Diseases that affect neural function

Numerous diseases of the nervous system can result in a loss of neuromuscular function. However, these can be roughly divided into those that lead to neuronal death, those that result in the loss of the myelin sheath around the neuron preventing the conduction of action potentials, and those that affect the generation or release of neurotransmitters. Of the three categories, for the application of motor prostheses only those diseases that cause neuronal death can be treated. More specifically, only those diseases that do not affect the nerve going to the muscle have benefited from the use of these systems. Current motor prosthesis technology is dependent upon the artificial generation of action potentials in the nerve going to the muscle to cause muscle contraction. Anything that affects action potential conduction in the nerve and the subsequent excitation of the muscle via the neuromuscular junction will prevent effective use of the motor prosthesis. Therefore, the applications of motor prostheses to the restoration of function in such diseases as multiple sclerosis and neuropathy are limited at this time.

Table 12.1 Summary of Neurological Conditions and the Associated Deficits

Table 12.1 Summary of Neurological Conditions and the Associated Deficits

Note: Highlighted in the table are specific applications to which motor prostheses have been developed and employed. Also indicated are what are believed to be possible future avenues of motor prosthesis investigation.

Table 12.1 provides a summary of the expected deficits associated with brain injury, spinal cord injury, and certain diseases of the nervous system. Not all the deficits listed will occur with each injury or disease, and each individual will present a unique case. The highlighted areas in the table are those areas to which the motor prosthesis can and has been applied for use as a rehabilitation tool. Also given in the table are some suggestions of what are believed to be possible future applications for motor prostheses. As can be seen in this table, the motor prosthesis can be a valuable clinical tool for the restoration of motor function, the restoration of biological functions, and for motor relearning and training.

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