Highly integrated bionic prostheses resolve the thermal asymmetry between residual amputated and contralateral limbs

Residual limbs after amputation present colder temperatures than unaffected contralateral limbs. This temperature asymmetry has been attributed to autonomic and cognitive factors, such as changes in body representation. An ideal limb replacement should restore the body representation and resolve the temperature asymmetry, but conventional prostheses, commonly characterized as disembodied, fail to do so. Neuromusculoskeletal prostheses are a new concept of artificial limbs that directly interface with the user's nerves, muscles, and skeleton, and are operated in daily life by bidirectionally transferring control and somatosensory information. Here, we show that the temperature asymmetry commonly found in people with amputations is resolved when using a neuromusculoskeletal prosthesis but reappears when it is removed. A potential explanation for this phenomenon might be the increased embodiment reported by users of neuromusculoskeletal prostheses, which in turn would suggest unconscious perceptual mechanisms mediating the temperature asymmetry commonly found between intact and residual limbs after amputation.