Ultrasound-Powered Implants: A Critical Review of Piezoelectric Material Selection and Applications

A Self-Healing Optoacoustic Patch with High Damage Threshold and Conversion Efficiency for Biomedical Applications

Compared with traditional piezoelectric ultrasonic devices, optoacoustic devices have unique advantages such as a simple preparation process, anti-electromagnetic interference, and wireless long-distance power supply. However, current optoacoustic devices remain limited due to a low damage threshold and energy conversion efficiency, which seriously hinder their widespread applications. In this study, using a self-healing polydimethylsiloxane (PDMS, Fe-Hpdca-PDMS) and carbon nanotube composite, a flexible optoacoustic patch is developed, which possesses the self-healing capability at room temperature, and can even recover from damage induced by cutting or laser irradiation. Moreover, this patch can generate high-intensity ultrasound (> 25 MPa) without the focusing structure. The laser damage threshold is greater than 183.44 mJ cm-2, and the optoacoustic energy conversion efficiency reaches a major achievement at 10.66 × 10-3, compared with other carbon-based nanomaterials and PDMS composites. This patch is also been successfully examined in the application of acoustic flow, thrombolysis, and wireless energy harvesting. All findings in this study provides new insight into designing and fabricating of novel ultrasound devices for biomedical applications.

Neuromuscular implants: Interfacing with skeletal muscle for improved clinical translation of prosthetic limbs

After an amputation, advanced prosthetic limbs can be used to interface with the nervous system and restore motor function. Despite numerous breakthroughs in the field, many of the recent research advancements have not been widely integrated into clinical practice. This review highlights recent innovations in neuromuscular implants-specifically those that interface with skeletal muscle-which could improve the clinical translation of prosthetic technologies. Skeletal muscle provides a physiologic gateway to harness and amplify signals from the nervous system. Recent surgical advancements in muscle reinnervation surgeries leverage the "bio-amplification" capabilities of muscle, enabling more intuitive control over a greater number of degrees of freedom in prosthetic limbs than previously achieved. We anticipate that state-of-the-art implantable neuromuscular interfaces that integrate well with skeletal muscle and novel surgical interventions will provide a long-term solution for controlling advanced prostheses. Flexible electrodes are expected to play a crucial role in reducing foreign body responses and improving the longevity of the interface. Additionally, innovations in device miniaturization and ongoing exploration of shape memory polymers could simplify surgical procedures for implanting such interfaces. Once implanted, wireless strategies for powering and transferring data from the interface can eliminate bulky external wires, reduce infection risk, and enhance day-to-day usability. By outlining the current limitations of neuromuscular interfaces along with potential future directions, this review aims to guide continued research efforts and future collaborations between engineers and specialists in the field of neuromuscular and musculoskeletal medicine.

Evaluation of a Machine Learning Algorithm to Classify Ultrasonic Transducer Misalignment and Deployment Using TinyML

The challenge for ultrasonic (US) power transfer systems, in implanted/wearable medical devices, is to determine when misalignment occurs (e.g., due to body motion) and apply directional correction accordingly. In this study, a number of machine learning algorithms were evaluated to classify US transducer misalignment, based on data signal transmissions between the transmitter and receiver. Over seven hundred US signals were acquired across a range of transducer misalignments. Signal envelopes and spectrograms were used to train and evaluate machine learning (ML) algorithms, classifying misalignment extent. The algorithms included an autoencoder, convolutional neural network (CNN) and neural network (NN). The best performing algorithm, was deployed onto a TinyML device for evaluation. Such systems exploit low power microcontrollers developed specifically around edge device applications, where algorithms were configured to run on low power, restricted memory systems. TensorFlow Lite and Edge Impulse, were used to deploy trained models onto the edge device, to classify signals according to transducer misalignment extent. TinyML deployment, demonstrated near real-time (<350 ms) signal classification achieving accuracies > 99%. This opens the possibility to apply such ML alignment algorithms to US arrays (capacitive micro-machined ultrasonic transducer (CMUT), piezoelectric micro-machined ultrasonic transducer (PMUT) devices) capable of beam-steering, significantly enhancing power delivery in implanted and body worn systems.

First-in-human demonstration of floating EMG sensors and stimulators wirelessly powered and operated by volume conduction

BACKGROUND

Recently we reported the design and evaluation of floating semi-implantable devices that receive power from and bidirectionally communicate with an external system using coupling by volume conduction. The approach, of which the semi-implantable devices are proof-of-concept prototypes, may overcome some limitations presented by existing neuroprostheses, especially those related to implant size and deployment, as the implants avoid bulky components and can be developed as threadlike devices. Here, it is reported the first-in-human acute demonstration of these devices for electromyography (EMG) sensing and electrical stimulation.

METHODS

A proof-of-concept device, consisting of implantable thin-film electrodes and a nonimplantable miniature electronic circuit connected to them, was deployed in the upper or lower limb of six healthy participants. Two external electrodes were strapped around the limb and were connected to the external system which delivered high frequency current bursts. Within these bursts, 13 commands were modulated to communicate with the implant.

RESULTS

Four devices were deployed in the biceps brachii and the gastrocnemius medialis muscles, and the external system was able to power and communicate with them. Limitations regarding insertion and communication speed are reported. Sensing and stimulation parameters were configured from the external system. In one participant, electrical stimulation and EMG acquisition assays were performed, demonstrating the feasibility of the approach to power and communicate with the floating device.

CONCLUSIONS

This is the first-in-human demonstration of EMG sensors and electrical stimulators powered and operated by volume conduction. These proof-of-concept devices can be miniaturized using current microelectronic technologies, enabling fully implantable networked neuroprosthetics.

Advances in Wireless, Batteryless, Implantable Electronics for Real-Time, Continuous Physiological Monitoring

This review summarizes recent progress in developing wireless, batteryless, fully implantable biomedical devices for real-time continuous physiological signal monitoring, focusing on advancing human health care. Design considerations, such as biological constraints, energy sourcing, and wireless communication, are discussed in achieving the desired performance of the devices and enhanced interface with human tissues. In addition, we review the recent achievements in materials used for developing implantable systems, emphasizing their importance in achieving multi-functionalities, biocompatibility, and hemocompatibility. The wireless, batteryless devices offer minimally invasive device insertion to the body, enabling portable health monitoring and advanced disease diagnosis. Lastly, we summarize the most recent practical applications of advanced implantable devices for human health care, highlighting their potential for immediate commercialization and clinical uses.

Piezoelectric Effect Modulates Nanozyme Activity: Underlying Mechanism and Practical Application

Nanozyme activity relies on surface electron transfer processes. Notably, the piezoelectric effect plays a vital role in influencing nanozyme activity by generating positive and negative charges on piezoelectric materials' surfaces. This article comprehensively reviews the potential mechanisms and practical applications of regulating nanozyme activity through the piezoelectric effect. The article first elucidates how the piezoelectric effect enables nanozymes to exhibit catalytic activity. It is highlighted that the positive and negative charges produced by this effect directly participate in redox reactions, leading to the conversion of materials from an inactive to an active state. Moreover, the piezoelectric field generated can enhance nanozyme activity by accelerating electron transfer rates or reducing binding energy between nanozymes and substrates. Practical applications of piezoelectric nanozymes are explored in the subsequent section, including water pollutant degradation, bacterial disinfection, biological detection, and tumor therapy, which demonstrate the versatile potentials of the piezoelectric effect in nanozyme applications. The review concludes by emphasizing the need for further research into the catalytic mechanisms of piezoelectric nanozymes, suggesting expanding the scope of catalytic types and exploring new application areas. Furthermore, the promising direction of synergistic catalytic therapy is discussed as an inspiring avenue for future research.

Biodegradable piezoelectric skin-wound scaffold

Electrical stimulation (ES) induces wound healing and skin regeneration. Combining ES with the tissue-engineering approach, which relies on biomaterials to construct a replacement tissue graft, could offer a self-stimulated scaffold to heal skin-wounds without using potentially toxic growth factors and exogenous cells. Unfortunately, current ES technologies are either ineffective (external stimulations) or unsafe (implanted electrical devices using toxic batteries). Hence, we propose a novel wound-healing strategy that integrates ES with tissue engineering techniques by utilizing a biodegradable self-charged piezoelectric PLLA (Poly (l-lactic acid)) nanofiber matrix. This unique, safe, and stable piezoelectric scaffold can be activated by an external ultrasound (US) to produce well-controlled surface-charges with different polarities, thus serving multiple functions to suppress bacterial growth (negative surface charge) and promote skin regeneration (positive surface charge) at the same time. We demonstrate that the scaffold activated by low intensity/low frequency US can facilitate the proliferation of fibroblast/epithelial cells, enhance expression of genes (collagen I, III, and fibronectin) typical for the wound healing process, and suppress the growth of S. aureus and P. aeruginosa bacteria in vitro simultaneously. This approach induces rapid skin regeneration in a critical-sized skin wound mouse model in vivo. The piezoelectric PLLA skin scaffold thus assumes the role of a multi-tasking, biodegradable, battery-free electrical stimulator which is important for skin-wound healing and bacterial infection prevention simultaneuosly.

Improving APT Systems' Performance in Air via Impedance Matching and 3D-Printed Clamp

This paper presents a study on improving the performance of the acoustic piezoelectric transducer system in air, as the low acoustic impedance of air leads to suboptimal system performance. Impedance matching techniques can enhance the acoustic power transfer (APT) system's performance in air. This study integrates an impedance matching circuit into the Mason circuit and investigates the impact of fixed constraints on the piezoelectric transducer's sound pressure and output voltage. Additionally, this paper proposes a novel equilateral triangular peripheral clamp that is entirely 3D-printable and cost-effective. This study analyses the peripheral clamp's impedance and distance characteristics and confirms its effectiveness through consistent experimental and simulation results. The findings of this study can aid researchers and practitioners in various fields that employ APT systems to improve their performance in air.

Piezo bender controller for precise optical dispersion compensation based on single-shot optical interferometry

Ultrafast lasers concentrate the energy in a short pulse with a duration of several tens to hundreds of femtoseconds. The resulting high peak power induces various nonlinear optical phenomena that find use in many different fields. However, in practical applications, the optical dispersion broadens the laser pulse width and spreads the energy in time, thereby reducing the peak power. Accordingly, the present study develops a piezo bender-based pulse compressor to compensate for this dispersion effect and restore the laser pulse width. The piezo bender has a rapid response time and a large deformation capacity and thus provides a highly effective means of performing dispersion compensation. However, due to hysteresis and creep effects, the piezo bender is unable to maintain a stable shape over time and hence the compensation effect is gradually degraded. To address this problem, this study further proposes a single-shot modified laterally sampled laser interferometer to estimate the parabolic shape of the piezo bender. The curvature variation of the bender is then sent as a feedback signal to a closed-loop controller to restore the bender to the desired shape. It is shown that the steady-state error of the converged group delay dispersion is around 530 fs². Moreover, the ultrashort laser pulse is compressed from 1620 fs in the original condition to 140 fs in the compressed condition, corresponding to a 12-fold improvement.

Modeling and Measurement of an Ultrasound Power Delivery System for Charging Implantable Devices Using an AlN-Based pMUT as Receiver

Ultrasound power delivery can be considered a convenient technique for charging implantable medical devices. In this work, an intra-body system has been modeled to characterize the phenomenon of ultrasound power transmission. The proposed system comprises a Langevin transducer as transmitter and an AlN-based square piezoelectric micro-machined ultrasonic transducer as receiver. The medium layers, in which elastic waves propagate, were made by polydimethylsiloxane to mimic human tissue and stainless steel to replace the case of the implantable device. To characterize the behavior of the transducers, measurements of impedance and phase, velocity and displacement, and acoustic pressure field were carried out in the experimental activity. Then, voltage and power output were measured to analyze the performance of the ultrasound power delivery system. For a root mean square voltage input of approximately 35 V, the power density resulted in 21.6 µW cm^-2. Such a result corresponds to the data obtained with simulation through a one-dimensional lumped parameter transmission line model. The methodology proposed to develop the ultrasound power delivery (UPD) system, as well as the use of non-toxic materials for the fabrication of the intra-body elements, are a valid design approach to raise awareness of using wireless power transfer techniques for charging implantable devices.

An implantable ultrasound-powered device for the treatment of brain cancer using electromagnetic fields

Brain tumors have been proved challenging to treat. Here, we present a promising alternative by developing an implantable ultrasound-powered tumor treating device (UP-TTD) that electromagnetically disrupts the rapid division of cancer cells without any adverse effects on normal neurons, thereby safely inhibiting brain cancer recurrence. In vitro and in vivo experiments confirmed the significant therapeutic effect of the UP-TTD, with ~58% inhibition on growth rate of clinical tumor cells and ~78% reduction of cancer area in tumor-bearing rats. This UP-TTD is wireless ultrasound-powered, chip-sized, lightweight, and easy to operate on complex surfaces, with a largely boosting therapeutic efficiency and reducing energy consumption. Meanwhile, various treatment parameters could be tuned from the UP-TTD without increasing its size or adding circuits on the integrated chip. The tuning process was simulated and discussed, showing an excellent agreement with the experimental data. The encouraging results of the UP-TTD raise the possibility of a new modality for brain cancer treatment.

Towards Resorbable Elastomeric Circuit Boards for Implantable Medical Devices

IMDs are typically considered for chronic-use applications and a limited set of implant locations. Resorbable IMDs seek to combine advances in flexible electronics with functional soft materials to enable new applications, including acute care, aiming at temporary interfacing with soft tissues. Poly(oc-tamethylene maleate (anhydride) citrate) (POMaC) is an elasto-mer with demonstrated high biocompatibility and bioresorbability, as well as tunable stiffness and surface properties. Despite its promises, POMaC has not yet been applied in engineering flexible electronics. Herein, a POMaC-based circuit board is demonstrated and characterized. The monomer composition and thermal degradation properties of the pre-polymer was characterized. POMaC-based circuit boards were constructed using traditional microfabrication methods, including spin coating and metallization. POMaC pre-polymer and films were thermally stable to 300°C, exhibit controlled degradation in simulated physiological conditions, and are cytocompatible. Deposited traces were stable during fabrication and processing, and an LED circuit was designed and fabricated using surface mount devices on a POMaC-circuit board. The results indicate the feasibility of POMaC-based circuit boards for use in resorbable IMDs. Future work will investigate more complex circuits, fully encapsulated devices, and mechanical characterization.

Floating EMG sensors and stimulators wirelessly powered and operated by volume conduction for networked neuroprosthetics

Background

Implantable neuroprostheses consisting of a central electronic unit wired to electrodes benefit thousands of patients worldwide. However, they present limitations that restrict their use. Those limitations, which are more adverse in motor neuroprostheses, mostly arise from their bulkiness and the need to perform complex surgical implantation procedures. Alternatively, it has been proposed the development of distributed networks of intramuscular wireless microsensors and microstimulators that communicate with external systems for analyzing neuromuscular activity and performing stimulation or controlling external devices. This paradigm requires the development of miniaturized implants that can be wirelessly powered and operated by an external system. To accomplish this, we propose a wireless power transfer (WPT) and communications approach based on volume conduction of innocuous high frequency (HF) current bursts. The currents are applied through external textile electrodes and are collected by the wireless devices through two electrodes for powering and bidirectional digital communications. As these devices do not require bulky components for obtaining power, they may have a flexible threadlike conformation, facilitating deep implantation by injection.

Methods

We report the design and evaluation of advanced prototypes based on the above approach. The system consists of an external unit, floating semi-implantable devices for sensing and stimulation, and a bidirectional communications protocol. The devices are intended for their future use in acute human trials to demonstrate the distributed paradigm. The technology is assayed in vitro using an agar phantom, and in vivo in hindlimbs of anesthetized rabbits.

Results

The semi-implantable devices were able to power and bidirectionally communicate with the external unit. Using 13 commands modulated in innocuous 3 MHz HF current bursts, the external unit configured the sensing and stimulation parameters, and controlled their execution. Raw EMG was successfully acquired by the wireless devices at 1 ksps.

Conclusions

The demonstrated approach overcomes key limitations of existing neuroprostheses, paving the way to the development of distributed flexible threadlike sensors and stimulators. To the best of our knowledge, these devices are the first based on WPT by volume conduction that can work as EMG sensors and as electrical stimulators in a network of wireless devices.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12984-022-01033-3.