Purpose of the handbook

Since 1990, the field of neuroprosthetics has grown at a tremendous rate. But, what exactly is meant by the term neuroprosthetics, and why are neuroprostheses of such consuming interest? For the purposes of this handbook, a neuroprosthetic is a device or system that does one of the following:

1. Replaces nerve function lost as a result of disease or injury. The neuroprosthetic commonly acts as a bridge between functional elements of the nervous system and nerves or muscles over which control has been lost. Examples include the peripheral nerve bridges implanted into the spinal cord, lumbar anterior-root stimulator implants to allow standing in paraplegics, and systems to restore hand and upper limb movement in tetraplegics. The neuroprosthetic may also act as a bridge between the nervous system and a physical prosthesis, as is the case in upper limb replacement.

2. Augments or replaces damaged and destroyed sensory input pathways. The neuroprosthetic records and processes inputs from outside the body and transmits information to the sensory nerves for interpretation by the brain. Examples include the cochlear implant for restoring hearing and an assortment of retinal and visual cortex prostheses for restoring vision.

A common component of all the systems in Figure 1.1 is the need to interact directly with nerves. The system must either collect signals from nerves or generate signals on nerves, or both. The interaction may be with individual nerve cells and fibers or with nerve trunks containing hundreds to millions of axons. Just as important is the need to understand and speak the language of the nervous system and understanding that the language changes as the signaling requirements change. For example, the auditory and optic nerve systems have very different organizations, levels of signaling, and processing complexity as dictated by the different nature of the auditory and visual inputs. A neuroprosthesis, therefore, is a device or system that communicates with nerves to restore as much of the functionality of the nervous system as possible.

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