An Ultra High-Frequency 8-Channel Neurostimulator Circuit With [Formula: see text] Peak Power Efficiency

Development of Ocular Muscle Stimulation Systems and Optimization of Electrical Stimulus Parameters for Paralytic Strabismus Treatment

Paralysis of the extraocular muscles can lead to complications such as strabismus, diplopia, and loss of stereopsis. Current surgical treatments aim to mitigate these issues by resecting the paralyzed muscle or transposing the other recti muscles to the paralyzed muscle, but they do not fully improve the patient's quality of life. Electrical stimulation shows promise, while requiring further in vivo experiments and research on various stimulation parameters. In this study, we conducted experiments on rabbits to stimulate the superior rectus (SR) muscles using different parameters and stimulation waveforms. To provide various types of electrical stimulation, we developed the ocular muscle stimulation systems capable of both current controlled stimulation (CCS) and high-frequency stimulation (HFS), along with the chip that enables energy-efficient and safe switched-capacitor stimulation (SCS). We also developed electrodes for easy implantation and employed safe and efficient stimulation methods including CCS, SCS, and HFS. The in vivo animal experiments on normal and paralyzed SR muscles of rabbits showed that eyeball abduction angles were proportional to the current and pulse width of the stimulation. With the decaying exponential stimuli of the SCS system, eyeball abductions were 2.58× and 5.65× larger for normal and paralyzed muscles, respectively, compared to the rectangular stimulus of CCS. HFS achieved 0.92× and 0.26× abduction for normal and paralyzed muscles, respectively, with half energy compared to CCS. In addition, the continuous changes in eyeball abduction angle in response to varying stimulation intensity over time were observed.

A 3-mV Precision Dual-Mode-Controlled Fast Charge Balancing for Implantable Biphasic Neural Stimulators

This paper 5 presents a novel charge balancing (CB) with a current-control (CC) mode and a voltage-control (VC) mode for implantable biphasic stimulators, which can achieve one-step accurate anodic pulse generating. Compared with the conventional short-pulse-injection-based CB, the proposed method could reduce the balancing time and avoid inducing undesired artifact. The CC operation compensates the majority stimulation charge at high speed, while the VC operation guarantees a high CB precision. In order to eliminate the oscillation during the mode transition, a smooth CC-VC transition method is adopted. In addition, a digital auxiliary monitoring loop is introduced against the variations of the tissue-electrode interface impedance during the stimulation process to meet long-term CB requirement. The proposed stimulator has been fabricated in a 0.18 μm BCD process with 10 V voltage compliance, and the measured CB precision is less than 3 mV. The functionalities of the proposed CB have been verified successfully through in vitro experiments.

A 4-Channel Neural Stimulation IC Design With Charge Balancing and Multiple Current Output Modes

This article proposes a neural stimulation integrated circuit design with multiple current output modes. In the cathodic stimulation phase and anodic stimulation phase, each output current waveform can be independently selected to either exponential waveform or square wave, so the stimulator holds four stimulation modes. To minimize the headroom voltage of the output stage and enhance the power efficiency of the proposed stimulator, we introduce the exponentially decaying current which is realized by the exponential current generation circuit in this work. It can enhance the longer duration of the stimulation pulse as well. In case the residual charge may cause harm to patients, a charge balancing technique is implemented in this work for all operation modes. The four-channel stimulator IC is implemented in a 180-nm CMOS process, occupying a core area of 1.93 mm2. The measurement results show that the proposed stimulator realized a maximum power efficiency of 91.3% and the maximum stimulation duration is 3 times larger than previous works. Moreover, even in exponential output waveform mode, the maximum residual charge in a single cycle is only 255 pC due to the proposed charge balancing technique. The experiment results based on the PBS solution also show that the stimulator IC can remove residual charges within 60 μs, and the electrode voltage remains stable within a safe range under multicycle stimulation.

Trends in Volumetric-Energy Efficiency of Implantable Neurostimulators: A Review From a Circuits and Systems Perspective

This paper presents a comprehensive review of state-of-the-art, commercially available neurostimulators. We analyse key design parameters and performance metrics of 45 implantable medical devices across six neural target categories: deep brain, vagus nerve, spinal cord, phrenic nerve, sacral nerve and hypoglossal nerve. We then benchmark these alongside modern cardiac pacemaker devices that represent a more established market. This work studies trends in device size, electrode number, battery technology (i.e., primary and secondary use and chemistry), power consumption and longevity. This information is analysed to show the course of design decisions adopted by industry and identifying opportunity for further innovation. We identify fundamental limits in power consumption, longevity and size as well as the interdependencies and trade-offs. We propose a figure of merit to quantify volumetric efficiency within specific therapeutic targets, battery technologies/capacities, charging capabilities and electrode count. Finally, we compare commercially available implantable medical devices with recently developed systems in the research community. We envisage this analysis to aid circuit and system designers in system optimisation and identifying innovation opportunities, particularly those related to low power circuit design techniques.

A Low-Voltage and Power-Efficient Capless LDO Based on the Biaxially Driven Power Transistor Technique for Respiration Monitoring System

In this study, a 0.8-V- V_in 200-mA- I_o capless low-dropout voltage regulator (LDO) is developed for a wireless respiration monitoring system. The biaxially driven power transistor (BDP) technique is proposed in the LDO, with a current driven stimulation on the bulk and a voltage on the gate terminal. With the BDP technique, an adaptively biased current-driven loop (ABCL) is designed which can reduce the high threshold voltage of power transistor, thus presenting lower input voltage and reduced power consumption. Moreover, this loop can provide an improved dynamic response due to its increased discharging current. Based on an error amplifier with enhanced DC gain and gain bandwidth, the capless LDO achieves superior power supply rejection (PSR) and stability without a complex frequency compensation mechanism. The proposed LDO is fabricated in the SMIC 180 nm process with a chip area of 0.046 mm ². Measurement results indicate that this LDO can obtain a 200-mA load current range and greater than -66 dB PSR up to 1 kHz at a supply voltage as low as 0.8 V.

Energy efficiency of pulse shaping in electrical stimulation: the interdependence of biophysical effects and circuit design losses

Power efficiency in electrical stimulator circuits is crucial for developing large-scale multichannel applications like bidirectional brain-computer interfaces and neuroprosthetic devices. Many state-of-the-art papers have suggested that some non-rectangular pulse shapes are more energy-efficient for exciting neural excitation than the conventional rectangular shape. However, additional losses in the stimulator circuit, which arise from employing such pulses, were not considered. In this work, we analyze the total energy efficiency of a stimulation system featuring non-rectangular stimuli, taking into account the losses in the stimulator circuit. To this end, activation current thresholds for different pulse shapes and durations in cortical neurons are modeled, and the energy required to generate the pulses from a constant voltage supply is calculated. The proposed calculation reveals an energy increase of 14-51% for non-rectangular pulses compared to the conventional rectangular stimuli, instead of the decrease claimed in previous literature. This result indicates that a rectangular stimulation pulse is more power-efficient than the tested alternative shapes in large-scale multichannel electrical stimulation systems.

Energy Savings of Multi-Channel Neurostimulators with Non-Rectangular Current-Mode Stimuli Using Multiple Supply Rails

In neuromodulation applications, conventional current mode stimulation is often preferred over its voltage mode equivalent due to its good control of the injected charge. However, it comes at the cost of less energy-efficient output stages. To increase energy efficiency, recent studies have explored non-rectangular stimuli. The current work highlights the importance of an adaptive supply for an output stage with programmable non-rectangular stimuli and accordingly proposes a system-level architecture for multi-channel stimulators. In the proposed architecture, a multi-output DC/DC Converter (DDC) allows each channel to choose among the available supply levels (i.e., DDC outputs) independently and based on its instant voltage/current requirement. A system-level analysis is carried out in Matlab to calculate the possible energy savings of this solution, compared to the conventional approach with a fixed supply. The energy savings have been simulated for a variety of supply levels and waveform amplitudes, suggesting energy savings of up to 83% when employing 6 DDC outputs and the lowest current amplitude explored ( 250 μA), and as high as 26% for a full-scale amplitude (4 mA).

Design of Dual-Mode Stimulus Chip With Built-In High Voltage Generator for Biomedical Applications

In this work, a dual-mode stimulus chip with a built-in high voltage generator was proposed to offer a broad-range current or voltage stimulus patterns for biomedical applications. With an on-chip and built-in high voltage generator, this stimulus chip could generate the required high voltage supply without additional supply voltage. With a nearly 20 V operating voltage, the overstress and reliability issues of the stimulus circuits were thoroughly considered and carefully addressed in this work. This stimulus system only requires an area of 0.22 mm² per single channel and is fully on-chip implemented without any additional external components. The dual-mode stimulus chip was fabricated in a 0.25-μm 2.5V/5V/12V CMOS (complementary metal-oxide-semiconductor) process, which can generate the biphasic current or voltage stimulus pulses. The current level of stimulus is up to 5 mA, and the voltage level of stimulus can be up to 10 V. Moreover, this chip has been successfully applied to stimulate a guinea pig in an animal experiment. The proposed dual-mode stimulus system has been verified in electrical tests and also demonstrated its stimulation function in animal experiments.