A wireless millimetre-scale implantable neural stimulator with ultrasonically powered bidirectional communication

Multifunctional magneto-electric and exosome-loaded hydrogel enhances neuronal differentiation and immunoregulation through remote non-invasive electrical stimulation for neurological recovery after spinal cord injury

Intervention in the differentiation of neural stem cells (NSCs) is emerging as a highly promising approach for the treatment of spinal cord injury (SCI). However, NSCs at the injury site often suffer from low survival and uncontrolled differentiation. Whereas electrical stimulation has proven effective in regulating the fate of NSCs and promoting tissue repair, however, conventional electrical stimulation therapy has failed to be widely applied due to challenges such as invasiveness and technical complexity. To overcome these limitations, we developed a biomimetic magneto-electric hydrogel incorporating Fe3O4@BaTiO3 core-shell nanoparticles and human umbilical mesenchymal stem cell exosomes (HUMSC-Exos) around the concept of constructing remote noninvasive electrical stimulation for the synergistic treatment of SCI. The Fe3O4@BaTiO3 is activated by the peripheral magnetic field to generate electrical stimulation, which, in conjunction with the synergistic effects of HUMSC-Exos, significantly alleviates the early inflammatory response associated with SCI and enhances the regeneration of newborn neurons and axons, thereby creating favorable conditions for functional recovery post-SCI. Our findings indicate that applying this magneto-exosome hydrogel in a rat model of SCI leads to substantial functional recovery. This innovative combination represents a promising therapeutic strategy for SCI repair.

Continuous operation of battery-free implants enables advanced fracture recovery monitoring

Substantial hurdles in achieving a digitally connected body with seamless, chronic, high-fidelity organ interfaces include challenges of sourcing energy and ensuring reliable connectivity. Operation is currently limited by batteries that occupy large volumes. Wireless, battery-free operation is therefore paramount, requiring a system-level solution that enables seamless connection of wearable and implantable devices. Here, we present a technological framework that enables wireless, battery-free implant operation in freely moving subjects, with streaming of high-fidelity information from low-displacement, battery-free implants with little user interaction. This is accomplished using at-distance wirelessly recharged, wearable biosymbiotic devices for powering and communication with fully implantable NFC-enabled implants. We demonstrate this capability with osseosurface electronics that stream bone health insight. Eleven-month-long large animal studies highlight the ability of implants to relay information on bone health without negative impact on the subjects. Clinical translatability is shown through fracture healing studies that demonstrate biomarkers of bone union.

Wireless ultrasonic power transfer using a pre-charged CMUT structure with a built-in charge storage capacitor

Capacitive micromachined ultrasonic transducer (CMUT) technology is a potential candidate to implement an ultrasonic power receiver for implantable medical devices (IMDs) because CMUT technology employs photolithography-based microfabrication techniques amenable to miniaturization, integration with electronics, and biocompatibility. Pre-charged CMUTs operating in constant-charge mode eliminate the DC bias and this mode of operation is more suitable for ultrasound power transfer to IMDs. We designed and fabricated a novel pre-charged CMUT structure with a built-in charge storage capacitor. This new configuration features a floating electrode between the upper and lower electrodes. Charges are stored on this floating electrode prior to implantation by directly bringing the floating electrode into contact with the bottom electrode while applying a DC bias between the top and bottom electrodes of the CMUT. After pre-charging the CMUT, the charges are retained without any leakage, as confirmed by occasional measurements over the course of about two years. We have also demonstrated that this device allows operation without a DC bias and can be used as a power receiver in an IMD. In the presented design, the CMUT can be pre-charged at a desired precise charge level. The amount of trapped charge can be controlled by holding the floating electrode in contact with the bottom electrode by applying external ultrasound pressure and simultaneously maintaining a DC bias. The maximum received power was 10.1 mW, corresponding to a received power density of 3.1 mW/mm2, with a 14.5% efficiency. We have achieved an acoustic-to-electrical power conversion efficiency as high as 29.7% at lower input power levels.

Advanced development of conductive biomaterials for enhanced peripheral nerve regeneration: a review

Peripheral nerve injury (PNI), as a major cause of disability worldwide, makes it difficult to achieve effective repair and regeneration. Including autologous nerve transplantation, traditional therapies are restricted by surgical intricacy, donor scarcity, and inconsistent recovery effects. As to nerve guidance conduits (NGCs), conductive materials have brought novel pathways for PNI repair. Such materials boost nerve regeneration via electrical stimulation and bring key mechanical stability and biophysical signaling. This review summarizes the progress in conductive materials for PNI therapy while emphasizing their functions in electrical stimulation (ES), bioelectric signal transmission, and cell behavior guidance, as well as revealing the design and function needs of nerve conduits. Additionally, our review highlights the demand for follow-up studies to accentuate material optimization and improve real-time electrical signal supervision. Accordingly, this research is insightful and contributes to developing PNI repair. This results in more efficacious therapies and enhanced outcomes.

An implantable hydrogel-based phononic crystal for continuous and wireless monitoring of internal tissue strains

Conventional implantable electronic sensors for continuous monitoring of internal tissue strains are yet to match the biomechanics of tissues while maintaining biodegradability, biocompatibility and wireless monitoring capability. Here we present a two-dimensional phononic crystal composed of periodic air columns in soft hydrogel, which was named ultrasonic metagel, and we demonstrate its use as implantable sensor for continuous and wireless monitoring of internal tissue strains. The metagel's deformation shifts its ultrasonic bandgap, which can be wirelessly detected by an external ultrasonic probe. We demonstrate ex vivo the ability of the metagel sensor for monitoring tissue strains on porcine tendon, wounded tissue and heart. In live pigs, we further demonstrate the ability of the metagel to monitor tendon stretching, respiration and heartbeat, working stably during 30 days of implantation, and we loaded the metagel with growth factors to achieve different healing rates in subcutaneous wounds. The metagel results almost completely degraded 12 weeks after implantation. Our finding highlights the clinical potential of the ultrasonic sensor for tendon rehabilitation monitoring and drug delivery efficacy evaluation.

An In Vivo Biostability Evaluation of ALD and Parylene-ALD Multilayers as Micro-Packaging Solutions for Small Single-Chip Implants

Miniaturization of next-generation active neural implants requires novel micro-packaging solutions that can maintain their long-term coating performance in the body. This work presents two thin-film coatings and evaluates their biostability and in vivo performance over a 7-month animal study. To evaluate the coatings on representative surfaces, two silicon microchips with different surface microtopography are used. Microchips are coated with either a ≈100 nm thick inorganic hafnium-based multilayer deposited via atomic layer deposition (ALD-ML), or a ≈6 µm thick hybrid organic-inorganic Parylene C and titanium-based ALD multilayer stack (ParC-ALD-ML). After 7 months of direct exposure to the body environment, the multilayer coatings are evaluated using optical and cross-sectional scanning electron microscopy. Time-of-flight secondary ion mass spectrometry (ToF-SIMS) is also used to evaluate the chemical stability and barrier performance of the layers after long-term exposure to body media. Results showed the excellent biostability of the 100 nm ALD-ML coating with no ionic penetration within the layer. For the ParC-ALD-ML, concurrent surface degradation and ion ingress are detected within the top ≈70 nm of the outer Parylene C layer. The results and evaluation techniques presented here can enable future material selection, packaging, and analysis, enhancing the functional stability of future chip-embedded neural implants.

Bioactive Inorganic Materials for Innervated Multi-Tissue Regeneration

Tissue engineering aims to repair damaged tissues with physiological functions recovery. Although several therapeutic strategies are there for tissue regeneration, the functional recovery of regenerated tissues still poses significant challenges due to the lack of concerns of tissue innervation. Design rationale of multifunctional biomaterials with both tissue-induction and neural induction activities shows great potential for functional tissue regeneration. Recently, the research and application of inorganic biomaterials attracts increasing attention in innervated multi-tissue regeneration, such as central nerves, bone, and skin, because of its superior tunable chemical composition, topographical structures, and physiochemical properties. More importantly, inorganic biomaterials are easily combined with other organic materials, biological factors, and external stimuli to enhance their therapeutic effects. This review presents a comprehensive overview of recent advancements of inorganic biomaterials for innervated multi-tissue regeneration. It begins with introducing classification and properties of typical inorganic biomaterials and design rationale of inorganic-based material composites. Then, recent progresses of inorganic biomaterials in regenerating various nerves and nerve-innervated tissues with functional recovery are systematically reviewed. Finally, the existing challenges and future perspectives are proposed. This review may pave the way for the direction of inorganic biomaterials and offers a new strategy for tissue regeneration in combination of innervation.

A 0.05 mm3 diode-based single charged-particle real-time radiation detector for electron radiotherapy

Real-time radiation monitoring at the single-particle level is an unmet need for electron radiotherapy, especially for dose deposition to targets in motion or critical OARs. We have developed a first-in-class CMOS-based 0.05 mm3 single electron sensitive detector. The chiplet integrates all the requisite electronics. The functionality of the system is verified under 6 and 9 MeV clinical electron beams. Percentage depth vs. pulse-width curves for 6 and 9 MeV beams are measured and verified using Monte-Carlo simulations. The proposed system has the potential to enhance the electron radiotherapy quality and safety, providing real-time dosimetry from multiple sites simultaneously.

Progress on Direct Regulation of Systemic Immunity by the Central Nervous System

This article reviews the research progress on the direct regulation of the immune system by the central nervous system (CNS). The traditional "neuro-endocrine-immune" network model has confirmed the close connection between the CNS and the immune system. However, due to the complex mediating role of the endocrine system, its application in clinical treatment is limited. In recent years, the direct regulation of the peripheral immune system through the CNS has provided new methods for the clinical treatment of neuroimmune-related diseases. This article analyzes the changes in the peripheral immune system after CNS injury and summarizes the effects of various stimulation methods, including transcranial magnetic stimulation, transcranial electrical stimulation, deep brain stimulation, spinal cord stimulation, and vagus nerve stimulation, on the peripheral immune system. Additionally, it explores the clinical research progress and future development directions of these stimulation methods. It is proposed that these neural regulation techniques exhibit positive effects in reducing peripheral inflammation, protecting immune cells and organ functions, and improving immunosuppressive states, providing new perspectives and therapeutic potential for the treatment of immune-related diseases.

Precise modulation of cell activity using sono-responsive nano-transducers

Ultrasound, as a form of mechanical energy, possesses a distinctive ability to deeply penetrate tissues, allowing for non-invasive manipulation of cellular activities. Utilizing nanomaterials in conjunction with ultrasound has enabled simple, efficient, spatiotemporally controllable, and minimally invasive regulation of cellular activities with ultrasound-generated electric, optical, acoustic, or chemical stimuli at the localized nanomaterials interface. This technology allows for precise and localized regulation of cellular activities, which is essential for studying and understanding complex biological processes, and also provides new opportunities for research, diagnostics, and therapeutics in the fields of biology and medicine. In this article, we review the state-of-the-art and ongoing developments in nanomaterials-enabled ultrasound cellular modulation, highlighting potential applications and advancements achieved through the integration of sono-responsive nanomaterials with ultrasound.

Single-layer MoS2/graphene-based stable on-chip Zn-ion microbattery for monolithically integrated electronics

Self-powered microelectronics are essential for the sustained and autonomous operations of wireless electronics and microrobots. However, they are challenged by integratable microenergy supplies. Herein, we report a single-layer (SL) MoS2/graphene heterostructure for stable Zn-ion microbatteries. The MoS2/graphene heterostructure not only provides high chemical affinity for Zn and generates perfect lattice matching for Zn (002) deposition, but also facilitates homogeneous current density distribution. As a result, Zn metal is reversibly epitaxially plating/stripping at/from the heterostructure, without the formation of dendrites. The MoS2/graphene-based Zn||MnO2 microbattery with a tiny footprint area sub-0.1 mm2 shows a stable high capacity of 0.16 mAh cm-2 at 0.5 mA cm-2 within 470 cycles. Using a single piece of crystalline MoS2/graphene film, on-chip microbatteries and transistors were simultaneously fabricated via a facile lithography process, achieving highly integrated self-powered field-effect transistors and photodetector. The SL MoS2/graphene-based self-powered monolithically integrated microsystem paves a new way for the multi-functionalization and miniaturization of next-generation electronics.

Biofluid-Permeable and Erosion-Resistant Wireless Neural-Electronic Interfaces for Neurohomeostasis Modulation

Neural-electronic interfaces through delivering electroceuticals to lesions and modulating pathological endogenous electrical environments offer exciting opportunities to treat drug-refractory neurological disorders. Such an interface should ideally be compatible with the neural tissue and aggressive biofluid environment. Unfortunately, no interface specifically designed for the biofluid environments is available so far; instead, simply stacking an encapsulation layer on silicon-based substrates makes them susceptible to biofluid leakage, device malfunction, and foreign-body reactions. Here, we developed a biofluid-permeable and erosion-resistant wireless neural-electronic interface (BNEI) that is composed of a flexible 3D interconnected poly(l-lactide) fibrous network with a dense and axially aligned piezoelectrical molecular chain arrangement architecture. The organized molecular chain structure enhances the tortuous pathway and longitudinal piezoelectric coefficient of poly(l-lactide) fibers, improves their water barrier properties, and enables efficient conversion of low-intensity acoustic vibrations transmitted in biofluids into electrical signals, achieving long-term stable and wireless neuromodulation. A 3-month clinical trial demonstrated that the BNEI can effectively accelerate the pathological cascade in peripheral neuropathy for nerve regeneration and transcranially modulate cerebellar-cerebral circuit dynamics, suppressing seizures in temporal lobe epilepsy. The BNEI can be a clinically scalable approach for wireless neuromodulation that is broadly applicable to the modulation of neurohomeostasis in both the peripheral and central nervous systems.

Vagus nerve stimulation and gut microbiota interactions: A novel therapeutic avenue for neuropsychiatric disorders

The rising prevalence of treatment-resistant neuropsychiatric disorders underscores the need for innovative and effective treatment strategies. The gut microbiota (GM) plays a pivotal role in the progression of these diseases, influencing the brain and mental health through the gut-brain axis (GBA). The vagus nerve plays a significant role in the GBA, making it a key area of focus for potential novel therapeutic interventions. Vagus nerve stimulation (VNS) was introduced and approved as a treatment for refractory forms of some neuropsychological disorders, such as depression and epilepsy. Considering its impact on several brain regions that play a vital part in mood, motivation, affection, and cognitive function, the VNS has shown significant therapeutic potential for treating a variety of neuropsychiatric disorders. Using VNS to target the bidirectional communication pathways linking the GM and the VN could present an exciting and novel approach to treating neuropsychological disorders. Imbalances in the GM, such as dysbiosis, can impair the communication pathways between the gut and the brain, contributing to the development of neuropsychological disorders. VNS shows potential for modulating these interconnected systems, helping to restore balance. Interestingly, the composition of the GM may also influence the effectiveness of VNS, as it has the potential to modify the brain's response to this therapeutic approach. This study provides a comprehensive analysis of a relatively unexplored but noteworthy interaction between VNS and GM in the treatment of neuropsychiatric disorders. In addition, we discussed the mechanisms, therapeutic potential, and clinical implications of VNS on the GBA across neuropsychiatric disorders.

Emerging Wearable Acoustic Sensing Technologies

Sound signals not only serve as the primary communication medium but also find application in fields such as medical diagnosis and fault detection. With public healthcare resources increasingly under pressure, and challenges faced by disabled individuals on a daily basis, solutions that facilitate low-cost private healthcare hold considerable promise. Acoustic methods have been widely studied because of their lower technical complexity compared to other medical solutions, as well as the high safety threshold of the human body to acoustic energy. Furthermore, with the recent development of artificial intelligence technology applied to speech recognition, speech recognition devices, and systems capable of assisting disabled individuals in interacting with scenes are constantly being updated. This review meticulously summarizes the sensing mechanisms, materials, structural design, and multidisciplinary applications of wearable acoustic devices applied to human health and human-computer interaction. Further, the advantages and disadvantages of the different approaches used in flexible acoustic devices in various fields are examined. Finally, the current challenges and a roadmap for future research are analyzed based on existing research progress to achieve more comprehensive and personalized healthcare.

Pre-Charged Collapse-Mode Capacitive Micromachined Ultrasonic Transducer (CMUT) Receivers for Efficient Power Transfer

Capacitive micromachined ultrasonic transducers (CMUTs) offer several advantages over standard lead zirconate titanate (PZT) transducers, particularly for implantable devices. To eliminate their typical need for an external bias voltage, we embedded a charge storage layer in the dielectric. The objective of this study was to evaluate the performance of plasma-enhanced chemical vapor deposition (PECVD) Si3N4 and atomic layer deposition (ALD) Al2O3 as materials for the charge storage layer and two different dielectric layer thicknesses, focusing on their application as receivers in a wireless power transfer link. Capacitance-voltage (CV) measurements revealed that Si3N4 has a higher charge storage capacity compared to Al2O3. Additionally, a thicker dielectric layer between the bottom electrode and the charge storage layer (Bdiel) improved both charge trapping and retention, as assessed in dynamic accelerated lifetime transmit (TX)-mode tests. We then analyzed the power conversion performance of the fabricated CMUTs through both simulations and experiments. We performed extensive modeling based on an equivalent circuit derived from electrical impedance measurements of the fabricated CMUTs. The model was used to predict the power conversion efficiency under various conditions, including the charging field strength, the operating frequency, and parasitic series resistance. Power transfer experiments at 1- and 2.4-MHz recorded efficiencies exceeding 80% with an optimally matched load and up to 54% with a purely resistive load. Results confirmed that, with optimal load matching, the efficiency of different CMUT variants is comparable, indicating that the optimal variant should be selected based on additional criteria, such as charge retention time.

TiOx-Based Implantable Memristor for Biomedical Engineering

Implantable memristors are considered an emerging electronic technology that can simulate brain memory function and demonstrate some promising applications in the biomedical field. However, it remains a critical challenge to enhance their long-term stability and biocompatibility in implantation environments. In this work, an implantable memristor has been successfully fabricated based on TiOx using magnetron sputtering. The device demonstrated excellent thermal stability and recoverability at elevated temperatures, providing important experimental evidence for its applications under high-temperature environments. More importantly, after long-term testing under biological mimicking environments, such as fresh pork and bullfrog tissues, the memristor maintained excellent bipolar resistive switching (RS) characteristics and stable memory performance, indicating its potential for use in medical fields. Further analysis revealed that the RS behaviors of the device are mainly controlled by space charge limited currents (SCLC), Ohmic conduction, and Schottky emission conduction mechanisms. Therefore, the long-term stability of the implantable memristor is validated under real biological environments, promoting the transition of implantable memristor from theory to practical applications and laying the foundation for further biomedical applications.

Millimeter-scale radioluminescent power for electronic sensors

The storage and generation of electrical energy at the mm-scale is a core roadblock to realizing many untethered miniature systems, including industrial, environmental, and medically implanted sensors. We describe the potential to address the sensor energy requirement in a two-step process by first converting alpha radiation into light, which can then be translated into electrical power through a photovoltaic harvester circuit protected by a clear sealant. Different phosphorescent and scintillating materials were mixed with the alpha-emitter Th-227, and the conversion efficiency of europium-doped yttrium oxide was the highest at around 2%. Measurements of the light generated by this phosphor when combined with Th-227 reveal that over 100 nW of optical power can be expected at volumes around 1 mm3 over more than two months. The use of a clear sealant, together with the evaporation of liquid solution following the mixture, can enable safe miniaturization for size-constrained medical and internet-of-things (IoT) sensor applications.

Evaluation of a Miniature, Injectable, Wireless Stimulator to Treat Obstructive Sleep Apnea

INTRODUCTION

Moderate-to-severe obstructive sleep apnea (OSA) affects a large segment of the US population and is characterized by repetitive and reversible obstruction of the upper airway during sleep. Untreated OSA is associated with increased incidence of heart attack, stroke, and motor vehicle accidents due to sleepiness. Continuous positive airway pressure is often prescribed, but most patients with OSA are nonadherent. One effective alternative is stimulation of the hypoglossal nerve (HGN) that acts to open and stiffen the airway. However, currently available HGN stimulators require major surgery to implant a pacemaker-like device and leads that connect to a cuff electrode encircling the HGN. In this study, we performed preliminary tests in rats and humans of a miniature stimulating device that, in the future, could be injected near the HGN with ultrasound guidance.

METHODS AND RESULTS

This device (1 × 9 mm) is activated wirelessly using a small wearable (3.5-cm diameter) that would be placed on the skin under the jaw in human patients. The system was effective in robustly activating the rat sciatic nerve at distances up to 2.5 cm from the wearable. Furthermore, the device delivered through injection could fully activate the rat sciatic nerve if placed at distances <4 mm from the nerve. The extent of migration of the device measured in seven rats over a one-month period was not significant for most injectables, but six of 18 did change position (mainly along the injection path). We discuss strategies for minimizing migration in the future. Lastly, we report on tests in one awake human subject, wherein wireless stimulation of the HGN caused >60% increase in airflow during inspiration.

CONCLUSION

Collectively, these initial experiments encourage future studies to determine the utility of this system in alleviating OSA in human subjects.

Wireless Frequency-Multiplexed Acoustic Array-based Acoustofluidics

Acoustofluidics has shown great potential in enabling on-chip technologies for driving liquid flows and manipulating particles and cells for engineering, chemical, and biomedical applications. To introduce on-demand liquid sample processing and micro/nano-object manipulation functions to wearable and embeddable electronics, wireless acoustofluidic chips are highly desired. This paper presents wireless acoustofluidic chips to generate acoustic waves carrying sufficient energy and achieve key acoustofluidic functions, including arranging particles and cells, generating fluid streaming, and enriching in-droplet particles. To enable these functions, our wireless acoustofluidic chips leverage mechanisms, including inductive coupling-based wireless power transfer (WPT), frequency multiplexing-based control of multiple acoustic waves, and the resultant acoustic radiation and drag forces. For validation, the wirelessly generated acoustic waves are measured using laser vibrometry when different materials (e.g., bone, tissue, and hand) are inserted between the WPT transmitter and receiver. Moreover, our wireless acoustofluidic chips successfully arrange nanoparticles into different patterns, align cells into parallel pearl chains, generate streaming, and enrich in-droplet microparticles. We anticipate this research to facilitate the development of embeddable wireless on-chip flow generators, wearable sensors with liquid sample processing functions, and implantable devices with flow generation and acoustic stimulation abilities for engineering, veterinary, and biomedical applications.

A Robust Backscatter Modulation Scheme for Uninterrupted Ultrasonic Powering and Back-Communication of Deep Implants

Traditionally, implants are powered by batteries, which have to be recharged by an inductive power link. In the recent years, ultrasonic power links are being investigated, promising more available power for deeply implanted miniaturized devices. These implants often need to transfer back information. For ultrasonically powered implants, this is usually achieved with on-off keying (OOK) based on backscatter modulation, or active driving of a secondary transducer. In this article, we propose to superimpose subcarriers, effectively leveraging frequency-shift keying (FSK), which increases the robustness of the link against interference and fading. It also allows for simultaneous powering and communication, and inherently provides the possibility of frequency domain multiplexing for implant networks. The modulation scheme can be implemented in miniaturized application-specific integrated circuits (ASICs), field programmable gate arrays (FPGAs), and microcontrollers. We have validated this modulation scheme in a water tank during continuous ultrasound and movement. We achieved symbol rates of up to 104 kBd, and were able to transfer data through 20 cm of water and through a 5 cm tissue phantom with additional misalignment and during movements. This approach could provide a robust uplink for miniaturized implants that are located deep inside the body and need continuous ultrasonic powering.

A Miniature Batteryless Bioelectronic Implant Using One Magnetoelectric Transducer for Wireless Powering and PWM Backscatter Communication

Wireless minimally invasive bioelectronic implants enable a wide range of applications in healthcare, medicine, and scientific research. Magnetoelectric (ME) wireless power transfer (WPT) has emerged as a promising approach for powering miniature bio-implants because of its remarkable efficiency, safety limit, and misalignment tolerance. However, achieving low-power and high-quality uplink communication using ME remains a challenge. This paper presents a pulse-width modulated (PWM) ME backscatter uplink communication enabled by a switched-capacitor energy extraction (SCEE) technique. The SCEE rapidly extracts and dissipates the kinetic energy within the ME transducer during its ringdown period, enabling time-domain PWM in ME backscatter. Various circuit techniques are presented to realize SCEE with low power consumption. This paper also describes the high-order modeling of ME transducers to facilitate the design and analysis, which shows good matching with measurement. Our prototyping system includes a millimeter-scale ME implant with a fully integrated system-on-chip (SoC) and a portable transceiver for power transfer and bidirectional communication. SCEE is proven to induce 50% amplitude reduction within 2 ME cycles, leading to a PWM ME backscatter uplink with 17.73 kbps data rate and 0.9 pJ/bit efficiency. It also achieves 8.510-5 bit-error-rate (BER) at a 5 cm distance, using a lightweight multi-layer-perception (MLP) decoding algorithm. Finally, the system demonstrates continuous wireless neural local-field potential (LFP) recording in an in vitro setup.

Medical Ultrasound Application Beyond Diagnosis: Insights From Ultrasound Sensing and Biological Response

Ultrasound (US) can easily penetrate media with excellent spatial precision corresponding to its wavelength. Naturally, US plays a pivotal role in the echolocation abilities of certain mammals such as bats and dolphins. In addition, medical US generated by transducers interact with tissues via delivering ultrasonic energy in the modes of heat generation, exertion of acoustic radiation force (ARF), and acoustic cavitation. Based on the principle of echolocation, various assistive devices for visual impairment people have been developed. High-Intensity Focused Ultrasound (HIFU) are developed for targeted ablation and tissue destruction. Besides thermal ablation, histotripsy with US is designed to damage tissue purely via mechanical effect without thermal coagulation. Low-Intensity Focused Ultrasound (LIFU) has been proven to be an effective stimulation method for neuromodulation. Furthermore, US has been reported to transiently increase the permeability of biological membranes, enabling acoustic transfection and blood-brain barrier open. All of these advances in US are changing the clinic. This review mainly introduces the advances in these aspects, focusing on the physical and biological principles, challenges, and future direction.

Patterned electrical brain stimulation by a wireless network of implantable microdevices

Transmitting meaningful information into brain circuits by electronic means is a challenge facing brain-computer interfaces. A key goal is to find an approach to inject spatially structured local current stimuli across swaths of sensory areas of the cortex. Here, we introduce a wireless approach to multipoint patterned electrical microstimulation by a spatially distributed epicortically implanted network of silicon microchips to target specific areas of the cortex. Each sub-millimeter-sized microchip harvests energy from an external radio-frequency source and converts this into biphasic current injected focally into tissue by a pair of integrated microwires. The amplitude, period, and repetition rate of injected current from each chip are controlled across the implant network by implementing a pre-scheduled, collision-free bitmap wireless communication protocol featuring sub-millisecond latency. As a proof-of-concept technology demonstration, a network of 30 wireless stimulators was chronically implanted into motor and sensory areas of the cortex in a freely moving rat for three months. We explored the effects of patterned intracortical electrical stimulation on trained animal behavior at average RF powers well below regulatory safety limits.

Endocisternal interfaces for minimally invasive neural stimulation and recording of the brain and spinal cord

Minimally invasive neural interfaces can be used to diagnose, manage and treat many disorders, with reduced risks of surgical complications. However, endovascular probes lack access to key cortical, subcortical and spinal targets, and are not typically explantable after endothelialization. Here we report the development and testing, in sheep, of endocisternal neural interfaces that approach brain and spinal cord targets through inner and outer spaces filled with cerebrospinal fluid. Thus, the interfaces gain access to the entire brain convexity, to deep brain structures within the ventricles and to the spinal cord from the spinal subarachnoid space. We combined an endocisternal neural interface with wireless miniature magnetoelectrically powered bioelectronics so that it can be freely navigated percutaneously from the spinal space to the cranial subarachnoid space, and from the cranial subarachnoid space to the ventricles. In sheep, we show recording and stimulation functions, as well as repositioning of the flexible electrodes and explantation of the interface after chronic implantation. Minimally invasive endocisternal bioelectronics may enable chronic and transient therapies, particularly for stroke rehabilitation and epilepsy monitoring.

Integrated Bioelectronic and Optogenetic Methods to Study Brain-Body Circuits

The peripheral nervous system, consisting of somatic sensory circuits and autonomic effector circuits, enables communication between the body's organs and the brain. Dysregulation in these circuits is implicated in an array of disorders and represents a potential target for neuromodulation therapies. In this Perspective, we discuss recent advances in the neurobiological understanding of these brain-body pathways and the expansion of neurotechnologies beyond the brain to the viscera. We focus primarily on the development of integrated technologies that leverage bioelectronic devices with optogenetic tools. We highlight the discovery and application of ultrapotent and red-shifted channelrhodopsins for minimally invasive optogenetics and as tools to study brain-body circuits. These innovations enable studies of freely behaving animals and have enhanced our understanding of the role physiological signals play in brain states and behavior.

Omnidirectional Wireless Power Transfer for Millimetric Magnetoelectric Biomedical Implants

Miniature bioelectronic implants promise revolutionary therapies for cardiovascular and neurological disorders. Wireless power transfer (WPT) is a significant method for miniaturization, eliminating the need for bulky batteries in today's devices. Despite successful demonstrations of millimetric battery-free implants in animal models, the robustness and efficiency of WPT are known to degrade significantly under misalignment incurred by body movements, respiration, heart beating, and limited control of implant orientation during surgery. This paper presents an omnidirectional WPT platform for millimetric bioelectronic implants, employing the emerging magnetoelectric (ME) WPT modality, and "magnetic field steering" technique based on multiple transmitter (TX) coils. To accurately sense the weak coupling in a miniature implant and adaptively control the multi-coil TX array in a closed loop, we develop an Active Echo (AE) scheme using a tiny coil on the implant. Our prototype comprises a fully integrated 14.2mm3 implantable stimulator embedding a custom low-power System-on-Chip (SoC) powered by an ME film, a transmitter with a custom three-channel AE RX chip, and a multi-coil TX array with mutual inductance cancellation. The AE RX achieves -161dBm/Hz input-referred noise with 64dB gain tuning range to reliably sense the AE signal, and offers fast polarity detection for driver control. AE simultaneously enhances the robustness, efficiency, and charging range of ME WPT. Under 90° rotation from the ideal position, our omnidirectional WPT system achieves 6.8× higher power transfer efficiency (PTE) than a single-coil baseline. The tracking error of AE negligibly degrades the PTE by less than 2% from using ideal control.

Magnetic Detection of Neural Activity by Nanocoil Transducers

Electrophysiological recordings from brain cells are performed routinely using implanted electrodes, but they traditionally require a wired connection to the outside of the brain. A completely passive, wireless device that does not require on-board power for active transmission but that still facilitates remote detection could open the door for mass-scale direct recording of action potentials and transform the way we acquire brain signals. We present a nanofabricated coil that forms a neuroelectromagnetic junction, yielding a highly enhanced magnetic field transduction of electrophysiology. We show that this micrometer-scale device enables remote magnetic detection of neuronal fields from the center of the coil using room temperature superconducting quantum interference device (SQUID) microscopy. Further, time-locked stimulation in conjunction with magnetometry demonstrates thresholding behavior that affirms the viability of the technology for detection with no requirement for wires or on-board power. This strategy may permit unprecedented detection of electrophysiology using magnetoencephalography and magnetic resonance imaging.

Wireless neuromodulation at submillimeter precision via a microwave split-ring resonator

A broad spectrum of electromagnetic waves has been explored for wireless neuromodulation. Transcranial magnetic stimulation, with long wavelengths, cannot provide submillimeter spatial resolution. Visible light, with its short wavelengths, suffers from strong scattering in the deep tissue. Microwaves have centimeter-scale penetration depth and have been shown to reversibly inhibit neuronal activity. Yet, microwaves alone do not provide sufficient spatial precision to modulate target neurons without affecting surrounding tissues. Here, we report a split-ring resonator (SRR) that generates an enhanced microwave field at its gap with submillimeter spatial precision. With the SRR, microwaves at dosages below the safe exposure limit are shown to inhibit the firing of neurons within 1 mm of the SRR gap site. The microwave SRR reduced seizure activity at a low dose in both in vitro and in vivo models of epilepsy. This microwave dosage is confirmed to be biosafe via histological and biochemical assessment of brain tissue.

Active Neural Interface Circuits and Systems for Selective Control of Peripheral Nerves: A Review

Interfaces with peripheral nerves have been widely developed to enable bioelectronic control of neural activity. Peripheral nerve neuromodulation shows great potential in addressing motor dysfunctions, neurological disorders, and psychiatric conditions. The integration of high-density neural electrodes with stimulation and recording circuits poses a challenge in the design of neural interfaces. Recent advances in active electrode strategies have achieved improved reliability and performance by implementing in-situ control, stimulation, and recording of neural fibers. This paper presents an overview of state-of-the-art neural interface systems that comprise a range of neural electrodes, neurostimulators, and bio-amplifier circuits, with a special focus on interfaces for the peripheral nerves. A discussion on the efficacy of active electrode systems and recommendations for future directions conclude this paper.

Recent Advances in Implantable Neural Interfaces for Multimodal Electrical Neuromodulation

Electrical neuromodulation plays a pivotal role in enhancing patient outcomes among individuals suffering from neurological disorders. Implantable neural interfaces are vital components of the electrical neuromodulation system to ensure desirable performance; However, conventional devices are limited to a single function and are constructed with bulky and rigid materials, which often leads to mechanical incompatibility with soft tissue and an inability to adapt to the dynamic and complex 3D structures of biological systems. In addition, current implantable neural interfaces utilized in clinical settings primarily rely on wire-based techniques, which are associated with complications such as increased risk of infection, limited positioning options, and movement restrictions. Here, the state-of-art applications of electrical neuromodulation are presented. Material schemes and device structures that can be employed to develop robust and multifunctional neural interfaces, including flexibility, stretchability, biodegradability, self-healing, self-rolling, or morphing are discussed. Furthermore, multimodal wireless neuromodulation techniques, including optoelectronics, mechano-electrics, magnetoelectrics, inductive coupling, and electrochemically based self-powered devices are reviewed. In the end, future perspectives are given.

The development, use, and challenges of electromechanical tissue stimulation systems

BACKGROUND

Tissue stimulations greatly affect cell growth, phenotype, and function, and they play an important role in modeling tissue physiology. With the goal of understanding the cellular mechanisms underlying the response of tissues to external stimulations, in vitro models of tissue stimulation have been developed in hopes of recapitulating in vivo tissue function.

METHODS

Herein we review the efforts to create and validate tissue stimulators responsive to electrical or mechanical stimulation including tensile, compression, torsion, and shear.

RESULTS

Engineered tissue platforms have been designed to allow tissues to be subjected to selected types of mechanical stimulation from simple uniaxial to humanoid robotic stain through equal-biaxial strain. Similarly, electrical stimulators have been developed to apply selected electrical signal shapes, amplitudes, and load cycles to tissues, lending to usage in stem cell-derived tissue development, tissue maturation, and tissue functional regeneration. Some stimulators also allow for the observation of tissue morphology in real-time while cells undergo stimulation. Discussion on the challenges and limitations of tissue simulator development is provided.

CONCLUSIONS

Despite advances in the development of useful tissue stimulators, opportunities for improvement remain to better reproduce physiological functions by accounting for complex loading cycles, electrical and mechanical induction coupled with biological stimuli, and changes in strain affected by applied inputs.

Multi-Channel Microscale Nerve Cuffs for Spatially Selective Neuromodulation

Peripheral nerve modulation via electrical stimulation shows promise for treating several diseases, but current approaches lack selectivity, leading to side effects. Exploring selective neuromodulation with commercially available nerve cuffs is impractical due to their high cost and limited spatial resolution. While custom cuffs reported in the literature achieve high spatial resolutions, they require specialized microfabrication equipment and significant effort to produce even a single design. This inability to rapidly and cost-effectively prototype novel cuff designs impedes research into selective neuromodulation therapies in acute studies. To address this, we developed a reproducible method to easily create multi-channel epineural nerve cuffs for selective fascicular neuromodulation. Leveraging commercial flexible printed circuit (FPC) technology, we created cuffs with high spatial resolution (50 μm) and customizable parameters like electrode size, channel count, and cuff diameter. We designed cuffs to accommodate adult mouse or rat sciatic nerves (300-1500 μm diameter). We coated the electrodes with PEDOT:PSS to improve the charge injection capacity. We demonstrated selective neuromodulation in both rats and mice, achieving preferential activation of the tibialis anterior (TA) and lateral gastrocnemius (LG) muscles. Selectivity was confirmed through micro-computed tomography (μCT) and quantified through a selectivity index. These results demonstrate the potential of this fabrication method for enabling selective neuromodulation studies while significantly reducing production time and costs compared to traditional approaches.

Millimetric devices for nerve stimulation: a promising path towards miniaturization

Nerve stimulation is a rapidly developing field, demonstrating positive outcomes across several conditions. Despite potential benefits, current nerve stimulation devices are large, complicated, and are powered via implanted pulse generators. These factors necessitate invasive surgical implantation and limit potential applications. Reducing nerve stimulation devices to millimetric sizes would make these interventions less invasive and facilitate broader therapeutic applications. However, device miniaturization presents a serious engineering challenge. This review presents significant advancements from several groups that have overcome this challenge and developed millimetric-sized nerve stimulation devices. These are based on antennas, mini-coils, magneto-electric and opto-electronic materials, or receive ultrasound power. We highlight key design elements, findings from pilot studies, and present several considerations for future applications of these devices.

Design and prediction of laser-induced damage threshold of CNT-PDMS optoacoustic transducer

The optoacoustic transducer has emerged as a new candidate for medical ultrasound applications and attracts considerable attention. Optoacoustic diagnosis and treatment sometimes require high-intensity acoustic pressure, which is often accompanied by the problem of laser-induced damage. Addressing the laser-induced damage phenomenon from a theoretical perspective holds paramount importance. In this study, the theoretical model of laser-induced damage of the carbon nanotubes-polydimethylsiloxane (CNT-PDMS) composite optoacoustic transducer is established. It is found that this laser-induced damage belongs to thermal ablation damage. Furthermore, the correctness of this theory can be confirmed by experimental results. Most importantly, when the laser energy density is less than threshold value of laser energy density, the optoacoustic transducer can work stable for long time. These encouraging results demonstrate that this work can provide significant guidance for the exploration and utilization of optoacoustic transducers.

Electromagnetic Cellularized Patch with Wirelessly Electrical Stimulation for Promoting Neuronal Differentiation and Spinal Cord Injury Repair

Although stem cell therapy holds promise for the treatment of spinal cord injury (SCI), its practical applications are limited by the low degree of neural differentiation. Electrical stimulation is one of the most effective ways to promote the differentiation of stem cells into neurons, but conventional wired electrical stimulation may cause secondary injuries, inflammation, pain, and infection. Here, based on the high conductivity of graphite and the electromagnetic induction effect, graphite nanosheets with neural stem cells (NSCs) are proposed as an electromagnetic cellularized patch to generate in situ wirelessly pulsed electric signals under a rotating magnetic field for regulating neuronal differentiation of NSCs to treat SCI. The strength and frequency of the induced voltage can be controlled by adjusting the rotation speed of the magnetic field. The generated pulsed electrical signals promote the differentiation of NSCs into functional mature neurons and increase the proportion of neurons from 12.5% to 33.7%. When implanted in the subarachnoid region of the injured spinal cord, the electromagnetic cellularized patch improves the behavioral performance of the hind limbs and the repair of spinal cord tissue in SCI mice. This work opens a new avenue for remote treatment of SCI and other nervous system diseases.

Enhancing Ultrasound Power Transfer: Efficiency, Acoustics, and Future Directions

Implantable medical devices (IMDs), like pacemakers regulating heart rhythm or deep brain stimulators treating neurological disorders, revolutionize healthcare. However, limited battery life necessitates frequent surgeries for replacements. Ultrasound power transfer (UPT) emerges as a promising solution for sustainable IMD operation. Current research prioritizes implantable materials, with less emphasis on sound field analysis and maximizing energy transfer during wireless power delivery. This review addresses this gap. A comprehensive analysis of UPT technology, examining cutting-edge system designs, particularly in power supply and efficiency is provided. The review critically examines existing efficiency models, summarizing the key parameters influencing energy transmission in UPT systems. For the first time, an energy flow diagram of a general UPT system is proposed to offer insights into the overall functioning. Additionally, the review explores the development stages of UPT technology, showcasing representative designs and applications. The remaining challenges, future directions, and exciting opportunities associated with UPT are discussed. By highlighting the importance of sustainable IMDs with advanced functions like biosensing and closed-loop drug delivery, as well as UPT's potential, this review aims to inspire further research and advancements in this promising field.

A multi-channel stimulator with an active electrode array implant for vagal-cardiac neuromodulation studies

BACKGROUND

Implantable vagus nerve stimulation is a promising approach for restoring autonomic cardiovascular functions after heart transplantation. For successful treatment a system should have multiple electrodes to deliver precise stimulation and complex neuromodulation patterns.

METHODS

This paper presents an implantable multi-channel stimulation system for vagal-cardiac neuromodulation studies in swine species. The system comprises an active electrode array implant percutaneously connected to an external wearable controller. The active electrode array implant has an integrated stimulator ASIC mounted on a ceramic substrate connected to an intraneural electrode array via micro-rivet bonding. The implant is silicone encapsulated for biocompatibility and implanted lifetime. The stimulation parameters are remotely transmitted via a Bluetooth telemetry link.

RESULTS

The size of the encapsulated active electrode array implant is 8 mm × 10 mm × 3 mm. The stimulator ASIC has 10-bit current amplitude resolution and 16 independent output channels, each capable of delivering up to 550 µA stimulus current and a maximum voltage of 20 V. The active electrode array implant was subjected to in vitro accelerated lifetime testing at 70 °C for 7 days with no degradation in performance. After over 2 h continuous stimulation, the surface temperature change of the implant was less than 0.5 °C. In addition, in vivo testing on the sciatic nerve of a male Göttingen minipig demonstrated that the implant could effectively elicit an EMG response that grew progressively stronger on increasing the amplitude of the stimulation.

CONCLUSIONS

The multi-channel stimulator is suitable for long term implantation. It shows potential as a useful tool in vagal-cardiac neuromodulation studies in animal models for restoring autonomic cardiovascular functions after heart transplantation.

Coupling of photovoltaics with neurostimulation electrodes-optical to electrolytic transduction

Objective.The wireless transfer of power for driving implantable neural stimulation devices has garnered significant attention in the bioelectronics field. This study explores the potential of photovoltaic (PV) power transfer, utilizing tissue-penetrating deep-red light-a novel and promising approach that has received less attention compared to traditional induction or ultrasound techniques. Our objective is to critically assess key parameters for directly powering neurostimulation electrodes with PVs, converting light impulses into neurostimulation currents.Approach.We systematically investigate varying PV cell size, optional series configurations, and coupling with microelectrodes fabricated from a range of materials such as Pt, TiN, IrOx, Ti, W, PtOx, Au, or poly(3,4 ethylenedioxythiophene):poly(styrene sulfonate). Additionally, two types of PVs, ultrathin organic PVs and monocrystalline silicon PVs, are compared. These combinations are employed to drive pairs of electrodes with different sizes and impedances. The readout method involves measuring electrolytic current using a straightforward amplifier circuit.Main results.Optimal PV selection is crucial, necessitating sufficiently large PV cells to generate the desired photocurrent. Arranging PVs in series is essential to produce the appropriate voltage for driving current across electrode/electrolyte impedances. By carefully choosing the PV arrangement and electrode type, it becomes possible to emulate electrical stimulation protocols in terms of charge and frequency. An important consideration is whether the circuit is photovoltage-limited or photocurrent-limited. High charge-injection capacity electrodes made from pseudo-faradaic materials impose a photocurrent limit, while more capacitive materials like Pt are photovoltage-limited. Although organic PVs exhibit lower efficiency than silicon PVs, in many practical scenarios, stimulation current is primarily limited by the electrodes rather than the PV driver, leading to potential parity between the two types.Significance.This study provides a foundational guide for designing a PV-powered neurostimulation circuit. The insights gained are applicable to bothin vitroandin vivoapplications, offering a resource to the neural engineering community.

Remotely Controlled Electrochemical Degradation of Metallic Implants

Biodegradable medical implants promise to benefit patients by eliminating risks and discomfort associated with permanent implantation or surgical removal. The time until full resorption is largely determined by the implant's material composition, geometric design, and surface properties. Implants with a fixed residence time, however, cannot account for the needs of individual patients, thereby imposing limits on personalization. Here, an active Fe-based implant system is reported whose biodegradation is controlled remotely and in situ. This is achieved by incorporating a galvanic cell within the implant. An external and wireless signal is used to activate the on-board electronic circuit that controls the corrosion current between the implant body and an integrated counter electrode. This configuration leads to the accelerated degradation of the implant and allows to harvest electrochemical energy that is naturally released by corrosion. In this study, the electrochemical properties of the Fe-30Mn-1C/Pt galvanic cell model system is first investigated and high-resolution X-ray microcomputed tomography is used to evaluate the galvanic degradation of stent structures. Subsequently, a centimeter-sized active implant prototype is assembled with conventional electronic components and the remotely controlled corrosion is tested in vitro. Furthermore, strategies toward the miniaturization and full biodegradability of this system are presented.

Ultrasound-Responsive Aligned Piezoelectric Nanofibers Derived Hydrogel Conduits for Peripheral Nerve Regeneration

Nerve guidance conduits (NGCs) are considered as promising treatment strategy and frontier trend for peripheral nerve regeneration, while their therapeutic outcomes are limited by the lack of controllable drug delivery and available physicochemical cues. Herein, novel aligned piezoelectric nanofibers derived hydrogel NGCs with ultrasound (US)-triggered electrical stimulation (ES) and controllable drug release for repairing peripheral nerve injury are proposed. The inner layer of the NGCs is the barium titanate piezoelectric nanoparticles (BTNPs)-doped polyvinylidene fluoride-trifluoroethylene [BTNPs/P(VDF-TrFE)] electrospinning nanofibers with improved piezoelectricity and aligned orientation. The outer side of the NGCs is the thermoresponsive poly(N-isopropylacrylamide) hybrid hydrogel with bioactive drug encapsulation. Such NGCs can not only induce neuronal-oriented extension and promote neurite outgrowth with US-triggered wireless ES, but also realize the controllable nerve growth factor release with the hydrogel shrinkage under US-triggered heating. Thus, the NGC can positively accelerate the functional recovery and nerve axonal regeneration of rat models with long sciatic nerve defects. It is believed that the proposed US-responsive aligned piezoelectric nanofibers derived hydrogel NGCs will find important applications in clinic neural tissue engineering.

Injectable ultrasonic sensor for wireless monitoring of intracranial signals

Direct and precise monitoring of intracranial physiology holds immense importance in delineating injuries, prognostication and averting disease1. Wired clinical instruments that use percutaneous leads are accurate but are susceptible to infection, patient mobility constraints and potential surgical complications during removal2. Wireless implantable devices provide greater operational freedom but include issues such as limited detection range, poor degradation and difficulty in size reduction in the human body3. Here we present an injectable, bioresorbable and wireless metastructured hydrogel (metagel) sensor for ultrasonic monitoring of intracranial signals. The metagel sensors are cubes 2 × 2 × 2 mm3 in size that encompass both biodegradable and stimulus-responsive hydrogels and periodically aligned air columns with a specific acoustic reflection spectrum. Implanted into intracranial space with a puncture needle, the metagel deforms in response to physiological environmental changes, causing peak frequency shifts of reflected ultrasound waves that can be wirelessly measured by an external ultrasound probe. The metagel sensor can independently detect intracranial pressure, temperature, pH and flow rate, realize a detection depth of 10 cm and almost fully degrade within 18 weeks. Animal experiments on rats and pigs indicate promising multiparametric sensing performances on a par with conventional non-resorbable wired clinical benchmarks.

Progress in the development of piezoelectric biomaterials for tissue remodeling

Piezoelectric biomaterials have demonstrated significant potential in the past few decades to heal damaged tissue and restore cellular functionalities. Herein, we discuss the role of bioelectricity in tissue remodeling and explore ways to mimic such tissue-like properties in synthetic biomaterials. In the past decade, biomedical engineers have adopted emerging functional biomaterials-based tissue engineering approaches using innovative bioelectronic stimulation protocols based on dynamic stimuli to direct cellular activation, proliferation, and differentiation on engineered biomaterial constructs. The primary focus of this review is to discuss the concepts of piezoelectric energy harvesting, piezoelectric materials, and their application in soft (skin and neural) and hard (dental and bone) tissue regeneration. While discussing the prospective applications as an engineered tissue, an important distinction has been made between piezoceramics, piezopolymers, and their composites. The superiority of piezopolymers over piezoceramics to circumvent issues such as stiffness mismatch, biocompatibility, and biodegradability are highlighted. We aim to provide a comprehensive review of the field and identify opportunities for the future to develop clinically relevant and state-of-the-art biomaterials for personalized and remote health care.

Force-Based Neuromodulation

Technologies for neuromodulation have rapidly developed in the past decade with a particular emphasis on creating noninvasive tools with high spatial and temporal precision. The existence of such tools is critical in the advancement of our understanding of neural circuitry and its influence on behavior and neurological disease. Existing technologies have employed various modalities, such as light, electrical, and magnetic fields, to interface with neural activity. While each method offers unique advantages, many struggle with modulating activity with high spatiotemporal precision without the need for invasive tools. One modality of interest for neuromodulation has been the use of mechanical force. Mechanical force encapsulates a broad range of techniques, ranging from mechanical waves delivered via focused ultrasound (FUS) to torque applied to the cell membrane.Mechanical force can be delivered to the tissue in two forms. The first form is the delivery of a mechanical force through focused ultrasound. Energy delivery facilitated by FUS has been the foundation for many neuromodulation techniques, owing to its precision and penetration depth. FUS possesses the potential to penetrate deeply (∼centimeters) into tissue while maintaining relatively precise spatial resolution, although there exists a trade-off between the penetration depth and spatial resolution. FUS may work synergistically with ultrasound-responsive nanotransducers or devices to produce a secondary energy, such as light, heat, or an electric field, in the target region. This layered technology, first enabled by noninvasive FUS, overcomes the need for bulky invasive implants and also often improves the spatiotemporal precision of light, heat, electrical fields, or other techniques alone. Conversely, the second form of mechanical force modulation is the generation of mechanical force from other modalities, such as light or magnetic fields, for neuromodulation via mechanosensitive proteins. This approach localizes the mechanical force at the cellular level, enhancing the precision of the original energy delivery. Direct interaction of mechanical force with tissue presents translational potential in its ability to interface with endogenous mechanosensitive proteins without the need for transgenes.In this Account, we categorize force-mediated neuromodulation into two categories: 1) methods where mechanical force is the primary stimulus and 2) methods where mechanical force is generated as a secondary stimulus in response to other modalities. We summarize the general design principles and current progress of each respective approach. We identify the key advantages of the limitations of each technology, particularly noting features in spatiotemporal precision, the need for transgene delivery, and the potential outlook. Finally, we highlight recent technologies that leverage mechanical force for enhanced spatiotemporal precision and advanced applications.

A reconfigurable integrated smart device for real-time monitoring and synergistic treatment of rheumatoid arthritis

Rheumatoid arthritis (RA) is a global autoimmune disease that requires long-term management. Ambulatory monitoring and treatment of RA favors remission and rehabilitation. Here, we developed a wearable reconfigurable integrated smart device (ISD) for real-time inflammatory monitoring and synergistic therapy of RA. The device establishes an electrical-coupling and substance delivery interfaces with the skin through template-free conductive polymer microneedles that exhibit high capacitance, low impedance, and appropriate mechanical properties. The reconfigurable electronics drive the microneedle-skin interfaces to monitor tissue impedance and on-demand drug delivery. Studies in vitro demonstrated the anti-inflammatory effect of electrical stimulation on macrophages and revealed the molecular mechanism. In a rodent model, impedance sensing was validated to hint inflammation condition and facilitate diagnosis through machine learning model. The outcome of subsequent synergistic therapy showed notable relief of symptoms, elimination of synovial inflammation, and avoidance of bone destruction.

Flexible, Biodegradable, and Wireless Magnetoelectric Paper for Simple In Situ Personalization of Bioelectric Implants

Bioelectronic implants delivering electrical stimulation offer an attractive alternative to traditional pharmaceuticals in electrotherapy. However, achieving simple, rapid, and cost-effective personalization of these implants for customized treatment in unique clinical and physical scenarios presents a substantial challenge. This challenge is further compounded by the need to ensure safety and minimal invasiveness, requiring essential attributes such as flexibility, biocompatibility, lightness, biodegradability, and wireless stimulation capability. Here, a flexible, biodegradable bioelectronic paper with homogeneously distributed wireless stimulation functionality for simple personalization of bioelectronic implants is introduced. The bioelectronic paper synergistically combines i) lead-free magnetoelectric nanoparticles (MENs) that facilitate electrical stimulation in response to external magnetic field and ii) flexible and biodegradable nanofibers (NFs) that enable localization of MENs for high-selectivity stimulation, oxygen/nutrient permeation, cell orientation modulation, and biodegradation rate control. The effectiveness of wireless electrical stimulation in vitro through enhanced neuronal differentiation of neuron-like PC12 cells and the controllability of their microstructural orientation are shown. Also, scalability, design flexibility, and rapid customizability of the bioelectronic paper are shown by creating various 3D macrostructures using simple paper crafting techniques such as cutting and folding. This platform holds promise for simple and rapid personalization of temporary bioelectronic implants for minimally invasive wireless stimulation therapies.

A Wireless Battery-Free Implant With Optical Telemetry for In Vivo Cortical Stimulation

We present a 100 μm-thick, wireless, and battery-free implant for brain stimulation through a U.S. Food and Drug Administration-approved collagen dura substitute without contact with the brain's surface, while providing visible-light spectrum telemetry to track the onset of stimulation. The device is fabricated on a 16 × 6.67 mm2 biocompatible parylene/PDMS substrate and is encapsulated with a 2 μm-thick transparent parylene layer that enables the relay of the LED brightness. The in vivo rodent testing confirmed the implant's ability to trigger motor response while generating observable brightness through the skin. The results reveal the prospect of wireless stimulation with enhanced safety by eliminating contact between the implant and the brain, with optical telemetry for facilitated tracking.

Ultra-low frequency magnetic energy focusing for highly effective wireless powering of deep-tissue implantable electronic devices

The limited lifespan of batteries is a challenge in the application of implantable electronic devices. Existing wireless power technologies such as ultrasound, near-infrared light and magnetic fields cannot charge devices implanted in deep tissues, resulting in energy attenuation through tissues and thermal generation. Herein, an ultra-low frequency magnetic energy focusing (ULFMEF) methodology was developed for the highly effective wireless powering of deep-tissue implantable devices. A portable transmitter was used to output the low-frequency magnetic field (<50 Hz), which remotely drives the synchronous rotation of a magnetic core integrated within the pellet-like implantable device, generating an internal rotating magnetic field to induce wireless electricity on the coupled coils of the device. The ULFMEF can achieve energy transfer across thick tissues (up to 20 cm) with excellent transferred power (4-15 mW) and non-heat effects in tissues, which is remarkably superior to existing wireless powering technologies. The ULFMEF is demonstrated to wirelessly power implantable micro-LED devices for optogenetic neuromodulation, and wirelessly charged an implantable battery for programmable electrical stimulation on the sciatic nerve. It also bypassed thick and tough protective shells to power the implanted devices. The ULFMEF thus offers a highly advanced methodology for the generation of wireless powered biodevices.

There and Back Again: Building Systems That Integrate, Interface, and Interact with the Human Body

Since Dr. Theodor Schwann posed the extension of Cell Theory to mammals in 1839, scientists have dreamt up ways to interface with and influence the cells. Recently, considerable ground in this area is gained, particularly in the scope of bioelectronics. New advances in this area have provided with a means to record electrical activity from cells, examining neural firing or epithelial barrier integrity, and stimulate cells through applied electrical fields. Many of these applications utilize invasive implantation systems to perform this interaction in close proximity to the cells in question. Traditionally, the body's immune system fights back against these systems through the foreign body response, limiting the efficacy of long-term interactions. New technologies in tissue engineering, biomaterials science, and bioelectronics offer the potential to circumvent the foreign body response and create stable long-term biological interfaces. Looking ahead, the next advancements in the biomedical sciences can truly integrate, interface, and interact with the human body.

Monolithically integrated micro-supercapacitors with high areal number density produced by surface adhesive-directed electrolyte assembly

Accurately placing very small amounts of electrolyte on tiny micro-supercapacitors (MSCs) arrays in close proximity is a major challenge. This difficulty hinders the development of densely-compact monolithically integrated MSCs (MIMSCs). To overcome this grand challenge, we demonstrate a controllable electrolyte directed assembly strategy for precise isolation of densely-packed MSCs at micron scale, achieving scalable production of MIMSCs with ultrahigh areal number density and output voltage. We fabricate a patterned adhesive surface across MIMSCs, that induce electrolyte directed assembly on 10,000 highly adhesive MSC regions, achieving a 100 µm-scale spatial separation between each electrolyte droplet within seconds. The resultant MIMSCs achieve an areal number density of 210 cells cm-2 and a high areal voltage of 555 V cm-2. Further, cycling the MIMSCs at 190 V over 9000 times manifests no performance degradation. A seamlessly integrated system of ultracompact wirelessly-chargeable MIMSCs is also demonstrated to show its practicality and versatile applicability.

SENTRI: Single-Particle Energy Transducer for Radionuclide Injections for Personalized Targeted Radionuclide Cancer Therapy

PURPOSE

Targeted radionuclide therapy (TRT), whereby a tumor-targeted molecule is linked to a therapeutic beta- or alpha-emitting radioactive nuclide, is a promising treatment modality for patients with metastatic cancer, delivering radiation systemically. However, patients still progress due to suboptimal dosing, driven by the large patient-to-patient variability. Therefore, the ability to continuously monitor the real-time dose deposition in tumors and organs at risk provides an additional dimension of information during clinical trials that can enable insights into better strategies to personalize TRT.

METHODS AND MATERIALS

Here, we present a single beta-particle sensitive dosimeter consisting of a 0.27-mm3 monolithic silicon chiplet directly implanted into the tumor. To maximize the sensitivity and have enough detection area, minimum-size diodes (1 μm2) are arrayed in 64 × 64. Signal amplifiers, buffers, and on-chip memories are all integrated in the chip. For verification, PC3-PIP (prostate-specific membrane antigen [PSMA]+) and PC3-flu (PSMA-) cell lines are injected into the left and right flanks of the mice, respectively. The devices are inserted into each tumor and measure activities at 5 different time points (0-2 hours, 7-9 hours, 12-14 hours, 24-26 hours, and 48-50 hours) after 177Lu-PSMA-617 injections. Single-photon emission computed tomography/computed tomography scans are used to verify measured data.

RESULTS

With a wide detection range from 0.013 to 8.95 MBq/mL, the system is capable of detecting high tumor uptake as well as low doses delivered to organs at risk in real time. The measurement data are highly proportional (R2 > 0.99) to the 177Lu-PSMA-617 activity. The in vivo measurement data agree well with the single-photon emission computed tomography/computed tomography results within acceptable errors (±1.5%ID/mL).

CONCLUSIONS

Given the recent advances in clinical use of TRT in prostate cancer, the proposed system is verified in a prostate cancer mouse model using 177Lu-PSMA-617.