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Micera S, Menciassi A, Cianferotti L, Gruppioni E, Lionetti V. Organ Neuroprosthetics: Connecting Transplanted and Artificial Organs with the Nervous System. Adv Healthc Mater 2024:e2302896. [PMID: 38656615 DOI: 10.1002/adhm.202302896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 04/01/2024] [Indexed: 04/26/2024]
Abstract
Implantable neural interfaces with the central and peripheral nervous systems are currently used to restore sensory, motor, and cognitive functions in disabled people with very promising results. They have also been used to modulate autonomic activities to treat diseases such as diabetes or hypertension. Here, this study proposes to extend the use of these technologies to (re-)establish the connection between new (transplanted or artificial) organs and the nervous system in order to increase the long-term efficacy and the effective biointegration of these solutions. In this perspective paper, some clinically relevant applications of this approach are briefly described. Then, the choices that neural engineers must implement about the type, implantation location, and closed-loop control algorithms to successfully realize this approach are highlighted. It is believed that these new "organ neuroprostheses" are going to become more and more valuable and very effective solutions in the years to come.
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Affiliation(s)
- Silvestro Micera
- The BioRobotics Institute and Department of Excellence in Robotics and AI, Scuola Superiore Sant'Anna, Pisa, 56127, Italy
- Interdisciplinary Research Center Health Science, Scuola Superiore Sant'Anna, Pisa, 56127, Italy
- Bertarelli Foundation Chair in Translational Neuroengineering, Neuro-X Institute, School of Engineering, Ecole Polytechnique Federale de Lausanne (EPFL), Lausanne, 1015, Switzerland
| | - Arianna Menciassi
- The BioRobotics Institute and Department of Excellence in Robotics and AI, Scuola Superiore Sant'Anna, Pisa, 56127, Italy
- Interdisciplinary Research Center Health Science, Scuola Superiore Sant'Anna, Pisa, 56127, Italy
| | - Luisella Cianferotti
- Department of Experimental and Clinical Biomedical Sciences, University of Florence, Florence, 50121, Italy
| | | | - Vincenzo Lionetti
- Interdisciplinary Research Center Health Science, Scuola Superiore Sant'Anna, Pisa, 56127, Italy
- UOSVD Anesthesia and Resuscitation, Fondazione Toscana G. Monasterio, Pisa, 56127, Italy
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2
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Cui J, Mivalt F, Sladky V, Kim J, Richner TJ, Lundstrom BN, Van Gompel JJ, Wang HL, Miller KJ, Gregg N, Wu LJ, Denison T, Winter B, Brinkmann BH, Kremen V, Worrell GA. Acute to long-term characteristics of impedance recordings during neurostimulation in humans. J Neural Eng 2024; 21:10.1088/1741-2552/ad3416. [PMID: 38484397 PMCID: PMC11044203 DOI: 10.1088/1741-2552/ad3416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Accepted: 03/14/2024] [Indexed: 03/26/2024]
Abstract
Objective.This study aims to characterize the time course of impedance, a crucial electrophysiological property of brain tissue, in the human thalamus (THL), amygdala-hippocampus, and posterior hippocampus over an extended period.Approach.Impedance was periodically sampled every 5-15 min over several months in five subjects with drug-resistant epilepsy using an investigational neuromodulation device. Initially, we employed descriptive piecewise and continuous mathematical models to characterize the impedance response for approximately three weeks post-electrode implantation. We then explored the temporal dynamics of impedance during periods when electrical stimulation was temporarily halted, observing a monotonic increase (rebound) in impedance before it stabilized at a higher value. Lastly, we assessed the stability of amplitude and phase over the 24 h impedance cycle throughout the multi-month recording.Main results.Immediately post-implantation, the impedance decreased, reaching a minimum value in all brain regions within approximately two days, and then increased monotonically over about 14 d to a stable value. The models accounted for the variance in short-term impedance changes. Notably, the minimum impedance of the THL in the most epileptogenic hemisphere was significantly lower than in other regions. During the gaps in electrical stimulation, the impedance rebound decreased over time and stabilized around 200 days post-implant, likely indicative of the foreign body response and fibrous tissue encapsulation around the electrodes. The amplitude and phase of the 24 h impedance oscillation remained stable throughout the multi-month recording, with circadian variation in impedance dominating the long-term measures.Significance.Our findings illustrate the complex temporal dynamics of impedance in implanted electrodes and the impact of electrical stimulation. We discuss these dynamics in the context of the known biological foreign body response of the brain to implanted electrodes. The data suggest that the temporal dynamics of impedance are dependent on the anatomical location and tissue epileptogenicity. These insights may offer additional guidance for the delivery of therapeutic stimulation at various time points post-implantation for neuromodulation therapy.
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Affiliation(s)
- Jie Cui
- Department of Neurology, Mayo Clinic, Rochester, Minnesota, USA
- Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, Minnesota, USA
- Mayo College of Medicine and Science, Mayo Clinic, Rochester, Minnesota, USA
| | - Filip Mivalt
- Department of Neurology, Mayo Clinic, Rochester, Minnesota, USA
- Department of Biomedical Engineering, Faculty of Electrical Engineering and Communication, Brno University of Technology, Brno, Czech Republic
- International Clinical Research Center, St. Anne’s University Hospital, Brno, Czech Republic
| | - Vladimir Sladky
- Department of Neurology, Mayo Clinic, Rochester, Minnesota, USA
- International Clinical Research Center, St. Anne’s University Hospital, Brno, Czech Republic
- Faculty of Biomedical Engineering, Czech Technical University in Prague, Kladno, Czech Republic
| | - Jiwon Kim
- Department of Neurology, Mayo Clinic, Rochester, Minnesota, USA
| | | | | | | | - Hai-long Wang
- Department of Neurology, Mayo Clinic, Rochester, Minnesota, USA
| | - Kai J. Miller
- Department of Neurologic Surgery, Mayo Clinic, Rochester, MN, USA
| | - Nicholas Gregg
- Department of Neurology, Mayo Clinic, Rochester, Minnesota, USA
| | - Long Jun Wu
- Department of Neurology, Mayo Clinic, Rochester, Minnesota, USA
| | - Timothy Denison
- Department of Engineering Science, University of Oxford; MRC Brain Network Dynamics Unit, University of Oxford, OX3 7DQ UK
| | - Bailey Winter
- Department of Neurology, Mayo Clinic, Rochester, Minnesota, USA
- Mayo College of Medicine and Science, Mayo Clinic, Rochester, Minnesota, USA
| | - Benjamin H. Brinkmann
- Department of Neurology, Mayo Clinic, Rochester, Minnesota, USA
- Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, Minnesota, USA
| | - Vaclav Kremen
- Department of Neurology, Mayo Clinic, Rochester, Minnesota, USA
- Czech Institute of Informatics, Robotics, and Cybernetics, Czech Technical University, Prague, Czech Republic
| | - Gregory A. Worrell
- Department of Neurology, Mayo Clinic, Rochester, Minnesota, USA
- Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, Minnesota, USA
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Kundu A, Patrick E, Currlin S, Madler R, Delgado F, Fahmy A, Verplancke R, Ballini M, Braeken D, de Beeck MO, Maghari N, Otto KJ, Bashirullah R. Using Compound Neural Action Potentials for Functional Validation of a High-Density Intraneural Interface: A Preliminary Study. MICROMACHINES 2024; 15:280. [PMID: 38399008 PMCID: PMC10891740 DOI: 10.3390/mi15020280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Revised: 02/14/2024] [Accepted: 02/15/2024] [Indexed: 02/25/2024]
Abstract
Compound nerve action potentials (CNAPs) were used as a metric to assess the stimulation performance of a novel high-density, transverse, intrafascicular electrode in rat models. We show characteristic CNAPs recorded from distally implanted cuff electrodes. Evaluation of the CNAPs as a function of stimulus current and calculation of recruitment plots were used to obtain a qualitative approximation of the neural interface's placement and orientation inside the nerve. This method avoids elaborate surgeries required for the implantation of EMG electrodes and thus minimizes surgical complications and may accelerate the healing process of the implanted subject.
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Affiliation(s)
- Aritra Kundu
- Department of Bioengineering, Imperial College London, SW7 2AZ London, UK
- Department of Electrical and Computer Engineering, University of Florida, Gainesville, FL 32611, USA; (E.P.); (N.M.)
| | - Erin Patrick
- Department of Electrical and Computer Engineering, University of Florida, Gainesville, FL 32611, USA; (E.P.); (N.M.)
| | - Seth Currlin
- Department of Biomedical Engineering, University of Florida, Gainesville, FL 32611, USA (K.J.O.)
| | - Ryan Madler
- Department of Electrical and Computer Engineering, University of Florida, Gainesville, FL 32611, USA; (E.P.); (N.M.)
| | - Francisco Delgado
- Department of Biomedical Engineering, University of Florida, Gainesville, FL 32611, USA (K.J.O.)
| | - Ahmed Fahmy
- Department of Electrical and Computer Engineering, University of Florida, Gainesville, FL 32611, USA; (E.P.); (N.M.)
| | - Rik Verplancke
- Centre for Microsystems Technology (CMST), IMEC and Ghent University, 9052 Zwijnaarde, Belgium (M.O.d.B.)
| | | | | | - Maaike Op de Beeck
- Centre for Microsystems Technology (CMST), IMEC and Ghent University, 9052 Zwijnaarde, Belgium (M.O.d.B.)
- IMEC, Kapeldreef 75, 3001 Leuven, Belgium;
| | - Nima Maghari
- Department of Electrical and Computer Engineering, University of Florida, Gainesville, FL 32611, USA; (E.P.); (N.M.)
| | - Kevin J. Otto
- Department of Biomedical Engineering, University of Florida, Gainesville, FL 32611, USA (K.J.O.)
| | - Rizwan Bashirullah
- Department of Electrical and Computer Engineering, University of Florida, Gainesville, FL 32611, USA; (E.P.); (N.M.)
- Galvani Bioelectronics, South San Francisco, CA 94080, USA
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Paggi V, Fallegger F, Serex L, Rizzo O, Galan K, Giannotti A, Furfaro I, Zinno C, Bernini F, Micera S, Lacour SP. A soft, scalable and adaptable multi-contact cuff electrode for targeted peripheral nerve modulation. Bioelectron Med 2024; 10:6. [PMID: 38350988 PMCID: PMC10865708 DOI: 10.1186/s42234-023-00137-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Accepted: 12/10/2023] [Indexed: 02/15/2024] Open
Abstract
BACKGROUND Cuff electrodes target various nerves throughout the body, providing neuromodulation therapies for motor, sensory, or autonomic disorders. However, when using standard, thick silicone cuffs, fabricated in discrete circular sizes, complications may arise, namely cuff displacement or nerve compression, due to a poor adaptability to variable nerve shapes and sizes encountered in vivo. Improvements in cuff design, materials, closing mechanism and surgical approach are necessary to overcome these issues. METHODS In this work, we propose a microfabricated multi-channel silicone-based soft cuff electrode with a novel easy-to-implant and size-adaptable design and evaluate a number of essential features such as nerve-cuff contact, nerve compression, cuff locking stability, long-term integration and stimulation selectivity. We also compared performance to that of standard fixed-size cuffs. RESULTS The belt-like cuff made of 150 μm thick silicone membranes provides a stable and pressure-free conformal contact, independently of nerve size variability, combined with a straightforward implantation procedure. The adaptable design and use of soft materials lead to limited scarring and demyelination after 6-week implantation. In addition, multi-contact designs, ranging from 6 to 16 electrodes, allow for selective stimulation in models of rat and pig sciatic nerve, achieving targeted activation of up to 5 hindlimb muscles. CONCLUSION These results suggest a promising alternative to classic fixed-diameter cuffs and may facilitate the adoption of soft, adaptable cuffs in clinical settings.
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Affiliation(s)
- Valentina Paggi
- Laboratory for Soft Bioelectronic Interfaces, Neuro-X Institute, Ecole Polytechnique Fédérale de Lausanne (EPFL), Geneva, Switzerland
| | - Florian Fallegger
- Laboratory for Soft Bioelectronic Interfaces, Neuro-X Institute, Ecole Polytechnique Fédérale de Lausanne (EPFL), Geneva, Switzerland
| | | | - Olivier Rizzo
- Laboratory for Soft Bioelectronic Interfaces, Neuro-X Institute, Ecole Polytechnique Fédérale de Lausanne (EPFL), Geneva, Switzerland
- Bertarelli Foundation Chair in Translational NeuroEngineering, Neuro-X Institute, École Polytechnique Fédérale de Lausanne (EPFL), Geneva, Switzerland
| | - Katia Galan
- Laboratory for Soft Bioelectronic Interfaces, Neuro-X Institute, Ecole Polytechnique Fédérale de Lausanne (EPFL), Geneva, Switzerland
| | - Alice Giannotti
- The BioRobotics Institute and Department of Excellence in Robotics and AI, Scuola Superiore Sant'Anna, Pisa, Italy
| | - Ivan Furfaro
- Laboratory for Soft Bioelectronic Interfaces, Neuro-X Institute, Ecole Polytechnique Fédérale de Lausanne (EPFL), Geneva, Switzerland
| | - Ciro Zinno
- The BioRobotics Institute and Department of Excellence in Robotics and AI, Scuola Superiore Sant'Anna, Pisa, Italy
| | - Fabio Bernini
- The BioRobotics Institute and Department of Excellence in Robotics and AI, Scuola Superiore Sant'Anna, Pisa, Italy
| | - Silvestro Micera
- Bertarelli Foundation Chair in Translational NeuroEngineering, Neuro-X Institute, École Polytechnique Fédérale de Lausanne (EPFL), Geneva, Switzerland
- The BioRobotics Institute and Department of Excellence in Robotics and AI, Scuola Superiore Sant'Anna, Pisa, Italy
| | - Stéphanie P Lacour
- Laboratory for Soft Bioelectronic Interfaces, Neuro-X Institute, Ecole Polytechnique Fédérale de Lausanne (EPFL), Geneva, Switzerland.
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Taghlabi KM, Cruz-Garza JG, Hassan T, Potnis O, Bhenderu LS, Guerrero JR, Whitehead RE, Wu Y, Luan L, Xie C, Robinson JT, Faraji AH. Clinical outcomes of peripheral nerve interfaces for rehabilitation in paralysis and amputation: a literature review. J Neural Eng 2024; 21:011001. [PMID: 38237175 DOI: 10.1088/1741-2552/ad200f] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 01/18/2024] [Indexed: 02/02/2024]
Abstract
Peripheral nerve interfaces (PNIs) are electrical systems designed to integrate with peripheral nerves in patients, such as following central nervous system (CNS) injuries to augment or replace CNS control and restore function. We review the literature for clinical trials and studies containing clinical outcome measures to explore the utility of human applications of PNIs. We discuss the various types of electrodes currently used for PNI systems and their functionalities and limitations. We discuss important design characteristics of PNI systems, including biocompatibility, resolution and specificity, efficacy, and longevity, to highlight their importance in the current and future development of PNIs. The clinical outcomes of PNI systems are also discussed. Finally, we review relevant PNI clinical trials that were conducted, up to the present date, to restore the sensory and motor function of upper or lower limbs in amputees, spinal cord injury patients, or intact individuals and describe their significant findings. This review highlights the current progress in the field of PNIs and serves as a foundation for future development and application of PNI systems.
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Affiliation(s)
- Khaled M Taghlabi
- Department of Neurological Surgery, Houston Methodist Hospital, Houston, TX 77030, United States of America
- Center for Neural Systems Restoration, Houston Methodist Research Institute, Houston, TX 77030, United States of America
- Clinical Innovations Laboratory, Houston Methodist Research Institute, Houston, TX 77030, United States of America
| | - Jesus G Cruz-Garza
- Department of Neurological Surgery, Houston Methodist Hospital, Houston, TX 77030, United States of America
- Center for Neural Systems Restoration, Houston Methodist Research Institute, Houston, TX 77030, United States of America
- Clinical Innovations Laboratory, Houston Methodist Research Institute, Houston, TX 77030, United States of America
| | - Taimur Hassan
- Department of Neurological Surgery, Houston Methodist Hospital, Houston, TX 77030, United States of America
- Center for Neural Systems Restoration, Houston Methodist Research Institute, Houston, TX 77030, United States of America
- Clinical Innovations Laboratory, Houston Methodist Research Institute, Houston, TX 77030, United States of America
- School of Medicine, Texas A&M University, Bryan, TX 77807, United States of America
| | - Ojas Potnis
- Department of Neurological Surgery, Houston Methodist Hospital, Houston, TX 77030, United States of America
- Center for Neural Systems Restoration, Houston Methodist Research Institute, Houston, TX 77030, United States of America
- Clinical Innovations Laboratory, Houston Methodist Research Institute, Houston, TX 77030, United States of America
- School of Engineering Medicine, Texas A&M University, Houston, TX 77030, United States of America
| | - Lokeshwar S Bhenderu
- Department of Neurological Surgery, Houston Methodist Hospital, Houston, TX 77030, United States of America
- Center for Neural Systems Restoration, Houston Methodist Research Institute, Houston, TX 77030, United States of America
- Clinical Innovations Laboratory, Houston Methodist Research Institute, Houston, TX 77030, United States of America
- School of Medicine, Texas A&M University, Bryan, TX 77807, United States of America
| | - Jaime R Guerrero
- Department of Neurological Surgery, Houston Methodist Hospital, Houston, TX 77030, United States of America
- Center for Neural Systems Restoration, Houston Methodist Research Institute, Houston, TX 77030, United States of America
- Clinical Innovations Laboratory, Houston Methodist Research Institute, Houston, TX 77030, United States of America
| | - Rachael E Whitehead
- Department of Academic Affairs, Houston Methodist Academic Institute, Houston, TX 77030, United States of America
| | - Yu Wu
- Rice Neuroengineering Initiative, Rice University, Houston, TX 77005, United States of America
- Department of Electrical and Computer Engineering, Rice University, Houston, TX 77005, United States of America
| | - Lan Luan
- Rice Neuroengineering Initiative, Rice University, Houston, TX 77005, United States of America
- Department of Electrical and Computer Engineering, Rice University, Houston, TX 77005, United States of America
| | - Chong Xie
- Rice Neuroengineering Initiative, Rice University, Houston, TX 77005, United States of America
- Department of Electrical and Computer Engineering, Rice University, Houston, TX 77005, United States of America
| | - Jacob T Robinson
- Rice Neuroengineering Initiative, Rice University, Houston, TX 77005, United States of America
- Department of Electrical and Computer Engineering, Rice University, Houston, TX 77005, United States of America
| | - Amir H Faraji
- Department of Neurological Surgery, Houston Methodist Hospital, Houston, TX 77030, United States of America
- Center for Neural Systems Restoration, Houston Methodist Research Institute, Houston, TX 77030, United States of America
- Clinical Innovations Laboratory, Houston Methodist Research Institute, Houston, TX 77030, United States of America
- Rice Neuroengineering Initiative, Rice University, Houston, TX 77005, United States of America
- Department of Electrical and Computer Engineering, Rice University, Houston, TX 77005, United States of America
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6
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Cui J, Mivalt F, Sladky V, Kim J, Richner TJ, Lundstrom BN, Van Gompel JJ, Wang HL, Miller KJ, Gregg N, Wu LJ, Denison T, Winter B, Brinkmann BH, Kremen V, Worrell GA. Acute to long-term characteristics of impedance recordings during neurostimulation in humans. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.01.23.24301672. [PMID: 38343858 PMCID: PMC10854350 DOI: 10.1101/2024.01.23.24301672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/17/2024]
Abstract
Objective This study aims to characterize the time course of impedance, a crucial electrophysiological property of brain tissue, in the human thalamus (THL), amygdala-hippocampus (AMG-HPC), and posterior hippocampus (post-HPC) over an extended period. Approach Impedance was periodically sampled every 5-15 minutes over several months in five subjects with drug-resistant epilepsy using an experimental neuromodulation device. Initially, we employed descriptive piecewise and continuous mathematical models to characterize the impedance response for approximately three weeks post-electrode implantation. We then explored the temporal dynamics of impedance during periods when electrical stimulation was temporarily halted, observing a monotonic increase (rebound) in impedance before it stabilized at a higher value. Lastly, we assessed the stability of amplitude and phase over the 24-hour impedance cycle throughout the multi-month recording. Main results Immediately post-implantation, the impedance decreased, reaching a minimum value in all brain regions within approximately two days, and then increased monotonically over about 14 days to a stable value. The models accounted for the variance in short-term impedance changes. Notably, the minimum impedance of the THL in the most epileptogenic hemisphere was significantly lower than in other regions. During the gaps in electrical stimulation, the impedance rebound decreased over time and stabilized around 200 days post-implant, likely indicative of the foreign body response and fibrous tissue encapsulation around the electrodes. The amplitude and phase of the 24-hour impedance oscillation remained stable throughout the multi-month recording, with circadian variation in impedance dominating the long-term measures. Significance Our findings illustrate the complex temporal dynamics of impedance in implanted electrodes and the impact of electrical stimulation. We discuss these dynamics in the context of the known biological foreign body response of the brain to implanted electrodes. The data suggest that the temporal dynamics of impedance are dependent on the anatomical location and tissue epileptogenicity. These insights may offer additional guidance for the delivery of therapeutic stimulation at various time points post-implantation for neuromodulation therapy.
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Affiliation(s)
- Jie Cui
- Department of Neurology, Mayo Clinic, Rochester, Minnesota, USA
- Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, Minnesota, USA
- Mayo College of Medicine and Science, Mayo Clinic, Rochester, Minnesota, USA
| | - Filip Mivalt
- Department of Neurology, Mayo Clinic, Rochester, Minnesota, USA
- Department of Biomedical Engineering, Faculty of Electrical Engineering and Communication, Brno University of Technology, Brno, Czech Republic
- International Clinical Research Center, St. Anne’s University Hospital, Brno, Czech Republic
| | - Vladimir Sladky
- Department of Neurology, Mayo Clinic, Rochester, Minnesota, USA
- International Clinical Research Center, St. Anne’s University Hospital, Brno, Czech Republic
- Faculty of Biomedical Engineering, Czech Technical University in Prague, Kladno, Czech Republic
| | - Jiwon Kim
- Department of Neurology, Mayo Clinic, Rochester, Minnesota, USA
| | | | | | | | - Hai-long Wang
- Department of Neurology, Mayo Clinic, Rochester, Minnesota, USA
| | - Kai J. Miller
- Department of Neurologic Surgery, Mayo Clinic, Rochester, MN, USA
| | - Nicholas Gregg
- Department of Neurology, Mayo Clinic, Rochester, Minnesota, USA
| | - Long Jun Wu
- Department of Neurology, Mayo Clinic, Rochester, Minnesota, USA
| | - Timothy Denison
- Department of Engineering Science, University of Oxford; MRC Brain Network Dynamics Unit, University of Oxford, OX3 7DQ UK
| | - Bailey Winter
- Department of Neurology, Mayo Clinic, Rochester, Minnesota, USA
- Mayo College of Medicine and Science, Mayo Clinic, Rochester, Minnesota, USA
| | - Benjamin H. Brinkmann
- Department of Neurology, Mayo Clinic, Rochester, Minnesota, USA
- Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, Minnesota, USA
| | - Vaclav Kremen
- Department of Neurology, Mayo Clinic, Rochester, Minnesota, USA
- Czech Institute of Informatics, Robotics, and Cybernetics, Czech Technical University, Prague, Czech Republic
| | - Gregory A. Worrell
- Department of Neurology, Mayo Clinic, Rochester, Minnesota, USA
- Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, Minnesota, USA
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7
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Lim J, Zoss PA, Powley TL, Lee H, Ward MP. A flexible, thin-film microchannel electrode array device for selective subdiaphragmatic vagus nerve recording. MICROSYSTEMS & NANOENGINEERING 2024; 10:16. [PMID: 38264708 PMCID: PMC10803373 DOI: 10.1038/s41378-023-00637-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 10/18/2023] [Accepted: 11/17/2023] [Indexed: 01/25/2024]
Abstract
The vagus nerve (VN) plays an important role in regulating physiological conditions in the gastrointestinal (GI) tract by communicating via the parasympathetic pathway to the enteric nervous system (ENS). However, the lack of knowledge in the neurophysiology of the VN and GI tract limits the development of advanced treatments for autonomic dysfunctions related to the VN. To better understand the complicated underlying mechanisms of the VN-GI tract neurophysiology, it is necessary to use an advanced device enabled by microfabrication technologies. Among several candidates including intraneural probe array and extraneural cuff electrodes, microchannel electrode array devices can be used to interface with smaller numbers of nerve fibers by securing them in the separate channel structures. Previous microchannel electrode array devices to interface teased nerve structures are relatively bulky with thickness around 200 µm. The thick design can potentially harm the delicate tissue structures, including the nerve itself. In this paper, we present a flexible thin film based microchannel electrode array device (thickness: 11.5 µm) that can interface with one of the subdiaphragmatic nerve branches of the VN in a rat. We demonstrated recording evoked compound action potentials (ECAP) from a transected nerve ending that has multiple nerve fibers. Moreover, our analysis confirmed that the signals are from C-fibers that are critical in regulating autonomic neurophysiology in the GI tract.
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Affiliation(s)
- Jongcheon Lim
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, IN USA
- Birck Nanotechnology Center, Purdue University, West Lafayette, IN USA
- Center for Implantable Devices, Purdue University, West Lafayette, IN USA
| | - Peter A. Zoss
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, IN USA
| | - Terry L. Powley
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, IN USA
- Department of Psychological Sciences, Purdue University, West Lafayette, IN USA
- Purdue Institute of Integrative Neuroscience, Purdue University, West Lafayette, IN USA
| | - Hyowon Lee
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, IN USA
- Birck Nanotechnology Center, Purdue University, West Lafayette, IN USA
- Center for Implantable Devices, Purdue University, West Lafayette, IN USA
| | - Matthew P. Ward
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, IN USA
- Indiana University School of Medicine, Indianapolis, IN USA
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8
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Amani Hamedani H, Stegall T, Yang Y, Wang H, Menon A, Bhalotia A, Karathanasis E, Capadona JR, Hess-Dunning A. Flexible multifunctional titania nanotube array platform for biological interfacing. MRS BULLETIN 2023; 49:299-309. [PMID: 38645611 PMCID: PMC11026245 DOI: 10.1557/s43577-023-00628-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 10/19/2023] [Indexed: 04/23/2024]
Abstract
Abstract The current work presents a novel flexible multifunctional platform for biological interface applications. The use of titania nanotube arrays (TNAs) as a multifunctional material is explored for soft-tissue interface applications. In vitro biocompatibility of TNAs to brain-derived cells was first examined by culturing microglia cells-the resident immune cells of the central nervous system on the surface of TNAs. The release profile of an anti-inflammatory drug, dexamethasone from TNAs-on-polyimide substrates, was then evaluated under different bending modes. Flexible TNAs-on-polyimide sustained a linear release of anti-inflammatory dexamethasone up to ~11 days under different bending conditions. Finally, microfabrication processes for patterning and transferring TNA microsegments were developed to facilitate structural stability during device flexing and to expand the set of compatible polymer substrates. The techniques developed in this study can be applied to integrate TNAs or other similar nanoporous inorganic films onto various polymer substrates. Impact statement Titania nanotube arrays (TNAs) are highly tunable and biocompatible structures that lend themselves to multifunctional implementation in implanted devices. A particularly important aspect of titania nanotubes is their ability to serve as nano-reservoirs for drugs or other therapeutic agents that slowly release after implantation. To date, TNAs have been used to promote integration with rigid, dense tissues for dental and orthopedic applications. This work aims to expand the implant applications that can benefit from TNAs by integrating them onto soft polymer substrates, thereby promoting compatibility with soft tissues. The successful direct growth and integration of TNAs on polymer substrates mark a critical step toward developing mechanically compliant implantable systems with drug delivery from nanostructured inorganic functional materials. Diffusion-driven release kinetics and the high drug-loading efficiency of TNAs offer tremendous potential for sustained drug delivery for scientific investigations, to treat injury and disease, and to promote device integration with biological tissues. This work opens new opportunities for developing novel and more effective implanted devices that can significantly improve patient outcomes and quality of life. Graphical abstract Supplementary information The online version contains supplementary material available at 10.1557/s43577-023-00628-y.
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Affiliation(s)
- Hoda Amani Hamedani
- Advanced Platform Technology Center, Louis Stokes Cleveland Veterans Affairs Medical Center, Cleveland, USA
- Department of Materials Science and Engineering, Case Western Reserve University, Cleveland, USA
| | - Thomas Stegall
- Advanced Platform Technology Center, Louis Stokes Cleveland Veterans Affairs Medical Center, Cleveland, USA
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, USA
| | - Yi Yang
- Department of Electrical, Computer, and Systems Engineering, Case Western Reserve University, Cleveland, USA
| | - Haochen Wang
- Department of Electrical, Computer, and Systems Engineering, Case Western Reserve University, Cleveland, USA
| | - Ashwin Menon
- Department of Mechanical Engineering, Case Western Reserve University, Cleveland, USA
| | - Anubhuti Bhalotia
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, USA
| | - Efstathios Karathanasis
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, USA
- Case Comprehensive Cancer Center, School of Medicine, Case Western Reserve University, Cleveland, USA
| | - Jeffrey R. Capadona
- Advanced Platform Technology Center, Louis Stokes Cleveland Veterans Affairs Medical Center, Cleveland, USA
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, USA
| | - Allison Hess-Dunning
- Advanced Platform Technology Center, Louis Stokes Cleveland Veterans Affairs Medical Center, Cleveland, USA
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, USA
- Department of Electrical, Computer, and Systems Engineering, Case Western Reserve University, Cleveland, USA
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9
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Carmina D, Benfenati V, Simonelli C, Rotolo A, Cardano P, Grovale N, Mangoni di S Stefano L, de Santo T, Zamboni R, Palermo V, Muccini M, De Seta F. Innovative solutions for disease management. Bioelectron Med 2023; 9:28. [PMID: 38053220 DOI: 10.1186/s42234-023-00131-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Accepted: 11/06/2023] [Indexed: 12/07/2023] Open
Abstract
The increasing prevalence of chronic diseases is a driver for emerging big data technologies for healthcare including digital platforms for data collection, systems for active patient engagement and education, therapy specific predictive models, optimized patient pathway models. Powerful bioelectronic medicine tools for data collection, analysis and visualization allow for joint processing of large volumes of heterogeneous data, which in turn can produce new insights about patient outcomes and alternative interpretations of clinical patterns that can lead to implementation of optimized clinical decisions and clinical patient pathway by healthcare professionals.With this perspective, we identify innovative solutions for disease management and evaluate their impact on patients, payers and society, by analyzing their impact in terms of clinical outcomes (effectiveness, safety, and quality of life) and economic outcomes (cost-effectiveness, savings, and productivity).As a result, we propose a new approach based on the main pillars of innovation in the disease management area, i.e. progressive patient care models, patient-centric approaches, bioelectronics for precise medicine, and lean management that, combined with an increase in appropriate private-public-citizen-partnership, leads towards Patient-Centric Healthcare.
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Affiliation(s)
- Dafni Carmina
- Medtronic Clinical & Regulatory Solutions - Study & Scientific Solutions, Via Aurelia 866, Roma, 00165, Italy.
| | - Valentina Benfenati
- Consiglio Nazionale delle Ricerche, Istituto per la Sintesi Organica e Fotoreattività, via Gobetti 101, Bologna, 40129, Italy.
| | - Claudia Simonelli
- Medtronic Clinical & Regulatory Solutions - Study & Scientific Solutions, Via Aurelia 866, Roma, 00165, Italy
| | - Alessia Rotolo
- Consiglio Nazionale delle Ricerche, Istituto per lo Studio dei Materiali Nanostrutturati, via Gobetti 101, Bologna, 40129, Italy
| | - Paola Cardano
- Medtronic Clinical & Regulatory Solutions - Study & Scientific Solutions, Via Aurelia 866, Roma, 00165, Italy
| | - Nicoletta Grovale
- Medtronic Clinical & Regulatory Solutions - Study & Scientific Solutions, Via Aurelia 866, Roma, 00165, Italy
| | | | - Tiziana de Santo
- Medtronic Clinical & Regulatory Solutions - Study & Scientific Solutions, Via Aurelia 866, Roma, 00165, Italy
| | - Roberto Zamboni
- Consiglio Nazionale delle Ricerche, Istituto per la Sintesi Organica e Fotoreattività, via Gobetti 101, Bologna, 40129, Italy
| | - Vincenzo Palermo
- Consiglio Nazionale delle Ricerche, Istituto per la Sintesi Organica e Fotoreattività, via Gobetti 101, Bologna, 40129, Italy
| | - Michele Muccini
- Consiglio Nazionale delle Ricerche, Istituto per lo Studio dei Materiali Nanostrutturati, via Gobetti 101, Bologna, 40129, Italy
- Mister Smart Innovation S, via Gobetti 101, Bologna, 40129, Italy
| | - Francesco De Seta
- Medtronic Clinical & Regulatory Solutions - Study & Scientific Solutions, Via Aurelia 866, Roma, 00165, Italy
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10
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Giannotti A, Lo Vecchio S, Musco S, Pollina L, Vallone F, Strauss I, Paggi V, Bernini F, Gabisonia K, Carlucci L, Lenzi C, Pirone A, Giannessi E, Miragliotta V, Lacour S, Del Popolo G, Moccia S, Micera S. Decoding bladder state from pudendal intraneural signals in pigs. APL Bioeng 2023; 7:046101. [PMID: 37811476 PMCID: PMC10558243 DOI: 10.1063/5.0156484] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Accepted: 09/11/2023] [Indexed: 10/10/2023] Open
Abstract
Neuroprosthetic devices used for the treatment of lower urinary tract dysfunction, such as incontinence or urinary retention, apply a pre-set continuous, open-loop stimulation paradigm, which can cause voiding dysfunctions due to neural adaptation. In the literature, conditional, closed-loop stimulation paradigms have been shown to increase bladder capacity and voiding efficacy compared to continuous stimulation. Current limitations to the implementation of the closed-loop stimulation paradigm include the lack of robust and real-time decoding strategies for the bladder fullness state. We recorded intraneural pudendal nerve signals in five anesthetized pigs. Three bladder-filling states, corresponding to empty, full, and micturition, were decoded using the Random Forest classifier. The decoding algorithm showed a mean balanced accuracy above 86.67% among the three classes for all five animals. Our approach could represent an important step toward the implementation of an adaptive real-time closed-loop stimulation protocol for pudendal nerve modulation, paving the way for the design of an assisted-as-needed neuroprosthesis.
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Affiliation(s)
- A. Giannotti
- The BioRobotics Institute and Department of Excellence in Robotics and AI, Scuola Superiore Sant'Anna, Pisa, Italy
| | - S. Lo Vecchio
- The BioRobotics Institute and Department of Excellence in Robotics and AI, Scuola Superiore Sant'Anna, Pisa, Italy
| | - S. Musco
- Neuro-Urology Department, Careggi University Hospital, Firenze, Italy
| | - L. Pollina
- Bertarelli Foundation Chair in Translational NeuroEngineering, Neuro-X Institute, École Polytechnique Fédérale de Lausanne, Lausanne, Switzerland
| | - F. Vallone
- The BioRobotics Institute and Department of Excellence in Robotics and AI, Scuola Superiore Sant'Anna, Pisa, Italy
| | - I. Strauss
- Laboratory for Biomedical Microtechnology, Department of Microsystems Engineering–IMTEK, IMBIT//NeuroProbes BrainLinks-BrainTools Cluster of Excellence, University of Freiburg, Freiburg, Germany
| | - V. Paggi
- Bertarelli Foundation Chair in Microengineering and Bioengineering, Neuro-X Institute, École Polytechnique Fédérale de Lausanne, Lausanne, Switzerland
| | - F. Bernini
- BioMedLab, Scuola Superiore Sant'Anna, Pisa, Italy
| | - K. Gabisonia
- BioMedLab, Scuola Superiore Sant'Anna, Pisa, Italy
| | - L. Carlucci
- BioMedLab, Scuola Superiore Sant'Anna, Pisa, Italy
| | - C. Lenzi
- Department of Veterinary Sciences, University of Pisa, Pisa, Italy
| | - A. Pirone
- Department of Veterinary Sciences, University of Pisa, Pisa, Italy
| | - E. Giannessi
- Department of Veterinary Sciences, University of Pisa, Pisa, Italy
| | - V. Miragliotta
- Department of Veterinary Sciences, University of Pisa, Pisa, Italy
| | - S. Lacour
- Bertarelli Foundation Chair in Microengineering and Bioengineering, Neuro-X Institute, École Polytechnique Fédérale de Lausanne, Lausanne, Switzerland
| | - G. Del Popolo
- Neuro-Urology Department, Careggi University Hospital, Firenze, Italy
| | - S. Moccia
- The BioRobotics Institute and Department of Excellence in Robotics and AI, Scuola Superiore Sant'Anna, Pisa, Italy
| | - S. Micera
- Author to whom correspondence should be addressed:
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11
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Ron T, Leon A, Kafri A, Ashraf A, Na J, Babu A, Banerjee R, Brookbank H, Muddaluri SR, Little KJ, Aghion E, Pixley S. Nerve Regeneration with a Scaffold Incorporating an Absorbable Zinc-2% Iron Alloy Filament to Improve Axonal Guidance. Pharmaceutics 2023; 15:2595. [PMID: 38004574 PMCID: PMC10674795 DOI: 10.3390/pharmaceutics15112595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Revised: 10/30/2023] [Accepted: 11/02/2023] [Indexed: 11/26/2023] Open
Abstract
Peripheral nerve damage that results in lost segments requires surgery, but currently available hollow scaffolds have limitations that could be overcome by adding internal guidance support. A novel solution is to use filaments of absorbable metals to supply physical support and guidance for nerve regeneration that then safely disappear from the body. Previously, we showed that thin filaments of magnesium metal (Mg) would support nerve regeneration. Here, we tested another absorbable metal, zinc (Zn), using a proprietary zinc alloy with 2% iron (Zn-2%Fe) that was designed to overcome the limitations of both Mg and pure Zn metal. Non-critical-sized gaps in adult rat sciatic nerves were repaired with silicone conduits plus single filaments of Zn-2%Fe, Mg, or no metal, with autografts as controls. After seventeen weeks, all groups showed equal recovery of function and axonal density at the distal end of the conduit. The Zn alloy group showed some improvements in early rat health and recovery of function. The alloy had a greater local accumulation of degradation products and inflammatory cells than Mg; however, both metals had an equally thin capsule (no difference in tissue irritation) and no toxicity or inflammation in neighboring nerve tissues. Therefore, Zn-2%Fe, like Mg, is biocompatible and has great potential for use in nervous tissue regeneration and repair.
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Affiliation(s)
- Tomer Ron
- Department of Materials Engineering, Ben-Gurion University of the Negev, Beer-Sheva 8410501, Israel
| | - Avi Leon
- Department of Materials Engineering, Ben-Gurion University of the Negev, Beer-Sheva 8410501, Israel
| | - Alon Kafri
- Department of Materials Engineering, Ben-Gurion University of the Negev, Beer-Sheva 8410501, Israel
- Nuclear Research Centre-Negev, Beer-Sheva 84190, Israel
| | - Ahmed Ashraf
- College of Medicine, University of Cincinnati, Cincinnati, OH 45267, USA
| | - John Na
- College of Medicine, University of Cincinnati, Cincinnati, OH 45267, USA
| | - Ashvin Babu
- School of Medicine, Case Western Reserve University, Cleveland, OH 44106, USA
| | - Runima Banerjee
- College of Engineering & Applied Sciences, University of Cincinnati, Cincinnati, OH 45221, USA
| | - Hunter Brookbank
- College of Arts & Sciences, University of Cincinnati, Cincinnati, OH 45221, USA
| | | | - Kevin J. Little
- Department of Orthopedic Surgery, College of Medicine, University of Cincinnati, Cincinnati, OH 45267, USA
- Pediatric Hand & Upper Extremity Center, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH 45229, USA
| | - Eli Aghion
- Department of Materials Engineering, Ben-Gurion University of the Negev, Beer-Sheva 8410501, Israel
| | - Sarah Pixley
- Department of Pharmacology & Systems Physiology, College of Medicine, University of Cincinnati, Cincinnati, OH 45267, USA
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12
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Song S, Fallegger F, Trouillet A, Kim K, Lacour SP. Deployment of an electrocorticography system with a soft robotic actuator. Sci Robot 2023; 8:eadd1002. [PMID: 37163609 DOI: 10.1126/scirobotics.add1002] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
Electrocorticography (ECoG) is a minimally invasive approach frequently used clinically to map epileptogenic regions of the brain and facilitate lesion resection surgery and increasingly explored in brain-machine interface applications. Current devices display limitations that require trade-offs among cortical surface coverage, spatial electrode resolution, aesthetic, and risk consequences and often limit the use of the mapping technology to the operating room. In this work, we report on a scalable technique for the fabrication of large-area soft robotic electrode arrays and their deployment on the cortex through a square-centimeter burr hole using a pressure-driven actuation mechanism called eversion. The deployable system consists of up to six prefolded soft legs, and it is placed subdurally on the cortex using an aqueous pressurized solution and secured to the pedestal on the rim of the small craniotomy. Each leg contains soft, microfabricated electrodes and strain sensors for real-time deployment monitoring. In a proof-of-concept acute surgery, a soft robotic electrode array was successfully deployed on the cortex of a minipig to record sensory cortical activity. This soft robotic neurotechnology opens promising avenues for minimally invasive cortical surgery and applications related to neurological disorders such as motor and sensory deficits.
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Affiliation(s)
- Sukho Song
- Laboratory for Soft Bioelectronic Interfaces, Neuro-X Institute, Ecole Polytechnique Fédérale de Lausanne (EPFL), 1202 Geneva, Switzerland
- Laboratory of Sustainability Robotics, Swiss Federal Laboratories for Materials Science and Technology (Empa), 8600 Dübendorf, Switzerland
| | - Florian Fallegger
- Laboratory for Soft Bioelectronic Interfaces, Neuro-X Institute, Ecole Polytechnique Fédérale de Lausanne (EPFL), 1202 Geneva, Switzerland
| | - Alix Trouillet
- Laboratory for Soft Bioelectronic Interfaces, Neuro-X Institute, Ecole Polytechnique Fédérale de Lausanne (EPFL), 1202 Geneva, Switzerland
| | - Kyungjin Kim
- Laboratory for Soft Bioelectronic Interfaces, Neuro-X Institute, Ecole Polytechnique Fédérale de Lausanne (EPFL), 1202 Geneva, Switzerland
- Department of Mechanical Engineering, University of Connecticut, Storrs, CT 06269, USA
| | - Stéphanie P Lacour
- Laboratory for Soft Bioelectronic Interfaces, Neuro-X Institute, Ecole Polytechnique Fédérale de Lausanne (EPFL), 1202 Geneva, Switzerland
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13
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Stieglitz T, Gueli C, Martens J, Floto N, Eickenscheidt M, Sporer M, Ortmanns M. Highly conformable chip-in-foil implants for neural applications. MICROSYSTEMS & NANOENGINEERING 2023; 9:54. [PMID: 37180455 PMCID: PMC10167239 DOI: 10.1038/s41378-023-00527-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 02/26/2023] [Accepted: 03/24/2023] [Indexed: 05/16/2023]
Abstract
Demands for neural interfaces around functionality, high spatial resolution, and longevity have recently increased. These requirements can be met with sophisticated silicon-based integrated circuits. Embedding miniaturized dice in flexible polymer substrates significantly improves their adaptation to the mechanical environment in the body, thus improving the systems' structural biocompatibility and ability to cover larger areas of the brain. This work addresses the main challenges in developing a hybrid chip-in-foil neural implant. Assessments considered (1) the mechanical compliance to the recipient tissue that allows a long-term application and (2) the suitable design that allows the implant's scaling and modular adaptation of chip arrangement. Finite element model studies were performed to identify design rules regarding die geometry, interconnect routing, and positions for contact pads on dice. Providing edge fillets in the die base shape proved an effective measure to improve die-substrate integrity and increase the area available for contact pads. Furthermore, routing of interconnects in the immediate vicinity of die corners should be avoided, as the substrate in these areas is prone to mechanical stress concentration. Contact pads on dice should be placed with a clearance from the die rim to avoid delamination when the implant conforms to a curvilinear body. A microfabrication process was developed to transfer, align, and electrically interconnect multiple dice into conformable polyimide-based substrates. The process enabled arbitrary die shape and size over independent target positions on the conformable substrate based on the die position on the fabrication wafer.
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Affiliation(s)
- Thomas Stieglitz
- Laboratory for Biomedical Microtechnology, Department of Microsystems Engineering - IMTEK, University of Freiburg, D-79110 Freiburg, Germany
- BrainLinks-BrainTools// IMBIT, University of Freiburg, D-79110 Freiburg, Germany
| | - Calogero Gueli
- Laboratory for Biomedical Microtechnology, Department of Microsystems Engineering - IMTEK, University of Freiburg, D-79110 Freiburg, Germany
| | - Julien Martens
- Laboratory for Biomedical Microtechnology, Department of Microsystems Engineering - IMTEK, University of Freiburg, D-79110 Freiburg, Germany
- BrainLinks-BrainTools// IMBIT, University of Freiburg, D-79110 Freiburg, Germany
| | - Niklas Floto
- Laboratory for Biomedical Microtechnology, Department of Microsystems Engineering - IMTEK, University of Freiburg, D-79110 Freiburg, Germany
- BrainLinks-BrainTools// IMBIT, University of Freiburg, D-79110 Freiburg, Germany
| | - Max Eickenscheidt
- Laboratory for Biomedical Microtechnology, Department of Microsystems Engineering - IMTEK, University of Freiburg, D-79110 Freiburg, Germany
| | - Markus Sporer
- Institute of Microelectronics, University of Ulm, D-89081 Ulm, Germany
| | - Maurits Ortmanns
- Institute of Microelectronics, University of Ulm, D-89081 Ulm, Germany
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14
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Bensmaia SJ, Tyler DJ, Micera S. Restoration of sensory information via bionic hands. Nat Biomed Eng 2023; 7:443-455. [PMID: 33230305 PMCID: PMC10233657 DOI: 10.1038/s41551-020-00630-8] [Citation(s) in RCA: 74] [Impact Index Per Article: 74.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2019] [Accepted: 09/13/2020] [Indexed: 12/19/2022]
Abstract
Individuals who have lost the use of their hands because of amputation or spinal cord injury can use prosthetic hands to restore their independence. A dexterous prosthesis requires the acquisition of control signals that drive the movements of the robotic hand, and the transmission of sensory signals to convey information to the user about the consequences of these movements. In this Review, we describe non-invasive and invasive technologies for conveying artificial sensory feedback through bionic hands, and evaluate the technologies' long-term prospects.
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Affiliation(s)
- Sliman J Bensmaia
- Department of Organismal Biology and Anatomy, University of Chicago, Chicago, IL, USA.
- Committee on Computational Neuroscience, University of Chicago, Chicago, IL, USA.
- Grossman Institute for Neuroscience, Quantitative Biology, and Human Behavior, University of Chicago, Chicago, IL, USA.
| | - Dustin J Tyler
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH, USA
- Louis Stokes Cleveland Veterans Affairs Medical Center, Cleveland, OH, USA
| | - Silvestro Micera
- The BioRobotics Institute, Scuola Superiore Sant'Anna, Pisa, Italy.
- Translational Neural Engineering Laboratory, Center for Neuroprosthetics and Institute of Bioengineering, School of Engineering, École Polytechnique Federale de Lausanne, Lausanne, Switzerland.
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15
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Farina D, Vujaklija I, Brånemark R, Bull AMJ, Dietl H, Graimann B, Hargrove LJ, Hoffmann KP, Huang HH, Ingvarsson T, Janusson HB, Kristjánsson K, Kuiken T, Micera S, Stieglitz T, Sturma A, Tyler D, Weir RFF, Aszmann OC. Toward higher-performance bionic limbs for wider clinical use. Nat Biomed Eng 2023; 7:473-485. [PMID: 34059810 DOI: 10.1038/s41551-021-00732-x] [Citation(s) in RCA: 68] [Impact Index Per Article: 68.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Accepted: 04/01/2021] [Indexed: 12/19/2022]
Abstract
Most prosthetic limbs can autonomously move with dexterity, yet they are not perceived by the user as belonging to their own body. Robotic limbs can convey information about the environment with higher precision than biological limbs, but their actual performance is substantially limited by current technologies for the interfacing of the robotic devices with the body and for transferring motor and sensory information bidirectionally between the prosthesis and the user. In this Perspective, we argue that direct skeletal attachment of bionic devices via osseointegration, the amplification of neural signals by targeted muscle innervation, improved prosthesis control via implanted muscle sensors and advanced algorithms, and the provision of sensory feedback by means of electrodes implanted in peripheral nerves, should all be leveraged towards the creation of a new generation of high-performance bionic limbs. These technologies have been clinically tested in humans, and alongside mechanical redesigns and adequate rehabilitation training should facilitate the wider clinical use of bionic limbs.
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Affiliation(s)
- Dario Farina
- Department of Bioengineering, Imperial College London, London, UK.
| | - Ivan Vujaklija
- Department of Electrical Engineering and Automation, Aalto University, Espoo, Finland
| | - Rickard Brånemark
- Center for Extreme Bionics, Biomechatronics Group, MIT Media Lab, Massachusetts Institute of Technology, Cambridge, MA, USA
- Department of Orthopaedics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Anthony M J Bull
- Department of Bioengineering, Imperial College London, London, UK
| | - Hans Dietl
- Ottobock Products SE & Co. KGaA, Vienna, Austria
| | | | - Levi J Hargrove
- Center for Bionic Medicine, Shirley Ryan AbilityLab, Chicago, IL, USA
- Department of Physical Medicine & Rehabilitation, Northwestern University, Chicago, IL, USA
- Department of Biomedical Engineering, Northwestern University, Chicago, IL, USA
| | - Klaus-Peter Hoffmann
- Department of Medical Engineering & Neuroprosthetics, Fraunhofer-Institut für Biomedizinische Technik, Sulzbach, Germany
| | - He Helen Huang
- NCSU/UNC Joint Department of Biomedical Engineering, North Carolina State University, Raleigh, NC, USA
- University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Thorvaldur Ingvarsson
- Department of Research and Development, Össur Iceland, Reykjavík, Iceland
- Faculty of Medicine, University of Iceland, Reykjavík, Iceland
| | - Hilmar Bragi Janusson
- School of Engineering and Natural Sciences, University of Iceland, Reykjavík, Iceland
| | | | - Todd Kuiken
- Center for Bionic Medicine, Shirley Ryan AbilityLab, Chicago, IL, USA
- Department of Physical Medicine & Rehabilitation, Northwestern University, Chicago, IL, USA
- Department of Biomedical Engineering, Northwestern University, Chicago, IL, USA
| | - Silvestro Micera
- The Biorobotics Institute and Department of Excellence in Robotics and AI, Scuola Superiore Sant'Anna, Pontedera, Italy
- Department of Excellence in Robotics and AI, Scuola Superiore Sant'Anna, Pontedera, Italy
- Bertarelli Foundation Chair in Translational NeuroEngineering, Center for Neuroprosthetics and Institute of Bioengineering, School of Engineering, Ecole Polytechnique Federale de Lausanne, Lausanne, Switzerland
| | - Thomas Stieglitz
- Laboratory for Biomedical Microtechnology, Department of Microsystems Engineering-IMTEK, BrainLinks-BrainTools Center and Bernstein Center Freiburg, University of Freiburg, Freiburg, Germany
| | - Agnes Sturma
- Department of Bioengineering, Imperial College London, London, UK
- Clinical Laboratory for Bionic Extremity Reconstruction, Department of Plastic and Reconstructive Surgery, Medical University of Vienna, Vienna, Austria
| | - Dustin Tyler
- Case School of Engineering, Case Western Reserve University, Cleveland, OH, USA
- Louis Stokes Veterans Affairs Medical Centre, Cleveland, OH, USA
| | - Richard F Ff Weir
- Biomechatronics Development Laboratory, Bioengineering Department, University of Colorado Denver and VA Eastern Colorado Healthcare System, Aurora, CO, USA
| | - Oskar C Aszmann
- Clinical Laboratory for Bionic Extremity Reconstruction, Department of Plastic and Reconstructive Surgery, Medical University of Vienna, Vienna, Austria
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16
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Sun T, Tsaava T, Peragine J, Crosfield C, Lopez MF, Modi R, Sharma R, Li C, Sohal H, Chang EH, Rieth L. Flexible IrO x neural electrode for mouse vagus nerve stimulation. Acta Biomater 2023; 159:394-409. [PMID: 36669547 PMCID: PMC10823593 DOI: 10.1016/j.actbio.2023.01.026] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 12/26/2022] [Accepted: 01/10/2023] [Indexed: 01/19/2023]
Abstract
Vagus nerve stimulation (VNS) is being actively explored as a treatment for multiple conditions as part of bioelectronic medicine research. Reliable and safe VNS in mouse models is a critical need for understanding mechanisms of these. We report on the development and evaluation of a microfabricated cuff electrode (MouseFlex) constructed of polyimide (PI) and with iridium oxide (IrOx) electrodes that is thermoformed to 86 µm ± 12 µm radius to interface the mouse cervical vagus nerve (r ≈ 50 µm). Innovative bench-top methods were used to evaluate the stimulation stability and electrochemical properties of electrodes. Our aggressive stimulation stability (Stim-Stab) test utilized 1 billion pulses at a 1000 Hz with a current density of 6.28 A/cm2 (1.51 mC/cm2/phase) delivering 3023 × 103 C/cm2 to evaluate electrode lifetimes, and all electrodes remained functional. We also investigated the effects of thermoforming on their impedance, charge storage capacity (CSC), and charge injection capacity (CIC). The modest changes in electrochemical properties indicate that the thermoforming process was well tolerated. Thermoformed electrode safety and efficacy were evaluated in-vivo by performing acute VNS in mice and monitoring their heart and respiration rate as biomarkers. Their electrochemical properties were also measured before, during and after VNS. Bradycardia and bradypnea were reliably induced at stimulation currents of 100 to 200 µA, well below the in-vivo CIC of ∼1250 µA (∼0.5 mC/cm2), supporting their safety and efficacy. The electrode impedance increased and CIC decreased during in-vivo use, but largely reversed these changes in in-vitro testing after enzymatic cleaning, supporting their tolerance for surgical use. STATEMENT OF SIGNIFICANCE: Vagus nerve stimulation (VNS) is a rapidly growing aspect of healthcare and bioelectronic medicine research. Reliable and safe VNS in mice with small diameter (d ≈ 100 µm) nerves has been a challenge due to achieving intimate contact with the nerve, and the stimulation stability of commonly used electrodes. We demonstrate a microfabricated (MouseFlex) cuff electrode constructed of polyimide with IrOx electrodes that is thermoformed to contact the mouse cervical vagus. Bench studies highlight the stimulation stability exceeded 109 pulses at 6.28 A/cm2 and their electrochemical properties were measured before, during, and after bench and nerve stimulation. Nerve stimulation induced bradycardia and bradypnea at currents below the in-vivo charge injection capacity, supporting their safety, efficacy, and tolerance for surgical handling.
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Affiliation(s)
- Tao Sun
- Mechanical & Aerospace Engineering Department, Benjamin M. Statler College of Engineering & Mineral Resources, West Virginia University, Morgantown, WV 26505, United States
| | - Téa Tsaava
- Institute of Bioelectronic Medicine, Feinstein Institutes for Medical Research, Manhasset, New York 11030, United States
| | - Joanne Peragine
- Institute of Bioelectronic Medicine, Feinstein Institutes for Medical Research, Manhasset, New York 11030, United States
| | - Christine Crosfield
- Institute of Bioelectronic Medicine, Feinstein Institutes for Medical Research, Manhasset, New York 11030, United States
| | | | - Romil Modi
- Institute of Bioelectronic Medicine, Feinstein Institutes for Medical Research, Manhasset, New York 11030, United States
| | - Rohit Sharma
- Electrical and Computer Engineering Department, University of Utah, Salt Lake City, UT 84112, United States; Applied Biosensors, Salt Lake City, UT 84115, United States
| | - Chunyan Li
- Institute of Bioelectronic Medicine, Feinstein Institutes for Medical Research, Manhasset, New York 11030, United States
| | | | - Eric H Chang
- Institute of Bioelectronic Medicine, Feinstein Institutes for Medical Research, Manhasset, New York 11030, United States
| | - Loren Rieth
- Mechanical & Aerospace Engineering Department, Benjamin M. Statler College of Engineering & Mineral Resources, West Virginia University, Morgantown, WV 26505, United States.
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17
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Borda E, Medagoda DI, Airaghi Leccardi MJI, Zollinger EG, Ghezzi D. Conformable neural interface based on off-stoichiometry thiol-ene-epoxy thermosets. Biomaterials 2023; 293:121979. [PMID: 36586146 DOI: 10.1016/j.biomaterials.2022.121979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Revised: 11/29/2022] [Accepted: 12/21/2022] [Indexed: 12/28/2022]
Abstract
Off-stoichiometry thiol-ene-epoxy (OSTE+) thermosets show low permeability to gases and little absorption of dissolved molecules, allow direct low-temperature dry bonding without surface treatments, have a low Young's modulus, and can be manufactured via UV polymerisation. For these reasons, OSTE+ thermosets have recently gained attention for the rapid prototyping of microfluidic chips. Moreover, their compatibility with standard clean-room processes and outstanding mechanical properties make OSTE+ an excellent candidate as a novel material for neural implants. Here we exploit OSTE+ to manufacture a conformable multilayer micro-electrocorticography array with 16 platinum electrodes coated with platinum black. The mechanical properties allow conformability to curved surfaces such as the brain. The low permeability and strong adhesion between layers improve the stability of the device. Acute experiments in mice show the multimodal capacity of the array to record and stimulate the neural tissue by smoothly conforming to the mouse cortex. Devices are not cytotoxic, and immunohistochemistry stainings reveal only modest foreign body reaction after two and six weeks of chronic implantation. This work introduces OSTE+ as a promising material for implantable neural interfaces.
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Affiliation(s)
- Eleonora Borda
- Medtronic Chair in Neuroengineering, Center for Neuroprosthetics and Institute of Bioengineering, School of Engineering, École Polytechnique Fédérale de Lausanne, Switzerland
| | - Danashi Imani Medagoda
- Medtronic Chair in Neuroengineering, Center for Neuroprosthetics and Institute of Bioengineering, School of Engineering, École Polytechnique Fédérale de Lausanne, Switzerland
| | - Marta Jole Ildelfonsa Airaghi Leccardi
- Medtronic Chair in Neuroengineering, Center for Neuroprosthetics and Institute of Bioengineering, School of Engineering, École Polytechnique Fédérale de Lausanne, Switzerland
| | - Elodie Geneviève Zollinger
- Medtronic Chair in Neuroengineering, Center for Neuroprosthetics and Institute of Bioengineering, School of Engineering, École Polytechnique Fédérale de Lausanne, Switzerland
| | - Diego Ghezzi
- Medtronic Chair in Neuroengineering, Center for Neuroprosthetics and Institute of Bioengineering, School of Engineering, École Polytechnique Fédérale de Lausanne, Switzerland.
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18
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Pavlov VA, Tracey KJ. Bioelectronic medicine: Preclinical insights and clinical advances. Neuron 2022; 110:3627-3644. [PMID: 36174571 PMCID: PMC10155266 DOI: 10.1016/j.neuron.2022.09.003] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2022] [Revised: 07/28/2022] [Accepted: 09/02/2022] [Indexed: 11/17/2022]
Abstract
The nervous system maintains homeostasis and health. Homeostatic disruptions underlying the pathobiology of many diseases can be controlled by bioelectronic devices targeting CNS and peripheral neural circuits. New insights into the regulatory functions of the nervous system and technological developments in bioelectronics drive progress in the emerging field of bioelectronic medicine. Here, we provide an overview of key aspects of preclinical research, translation, and clinical advances in bioelectronic medicine.
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Affiliation(s)
- Valentin A Pavlov
- Institute of Bioelectronic Medicine, the Feinstein Institutes for Medical Research, Northwell Health, Manhasset, NY, USA; Elmezzi Graduate School of Molecular Medicine, Northwell Health, Manhasset, NY, USA; Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA.
| | - Kevin J Tracey
- Institute of Bioelectronic Medicine, the Feinstein Institutes for Medical Research, Northwell Health, Manhasset, NY, USA; Elmezzi Graduate School of Molecular Medicine, Northwell Health, Manhasset, NY, USA; Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA.
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19
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Valle G. Peripheral neurostimulation for encoding artificial somatosensations. Eur J Neurosci 2022; 56:5888-5901. [PMID: 36097134 PMCID: PMC9826263 DOI: 10.1111/ejn.15822] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2022] [Revised: 08/08/2022] [Accepted: 09/08/2022] [Indexed: 01/11/2023]
Abstract
The direct neural stimulation of peripheral or central nervous systems has been shown as an effective tool to treat neurological conditions. The electrical activation of the nervous sensory pathway can be adopted to restore the artificial sense of touch and proprioception in people suffering from sensory-motor disorders. The modulation of the neural stimulation parameters has a direct effect on the electrically induced sensations, both when targeting the somatosensory cortex and the peripheral somatic nerves. The properties of the artificial sensations perceived, as their location, quality and intensity are strongly dependent on the direct modulation of pulse width, amplitude and frequency of the neural stimulation. Different sensory encoding schemes have been tested in patients showing distinct effects and outcomes according to their impact on the neural activation. Here, I reported the most adopted neural stimulation strategies to artificially encode somatosensation into the peripheral nervous system. The real-time implementation of these strategies in bionic devices is crucial to exploit the artificial sensory feedback in prosthetics. Thus, neural stimulation becomes a tool to directly communicate with the human nervous system. Given the importance of adding artificial sensory information to neuroprosthetic devices to improve their control and functionality, the choice of an optimal neural stimulation paradigm could increase the impact of prosthetic devices on the quality of life of people with sensorimotor disabilities.
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Affiliation(s)
- Giacomo Valle
- Laboratory for Neuroengineering, Department of Health Sciences and TechnologyInstitute for Robotics and Intelligent Systems, ETH ZürichZürichSwitzerland
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20
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Valle G, Aiello G, Ciotti F, Cvancara P, Martinovic T, Kravic T, Navarro X, Stieglitz T, Bumbasirevic M, Raspopovic S. Multifaceted understanding of human nerve implants to design optimized electrodes for bioelectronics. Biomaterials 2022; 291:121874. [DOI: 10.1016/j.biomaterials.2022.121874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Accepted: 10/23/2022] [Indexed: 11/24/2022]
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21
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Silveira C, Khushaba RN, Brunton E, Nazarpour K. Spatio-temporal feature extraction in sensory electroneurographic signals. PHILOSOPHICAL TRANSACTIONS. SERIES A, MATHEMATICAL, PHYSICAL, AND ENGINEERING SCIENCES 2022; 380:20210268. [PMID: 35658682 PMCID: PMC9289791 DOI: 10.1098/rsta.2021.0268] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/24/2021] [Accepted: 11/08/2021] [Indexed: 06/15/2023]
Abstract
The recording and analysis of peripheral neural signal can provide insight for various prosthetic and bioelectronics medicine applications. However, there are few studies that investigate how informative features can be extracted from population activity electroneurographic (ENG) signals. In this study, five feature extraction frameworks were implemented on sensory ENG datasets and their classification performance was compared. The datasets were collected in acute rat experiments where multi-channel nerve cuffs recorded from the sciatic nerve in response to proprioceptive stimulation of the hindlimb. A novel feature extraction framework, which incorporates spatio-temporal focus and dynamic time warping, achieved classification accuracies above 90% while keeping a low computational cost. This framework outperformed the remaining frameworks tested in this study and has improved the discrimination accuracy of the sensory signals. Thus, this study has extended the tools available to extract features from sensory population activity ENG signals. This article is part of the theme issue 'Advanced neurotechnologies: translating innovation for health and well-being'.
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Affiliation(s)
- C. Silveira
- School of Engineering, Newcastle University, Newcastle upon Tyne NE1 7RU, UK
| | - R. N. Khushaba
- Australian Center for Field Robotics, The University of Sydney, New South Wales 2006, Australia
| | - E. Brunton
- National Vision Research Institute, Australian College of Optometry, Carlton, Victoria 3053, Australia
- Department of Optometry and Vision Sciences, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, Victoria 3010, Australia
| | - K. Nazarpour
- Edinburgh Neuroprosthetics Laboratory, School of Informatics, University of Edinburgh, Edinburgh EH8 9AB, UK
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22
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Akouissi O, Lacour SP, Micera S, DeSimone A. A finite element model of the mechanical interactions between peripheral nerves and intrafascicular implants. J Neural Eng 2022; 19. [PMID: 35861557 DOI: 10.1088/1741-2552/ac7d0e] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Accepted: 06/29/2022] [Indexed: 11/11/2022]
Abstract
Objective.Intrafascicular peripheral nerve implants are key components in the development of bidirectional neuroprostheses such as touch-enabled bionic limbs for amputees. However, the durability of such interfaces is hindered by the immune response following the implantation. Among the causes linked to such reaction, the mechanical mismatch between host nerve and implant is thought to play a decisive role, especially in chronic settings.Approach.Here we focus on modeling mechanical stresses induced on the peripheral nerve by the implant's micromotion using finite element analysis. Through multiple parametric sweeps, we analyze the role of the implant's material, geometry (aspect-ratio and shape), and surface coating, deriving a set of parameters for the design of better-integrated implants.Main results.Our results indicate that peripheral nerve implants should be designed and manufactured with smooth edges, using materials at most three orders of magnitude stiffer than the nerve, and with innovative geometries to redistribute micromotion-associated loads to less delicate parts of the nerve such as the epineurium.Significance.Overall, our model is a useful tool for the peripheral nerve implant designer that is mindful of the importance of implant mechanics for long term applications.
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Affiliation(s)
- Outman Akouissi
- Bertarelli Foundation Chair in Neuroprosthetic Technology, Laboratory for Soft Bioelectronic Interfaces, Neuro-X Institute, Ecole Polytechnique Fédérale de Lausanne (EPFL), Geneva, 1202, Switzerland.,Bertarelli Foundation Chair in Translational Neuroengineering, Translational Neural Engineering Laboratory, Neuro-X Institute, Ecole Polytechnique Fédérale de Lausanne (EPFL), Geneva, 1202, Switzerland
| | - Stéphanie P Lacour
- Bertarelli Foundation Chair in Neuroprosthetic Technology, Laboratory for Soft Bioelectronic Interfaces, Neuro-X Institute, Ecole Polytechnique Fédérale de Lausanne (EPFL), Geneva, 1202, Switzerland
| | - Silvestro Micera
- Bertarelli Foundation Chair in Translational Neuroengineering, Translational Neural Engineering Laboratory, Neuro-X Institute, Ecole Polytechnique Fédérale de Lausanne (EPFL), Geneva, 1202, Switzerland.,The Biorobotics Institute and Department of Excellence in Robotics & AI, Health Science Interdisciplinary Center, Scuola Superiore Sant'Anna, Pisa, Italy
| | - Antonio DeSimone
- The Biorobotics Institute and Department of Excellence in Robotics & AI, Health Science Interdisciplinary Center, Scuola Superiore Sant'Anna, Pisa, Italy.,SISSA-International School for Advanced Studies, 34136 Trieste, Italy
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23
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Harland B, Aqrawe Z, Vomero M, Boehler C, Cheah E, Raos B, Asplund M, O'Carroll SJ, Svirskis D. A Subdural Bioelectronic Implant to Record Electrical Activity from the Spinal Cord in Freely Moving Rats. ADVANCED SCIENCE (WEINHEIM, BADEN-WURTTEMBERG, GERMANY) 2022; 9:e2105913. [PMID: 35499184 PMCID: PMC9284137 DOI: 10.1002/advs.202105913] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 04/06/2022] [Indexed: 05/28/2023]
Abstract
Bioelectronic devices have found use at the interface with neural tissue to investigate and treat nervous system disorders. Here, the development and characterization of a very thin flexible bioelectronic implant inserted along the thoracic spinal cord in rats directly in contact with and conformable to the dorsal surface of the spinal cord are presented. There is no negative impact on hind-limb functionality nor any change in the volume or shape of the spinal cord. The bioelectronic implant is maintained in rats for a period of 12 weeks. The first subdural recordings of spinal cord activity in freely moving animals are presented; rats are plugged in via a recording cable and allowed to freely behave and move around on a raised platform. Recordings contained multiple distinct voltage waveforms spatially localize to individual electrodes. This device has great potential to monitor electrical signaling in the spinal cord after an injury and in the future, this implant will facilitate the identification of biomarkers in spinal cord injury and recovery, while enabling the delivery of localized electroceutical and chemical treatments.
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Affiliation(s)
- Bruce Harland
- School of PharmacyThe University of AucklandAuckland1023New Zealand
| | - Zaid Aqrawe
- School of PharmacyThe University of AucklandAuckland1023New Zealand
| | - Maria Vomero
- Department of Microsystems Engineering (IMTEK)BrainLinks‐BrainTools CenterUniversity of FreiburgFreiburg79110Germany
| | - Christian Boehler
- Department of Microsystems Engineering (IMTEK)BrainLinks‐BrainTools CenterUniversity of FreiburgFreiburg79110Germany
| | - Ernest Cheah
- School of PharmacyThe University of AucklandAuckland1023New Zealand
| | - Brad Raos
- School of PharmacyThe University of AucklandAuckland1023New Zealand
| | - Maria Asplund
- Department of Microsystems Engineering (IMTEK)BrainLinks‐BrainTools Center and Freiburg Institute for Advanced Studies (FRIAS)University of FreiburgFreiburg79110Germany
- Division of Nursing and Medical TechnologyLuleå University of TechnologyLuleå971 87Sweden
| | - Simon J. O'Carroll
- Department of Anatomy & Medical ImagingSchool of Medical SciencesThe University of AucklandAuckland1023New Zealand
| | - Darren Svirskis
- School of PharmacyThe University of AucklandAuckland1023New Zealand
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24
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Fan Q, Dai H, Bai J, Xu J, Ma Q, Fei Z, Zhou X, Leong KW, Wang C. Degradation-resistant implanted biomaterials establish an immunosuppressive microenvironment that induces T cell exhaustion by recruiting myeloid cells. FUNDAMENTAL RESEARCH 2022. [DOI: 10.1016/j.fmre.2021.10.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
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25
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Dhawan V, Cui XT. Carbohydrate based biomaterials for neural interface applications. J Mater Chem B 2022; 10:4714-4740. [PMID: 35702979 DOI: 10.1039/d2tb00584k] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Neuroprosthetic devices that record and modulate neural activities have demonstrated immense potential for bypassing or restoring lost neurological functions due to neural injuries and disorders. However, implantable electrical devices interfacing with brain tissue are susceptible to a series of inflammatory tissue responses along with mechanical or electrical failures which can affect the device performance over time. Several biomaterial strategies have been implemented to improve device-tissue integration for high quality and stable performance. Ranging from developing smaller, softer, and more flexible electrode designs to introducing bioactive coatings and drug-eluting layers on the electrode surface, such strategies have shown different degrees of success but with limitations. With their hydrophilic properties and specific bioactivities, carbohydrates offer a potential solution for addressing some of the limitations of the existing biomolecular approaches. In this review, we summarize the role of polysaccharides in the central nervous system, with a primary focus on glycoproteins and proteoglycans, to shed light on their untapped potential as biomaterials for neural implants. Utilization of glycosaminoglycans for neural interface and tissue regeneration applications is comprehensively reviewed to provide the current state of carbohydrate-based biomaterials for neural implants. Finally, we will discuss the challenges and opportunities of applying carbohydrate-based biomaterials for neural tissue interfaces.
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Affiliation(s)
- Vaishnavi Dhawan
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, USA. .,Center for Neural Basis of Cognition, Pittsburgh, PA, USA
| | - Xinyan Tracy Cui
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, USA. .,Center for Neural Basis of Cognition, Pittsburgh, PA, USA.,McGowan Institute for Regenerative Medicine, Pittsburgh, PA, USA
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26
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Bhaskara S, Sakorikar T, Chatterjee S, Shabari Girishan K, Pandya HJ. Recent advancements in Micro-engineered devices for surface and deep brain animal studies: A review. SENSING AND BIO-SENSING RESEARCH 2022. [DOI: 10.1016/j.sbsr.2022.100483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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27
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Koppaka S, Hess-Dunning A, Tyler DJ. Biomechanical characterization of isolated epineurial and perineurial membranes of rabbit sciatic nerve. J Biomech 2022; 136:111058. [DOI: 10.1016/j.jbiomech.2022.111058] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Revised: 01/31/2022] [Accepted: 03/21/2022] [Indexed: 01/31/2023]
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28
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Yan D, Jiman AA, Bottorff EC, Patel PR, Meli D, Welle EJ, Ratze DC, Havton LA, Chestek CA, Kemp SWP, Bruns TM, Yoon E, Seymour JP. Ultraflexible and Stretchable Intrafascicular Peripheral Nerve Recording Device with Axon-Dimension, Cuff-Less Microneedle Electrode Array. SMALL (WEINHEIM AN DER BERGSTRASSE, GERMANY) 2022; 18:e2200311. [PMID: 35491522 PMCID: PMC9167574 DOI: 10.1002/smll.202200311] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/16/2022] [Revised: 03/08/2022] [Indexed: 05/03/2023]
Abstract
Peripheral nerve mapping tools with higher spatial resolution are needed to advance systems neuroscience, and potentially provide a closed-loop biomarker in neuromodulation applications. Two critical challenges of microscale neural interfaces are 1) how to apply them to small peripheral nerves, and 2) how to minimize chronic reactivity. A flexible microneedle nerve array (MINA) is developed, which is the first high-density penetrating electrode array made with axon-sized silicon microneedles embedded in low-modulus thin silicone. The design, fabrication, acute recording, and chronic reactivity to an implanted MINA, are presented. Distinctive units are identified in the rat peroneal nerve. The authors also demonstrate a long-term, cuff-free, and suture-free fixation manner using rose bengal as a light-activated adhesive for two time-points. The tissue response is investigated at 1-week and 6-week time-points, including two sham groups and two MINA-implanted groups. These conditions are quantified in the left vagus nerve of rats using histomorphometry. Micro computed tomography (micro-CT) is added to visualize and quantify tissue encapsulation around the implant. MINA demonstrates a reduction in encapsulation thickness over previously quantified interfascicular methods. Future challenges include techniques for precise insertion of the microneedle electrodes and demonstrating long-term recording.
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Affiliation(s)
- Dongxiao Yan
- Department of Electrical Engineering and Computer Science, University of Michigan, Ann Arbor, MI, 48109, USA
| | - Ahmad A Jiman
- Department of Electrical and Computer Engineering, King Abdulaziz University, Jeddah, Saudi Arabia
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, 48109, USA
| | - Elizabeth C Bottorff
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, 48109, USA
| | - Paras R Patel
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, 48109, USA
| | - Dilara Meli
- Department of Materials Science and Engineering, Northwestern University, Evanston, IL, 60208, USA
| | - Elissa J Welle
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, 48109, USA
| | - David C Ratze
- Department of Electrical Engineering and Computer Science, University of Michigan, Ann Arbor, MI, 48109, USA
| | - Leif A Havton
- Departments of Neurology and Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA
- James J Peters Veterans Affairs Medical Center, Bronx, NY, 10468, USA
| | - Cynthia A Chestek
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, 48109, USA
| | - Stephen W P Kemp
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, 48109, USA
- Section of Plastic Surgery, University of Michigan, Ann Arbor, MI, 48105, USA
| | - Tim M Bruns
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, 48109, USA
| | - Euisik Yoon
- Department of Electrical Engineering and Computer Science, University of Michigan, Ann Arbor, MI, 48109, USA
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, 48109, USA
- Center for Nanomedicine, Institute for Basic Science (IBS) and Graduate Program of Nano Biomedical Engineering (Nano BME), Advanced Science Institute, Yonsei University, Seoul, South Korea
| | - John P Seymour
- Department of Electrical Engineering and Computer Science, University of Michigan, Ann Arbor, MI, 48109, USA
- Department of Neurosurgery, UTHealth, Houston, TX, 77030, USA
- Department of Electrical and Computer Engineering, Rice University, Houston, TX, 77030, USA
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29
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Redolfi Riva E, D’Alessio A, Micera S. Polysaccharide Layer-by-Layer Coating for Polyimide-Based Neural Interfaces. MICROMACHINES 2022; 13:mi13050692. [PMID: 35630159 PMCID: PMC9146946 DOI: 10.3390/mi13050692] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 04/19/2022] [Accepted: 04/27/2022] [Indexed: 02/01/2023]
Abstract
Implantable flexible neural interfaces (IfNIs) are capable of directly modulating signals of the central and peripheral nervous system by stimulating or recording the action potential. Despite outstanding results in acute experiments on animals and humans, their long-term biocompatibility is hampered by the effects of foreign body reactions that worsen electrical performance and cause tissue damage. We report on the fabrication of a polysaccharide nanostructured thin film as a coating of polyimide (PI)-based IfNIs. The layer-by-layer technique was used to coat the PI surface due to its versatility and ease of manufacturing. Two different LbL deposition techniques were tested and compared: dip coating and spin coating. Morphological and physiochemical characterization showed the presence of a very smooth and nanostructured thin film coating on the PI surface that remarkably enhanced surface hydrophilicity with respect to the bare PI surface for both the deposition techniques. However, spin coating offered more control over the fabrication properties, with the possibility to tune the coating’s physiochemical and morphological properties. Overall, the proposed coating strategies allowed the deposition of a biocompatible nanostructured film onto the PI surface and could represent a valid tool to enhance long-term IfNI biocompatibility by improving tissue/electrode integration.
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Affiliation(s)
- Eugenio Redolfi Riva
- The BioRobotics Institute, Department of Excellence in Robotics and AI, Scuola Superiore Sant’Anna, 56127 Pisa, Italy; (A.D.); (S.M.)
- Correspondence:
| | - Angela D’Alessio
- The BioRobotics Institute, Department of Excellence in Robotics and AI, Scuola Superiore Sant’Anna, 56127 Pisa, Italy; (A.D.); (S.M.)
| | - Silvestro Micera
- The BioRobotics Institute, Department of Excellence in Robotics and AI, Scuola Superiore Sant’Anna, 56127 Pisa, Italy; (A.D.); (S.M.)
- Translational Neuroengineering, Centre for Neuroprosthetics and Institute of Bioengineering, School of Engineering, École Polytechnique Fédérale de Lausanne (EPFL), 1000 Lausanne, Switzerland
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30
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Karczewski AM, Zeng W, Stratchko LM, Bachus KN, Poore SO, Dingle AM. Clinical Basis for Creating an Osseointegrated Neural Interface. Front Neurosci 2022; 16:828593. [PMID: 35495044 PMCID: PMC9039253 DOI: 10.3389/fnins.2022.828593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Accepted: 03/16/2022] [Indexed: 11/13/2022] Open
Abstract
As technology continues to improve within the neuroprosthetic landscape, there has been a paradigm shift in the approach to amputation and surgical implementation of haptic neural prosthesis for limb restoration. The Osseointegrated Neural Interface (ONI) is a proposed solution involving the transposition of terminal nerves into the medullary canal of long bones. This design combines concepts of neuroma formation and prevention with osseointegration to provide a stable environment for conduction of neural signals for sophisticated prosthetic control. While this concept has previously been explored in animal models, it has yet to be explored in humans. This anatomic study used three upper limb and three lower limb cadavers to assess the clinical feasibility of creating an ONI in humans. Anatomical measurement of the major peripheral nerves- circumference, length, and depth- were performed as they are critical for electrode design and rerouting of the nerves into the long bones. CT imaging was used for morphologic bone evaluation and virtual implantation of two osseointegrated implants were performed to assess the amount of residual medullary space available for housing the neural interfacing hardware. Use of a small stem osseointegrated implant was found to reduce bone removal and provide more intramedullary space than a traditional implant; however, the higher the amputation site, the less medullary space was available regardless of implant type. Thus the stability of the endoprosthesis must be maximized while still maintaining enough residual space for the interface components. The results from this study provide an anatomic basis required for establishing a clinically applicable ONI in humans. They may serve as a guide for surgical implementation of an osseointegrated endoprosthesis with intramedullary electrodes for prosthetic control.
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Affiliation(s)
- Alison M. Karczewski
- Division of Plastic Surgery, Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, WI, United States
| | - Weifeng Zeng
- Division of Plastic Surgery, Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, WI, United States
| | - Lindsay M. Stratchko
- Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, WI, United States
- *Correspondence: Lindsay M. Stratchko,
| | - Kent N. Bachus
- George E. Wahlen Department of Veterans Affairs Medical Center and the Department of Orthopaedics, University of Utah Orthopaedic Center, Salt Lake City, UT, United States
| | - Samuel O. Poore
- Division of Plastic Surgery, Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, WI, United States
| | - Aaron M. Dingle
- Division of Plastic Surgery, Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, WI, United States
- Aaron M. Dingle,
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31
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Ottaviani MM, Vallone F, Micera S, Recchia FA. Closed-Loop Vagus Nerve Stimulation for the Treatment of Cardiovascular Diseases: State of the Art and Future Directions. Front Cardiovasc Med 2022; 9:866957. [PMID: 35463766 PMCID: PMC9021417 DOI: 10.3389/fcvm.2022.866957] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Accepted: 03/14/2022] [Indexed: 01/07/2023] Open
Abstract
The autonomic nervous system exerts a fine beat-to-beat regulation of cardiovascular functions and is consequently involved in the onset and progression of many cardiovascular diseases (CVDs). Selective neuromodulation of the brain-heart axis with advanced neurotechnologies is an emerging approach to corroborate CVDs treatment when classical pharmacological agents show limited effectiveness. The vagus nerve is a major component of the cardiac neuroaxis, and vagus nerve stimulation (VNS) is a promising application to restore autonomic function under various pathological conditions. VNS has led to encouraging results in animal models of CVDs, but its translation to clinical practice has not been equally successful, calling for more investigation to optimize this technique. Herein we reviewed the state of the art of VNS for CVDs and discuss avenues for therapeutic optimization. Firstly, we provided a succinct description of cardiac vagal innervation anatomy and physiology and principles of VNS. Then, we examined the main clinical applications of VNS in CVDs and the related open challenges. Finally, we presented preclinical studies that aim at overcoming VNS limitations through optimization of anatomical targets, development of novel neural interface technologies, and design of efficient VNS closed-loop protocols.
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Affiliation(s)
- Matteo Maria Ottaviani
- Institute of Life Sciences, Scuola Superiore Sant’Anna, Pisa, Italy
- Department of Excellence in Robotics and Artificial Intelligence, The BioRobotics Institute, Scuola Superiore Sant’Anna, Pisa, Italy
| | - Fabio Vallone
- Department of Excellence in Robotics and Artificial Intelligence, The BioRobotics Institute, Scuola Superiore Sant’Anna, Pisa, Italy
| | - Silvestro Micera
- Department of Excellence in Robotics and Artificial Intelligence, The BioRobotics Institute, Scuola Superiore Sant’Anna, Pisa, Italy
- Bertarelli Foundation Chair in Translational Neural Engineering, Center for Neuroprosthetics, Institute of Bioengineering, Ecole Polytechnique Federale de Lausanne, Lausanne, Switzerland
| | - Fabio A. Recchia
- Institute of Life Sciences, Scuola Superiore Sant’Anna, Pisa, Italy
- Fondazione Toscana Gabriele Monasterio, Pisa, Italy
- Department of Physiology, Cardiovascular Research Center, Lewis Katz School of Medicine at Temple University, Philadelphia, PA, United States
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32
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Berggren M, Głowacki ED, Simon DT, Stavrinidou E, Tybrandt K. In Vivo Organic Bioelectronics for Neuromodulation. Chem Rev 2022; 122:4826-4846. [PMID: 35050623 PMCID: PMC8874920 DOI: 10.1021/acs.chemrev.1c00390] [Citation(s) in RCA: 29] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
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The nervous system
poses a grand challenge for integration with
modern electronics and the subsequent advances in neurobiology, neuroprosthetics,
and therapy which would become possible upon such integration. Due
to its extreme complexity, multifaceted signaling pathways, and ∼1
kHz operating frequency, modern complementary metal oxide semiconductor
(CMOS) based electronics appear to be the only technology platform
at hand for such integration. However, conventional CMOS-based electronics
rely exclusively on electronic signaling and therefore require an
additional technology platform to translate electronic signals into
the language of neurobiology. Organic electronics are just such a
technology platform, capable of converting electronic addressing into
a variety of signals matching the endogenous signaling of the nervous
system while simultaneously possessing favorable material similarities
with nervous tissue. In this review, we introduce a variety of organic
material platforms and signaling modalities specifically designed
for this role as “translator”, focusing especially on
recent implementation in in vivo neuromodulation.
We hope that this review serves both as an informational resource
and as an encouragement and challenge to the field.
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Affiliation(s)
- Magnus Berggren
- Laboratory of Organic Electronics, Department of Science and Technology, Linköping University, 601 74 Norrköping, Sweden
| | - Eric D Głowacki
- Laboratory of Organic Electronics, Department of Science and Technology, Linköping University, 601 74 Norrköping, Sweden.,Bioelectronics Materials and Devices, Central European Institute of Technology, Brno University of Technology, Purkyňova 656/123, 612 00 Brno, Czech Republic
| | - Daniel T Simon
- Laboratory of Organic Electronics, Department of Science and Technology, Linköping University, 601 74 Norrköping, Sweden
| | - Eleni Stavrinidou
- Laboratory of Organic Electronics, Department of Science and Technology, Linköping University, 601 74 Norrköping, Sweden
| | - Klas Tybrandt
- Laboratory of Organic Electronics, Department of Science and Technology, Linköping University, 601 74 Norrköping, Sweden
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Losanno E, Badi M, Wurth S, Borgognon S, Courtine G, Capogrosso M, Rouiller EM, Micera S. Bayesian optimization of peripheral intraneural stimulation protocols to evoke distal limb movements. J Neural Eng 2021; 18. [PMID: 34874320 DOI: 10.1088/1741-2552/ac3f6c] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Accepted: 12/02/2021] [Indexed: 11/12/2022]
Abstract
Objective.Motor neuroprostheses require the identification of stimulation protocols that effectively produce desired movements. Manual search for these protocols can be very time-consuming and often leads to suboptimal solutions, as several stimulation parameters must be personalized for each subject for a variety of target motor functions. Here, we present an algorithm that efficiently tunes peripheral intraneural stimulation protocols to elicit functionally relevant distal limb movements.Approach.We developed the algorithm using Bayesian optimization (BO) with multi-output Gaussian Processes (GPs) and defined objective functions based on coordinated muscle recruitment. We applied the algorithm offline to data acquired in rats for walking control and in monkeys for hand grasping control and compared different GP models for these two systems. We then performed a preliminary online test in a monkey to experimentally validate the functionality of our method.Main results.Offline, optimal intraneural stimulation protocols for various target motor functions were rapidly identified in both experimental scenarios. Using the model that performed best, the algorithm converged to stimuli that evoked functionally consistent movements with an average number of actions equal to 20% of the search space size in both the rat and monkey animal models. Online, the algorithm quickly guided the observations to stimuli that elicited functional hand gestures, although more selective motor outputs could have been achieved by refining the objective function used.Significance.These results demonstrate that BO can reliably and efficiently automate the tuning of peripheral neurostimulation protocols, establishing a translational framework to configure peripheral motor neuroprostheses in clinical applications. The proposed method can also potentially be applied to optimize motor functions using other stimulation modalities.
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Affiliation(s)
- E Losanno
- The Biorobotics Institute and Department of Excellent in Robotics and AI, Scuola Superiore Sant'Anna, Pisa, Italy
| | - M Badi
- Bertarelli Foundation Chair in Translational Neuroengineering, Center for Neuroprosthetics and Institute of Bioengineering, École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland
| | - S Wurth
- Bertarelli Foundation Chair in Translational Neuroengineering, Center for Neuroprosthetics and Institute of Bioengineering, École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland
| | - S Borgognon
- Department of Neuroscience and Movement Sciences, Platform of Translational Neurosciences, Section of Medicine, Faculty of Sciences and Medicine, University of Fribourg, Fribourg, Switzerland.,Center for Neuroprosthetics and BrainMind Institute, School of Life Sciences, Eécole Polytechnique Feédeérale de Lausanne (EPFL), Lausanne, Switzerland
| | - G Courtine
- Center for Neuroprosthetics and BrainMind Institute, School of Life Sciences, Eécole Polytechnique Feédeérale de Lausanne (EPFL), Lausanne, Switzerland.,Defitech Center for Interventional Neurotherapies (NeuroRestore), EPFL, University Hospital of Lausanne (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland
| | - M Capogrosso
- Department of Neurological Surgery, Rehabilitation and Neural Engineering Laboratories, University of Pittsburgh, Pittsburgh, PA, United States of America
| | - E M Rouiller
- Department of Neuroscience and Movement Sciences, Platform of Translational Neurosciences, Section of Medicine, Faculty of Sciences and Medicine, University of Fribourg, Fribourg, Switzerland
| | - S Micera
- The Biorobotics Institute and Department of Excellent in Robotics and AI, Scuola Superiore Sant'Anna, Pisa, Italy.,Bertarelli Foundation Chair in Translational Neuroengineering, Center for Neuroprosthetics and Institute of Bioengineering, École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland
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Xu B, Pei J, Feng L, Zhang XD. Graphene and graphene-related materials as brain electrodes. J Mater Chem B 2021; 9:9485-9496. [PMID: 34797365 DOI: 10.1039/d1tb01795k] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Neural electrodes are used for acquiring neuron signals in brain-machine interfaces, and they are crucial for next-generation neuron engineering and related medical applications. Thus, developing flexible, stable and high-resolution neural electrodes will play an important role in stimulation, acquisition, recording and analysis of signals. Compared with traditional metallic electrodes, electrodes based on graphene and other two-dimensional materials have attracted wide attention in electrophysiological recording and stimulation due to their excellent physical properties such as unique flexibility, low resistance, and high optical transparency. In this review, we have reviewed the recent progress of electrodes based on graphene, graphene/polymer compounds and graphene-related materials for neuron signal recording, stimulation, and related optical signal coupling technology, which provides an outlook on the role of electrodes in the nanotechnology-neuron interface as well as medical diagnosis.
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Affiliation(s)
- Boyu Xu
- Tianjin Key Laboratory of Brain Science and Neuroengineering, Academy of Medical Engineering and Translational Medicine, Tianjin University, Tianjin 300072, China.
| | - Jiahui Pei
- Tianjin Key Laboratory of Brain Science and Neuroengineering, Academy of Medical Engineering and Translational Medicine, Tianjin University, Tianjin 300072, China.
| | - Liefeng Feng
- Tianjin Key Laboratory of Low Dimensional Materials Physics and Preparing Technology, School of Sciences, Tianjin University, Tianjin 300350, China.
| | - Xiao-Dong Zhang
- Tianjin Key Laboratory of Brain Science and Neuroengineering, Academy of Medical Engineering and Translational Medicine, Tianjin University, Tianjin 300072, China. .,Tianjin Key Laboratory of Low Dimensional Materials Physics and Preparing Technology, School of Sciences, Tianjin University, Tianjin 300350, China.
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Gueli C, Martens J, Eickenscheidt M, Stieglitz T. Scalable Batch Transfer of Individual Silicon Dice for Ultra-Flexible Polyimide-Based Bioelectronic Devices. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2021; 2021:6880-6883. [PMID: 34892687 DOI: 10.1109/embc46164.2021.9630832] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Demands on flexible neural interfaces in terms of functionality, spatial resolution and longevity have increased in the past years. These requirements can be met by sophisticated integrated circuits developed in CMOS (complementary metal oxide semiconductor) technology. Embedding such fabricated dice into flexible polymeric substrates greatly enhances the adaption to the mechanical environment in the body. With the process developed here, 100 % of individual dice (n = 34, 390 x 390 μm2) could be transferred simultaneously into polyimide (PI) substrates with simple and exact positioning (0.2° rotational and 5 μm translational error). Levelled layer build-up and standard microfabrication technologies could be used for CMOS-post-processing in order to manufacture metal interconnections between contact pads of 100 μm thin dice and PI insulation as selectively patterned device substrate. The process allows for individual positioning according to desired shape of the final chip-in-foil-system and for upscaling the number of dice to be transferred. Furthermore, final distribution and embedding of dice on the flexible substrate is independent from their distribution on the CMOS fabrication wafer the and does not require additional adhesion promoters. During fabrication the transfer method is insensitive to high temperatures (450 °C in this study) and hence enables a wide range of post-processes. Shear strength between dice and PI substrate was characterized by shear tests and results (58.1 ± 13.7 MPa) are in the range achieved with the adhesive benzocyclobutene (BCB).
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36
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Development of a magnetically aligned regenerative tissue-engineered electronic nerve interface for peripheral nerve applications. Biomaterials 2021; 279:121212. [PMID: 34717196 DOI: 10.1016/j.biomaterials.2021.121212] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2021] [Revised: 10/11/2021] [Accepted: 10/20/2021] [Indexed: 01/18/2023]
Abstract
Peripheral nerve injuries can be debilitating to motor and sensory function, with severe cases often resulting in complete limb amputation. Over the past two decades, prosthetic limb technology has rapidly advanced to provide users with crude motor control of up to 20° of freedom; however, the nerve-interfacing technology required to provide high movement selectivity has not progressed at the same rate. The work presented here focuses on the development of a magnetically aligned regenerative tissue-engineered electronic nerve interface (MARTEENI) that combines polyimide "threads" encapsulated within a magnetically aligned hydrogel scaffold. The technology exploits tissue-engineered strategies to address concerns over traditional peripheral nerve interfaces including poor axonal sampling through the nerve and rigid substrates. A magnetically templated hydrogel is used to physically support the polyimide threads while also promoting regeneration in close proximity to the electrode sites on the polyimide. This work demonstrates the utility of magnetic templating for use in tuning the mechanical properties of hydrogel scaffolds to match the stiffness of native nerve tissue while providing an aligned substrate for Schwann cell migration in vitro. MARTEENI devices were fabricated and implanted within a 5-mm-long rat sciatic-nerve transection model to assess regeneration at 6 and 12 weeks. MARTEENI devices do not disrupt tissue remodeling and show axon densities equivalent to fresh tissue controls around the polyimide substrates. Devices are observed to have attenuated foreign-body responses around the polyimide threads. It is expected that future studies with functional MARTEENI devices will be able to record and stimulate single axons with high selectivity and low stimulation regimes.
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Badi M, Wurth S, Scarpato I, Roussinova E, Losanno E, Bogaard A, Delacombaz M, Borgognon S, C Vanc Ara P, Fallegger F, Su DK, Schmidlin E, Courtine G, Bloch J, Lacour SP, Stieglitz T, Rouiller EM, Capogrosso M, Micera S. Intrafascicular peripheral nerve stimulation produces fine functional hand movements in primates. Sci Transl Med 2021; 13:eabg6463. [PMID: 34705521 DOI: 10.1126/scitranslmed.abg6463] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
[Figure: see text].
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Affiliation(s)
- Marion Badi
- Bertarelli Foundation Chair in Translational Neuroengineering, Center for Neuroprosthetics, and Institute of Bioengineering, École Polytechnique Fédérale de Lausanne (EPFL), 1015 Lausanne, Switzerland
| | - Sophie Wurth
- Bertarelli Foundation Chair in Translational Neuroengineering, Center for Neuroprosthetics, and Institute of Bioengineering, École Polytechnique Fédérale de Lausanne (EPFL), 1015 Lausanne, Switzerland
| | - Ilaria Scarpato
- Bertarelli Foundation Chair in Translational Neuroengineering, Center for Neuroprosthetics, and Institute of Bioengineering, École Polytechnique Fédérale de Lausanne (EPFL), 1015 Lausanne, Switzerland
| | - Evgenia Roussinova
- Bertarelli Foundation Chair in Translational Neuroengineering, Center for Neuroprosthetics, and Institute of Bioengineering, École Polytechnique Fédérale de Lausanne (EPFL), 1015 Lausanne, Switzerland
| | - Elena Losanno
- Biorobotics Institute and Department of Excellence in Robotics and AI, Scuola Superiore Sant'Anna, 56025 Pisa, Italy
| | - Andrew Bogaard
- Department of Neuroscience and Movement Sciences, Platform of Translational Neurosciences, Section of Medicine, Faculty of Sciences and Medicine, University of Fribourg, 1700 Fribourg, Switzerland
| | - Maude Delacombaz
- Department of Neuroscience and Movement Sciences, Platform of Translational Neurosciences, Section of Medicine, Faculty of Sciences and Medicine, University of Fribourg, 1700 Fribourg, Switzerland
| | - Simon Borgognon
- Department of Neuroscience and Movement Sciences, Platform of Translational Neurosciences, Section of Medicine, Faculty of Sciences and Medicine, University of Fribourg, 1700 Fribourg, Switzerland.,Center for Neuroprosthetics and Brain Mind Institute, School of Life Sciences, EPFL, 1015 Lausanne, Switzerland
| | - Paul C Vanc Ara
- Laboratory for Biomedical Microtechnology, Department of Microsystems Engineering-IMTEK, Bernstein Center Freiburg, and BrainLinks-BrainTools Center, University of Freiburg, 79110 Freiburg, Germany
| | - Florian Fallegger
- Bertarelli Foundation Chair in Neuroprosthetic Technology, Laboratory for Soft Bioelectronics Interface, Institute of Microengineering, Institute of Bioengineering, Centre for Neuroprosthetics, 1202 Geneva, Switzerland
| | - David K Su
- Neurological Surgery, Harborview Medical Center, Seattle, WA 98104, USA
| | - Eric Schmidlin
- Department of Neuroscience and Movement Sciences, Platform of Translational Neurosciences, Section of Medicine, Faculty of Sciences and Medicine, University of Fribourg, 1700 Fribourg, Switzerland
| | - Grégoire Courtine
- Center for Neuroprosthetics and Brain Mind Institute, School of Life Sciences, EPFL, 1015 Lausanne, Switzerland.,Defitech Center for Interventional Neurotherapies (NeuroRestore), EPFL, University Hospital of Lausanne (CHUV), and University of Lausanne (UNIL), 1015 Lausanne, Switzerland
| | - Jocelyne Bloch
- Defitech Center for Interventional Neurotherapies (NeuroRestore), EPFL, University Hospital of Lausanne (CHUV), and University of Lausanne (UNIL), 1015 Lausanne, Switzerland
| | - Stéphanie P Lacour
- Bertarelli Foundation Chair in Neuroprosthetic Technology, Laboratory for Soft Bioelectronics Interface, Institute of Microengineering, Institute of Bioengineering, Centre for Neuroprosthetics, 1202 Geneva, Switzerland
| | - Thomas Stieglitz
- Laboratory for Biomedical Microtechnology, Department of Microsystems Engineering-IMTEK, Bernstein Center Freiburg, and BrainLinks-BrainTools Center, University of Freiburg, 79110 Freiburg, Germany
| | - Eric M Rouiller
- Department of Neuroscience and Movement Sciences, Platform of Translational Neurosciences, Section of Medicine, Faculty of Sciences and Medicine, University of Fribourg, 1700 Fribourg, Switzerland
| | - Marco Capogrosso
- Department of Neuroscience and Movement Sciences, Platform of Translational Neurosciences, Section of Medicine, Faculty of Sciences and Medicine, University of Fribourg, 1700 Fribourg, Switzerland.,Department of Neurological Surgery, Rehabilitation and Neural Engineering Laboratories, University of Pittsburgh, Pittsburgh, PA 15213, USA
| | - Silvestro Micera
- Bertarelli Foundation Chair in Translational Neuroengineering, Center for Neuroprosthetics, and Institute of Bioengineering, École Polytechnique Fédérale de Lausanne (EPFL), 1015 Lausanne, Switzerland.,Biorobotics Institute and Department of Excellence in Robotics and AI, Scuola Superiore Sant'Anna, 56025 Pisa, Italy
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38
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Portillo-Lara R, Goding JA, Green RA. Adaptive biomimicry: design of neural interfaces with enhanced biointegration. Curr Opin Biotechnol 2021; 72:62-68. [PMID: 34715548 DOI: 10.1016/j.copbio.2021.10.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Revised: 10/01/2021] [Accepted: 10/06/2021] [Indexed: 12/27/2022]
Abstract
Neural interfaces (NIs) have traditionally used inorganic device constructs paired with electrical stimulation to bypass injured or diseased electroactive tissues. These bioinert devices have significant impact on the neural tissue, being synthetic and causing large volumetric changes to the biological environment. The concept of biomimicry has become popular for tissue engineering technologies, reflecting biological properties as a component of material design. Tissue engineering strategies can be harnessed in bioelectronic device design to improve biological tolerance, but the need for improved integration with the native tissue remains an unmet need. Adaptive biomimetic designs that respond to the changing neural tissue environment associated with wound healing can actively address the immune response to improve biointegration. These adaptive approaches include responsive materials paired with stem cells and bioactive molecules as integrated components of NIs. Combining adaptive biomimetics with NIs provides a new, more natural approach for communicating with the nervous system.
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Affiliation(s)
- Roberto Portillo-Lara
- Department of Bioengineering, Imperial College London, SW7 2BP, London, United Kingdom
| | - Josef A Goding
- Department of Bioengineering, Imperial College London, SW7 2BP, London, United Kingdom
| | - Rylie A Green
- Department of Bioengineering, Imperial College London, SW7 2BP, London, United Kingdom.
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39
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Lai BQ, Zeng X, Han WT, Che MT, Ding Y, Li G, Zeng YS. Stem cell-derived neuronal relay strategies and functional electrical stimulation for treatment of spinal cord injury. Biomaterials 2021; 279:121211. [PMID: 34710795 DOI: 10.1016/j.biomaterials.2021.121211] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Revised: 10/09/2021] [Accepted: 10/20/2021] [Indexed: 01/06/2023]
Abstract
The inability of adult mammals to recover function lost after severe spinal cord injury (SCI) has been known for millennia and is mainly attributed to a failure of brain-derived nerve fiber regeneration across the lesion. Potential approaches to re-establishing locomotor function rely on neuronal relays to reconnect the segregated neural networks of the spinal cord. Intense research over the past 30 years has focused on endogenous and exogenous neuronal relays, but progress has been slow and the results often controversial. Treatments with stem cell-derived neuronal relays alone or together with functional electrical stimulation offer the possibility of improved repair of neuronal networks. In this review, we focus on approaches to recovery of motor function in paralyzed patients after severe SCI based on novel therapies such as implantation of stem cell-derived neuronal relays and functional electrical stimulation. Recent research progress offers hope that SCI patients will one day be able to recover motor function and sensory perception.
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Affiliation(s)
- Bi-Qin Lai
- Key Laboratory for Stem Cells and Tissue Engineering (Sun Yat-sen University), Ministry of Education, Guangzhou, 510080, China; Co-innovation Center of Neuroregeneration, Nantong University, Nantong, 226001, China
| | - Xiang Zeng
- Key Laboratory for Stem Cells and Tissue Engineering (Sun Yat-sen University), Ministry of Education, Guangzhou, 510080, China
| | - Wei-Tao Han
- Department of Histology and Embryology, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, 510080, China
| | - Ming-Tian Che
- Key Laboratory for Stem Cells and Tissue Engineering (Sun Yat-sen University), Ministry of Education, Guangzhou, 510080, China
| | - Ying Ding
- Department of Histology and Embryology, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, 510080, China
| | - Ge Li
- Key Laboratory for Stem Cells and Tissue Engineering (Sun Yat-sen University), Ministry of Education, Guangzhou, 510080, China
| | - Yuan-Shan Zeng
- Key Laboratory for Stem Cells and Tissue Engineering (Sun Yat-sen University), Ministry of Education, Guangzhou, 510080, China; Department of Histology and Embryology, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, 510080, China; Institute of Spinal Cord Injury, Sun Yat-sen University, Guangzhou, 510120, China; Co-innovation Center of Neuroregeneration, Nantong University, Nantong, 226001, China; Guangdong Provincial Key Laboratory of Brain Function and Disease, Zhongshan, School of Medicine, Sun Yat-sen University, Guangzhou, 510080, China.
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40
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Asadullah S, Mei S, Yang K, Hu X, Wang F, Yu B, Wu Z, Wei J. Tantalum oxide submicro-particles into microporous coating on polyimide possessing antibacterial property and inducing cellular response for orthopedic application. J Mech Behav Biomed Mater 2021; 124:104800. [PMID: 34507034 DOI: 10.1016/j.jmbbm.2021.104800] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 08/22/2021] [Accepted: 08/25/2021] [Indexed: 11/19/2022]
Abstract
Surface characteristics of the biomaterials have significant effects on response of osteoblast and formation of new bone tissue. In this study, to improve the bio-performance of polyimide (PI) as an implantable material for bone substitute, concentrated sulfuric acid suspension with tantalum (V) oxide (vTO) submicro-particles of 10w% (PIST10) and 15w% (PIST15) was utilized to modify PI surface. After sulfonation, microporous coatings including vTO particles were created on PI (PIST10 and PIST15) while microporous coating without vTO particles was also created on PI (PIS). Results showed that surface roughness, hydrophilicity and protein adsorption of PIST15 was remarkably higher than PIST10 and PIS. Furthermore, after soaking into simulated body fluid (SBF), no apatite mineralization on PIS was found, while PIST15 with high vTO content exhibited better apatite mineralization compared with PIST10. Moreover, PIS showed low antibacterial property, while PIST15 with high vTO content revealed better antibacterial property compared with PIST10. In addition, cellular response (such as adhesion, proliferation and alkaline phosphatase activity) of bone marrow stromal cells (BMSC) of rat to PIST15 was higher than PIST10 and PIS. In conclusion, the microporous coating of PIST15 including vTO submicro-particles possessed good antibacterial property and bioactivity, which significantly promoted the responses of BMSC. Therefore, PIST15 has potential application prospects for bone substitute.
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Affiliation(s)
- Syed Asadullah
- Key Laboratory for Ultrafine Materials of Ministry of Education, East China University of Science and Technology, Shanghai, 200237, China
| | - Shiqi Mei
- Key Laboratory for Ultrafine Materials of Ministry of Education, East China University of Science and Technology, Shanghai, 200237, China
| | - Kong Yang
- Institute of Qinghai-Tibetan Plateau, Southwest Minzu University, Chengdu, 610064, China.
| | - Xinglong Hu
- Key Laboratory for Ultrafine Materials of Ministry of Education, East China University of Science and Technology, Shanghai, 200237, China
| | - Fan Wang
- Key Laboratory for Ultrafine Materials of Ministry of Education, East China University of Science and Technology, Shanghai, 200237, China
| | - Baoqing Yu
- Department of Orthopedics, Shanghai Pudong Hospital, Fudan University Pudong Medical Center, Shanghai, 201399, China.
| | - Zhaoying Wu
- School of Biomedical Engineering, Sun Yat-sen University, Guangzhou, Guangdong, 510006, China
| | - Jie Wei
- Key Laboratory for Ultrafine Materials of Ministry of Education, East China University of Science and Technology, Shanghai, 200237, China.
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41
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Shokur S, Mazzoni A, Schiavone G, Weber DJ, Micera S. A modular strategy for next-generation upper-limb sensory-motor neuroprostheses. MED 2021; 2:912-937. [DOI: 10.1016/j.medj.2021.05.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Revised: 04/28/2021] [Accepted: 05/10/2021] [Indexed: 02/06/2023]
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Karczewski AM, Dingle AM, Poore SO. The Need to Work Arm in Arm: Calling for Collaboration in Delivering Neuroprosthetic Limb Replacements. Front Neurorobot 2021; 15:711028. [PMID: 34366820 PMCID: PMC8334559 DOI: 10.3389/fnbot.2021.711028] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Accepted: 06/22/2021] [Indexed: 11/21/2022] Open
Abstract
Over the last few decades there has been a push to enhance the use of advanced prosthetics within the fields of biomedical engineering, neuroscience, and surgery. Through the development of peripheral neural interfaces and invasive electrodes, an individual's own nervous system can be used to control a prosthesis. With novel improvements in neural recording and signal decoding, this intimate communication has paved the way for bidirectional and intuitive control of prostheses. While various collaborations between engineers and surgeons have led to considerable success with motor control and pain management, it has been significantly more challenging to restore sensation. Many of the existing peripheral neural interfaces have demonstrated success in one of these modalities; however, none are currently able to fully restore limb function. Though this is in part due to the complexity of the human somatosensory system and stability of bioelectronics, the fragmentary and as-yet uncoordinated nature of the neuroprosthetic industry further complicates this advancement. In this review, we provide a comprehensive overview of the current field of neuroprosthetics and explore potential strategies to address its unique challenges. These include exploration of electrodes, surgical techniques, control methods, and prosthetic technology. Additionally, we propose a new approach to optimizing prosthetic limb function and facilitating clinical application by capitalizing on available resources. It is incumbent upon academia and industry to encourage collaboration and utilization of different peripheral neural interfaces in combination with each other to create versatile limbs that not only improve function but quality of life. Despite the rapidly evolving technology, if the field continues to work in divided "silos," we will delay achieving the critical, valuable outcome: creating a prosthetic limb that is right for the patient and positively affects their life.
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Affiliation(s)
| | - Aaron M. Dingle
- Division of Plastic Surgery, Department of Surgery, University of Wisconsin–Madison, Madison, WI, United States
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Raspopovic S, Valle G, Petrini FM. Sensory feedback for limb prostheses in amputees. NATURE MATERIALS 2021; 20:925-939. [PMID: 33859381 DOI: 10.1038/s41563-021-00966-9] [Citation(s) in RCA: 71] [Impact Index Per Article: 23.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Accepted: 02/22/2021] [Indexed: 06/12/2023]
Abstract
Commercial prosthetic devices currently do not provide natural sensory information on the interaction with objects or movements. The subsequent disadvantages include unphysiological walking with a prosthetic leg and difficulty in controlling the force exerted with a prosthetic hand, thus creating health issues. Restoring natural sensory feedback from the prosthesis to amputees is an unmet clinical need. An optimal device should be able to elicit natural sensations of touch or proprioception, by delivering the complex signals to the nervous system that would be produced by skin, muscles and joints receptors. This Review covers the various neurotechnological approaches that have been proposed for the development of the optimal sensory feedback restoration device for arm and leg amputees.
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Affiliation(s)
- Stanisa Raspopovic
- Laboratory for Neuroengineering, Department of Health Sciences and Technology, Institute for Robotics and Intelligent Systems, ETH Zürich, Zurich, Switzerland.
| | - Giacomo Valle
- Laboratory for Neuroengineering, Department of Health Sciences and Technology, Institute for Robotics and Intelligent Systems, ETH Zürich, Zurich, Switzerland
| | - Francesco Maria Petrini
- Laboratory for Neuroengineering, Department of Health Sciences and Technology, Institute for Robotics and Intelligent Systems, ETH Zürich, Zurich, Switzerland
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Gori M, Vadalà G, Giannitelli SM, Denaro V, Di Pino G. Biomedical and Tissue Engineering Strategies to Control Foreign Body Reaction to Invasive Neural Electrodes. Front Bioeng Biotechnol 2021; 9:659033. [PMID: 34113605 PMCID: PMC8185207 DOI: 10.3389/fbioe.2021.659033] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Accepted: 04/27/2021] [Indexed: 12/21/2022] Open
Abstract
Neural-interfaced prostheses aim to restore sensorimotor limb functions in amputees. They rely on bidirectional neural interfaces, which represent the communication bridge between nervous system and neuroprosthetic device by controlling its movements and evoking sensory feedback. Compared to extraneural electrodes (i.e., epineural and perineural implants), intraneural electrodes, implanted within peripheral nerves, have higher selectivity and specificity of neural signal recording and nerve stimulation. However, being implanted in the nerve, their main limitation is represented by the significant inflammatory response that the body mounts around the probe, known as Foreign Body Reaction (FBR), which may hinder their rapid clinical translation. Furthermore, the mechanical mismatch between the consistency of the device and the surrounding neural tissue may contribute to exacerbate the inflammatory state. The FBR is a non-specific reaction of the host immune system to a foreign material. It is characterized by an early inflammatory phase eventually leading to the formation of a fibrotic capsule around intraneural interfaces, which increases the electrical impedance over time and reduces the chronic interface biocompatibility and functionality. Thus, the future in the reduction and control of the FBR relies on innovative biomedical strategies for the fabrication of next-generation neural interfaces, such as the development of more suitable designs of the device with smaller size, appropriate stiffness and novel conductive and biomimetic coatings for improving their long-term stability and performance. Here, we present and critically discuss the latest biomedical approaches from material chemistry and tissue engineering for controlling and mitigating the FBR in chronic neural implants.
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Affiliation(s)
- Manuele Gori
- Laboratory for Regenerative Orthopaedics, Department of Orthopaedic Surgery and Traumatology, Università Campus Bio-Medico di Roma, Rome, Italy
- Institute of Biochemistry and Cell Biology (IBBC) - National Research Council (CNR), Rome, Italy
| | - Gianluca Vadalà
- Laboratory for Regenerative Orthopaedics, Department of Orthopaedic Surgery and Traumatology, Università Campus Bio-Medico di Roma, Rome, Italy
| | - Sara Maria Giannitelli
- Laboratory of Tissue Engineering, Department of Engineering, Università Campus Bio-Medico di Roma, Rome, Italy
| | - Vincenzo Denaro
- Laboratory for Regenerative Orthopaedics, Department of Orthopaedic Surgery and Traumatology, Università Campus Bio-Medico di Roma, Rome, Italy
| | - Giovanni Di Pino
- NeXT: Neurophysiology and Neuroengineering of Human-Technology Interaction Research Unit, Università Campus Bio-Medico di Roma, Rome, Italy
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45
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Lienemann S, Zötterman J, Farnebo S, Tybrandt K. Stretchable gold nanowire-based cuff electrodes for low-voltage peripheral nerve stimulation. J Neural Eng 2021; 18. [PMID: 33957608 DOI: 10.1088/1741-2552/abfebb] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Accepted: 05/06/2021] [Indexed: 12/29/2022]
Abstract
Objective. Electrical stimulation of the peripheral nervous system (PNS) can treat various diseases and disorders, including the healing process after nerve injury. A major challenge when designing electrodes for PNS stimulation is the mechanical mismatch between the nerve and the device, which can lead to non-conformal contact, tissue damage and inefficient stimulation due to current leakage. Soft and stretchable cuff electrodes promise to tackle these challenges but often have limited performance and rely on unconventional materials. The aim of this study is to develop a high performance soft and stretchable cuff electrode based on inert materials for low-voltage nerve stimulation.Approach. We developed 50µm thick stretchable cuff electrodes based on silicone rubber, gold nanowire conductors and platinum coated nanowire electrodes. The electrode performance was characterized under strain cycling to assess the durability of the electrodes. The stimulation capability of the cuff electrodes was evaluated in anin vivosciatic nerve rat model by measuring the electromyography response to various stimulation pulses.Main results. The stretchable cuff electrodes showed excellent stability for 50% strain cycling and one million stimulation pulses. Saturated homogeneous stimulation of the sciatic nerve was achieved at only 200 mV due to the excellent conformability of the electrodes, the low conductor resistance (0.3 Ohm sq-1), and the low electrode impedance.Significance. The developed stretchable cuff electrode combines favourable mechanical properties and good electrode performance with inert and stable materials, making it ideal for low power supply applications within bioelectronic medicine.
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Affiliation(s)
- Samuel Lienemann
- Laboratory of Organic Electronics, Department of Science and Technology, Linköping University, 601 74 Norrköping, Sweden
| | - Johan Zötterman
- Department of Hand Surgery, Plastic Surgery and Burns, Linköping University Hospital, Linköping, Sweden.,Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Simon Farnebo
- Department of Hand Surgery, Plastic Surgery and Burns, Linköping University Hospital, Linköping, Sweden.,Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Klas Tybrandt
- Laboratory of Organic Electronics, Department of Science and Technology, Linköping University, 601 74 Norrköping, Sweden
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Redolfi Riva E, Micera S. Progress and challenges of implantable neural interfaces based on nature-derived materials. Bioelectron Med 2021; 7:6. [PMID: 33902750 PMCID: PMC8077843 DOI: 10.1186/s42234-021-00067-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Accepted: 03/31/2021] [Indexed: 12/31/2022] Open
Abstract
Neural interfaces are bioelectronic devices capable of stimulating a population of neurons or nerve fascicles and recording electrical signals in a specific area. Despite their success in restoring sensory-motor functions in people with disabilities, their long-term exploitation is still limited by poor biocompatibility, mechanical mismatch between the device and neural tissue and the risk of a chronic inflammatory response upon implantation.In this context, the use of nature-derived materials can help address these issues. Examples of these materials, such as extracellular matrix proteins, peptides, lipids and polysaccharides, have been employed for decades in biomedical science. Their excellent biocompatibility, biodegradability in the absence of toxic compound release, physiochemical properties that are similar to those of human tissues and reduced immunogenicity make them outstanding candidates to improve neural interface biocompatibility and long-term implantation safety. The objective of this review is to highlight progress and challenges concerning the impact of nature-derived materials on neural interface design. The use of these materials as biocompatible coatings and as building blocks of insulation materials for use in implantable neural interfaces is discussed. Moreover, future perspectives are presented to show the increasingly important uses of these materials for neural interface fabrication and their possible use for other applications in the framework of neural engineering.
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Affiliation(s)
- Eugenio Redolfi Riva
- The BioRobotics Institute and Department of Excellence in Robotics and AI, Scuola Superiore Sant'Anna, Pisa, Italy.
| | - Silvestro Micera
- The BioRobotics Institute and Department of Excellence in Robotics and AI, Scuola Superiore Sant'Anna, Pisa, Italy
- Bertarelli Foundation Chair in Translational Neuroengineering, Centre for Neuroprosthetics and Institute of Bioengineering, School of Engineering, École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland
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47
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Carnicer-Lombarte A, Chen ST, Malliaras GG, Barone DG. Foreign Body Reaction to Implanted Biomaterials and Its Impact in Nerve Neuroprosthetics. Front Bioeng Biotechnol 2021; 9:622524. [PMID: 33937212 PMCID: PMC8081831 DOI: 10.3389/fbioe.2021.622524] [Citation(s) in RCA: 131] [Impact Index Per Article: 43.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Accepted: 03/19/2021] [Indexed: 12/04/2022] Open
Abstract
The implantation of any foreign material into the body leads to the development of an inflammatory and fibrotic process-the foreign body reaction (FBR). Upon implantation into a tissue, cells of the immune system become attracted to the foreign material and attempt to degrade it. If this degradation fails, fibroblasts envelop the material and form a physical barrier to isolate it from the rest of the body. Long-term implantation of medical devices faces a great challenge presented by FBR, as the cellular response disrupts the interface between implant and its target tissue. This is particularly true for nerve neuroprosthetic implants-devices implanted into nerves to address conditions such as sensory loss, muscle paralysis, chronic pain, and epilepsy. Nerve neuroprosthetics rely on tight interfacing between nerve tissue and electrodes to detect the tiny electrical signals carried by axons, and/or electrically stimulate small subsets of axons within a nerve. Moreover, as advances in microfabrication drive the field to increasingly miniaturized nerve implants, the need for a stable, intimate implant-tissue interface is likely to quickly become a limiting factor for the development of new neuroprosthetic implant technologies. Here, we provide an overview of the material-cell interactions leading to the development of FBR. We review current nerve neuroprosthetic technologies (cuff, penetrating, and regenerative interfaces) and how long-term function of these is limited by FBR. Finally, we discuss how material properties (such as stiffness and size), pharmacological therapies, or use of biodegradable materials may be exploited to minimize FBR to nerve neuroprosthetic implants and improve their long-term stability.
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Affiliation(s)
- Alejandro Carnicer-Lombarte
- Electrical Engineering Division, Department of Engineering, University of Cambridge, Cambridge, United Kingdom
| | - Shao-Tuan Chen
- Electrical Engineering Division, Department of Engineering, University of Cambridge, Cambridge, United Kingdom
| | - George G. Malliaras
- Electrical Engineering Division, Department of Engineering, University of Cambridge, Cambridge, United Kingdom
| | - Damiano G. Barone
- Electrical Engineering Division, Department of Engineering, University of Cambridge, Cambridge, United Kingdom
- Division of Neurosurgery, Department of Clinical Neurosciences, University of Cambridge, Cambridge, United Kingdom
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48
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Cracchiolo M, Ottaviani MM, Panarese A, Strauss I, Vallone F, Mazzoni A, Micera S. Bioelectronic medicine for the autonomic nervous system: clinical applications and perspectives. J Neural Eng 2021; 18. [PMID: 33592597 DOI: 10.1088/1741-2552/abe6b9] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Accepted: 02/16/2021] [Indexed: 12/11/2022]
Abstract
Bioelectronic medicine (BM) is an emerging new approach for developing novel neuromodulation therapies for pathologies that have been previously treated with pharmacological approaches. In this review, we will focus on the neuromodulation of autonomic nervous system (ANS) activity with implantable devices, a field of BM that has already demonstrated the ability to treat a variety of conditions, from inflammation to metabolic and cognitive disorders. Recent discoveries about immune responses to ANS stimulation are the laying foundation for a new field holding great potential for medical advancement and therapies and involving an increasing number of research groups around the world, with funding from international public agencies and private investors. Here, we summarize the current achievements and future perspectives for clinical applications of neural decoding and stimulation of the ANS. First, we present the main clinical results achieved so far by different BM approaches and discuss the challenges encountered in fully exploiting the potential of neuromodulatory strategies. Then, we present current preclinical studies aimed at overcoming the present limitations by looking for optimal anatomical targets, developing novel neural interface technology, and conceiving more efficient signal processing strategies. Finally, we explore the prospects for translating these advancements into clinical practice.
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Affiliation(s)
- Marina Cracchiolo
- The BioRobotics Institute and Department of Excellence in Robotics & AI, The BioRobotics Institute, Scuola Superiore Sant'Anna, Pisa, Italy
| | - Matteo Maria Ottaviani
- The BioRobotics Institute and Department of Excellence in Robotics & AI, The BioRobotics Institute, Scuola Superiore Sant'Anna, Pisa, Italy
| | - Alessandro Panarese
- The BioRobotics Institute and Department of Excellence in Robotics & AI, The BioRobotics Institute, Scuola Superiore Sant'Anna, Pisa, Italy
| | - Ivo Strauss
- The BioRobotics Institute and Department of Excellence in Robotics & AI, The BioRobotics Institute, Scuola Superiore Sant'Anna, Pisa, Italy
| | - Fabio Vallone
- The BioRobotics Institute and Department of Excellence in Robotics & AI, The BioRobotics Institute, Scuola Superiore Sant'Anna, Pisa, Italy
| | - Alberto Mazzoni
- The BioRobotics Institute and Department of Excellence in Robotics & AI, The BioRobotics Institute, Scuola Superiore Sant'Anna, Pisa, Italy
| | - Silvestro Micera
- The BioRobotics Institute and Department of Excellence in Robotics & AI, The BioRobotics Institute, Scuola Superiore Sant'Anna, Pisa, Italy.,Bertarelli Foundation Chair in Translational NeuroEngineering, Centre for Neuroprosthetics and Institute of Bioengineering, École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland
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Millevolte AXT, Dingle AM, Ness JP, Novello J, Zeng W, Lu Y, Minor RL, Nemke B, Markel MD, Suminski AJ, Williams JC, Poore SO. Improving the Selectivity of an Osseointegrated Neural Interface: Proof of Concept For Housing Sieve Electrode Arrays in the Medullary Canal of Long Bones. Front Neurosci 2021; 15:613844. [PMID: 33790731 PMCID: PMC8006940 DOI: 10.3389/fnins.2021.613844] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2020] [Accepted: 02/16/2021] [Indexed: 01/15/2023] Open
Abstract
Sieve electrodes stand poised to deliver the selectivity required for driving advanced prosthetics but are considered inherently invasive and lack the stability required for a chronic solution. This proof of concept experiment investigates the potential for the housing and engagement of a sieve electrode within the medullary canal as part of an osseointegrated neural interface (ONI) for greater selectivity toward improving prosthetic control. The working hypotheses are that (A) the addition of a sieve interface to a cuff electrode housed within the medullary canal of the femur as part of an ONI would be capable of measuring efferent and afferent compound nerve action potentials (CNAPs) through a greater number of channels; (B) that signaling improves over time; and (C) that stimulation at this interface generates measurable cortical somatosensory evoked potentials through a greater number of channels. The modified ONI was tested in a rabbit (n = 1) amputation model over 12 weeks, comparing the sieve component to the cuff, and subsequently compared to historical data. Efferent CNAPs were successfully recorded from the sieve demonstrating physiological improvements in CNAPs between weeks 3 and 5, and somatosensory cortical responses recorded at 12 weeks postoperatively. This demonstrates that sieve electrodes can be housed and function within the medullary canal, demonstrated by improved nerve engagement and distinct cortical sensory feedback. This data presents the conceptual framework for housing more sophisticated sieve electrodes in bone as part of an ONI for improving selectivity with percutaneous connectivity toward improved prosthetic control.
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Affiliation(s)
- Augusto X T Millevolte
- Division of Plastic Surgery, Department of Surgery, University of Wisconsin - Madison, Madison, WI, United States.,Department of Biomedical Engineering, College of Engineering, University of Wisconsin - Madison, Madison, WI, United States
| | - Aaron M Dingle
- Division of Plastic Surgery, Department of Surgery, University of Wisconsin - Madison, Madison, WI, United States
| | - Jared P Ness
- Department of Biomedical Engineering, College of Engineering, University of Wisconsin - Madison, Madison, WI, United States
| | - Joseph Novello
- Department of Biomedical Engineering, College of Engineering, University of Wisconsin - Madison, Madison, WI, United States
| | - Weifeng Zeng
- Division of Plastic Surgery, Department of Surgery, University of Wisconsin - Madison, Madison, WI, United States
| | - Yan Lu
- Department of Medical Sciences, University of Wisconsin - Madison, Madison, WI, United States
| | - Rashea L Minor
- Department of Medical Sciences, University of Wisconsin - Madison, Madison, WI, United States
| | - Brett Nemke
- Department of Medical Sciences, University of Wisconsin - Madison, Madison, WI, United States
| | - Mark D Markel
- Department of Medical Sciences, University of Wisconsin - Madison, Madison, WI, United States
| | - Aaron J Suminski
- Department of Biomedical Engineering, College of Engineering, University of Wisconsin - Madison, Madison, WI, United States.,Department of Medical Sciences, University of Wisconsin - Madison, Madison, WI, United States.,Department of Neurological Surgery, University of Wisconsin - Madison, Madison, WI, United States
| | - Justin C Williams
- Department of Biomedical Engineering, College of Engineering, University of Wisconsin - Madison, Madison, WI, United States.,Department of Neurological Surgery, University of Wisconsin - Madison, Madison, WI, United States
| | - Samuel O Poore
- Division of Plastic Surgery, Department of Surgery, University of Wisconsin - Madison, Madison, WI, United States.,Department of Biomedical Engineering, College of Engineering, University of Wisconsin - Madison, Madison, WI, United States
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50
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Weigel T, Brennecke J, Hansmann J. Improvement of the Electronic-Neuronal Interface by Natural Deposition of ECM. MATERIALS 2021; 14:ma14061378. [PMID: 33809094 PMCID: PMC7999149 DOI: 10.3390/ma14061378] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 02/22/2021] [Accepted: 03/09/2021] [Indexed: 01/11/2023]
Abstract
The foreign body reaction to neuronal electrode implants limits potential applications as well as the therapeutic period. Developments in the basic electrode design might improve the tissue compatibility and thereby reduce the foreign body reaction. In this work, the approach of embedding 3D carbon nanofiber electrodes in extracellular matrix (ECM) synthesized by human fibroblasts for a compatible connection to neuronal cells was investigated. Porous electrode material was manufactured by solution coelectrospinning of polyacrylonitrile and polyamide as a fibrous porogen. Moreover, NaCl represented an additional particulate porogen. To achieve the required conductivity for an electrical interface, meshes were carbonized. Through the application of two different porogens, the electrodes’ flexibility and porosity was improved. Human dermal fibroblasts were cultured on the electrode surface for ECM generation and removed afterwards. Scanning electron microscopy imaging revealed a nano fibrous ECM network covering the carbon fibers. The collagen amount of the ECM coating was quantified by hydroxyproline-assays. The modification with the natural protein coating on the electrode functionality resulted in a minor increase of the electrical capacity, which slightly improved the already outstanding electrical interface properties. Increased cell numbers of SH-SY5Y cell line on ECM-modified electrodes demonstrated an improved cell adhesion. During cell differentiation, the natural ECM enhanced the formation of neurites regarding length and branching. The conducted experiments indicated the prevention of direct cell-electrode contacts by the modification, which might help to shield temporary the electrode from immunological cells to reduce the foreign body reaction and improve the electrodes’ tissue integration.
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Affiliation(s)
- Tobias Weigel
- Translational Center for Regenerative Therapies, Fraunhofer Institute for Silicate Research ISC, 97082 Wuerzburg, Germany;
- Department Tissue Engineering and Regenerative Medicine, University Hospital Wuerzburg, 97070 Wuerzburg, Germany;
- Correspondence:
| | - Julian Brennecke
- Department Tissue Engineering and Regenerative Medicine, University Hospital Wuerzburg, 97070 Wuerzburg, Germany;
| | - Jan Hansmann
- Translational Center for Regenerative Therapies, Fraunhofer Institute for Silicate Research ISC, 97082 Wuerzburg, Germany;
- Department Tissue Engineering and Regenerative Medicine, University Hospital Wuerzburg, 97070 Wuerzburg, Germany;
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