Natural integration of bionic limbs via spinal interfacing
Missing a limb leads to dramatic impairments in the capacity to move and interact with the environment and to a substantial worsening in quality of life. This deficiency is also associated with a large portion of the sensory-motor cortex facing neural deafness. Missing or damaged limbs can in principle be substituted by robotic limbs, connected to humans with neural interfacing. Despite massive research efforts, however, the bionic reconstruction of limbs currently faces important translational challenges. We aim at filling this gap between academic research and clinical impact with a patient-centric approach that synergistically combines breakthroughs in surgery (Aszmann), neural interfacing (Farina), and robotics (Bicchi). We propose to surgically create bio-connectors (compacted in a bio-hub) to access the spinal cord circuitries by using biological pathways of encoding and decoding neural information. Neural interfacing with the bio-hub will determine an input/output information flow with the spinal cord by decoding the activity of spinal neural cells (output) and stimulating transplanted biological afferent organs (input). The sensory-motor image of the missing limb emerging from this interfacing will be projected in soft robotic arms/legs that will embed kinematic synergies and tactile-proprioceptive functions, intimately matched with the neural sensory-motor synergies extracted from the bio-hub. In this way, Natural BionicS aims at creating a fully integrated, symbiotic replacement of human limbs with robotic parts that the user will feel and command as part of the body. This aim will be achieved with clinical translation aided by the establishment of a Bionic Clinical Board of the three PIs. Here the options of bionic reconstruction will be explored for each patient on a bi-monthly basis, the engineering solutions will be adapted to the clinical challenges, and patients will be identified who best profit from the radical new developments of Natural BionicS.