Epidural electrocorticography of phantom hand movement following long-term upper-limb amputation

Alireza Gharabaghi, Georgios Naros, Armin Walter, Alexander Roth, Martin Bogdan, Wolfgang Rosenstiel, Carsten Mehring, Niels Birbaumer

Research output: Contribution to journalArticlepeer-review


Introduction: Prostheses for upper-limb amputees are currently controlled by either myoelectric or peripheral neural signals. Performance and dexterity of these devices is still limited, particularly when it comes to controlling hand function. Movement-related brain activity might serve as a complementary bio-signal for motor control of hand prosthesis. Methods: We introduced a methodology to implant a cortical interface without direct exposure of the brain surface in an upper-limb amputee. This bi-directional interface enabled us to explore the cortical physiology following long-term transhumeral amputation. In addition, we investigated neurofeedback of electrocorticographic brain activity related to the patient's motor imagery to open his missing hand, i.e., phantom hand movement, for real-time control of a virtual hand prosthesis. Results: Both event-related brain activity and cortical stimulation revealed mutually overlapping cortical representations of the phantom hand. Phantom hand movements could be robustly classified and the patient required only three training sessions to gain reliable control of the virtual hand prosthesis in an online closed-loop paradigm that discriminated between hand opening and rest. Conclusion: Epidural implants may constitute a powerful and safe alternative communication pathway between the brain and external devices for upper-limb amputees, thereby facilitating the integrated use of different signal sources for more intuitive and specific control of multi-functional devices in clinical use.

Original languageEnglish
Article number285
JournalFrontiers in Human Neuroscience
Issue numberMAY
Publication statusPublished - May 6 2014


  • Amputee
  • Brain-computer interface
  • Brain-machine interface
  • Closed-loop control
  • Electrocorticography
  • Epidural implant
  • Neural prosthesis
  • Neurofeedback

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Neurology
  • Biological Psychiatry
  • Behavioral Neuroscience
  • Neuropsychology and Physiological Psychology


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