"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"449","DOI":"10.3389\/fnins.2018.00449","article-title":"FES-UPP: a flexible functional electrical stimulation system to support upper limb functional activity practice","volume":"12","author":"Sun","year":"2018","journal-title":"Front Neurosci"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"e242807","DOI":"10.1136\/bcr-2021-242807","article-title":"Hand dexterity rehabilitation using selective functional electrical stimulation in a person with stroke","volume":"14","author":"Martin-Odriozola","year":"2021","journal-title":"BMJ Case Rep"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"1272992","DOI":"10.3389\/fneur.2023.1272992","article-title":"A systematic review on functional electrical stimulation based rehabilitation systems for upper limb post-stroke recovery","volume":"14","author":"Khan","year":"2023","journal-title":"Front Neurol"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"eabg6463","DOI":"10.1126\/scitranslmed.abg6463","article-title":"Intrafascicular peripheral nerve stimulation produces fine functional hand movements in primates","volume":"13","author":"Badi","year":"2021","journal-title":"Sci Transl Med"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"580","DOI":"10.1152\/jn.00688.2011","article-title":"Intrafascicular stimulation of monkey arm nerves evokes coordinated grasp and sensory responses","volume":"109","author":"Ledbetter","year":"2013","journal-title":"J Neurophysiol"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"395","DOI":"10.1109\/TNSRE.2012.2189021","article-title":"Experimental validation of a hybrid computational model for selective stimulation using transverse intrafascicular multichannel electrodes","volume":"20","author":"Raspopovic","year":"2012","journal-title":"IEEE Trans Neural Syst Rehabil Eng"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"66","DOI":"10.1186\/s12984-020-00676-4","article-title":"Selective neural electrical stimulation restores hand and forearm movements in individuals with complete tetraplegia","volume":"17","author":"Tigra","year":"2020","journal-title":"J Neuroeng Rehabil"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"036003","DOI":"10.1088\/1741-2552\/aa8735","article-title":"Evaluation of high-density, multi-contact nerve cuffs for activation of grasp muscles in monkeys","volume":"15","author":"Brill","year":"2018","journal-title":"J Neural Eng"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"77","DOI":"10.1016\/j.jss.2013.12.014","article-title":"Invasive neural interfaces: the perspective of the surgeon","volume":"188","author":"Di Pino","year":"2014","journal-title":"J Surg Res"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1109\/EMBC40787.2023.10340246","article-title":"Preliminary results of branch level, brachial plexus peripheral nerve stimulation on a non-human primate","volume":"2023","author":"Fortune","year":"2023","journal-title":"Annu Int Conf IEEE Eng Med Biol Soc"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"706","DOI":"10.1109\/10.55681","article-title":"A nerve cuff technique for selective excitation of peripheral nerve trunk regions","volume":"37","author":"Sweeney","year":"1990","journal-title":"IEEE Trans Biomed Eng"},{"key":"ref17","first-page":"498","article-title":"Effects of different configurations of multi-contact cuff electrode on recruitment characteristics of nerve stimulation","author":"Tao","year":"2015"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"1827","DOI":"10.4103\/1673-5374.332153","article-title":"Effects of targeted muscle reinnervation on spinal cord motor neurons in rats following tibial nerve transection","volume":"17","author":"Lu","year":"2022","journal-title":"Neural Regen Res"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"286","DOI":"10.3389\/fnins.2016.00286","article-title":"Fascicular topography of the human median nerve for neuroprosthetic surgery","volume":"10","author":"Delgado-Martinez","year":"2016","journal-title":"Front Neurosci"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"108523","DOI":"10.1016\/j.jneumeth.2019.108523","article-title":"A review for the peripheral nerve interface designer","volume":"332","author":"Larson","year":"2020","journal-title":"J Neurosci Methods"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"795","DOI":"10.1016\/j.jelekin.2014.09.008","article-title":"Advances in functional electrical stimulation (FES)","volume":"24","author":"Popovic","year":"2014","journal-title":"J Electromyogr Kinesiol"},{"key":"ref22","first-page":"5","article-title":"The role of functional electrical stimulation in brachial plexus injury repair","volume-title":"Brachial plexus injury","author":"Lin","year":"2021"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"396","DOI":"10.1002\/ana.25018","article-title":"Axonal components of nerves innervating the human arm","volume":"82","author":"Gesslbauer","year":"2017","journal-title":"Ann Neurol"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"2409","DOI":"10.1007\/s00421-011-2087-9","article-title":"Neuromuscular electrical stimulation: implications of the electrically evoked sensory volley","volume":"111","author":"Bergquist","year":"2011","journal-title":"Eur J Appl Physiol"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"9","DOI":"10.1016\/j.cnp.2016.02.003","article-title":"Clinical uses of H reflexes of upper and lower limb muscles","volume":"1","author":"Burke","year":"2016","journal-title":"Clin Neurophysiol Pract"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"102","DOI":"10.1097\/jes.0b013e3180a0321b","article-title":"Central contributions to contractions evoked by tetanic neuromuscular electrical stimulation","volume":"35","author":"Collins","year":"2007","journal-title":"Exerc Sport Sci Rev"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"467","DOI":"10.1152\/jn.00355.2016","article-title":"High-frequency neuromuscular electrical stimulation modulates interhemispheric inhibition in healthy humans","volume":"117","author":"Gueugneau","year":"2017","journal-title":"J Neurophysiol"},{"key":"ref28","doi-asserted-by":"publisher","first-page":"339","DOI":"10.1016\/S0733-8619(01)00004-4","article-title":"H reflexes and F waves. Fundamentals, normal and abnormal patterns","volume":"20","author":"Fisher","year":"2002","journal-title":"Neurol Clin"}],"container-title":["Frontiers in Neurology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fneur.2025.1515986\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,3,18]],"date-time":"2025-03-18T05:23:34Z","timestamp":1742275414000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fneur.2025.1515986\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,3,18]]},"references-count":28,"alternative-id":["10.3389\/fneur.2025.1515986"],"URL":"https:\/\/doi.org\/10.3389\/fneur.2025.1515986","relation":{},"ISSN":["1664-2295"],"issn-type":[{"type":"electronic","value":"1664-2295"}],"subject":[],"published":{"date-parts":[[2025,3,18]]},"article-number":"1515986"}}