Design and In Vivo Verification of a CMOS Bone-Guided Cochlear Implant Microsystem

Auditory Brainstem Response (ABR) Recording of Simultaneous Electric-Acoustic Stimulation between Round Window Membrane and Basal Part of Cochlear Bone in guinea Pigs

HYPOTHESIS

Extracochlear electric-acoustic stimulation (EAS) between the round window membrane and the basal part of the cochlear bone exhibits distinct auditory brainstem response (ABR) characteristics.

BACKGROUND

The use of EAS in individuals with residual hearing is becoming increasingly common in clinical settings. Ongoing research has explored the characteristics of EAS-induced responses in hearing cochleae.

METHODS

This study explored a novel extracochlear EAS approach using round window membrane-cochlear bone stimulation to maintain cochlear integrity. The electrodes stimulate the basal part of the cochlea and spare the apex, making the model ideal for EAS candidates with profound high-frequency hearing loss and residual low-frequency hearing. ABR analyses of EAS were conducted to compare responses to acoustic, electrical, and combined stimulations.

RESULTS

The threshold of EAS was higher than that of acoustic stimulation (AS) or electric stimulation (ES). The maximum peak height of the amplitude (MPHA) in the EAS showed sound pressure level (SPL)- and electric current-dependent changes, with superior performance at higher SPLs. The MPHA latency shift index analysis demonstrated significant differences between the EAS and the AS or ES only. In the context of EAS, neural responses occurring before 4 ms are defined as early responses, which are related to the stimulus. Late responses, occurring after 4 ms, suggest distinct physiological mechanisms that may involve synaptic actions or specific interactions within the EAS.

CONCLUSION

Extracochlear EAS provides insights into its physiological implications, proposes a method for clinical application, and offers a potential avenue for improving hearing preservation and performance.

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.

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.

Effects of different electrodes used in bone-guided extracochlear implants on electrical stimulation of auditory nerves in guinea pigs

Objective:

Conventional cochlear implants provide patients who are deaf with hearing via electrical intracochlear stimulations. Stimulation electrodes are inserted into the cochlea through a cochleostomy or round window membrane (RWM) approach. However, these methods might induce cochlear ossificans and loss of residual hearing by damaging inner ear structures. To avoid an invasive electrode insertion, we developed a novel bone-guided extracochlear implant that stimulated the auditory nerves between the cochlear bones and the RWM to prevent cochlea damage. Power consumption plays an important role in wireless implantable electronic devices. Therefore, we aimed to investigate the effects of different electrodes on the stimulating threshold currents of the auditory nerve and the power consumption of bone-guided extracochlear implants using a commercial stimulator.

Materials and Methods:

Inert aurum (Au) electrodes were compared with biocompatible platinum (Pt) and iridium oxide (IrO_x) electrodes in practical implantable applications. IrO_x electrodes were used for their high-charge storage capacity, low impedance, and biocompatibility. The electrodes were fabricated via sputtering and were experimentally characterized with cyclic voltammetry and then examined using in vivo tests.

Results:

Based on electrical auditory brainstem responses, IrO_x electrodes yielded lower acoustic nerve-stimulating threshold currents (132 μA) compared with Au electrodes (204 μA). IrO_x electrodes also had a lower acoustic nerve stimulating threshold current (132 μA) compared with Pt electrodes (168 μA).

Conclusion:

As expected, IrO_x electrodes were beneficial in the development of multielectrode bone-guided extracochlear implants, with the lowest acoustic nerve-stimulating threshold and current consumptions compared with Au and Pt electrodes.