In-vivo testing of a novel wireless intraspinal microstimulation interface for restoration of motor function following spinal cord injury

BACKGROUND

Spinal cord injury causes a drastic loss in motor and sensory function. Intraspinal microstimulation (ISMS) is an electrical stimulation method developed for restoring motor function by activating the spinal networks below the level of injury. Current ISMS technology uses fine penetrating microwires to stimulate the ventral horn of the lumbar enlargement. The penetrating wires traverse the dura mater through a transdural conduit that connects to an implantable pulse generator.

OBJECTIVE

A wireless, fully intradural ISMS implant was developed to mitigate the potential complications associated with the transdural conduit, including tethering and leakage of cerebrospinal fluid.

METHODS

Two wireless floating microelectrode array (WFMA) devices were implanted in the lumbar enlargement of an adult domestic pig. Voltage transients were used to assess the electrochemical stability of the interface. Manual flexion and extension movements of the spine were performed to evaluate the mechanical stability of the interface. Post-mortem 9T MRI imaging was used to confirm the location of the electrodes.

RESULTS

The WFMA-based ISMS interface successfully evoked extension and flexion movements of the hip joint. Stimulation thresholds remained stable following manual extension and flexion of the spine.

CONCLUSION

The preliminary results demonstrate the surgical feasibility as well as the functionality of the proposed wireless ISMS system.

Contributed Session III: Characteristics of electrically-induced visual percepts in the first human with the Intracortical Visual Prosthesis

The Intracortical Visual Prosthesis (ICVP) consists of multiple wireless floating microelectrode arrays (WFMAs), each with 16 stimulating electrodes. Stimulation of these electrodes can potentially provide artificial vision for people who are blind. Twenty-five WFMAs were implanted in the right occipital visual cortex of a participant in an FDA-approved, NIH-sponsored Phase 1 clinical trial (NCT04634383). Here, we report characteristics of visual percepts elicited by the WFMAs (frequency: 200 Hz, cathodic phase duration: 200 µs, amplitude and train length up to 60 µA and 900 ms). Stimulation of single electrodes in 10 WFMAs and groups of 4 or more electrodes in 7 additional WFMAs consistently produced percepts during >10 sessions across approximately 3 months of testing. Phosphenes generated within a single WFMA were typically similar in appearance. Descriptions included configurations of rings, bright or dark dots, and constant or flickering bars, with sizes of 0.3-12° across. Phosphenes appeared as blueish-white, or occasionally orange, red, or having an iridescent texture. Ten WFMAs produced phosphenes within a 4° cluster centered 4° below and to the left of fixation. Phosphenes from 4 other WFMAs were located 4° below or 20° left of the cluster. When using these phosphenes to scan a virtual line, the participant was able to discriminate horizontal and vertical lines (46/51 correct, p < 10^-8, binomial test), and 45° and 135° diagonal lines (12/14 correct, p < 0.01).

Chronic stability of activated iridium oxide film voltage transients from wireless floating microelectrode arrays

Successful monitoring of the condition of stimulation electrodes is critical for maintaining chronic device performance for neural stimulation. As part of pre-clinical safety testing in preparation for a visual prostheses clinical trial, we evaluated the stability of the implantable devices and stimulation electrodes using a combination of current pulsing in saline and in canine visual cortex. Specifically, in saline we monitored the stability and performance of 3000 μm2 geometric surface area activated iridium oxide film (AIROF) electrodes within a wireless floating microelectrode array (WFMA) by measuring the voltage transient (VT) response through reverse telemetry. Eight WFMAs were assessed in vitro for 24 days, where n = 4 were pulsed continuously at 80 μA (16 nC/phase) and n = 4 remained in solution with no applied stimulation. Subsequently, twelve different WFMAs were implanted in visual cortex in n = 3 canine subjects (4 WFMAs each). After a 2-week recovery period, half of the electrodes in each of the twelve devices were pulsed continuously for 24 h at either 20, 40, 63, or 80 μA (200 μs pulse width, 100 Hz). VTs were recorded to track changes in the electrodes at set time intervals in both the saline and in vivo study. The VT response of AIROF electrodes remained stable during pulsing in saline over 24 days. Electrode polarization and driving voltage changed by less than 200 mV on average. The AIROF electrodes also maintained consistent performance, overall, during 24 h of pulsing in vivo. Four of the in vivo WFMA devices showed a change in polarization, access voltage, or driving voltage over time. However, no VT recordings indicated electrode failure, and the same trend was typically seen in both pulsed and unpulsed electrodes within the same device. Overall, accelerated stimulation testing in saline and in vivo indicated that AIROF electrodes in the WFMA were able to consistently deliver up to 16 nC per pulse and would be suitable for chronic clinical use.

The Use of Digital Image Correlation for Measurement of Strain Fields in a Novel Wireless Intraspinal Microstimulation Interface

BACKGROUND

Intraspinal microstimulation (ISMS) has emerged as a promising neuromodulation technique for restoring standing and overground walking in individuals with spinal cord injury. Current and emerging ISMS implant designs connect the electrodes to the stimulator through lead wires that cross the dura mater. To reduce possible complications associated with transdural leads such as tethering and leakage of cerebrospinal fluid, we aim to develop a wireless, fully intradural ISMS implant based upon our prior work in the cortex with the Wireless Floating Microelectrode Array (WFMA). Although we have extensive data about WFMA cortical stability, its mechanical and electrical stability in the spinal cord remain unknown. One of the quantifiable metrics to assess long-term implant stability is mechanical strain.

OBJECTIVE

The aim of the current work is to develop a method to assess implant stability by measuring strain fields in a surrogate of the human spinal cord.

METHODS

A physical model of the spinal cord was studied using an electromechanical testing apparatus, simulating typical spinal cord motion. Strain fields were digitally analyzed using an optical method known as digital image correlation (DIC).

RESULTS

Displacement and strain were visualized using contour plots. The strain values in the vicinity of each WFMA device were significantly different from the strain values in the same locations in the control surrogate spinal cord.

CONCLUSION

The results demonstrate that DIC can be used for in-vitro screening of intraspinal implants. Accurate optical strain measurements will enable researchers to optimize implant design over a wide range of motion conditions.

Wireless Transmission of Voltage Transients from a Chronically Implanted Neural Stimulation Device

OBJECTIVE

Consistent transmission of data from wireless neural devices is critical for monitoring the condition and performance of stimulation electrodes. To date, no wireless neural interface has demonstrated the ability to monitor the integrity of chronically implanted electrodes through wireless data transmission.

APPROACH

In this work, we present a method for wirelessly recording the voltage transient (VT) response to constant-current, cathodic-first asymmetric pulsing from a microelectrode array. We implanted six wireless devices in rat sciatic nerve and wirelessly recorded voltage transient measurements throughout a 38-week implantation period.

MAIN RESULTS

Electrode maximum cathodic potential excursion (Emc), access voltage, and driving voltage (extracted from each VT) remained stable throughout the 38-week study period. Average Emc(from an applied +0.6 V interpulse bias) in response to 4.7 µA, 200.2 µs pulses was 267 ± 107 mV at week 1 post-implantation and 282 ± 52 mV at week 38 post-implantation. Access voltage for the same 4.7 µA pulsing amplitude was 239 ± 65 mV at week 1 post-implantation and 268 ± 139 mV at week 38 post-implantation.

SIGNIFICANCE

The voltage transient response recorded via reverse telemetry from the wireless microelectrode array did not significantly change over a 38-week implantation period and was similar to previously reported VTs from wired microelectrodes with the same geometry. Additionally, the voltage transient response recorded wirelessly in phosphate buffered saline before and after device implantation appeared as expected, showing significantly less electrode polarization and smaller access voltage than the VT response in vivo.

Effects of Varying Pulse Width and Frequency of Wireless Stimulation in Rat Sciatic Nerve

Peripheral nerve stimulation is a commonly used method for assisting movements after spinal cord injury, stroke, traumatic brain injury, and other types of neurological damage or dysfunction. There are many different patterns of electrical stimulation used to accomplish movement. And so, our study investigated stimulation with a wireless floating microelectrode array (WFMA) in comparison to previously reported data on functional electrical stimulation. To determine the effect on hindlimb movement, we tested a range of frequencies and pulse widths using WFMAs that were implanted in the rat sciatic nerve for 38 weeks. Frequencies between 1 and 50 Hz did not change the minimum current amplitude required to elicit movement in the hindlimb. Increasing pulse width from 57.2 to 400.4 µs decreased the minimum current required but had an associated increase in total charge applied per pulse. Overall, the WFMA provides a stable wireless peripheral nerve interface suitable for functional electrical stimulation.Clinical Relevance- This work establishes the efficacy of various stimulation parameters for controlling movement with a wireless peripheral nerve stimulator.

Wireless microelectrode arrays for selective and chronically stable peripheral nerve stimulation for hindlimb movement

Objective. Maximizing the stability of implanted neural interfaces will be critical to developing effective treatments for neurological and neuromuscular disorders. Our research aims to develop a stable neural interface using wireless communication and intrafascicular microelectrodes to provide highly selective stimulation of neural tissue.Approach. We implanted a wireless floating microelectrode array into the left sciatic nerve of six rats. Over a 38 week implantation period, we recorded stimulation thresholds and movements evoked at each implanted electrode. We also tracked each animal's response to sensory stimuli and performance on two different walking tasks.Main results. Presence of the microelectrode array inside the sciatic nerve did not cause any obvious motor or sensory deficits in the hindlimb. Visible movement in the hindlimb was evoked by stimulating the sciatic nerve with currents as low as 4.1µA. Thresholds for most of the 96 electrodes we implanted were below 20µA, and predictable recruitment of plantar flexion and dorsiflexion was achieved by stimulating rat sciatic nerve with the intrafascicular microelectrode array. Further, motor recruitment patterns for each electrode did not change significantly throughout the study.Significance. Incorporating wireless communication and a low-profile neural interface facilitated highly stable motor recruitment thresholds and fine motor control in the hindlimb throughout an extensive 9.5 month assessment in rodent peripheral nerve. Results of this study indicate that use of the wireless device tested here could be extended to other applications requiring selective neural stimulation and chronic implantation.

Toward the development of a color visual prosthesis

Objective. All of the human prosthetic visual systems implanted so far have been achromatic. Schmidtet al(1996Brain119507-22) reported that at low stimulation intensities their subject reported that phosphenes usually had a specific hue, but when the stimulus intensity was increased, they desaturated to white. We speculate here that previous B/W prosthetic systems were unnecessarily over-stimulating the visual cortex to obtain white phosphenes, which may be why unexpected alterations in phosphenes and seizures were not an uncommon occurrence. A color prosthesis would have the advantage of being elicited by lower levels of stimulation, reducing the probability of causing epileptogenic responses.Approach.A 'hybrid' mode of stimulation is suggested, involving a combination of B/W and color stimulation, which could provide color information without reducing spatial resolution.Main results.Colors in the real world are spread along intensity and chromatic gradients.Significance.Software implementation strategies are discussed, as are the advantages and challenges for possible color prosthetic systems.

Activated iridium oxide film (AIROF) electrodes for neural tissue stimulation

OBJECTIVE

Iridium oxide films are commonly used as a high charge-injection electrode material in neural devices. Yet, few studies have performed in-depth assessments of material performance versus film thickness, especially for films grown on three-dimensional (instead of planar) metal surfaces in neutral pH electrolyte solutions. Further, few studies have investigated the driving voltage requirements for constant-current stimulation using activated iridium oxide (AIROF) electrodes, which will be a key constraint for future use in wirelessly powered neural devices.

APPROACH

In this study, iridium microwire probes were activated by repeated potential pulsing in room temperature phosphate buffered saline (pH 7.1-7.3). Electrochemical measurements were recorded in three different electrolyte conditions for probes with different geometric surface areas (GSAs) as the AIROF thickness was increased.

MAIN RESULTS

Maintaining an anodic potential bias during the inter-pulse interval was required for AIROF electrodes to deliver charge levels considered necessary for neural stimulation. Potential pulsing for 100-200 cycles was sufficient to achieve charge injection levels of 2.5 mC cm^-2 (50 nC/phase in a biphasic pulse) in PBS with 2000 µm² iridium probes. Increasing the electrode surface area to 3000 µm² and 4000 µm² significantly increased charge-injection capacity, reduced the driving voltage required to deliver a fixed amount of charge, and reduced polarization of the electrodes during constant-current pulsing.

SIGNIFICANCE

This study establishes methods for choosing an activation protocol and a desired GSA for three-dimensional iridium electrodes suitable for neural tissue insertion and stimulation, and provides guidelines for evaluating electrochemical performance of AIROF using model saline solutions.

Selective Wireless Stimulation of Rat Sciatic Nerve

Chronic stability of functional performance is a significant challenge to the success of implantable devices for neural stimulation and recording. Integrating wireless technology with typical microelectrode array designs is one approach that may reduce instances of mechanical failure and improve the long-term performance of neural devices. We have investigated the long-term stability of Wireless Floating Microelectrode Arrays (WMFAs) implanted in rat sciatic nerve, and their ability to selectively recruit muscles in the hind limb via neural stimulation. Thresholds as low as 4.1 μA were able to generate visible motion of the rear paw. Each implanted device (n=6) was able to selectively recruit plantar flexion and dorsiflexion of the rear paw, and selective stimulation of both movements was achieved throughout the study period. The evoked limb motion was electrode specific and was dependent on location within the fascicular structure of the nerve. Motor thresholds and movement patterns remained stable for more than 8 weeks after device implantation. No major changes in limb function were observed between the implanted and contralateral limb, or between implanted animals and control group animals. The results of this study show that WFMAs with intrafascicular electrodes implanted in a healthy peripheral nerve can provide stable and selective motor recruitment, without altering overall limb function.

Harmonization of Outcomes and Vision Endpoints in Vision Restoration Trials: Recommendations from the International HOVER Taskforce

Translational research in vision prosthetics, gene therapy, optogenetics, stem cell and other forms of transplantation, and sensory substitution is creating new therapeutic options for patients with neural forms of blindness. The technical challenges faced by each of these disciplines differ considerably, but they all face the same challenge of how to assess vision in patients with ultra-low vision (ULV), who will be the earliest subjects to receive new therapies.

Historically, there were few tests to assess vision in ULV patients. In the 1990s, the field of visual prosthetics expanded rapidly, and this activity led to a heightened need to develop better tests to quantify end points for clinical studies. Each group tended to develop novel tests, which made it difficult to compare outcomes across groups. The common lack of validation of the tests and the variable use of controls added to the challenge of interpreting the outcomes of these clinical studies.

In 2014, at the bi-annual International “Eye and the Chip” meeting of experts in the field of visual prosthetics, a group of interested leaders agreed to work cooperatively to develop the International Harmonization of Outcomes and Vision Endpoints in Vision Restoration Trials (HOVER) Taskforce. Under this banner, more than 80 specialists across seven topic areas joined an effort to formulate guidelines for performing and reporting psychophysical tests in humans who participate in clinical trials for visual restoration. This document provides the complete version of the consensus opinions from the HOVER taskforce, which, together with its rules of governance, will be posted on the website of the Henry Ford Department of Ophthalmology (www.artificialvision.org).

Research groups or companies that choose to follow these guidelines are encouraged to include a specific statement to that effect in their communications to the public. The Executive Committee of the HOVER Taskforce will maintain a list of all human psychophysical research in the relevant fields of research on the same website to provide an overview of methods and outcomes of all clinical work being performed in an attempt to restore vision to the blind. This website will also specify which scientific publications contain the statement of certification. The website will be updated every 2 years and continue to exist as a living document of worldwide efforts to restore vision to the blind.

The HOVER consensus document has been written by over 80 of the world's experts in vision restoration and low vision and provides recommendations on the measurement and reporting of patient outcomes in vision restoration trials.

Preparation of a neural electrode implantation device for in-vivo surgical use

An instrument designed for the implantation of neural electrode array devices has been refined in preparation for use in cortical implantation procedures in non-human primates. This instrument has undergone extensive testing to ensure its successful first use in a live surgical setting. This work describes the modifications made to the instrument and the testing performed on it during that preparatory period as well as planned future modifications and augmentations.

Accelerated-stress reliability evaluation for an encapsulated wireless cortical stimulator

In preparing a wireless cortical stimulator for use in the Intracortical Visual Prosthesis (ICVP) project at the Illinois Institute of Technology (IIT), an accelerated environmental stress test is being performed on prototype stimulator modules. Stimulator devices, containing a custom application specific integrated circuit (ASIC), and encapsulated with PDMS, were soaked in an autoclave chamber at 121°C and 100% relative humidity for more than 2200 hours with and without power supplied to the ASIC. Experimental results showed no physical degradation of the stimulator devices after soaking. Reverse telemetry that measures the stimulator internal power supply, recorded periodically over the entire test time, verified that the devices were electrically functioning, as designed, without deterioration. Taking into consideration other standard reliability test environments, the accelerated moisture resistance-biased autoclave testing duration of 2200 hours, as conducted in this study, overwhelms other less-severe test conditions and demonstrates long term stability of the proposed vision prosthesis device with proven thermo-mechanical and electrical robustness.

Low-power polling mode of the next-generation IMES2 implantable wireless EMG sensor

The IMES1 Implantable MyoElectric Sensor device is currently in human clinical trials led by the Alfred Mann Foundation. The IMES is implanted in a residual limb and is powered wirelessly using a magnetic field. EMG signals resulting from the amputee's voluntary movement are amplified and transmitted wirelessly by the IMES to an external controller which controls movement of an external motorized prosthesis. Development of the IMES technology is on-going, producing the next-generation IMES2. Among various improvements, a new feature of the IMES2 is a low-power polling mode. In this low-power mode, the IMES2 power consumption can be dramatically reduced when the limb is inactive through the use of a polled sampling. With the onset of EMG activity, the IMES2 system can switch to the normal higher sample rate to allow the acquisition of high-fidelity EMG data for prosthesis control.

Device for the implantation of neural electrode arrays

Electrode arrays used in neural recording and stimulation applications must be implanted carefully to minimize damage to the underlying tissue. A device has been designed to improve a surgeon's control over implantation parameters including depth, insertion velocity, and insertion force. The device has been designed to operate without contacting tissue and to respond to tissue movements in real time during insertion. This device uses an electrical motor to drive electrode arrays into tissue and allows for the monitoring of and response to electrode depth during insertion. A prototype device has been constructed and tests have been performed to determine the velocity and force characteristics of the motor when inside the device housing. Future versions of the device will use a custom-designed motor with longer linear travel, which will allow the insertion device to be held farther from tissue while still ensuring proper array insertion.

Multichannel wireless ECoG array ASIC devices

Surgical resection of epileptogenic foci is often a beneficial treatment for patients suffering debilitating seizures arising from intractable epilepsy [1], [2], [3]. Electrodes placed subdurally on the surface of the brain in the form of an ECoG array is one of the multiple methods for localizing epileptogenic zones for the purpose of defining the region for surgical resection. Currently, transcutaneous wires from ECoG grids limit the duration of time that implanted grids can be used for diagnosis. A wireless ECoG recording and stimulation system may be a solution to extend the diagnostic period. To avoid the transcutaneous connections, a 64-channel wireless silicon recording/stimulating ASIC was developed as the electronic component of a wireless ECoG array that uses SIROF electrodes on a polyimide substrate[4]. Here we describe two new ASIC devices that have been developed and tested as part of the on-going wireless ECoG system design.

An implantable neural stimulator for intraspinal microstimulation

This paper reports on a wireless stimulator device for use in animal experiments as part of an ongoing investigation into intraspinal stimulation (ISMS) for restoration of walking in humans with spinal cord injury. The principle behind using ISMS is the activation of residual motor-control neural networks within the spinal cord ventral horn below the level of lesion following a spinal cord injury. The attractiveness to this technique is that a small number of electrodes can be used to induce bilateral walking patterns in the lower limbs. In combination with advanced feedback algorithms, ISMS has the potential to restore walking for distances that exceed that produced by other types of functional electrical stimulation. Recent acute animal experiments have demonstrated the feasibility of using ISMS to produce the coordinated walking patterns. Here we described a wireless implantable stimulation system to be used in chronic animal experiments and for providing the basis for a system suitable for use in humans. Electrical operation of the wireless system is described, including a demonstration of reverse telemetry for monitoring the stimulating electrode voltages.

Electrical performance of penetrating microelectrodes chronically implanted in cat cortex

Penetrating microelectrode arrays with 2000 μm (2) sputtered iridium oxide (SIROF) electrode sites were implanted in cat cerebral cortex, and their long-term electrochemical performance evaluated in vivo by cyclic voltammetry (CV), electrochemical impedance spectroscopy (EIS), and current pulsing. Measurements were made from days 33 to 328 postimplantation. The CV-defined charge storage capacity, measured at 50 mV/s, increased linearly with time over the course of implantation for two arrays and was unchanged for one array. A modest decrease in 1 kHz impedance was also observed. These results suggest an ongoing increase in the apparent electrochemical surface area of the electrodes, which is attributed to electrical leakage pathways arising from cracking of Parylene insulation observed by SEM of explanted arrays. During current pulsing with a 0.0 V interpulse bias, the electrodes readily delivered 8 nC/phase in vitro, but some channels approached or exceeded the water reduction potential during in vivo pulsing. The charge injection capacity in vivo increased linearly with the interpulse bias (0-0.6 V Ag\vert AgCl) from 11.5 to 21.8 nC/ph and with pulse width (150-500 μs) from 8.8 to 14 nC/ph (at 0.0 V bias). These values are lower than those determined from measurements in buffered physiological saline, emphasizing the importance of in vivo measurements in assessing chronic electrode performance. The consequence of current leakage pathways on the charge-injection measurements is also discussed.

Identification and quantification of electrical leakage pathways in floating microelectrode arrays

The long-term reliability of neural recording and stimulation electrode arrays is becoming the limiting factor for neural interfaces. For effective electrode design, electrical connection to the surrounding neural tissue and fluid should be limited to the electrode tips, with all other leakage currents minimized. It is the goal of this study to identify and quantify electrical leakage within commercially available floating microelectrode arrays (FMAs). Both short term and accelerated stress tests were performed on entire FMAs, as well as on individual electrodes typical of such arrays. Preliminary results of these tests indicate that leakage currents are present due to water penetration of their insulation layer initially, but that prolonged water exposure at high temperature may seal the defects that cause these currents. SEM photos taken of the electrode shafts show extensive defect regions that may correlate with the test data.

Implantable FES Stimulation Systems: What is Needed?

Since their initial development, the performance gains in functional electrical stimulation (FES) systems have been modest. Conceptually, the replacement of normal neural function by artificial electronic systems is attractive, considering the continued technologic advancements in electronics, communication, and control. It is likely that efficacious FES systems will require complete implantation and activation of large numbers of motor units. One approach is to develop a neural interface that has a one-to-one relationship between stimulating electrodes and lower motor neurons. While technology may offer solutions to the design of miniaturized implantable stimulators, the high-density neural interface remains more elusive. During the past 20 years, research in the stimulation of peripheral motor systems has been primarily constrained by progress in two areas of research: strategies for the control of paralyzed muscle and sophistication of implantable stimulation systems. Often, a debate concerning which of these two areas is a "critical path" element yields no strategic ideas. It has been stated that a need must be demonstrated for a specific number of electrode channels before it is warranted to invest effort into the engineering of implantable systems that are capable of driving large numbers of electrodes. Indeed it is a logical approach to problem solving that the need should drive the development of function. Even study sections, in review of FES grant applications, often resort to this logic. In our opinion, when applied to FES, this argument is often fallacious and ignores the reality that research frequently requires that a threshold of experimental methodology be reached before any meaningful work can be accomplished. Practical trials of stimulation control strategies, long-term patient acceptance, and achievable function for FES systems cannot begin without the capability of stimulation. And, in order to determine whether or not stimulating large numbers of muscle groups can lead to more natural control of movement, suitable stimulation hardware must first exist, and be reliable. In the specific case of lower extremity FES research, it is likely that without a quantum advance in technologic capabilities, the practical utility of FES systems will continue to only be marginally close to normal function. To reach the level of being considered a routine treatment for spinal cord injury, FES systems should be able to offer improved functionality, ease of use, and near-equal reliability, compared to wheelchairs. At present, no FES systems attain this combination. The functional reliability of FES systems must approach 100%. As a trivial example, consider that for a standing, or walking, system, the perspectives of bioengineers and users may be quite different. While an engineer might be pleased to design a system that functions, as intended, 99% of the time, if a user falls down 1 time out of every 100, this is likely to be unacceptable. The minimal threshold of functional utility for FES systems is unclear, and will not be addressed here. Rather, we consider the issues of what features and capabilities are desirable for next generation implantable systems, and to what degree these desires approach engineering feasibility.

Intracortical visual prosthesis research - approach and progress

Following the early work of Brindley in the late 1960's, the NIH began intramural and extramural funding for stimulation of the primary visual coretex using fine-wire electrodes that are inserted into area VI for the prupose of restoring vision in individuals with blindness. More recently researchers with experience in this projectbecame part of our multi-institutional team with the intention to identify and close technological gaps so that the intracortical approach might be tested in humans on a chronic basis. Our team has formulated an approach for testing a prototype system in a human volunteer. Here, we describe our progress and expectations.

A power and data link for a wireless-implanted neural recording system

A wireless cortical neural recording system with a miniature-implanted package is needed in a variety of neuroscience and biomedical applications. Toward that end, we have developed a transcutaneous two-way communication and power system for wireless neural recording. Wireless powering and forward data transmission (into the body) at 1.25 Mbps is achieved using a frequency-shift keying modulated class E converter. The reverse telemetry (out of the body) carrier frequency is generated using an integer-N phase-locked loop, providing the necessary wideband data link to support simultaneous reverse telemetry from multiple implanted devices on separate channels. Each channel is designed to support reverse telemetry with a data rate in excess of 3 Mbps, which is sufficient for our goal of streaming 16 channels of raw neural data. We plan to incorporate this implantable power and telemetry system in a 1-cm diameter single-site cortical neural recording implant.

Dual inductive link coil design for a neural recording system

This paper reports an approach to the physical design of the coils used in a dual inductive link to provide two-way wireless communication and power for a neural recording system. The design approach makes use of an analytic model of the link performance in terms of the physical parameters of the link, which allows physical parameters to be iterated on a computer rather than on the bench to find the optimal design within the physical restrictions imposed. In particular, this approach was used to choose the optimal implant data coil sizing to maximize the difference between the contributions of the constructive and destructive paths of the reverse telemetry signal.

Neuronal loss due to prolonged controlled-current stimulation with chronically implanted microelectrodes in the cat cerebral cortex

Activated iridium microelectrodes were implanted for 450-1282 days in the sensorimotor cortex of seven adult domestic cats and then pulsed for 240 h (8 h per day for 30 days) at 50 Hz. Continuous stimulation at 2 nC/phase and with a geometric charge density of 100 microC cm(-2) produced no detectable change in neuronal density in the tissue surrounding the microelectrode tips. However, pulsing with a continuous 100% duty cycle at 4 nC/phase and with a geometric charge density of 200 microC cm(-2) induced loss of cortical neurons over a radius of at least 150 microm from the electrode tips. The same stimulus regimen but with a duty cycle of 50% (1 s of stimulation, and then 1 s without stimulation repeated for 8 h) produced neuronal loss within a smaller radius, approximately 60 microm from the center of the electrode tips. However, there also was significant loss of neurons surrounding the unpulsed electrodes, presumably as a result of mechanical injury due to their insertion into and long-term residence in the tissue, and this was responsible for most of the neuronal loss within 150 microm of the electrodes pulsed with the 50% duty cycle.

Inductive link design for miniature implants

Advances in microfabrication have allowed the integration of large numbers of electrodes onto one platform. The small size and high channel density of these microelectrode arrays which promise improved performance of a neural prosthesis also complicate the design of an inductive link to achieve efficient powering and communication with the implant. Stimulating or recording with many channels requires high data rate transmission. At the same time, power must be transmitted to the implanted device without exceeding power dissipation limits within the body. Using conventional design techniques, achieving all of these competing requirements simultaneously can require many time consuming iterations. It is proposed that a transcutaneous power and data link can be optimized to meet system level design parameters (power dissipation, data rate, secondary voltage, etc.) by having an analytic understanding of the interacting link level design parameters (receiver radius, carrier frequency, number of turns, implant location, etc.). We demonstrated this technique with the design of a transcutaneous power and data link for an intracortical visual prosthesis.

Detection, eye-hand coordination and virtual mobility performance in simulated vision for a cortical visual prosthesis device

In order to assess visual performance using a future cortical prosthesis device, the ability of normally sighted and low vision subjects to adapt to a dotted 'phosphene' image was studied. Similar studies have been conduced in the past and adaptation to phosphene maps has been shown but the phosphene maps used have been square or hexagonal in pattern. The phosphene map implemented for this testing is what is expected from a cortical implantation of the arrays of intracortical electrodes, generating multiple phosphenes. The dotted image created depends upon the surgical location of electrodes decided for implantation and the expected cortical response. The subjects under tests were required to perform tasks requiring visual inspection, eye-hand coordination and way finding. The subjects did not have any tactile feedback and the visual information provided was live dotted images captured by a camera on a head-mounted low vision enhancing system and processed through a filter generating images similar to the images we expect the blind persons to perceive. The images were locked to the subject's gaze by means of video-based pupil tracking. In the detection and visual inspection task, the subject scanned a modified checkerboard and counted the number of square white fields on a square checkerboard, in the eye-hand coordination task, the subject placed black checkers on the white fields of the checkerboard, and in the way-finding task, the subjects maneuvered themselves through a virtual maze using a game controller. The accuracy and the time to complete the task were used as the measured outcome. As per the surgical studies by this research group, it might be possible to implant up to 650 electrodes; hence, 650 dots were used to create images and performance studied under 0% dropout (650 dots), 25% dropout (488 dots) and 50% dropout (325 dots) conditions. It was observed that all the subjects under test were able to learn the given tasks and showed improvement in performance with practice even with a dropout condition of 50% (325 dots). Hence, if a cortical prosthesis is implanted in human subjects, they might be able to perform similar tasks and with practice should be able to adapt to dotted images even with a low resolution of 325 dots of phosphene.

IMES: an implantable myoelectric sensor

We present updated progress on the design, construction and testing of an upper-extremity prosthesis control system based on implantable myoelectric sensors. The miniature injectable implant consists of a single silicon chip packaged with transmit and receive coils. Preparation for human implantation of the IMES system is underway. As part of this process, critical design improvements in the IMES implant were required. Here we report improved functionality of the IMES implant, hardened protection against electrical malfunction and tissue damage.

Assessing polarization of AIROF microelectrodes

Activated Iridium Oxide Film (AIROF) microelectrodes are being proposed for use in multiple neural prosthesis designs because they are characterized by a high charge-delivery capacity. Implicit in their use, is the restriction of limiting the electrode polarization within limits that do not initiate water electrolysis at the electrode/electrolyte interface. These limits, the so-called "water window," are used to ensure that the AIROF electrodes can deliver charge reversibly in various electrolyte environments. Here, we present data from a set of experiments designed to refine the polarization limit criteria used for AIROF electrodes, in vivo. We observe the presence of a secondary ohmic voltage drop that is not seen in vitro. We hypothesize that this secondary ohmic drop may be caused by ion depletion within the AIROF pore structure. The magnitude of this ohmic drop appears to be a function of film thickness, increasing for thicker films. Although increasing the thickness of the AIROF can significantly increase its charge delivery capacity in vitro, the consequence of the thicker film, with respect to deliverable charge, is minimal and can be even detrimental for the in vivo environment. We believe that this phenomenon is mainly due to the ionic inaccessibility of the porous layer structure of the iridium oxide. This study may have widespread consequences for numerous neural prosthesis designs presently being developed, worldwide.

In vitro and in vivo charge capacity of AIROF microelectrodes

Activated Iridium Oxide Film (AIROF) microelectrodes are thought to be well-suited for neural stimulation of the cortex because they can sustain high charge capacity (about ten times higher than Pt microelectrodes) when characterized in phosphate-buffered saline (PBS) or other high ionic strength electrolytes. However, it is known that their capacity diminishes after they are implanted in vivo. It has been suggested that tissue encapsulation is an underlying cause. In this paper, we report electrochemical measurements of AIROF microelectrodes that were performed acutely in the brain of the zebra finch. The experiment showed that the interstitial fluid environment in the bird's brain did not maintain the high charge delivery capacity of the AIROF microelectrodes. A simple compensation for access resistance may create hazards to sustained electrode integrity.

A multifunctional neural electrode stimulation ASIC using NeuroTalk interface

The NeuroTalk interface, described in a companion paper allows for a standardized method of communication with implanted modules that contain custom application specific integrated circuits (ASIC). Here, we describe an example of one such ASIC that has been designed for use in a visual prosthesis. The ASIC is small enough to be incorporated within a 16-channel multielectrode stimulation array implanted in the cortex. In this paper we describe a version designed to operate over a 4-wire buss called NeuroTalk 2. Other versions of the ASIC operate using a single coil input for power and data, over a transcutaneous magnetic link.

Active floating micro electrode arrays (AFMA)

Neuroscientists have widely used metal microelectrodes inserted into the cortex to record neural signals from, and provide electrical stimulation to, neural tissue for many years. Recently, the demand for implanting electrode arrays within the cortex, for both stimulation and recording, has rapidly increased. We are developing Active-floating-micro-electrode-arrays (AFMA) that are intended for use as a multielectrode cortical interface while minimizing the number of wires leading from the array to extra-dural circuitry or connectors. When combined with a wireless module, these new microelectrode arrays should allow for simulation and recording within free-roaming animals. This paper mainly discusses the design, fabrication, and packing of the first generation AFMA. Our long-term vision is a wireless-transmission electrode system, for stimulation and recording in free-roaming animals, which uses a family of modular active implantable electrode arrays.

Neuro Talk. An interface for multifunctional neural engineering ASICs

With the availability of modern application specific integrated circuit (ASIC) design tools, simulation packages, and low-cost commercial silicon foundry processes, it is becoming increasingly easy for any laboratory, or small company, to develop a custom ASIC. For stimulation, as well as recording, chips that perform specialized functions can be designed, fabricated, and tested within a time period of 2-3 months. In many cases, the desired functionality can only be obtained by using VLSI design methods. Despite this increase in ASIC functionality, as related to neural engineering applications, there exists no common interface protocol for communicating with, and controlling, neural engineering ASICs. This would be analogous to each company that manufactures PC-based systems to have no common method of communication, e.g. USB, GBIB, RS-232, etc. While it might seem elusive, we propose the specification and development of a universal interface protocol for neural engineering ASICs. We have named this interface, NeuroTalk.

Some solutions to technical hurdles for developing a practical intracortical visual prosthesis device

The goal of cortical neuroprosthesis researchers of last four decades is to develop a practical intracortical visual prosthesis device. Although the concept of such a system seems straightforward, details of its configuration remain undefined. Knowledge of how the human visual system will respond to artificially-induced visually-based input is sparse. Combined with technological limitations, these have hindered the progress in developing a practical intracortical visual prosthesis device. The long-term objective of this research is to develop a continuously wearable intracortical visual prosthesis device. Earlier studies have used relatively small numbers of cortical electrodes, and these have been insufficient to generate an integrated visual perception. Surgical difficulties also complicate problem. A prototype visual prosthesis system needs to be adaptable to varying stimulation, image processing, and user interface needs. It also has the obvious requirement portability, implying extremely low power consumption and low weight so that the system can be used outside the confinement of a lab. We feel that available technology has sufficiently advanced to develop a first-generation intracortical visual prosthesis device. In this paper we propose some solutions to the challenges for developing this visual prosthesis device using existing technologies.

"Safe" charge-injection waveforms for iridium oxide (AIROF) microelectrodes

Use of anodic bias improves the charge-injection limits of activated iridium oxide (AIROF) microelectrodes. Asymmetric waveforms, in which the charge balancing anodic phase is delivered at a lower current density and longer pulse width, has been found to allow for higher values of anodic bias voltages, thus maximizing the AIROF charge-injection capacity. Limiting the voltage excursion of the AIROF below the value at which electrolysis of water occurs is essential to maintaining the long-term viability of implanted electrodes. However, maintaining the electrodes at an anodic bias state while keeping the electrode voltage within these electrochemically "safe" limits complicates the topology of the electronic driver circuitry. We present two possible driver topologies that use compliance-voltage limitation in combination with cathodic current modification.

A laboratory testing and driving system for AIROF microelectrodes

The charge-injection currents of AIROF (activated iridium oxide film) microelectrodes, which are subjected to charge-balanced biphasic pulsing or monophasic current pulsing, have to be limited such that the anodic and cathodic voltage excursions are kept within safe limits of operation. In earlier studies it has been shown that when using anodic bias asymmetry in the magnitude of the balanced biphasic waveform can be used to increase the charge injection capacity of AIROF electrodes. We present the design of a single-channel testing and driving system for laboratory testing and driving of AIROF microelectrodes within safe charge-injection limits.

The influence of electrolyte composition on the in vitro charge-injection limits of activated iridium oxide (AIROF) stimulation electrodes

The effects of ionic conductivity and buffer concentration of electrolytes used for in vitro measurement of the charge-injection limits of activated iridium oxide (AIROF) neural stimulation electrodes have been investigated. Charge-injection limits of AIROF microelectrodes were measured in saline with a range of phosphate buffer concentrations from [PO(4)(3-)] = 0 to [PO(4)(3-)] = 103 mM and ionic conductivities from 2-28 mS cm(-1). The charge-injection limits were insensitive to the buffer concentration, but varied significantly with ionic conductivity. Using 0.4 ms cathodal current pulses at 50 Hz, the charge-injection limit increased from 0.5 mC cm(-2) to 2.1 mC cm(-2) as the conductivity was increased from 2 mS cm(-1) to 28 mS cm(-1). An explanation is proposed in which the observed dependence on ionic conductivity arises from non-uniform reduction and oxidation within the porous AIROF and from uncorrected iR-drops that result in an overestimation of the redox potential during pulsing. Conversely, slow-sweep-rate cyclic voltammograms (CVs) were sensitive to buffer concentration with the potentials of the primary Ir(3+)/Ir(4+) reduction and oxidation reactions shifting approximately 300 mV as the buffer concentration decreased from [PO(4)(3-)] = 103 mM to [PO(4)(3-)] = 0 mM. The CV response was insensitive to ionic conductivity. A comparison of in vitro AIROF charge-injection limits in commonly employed electrolyte models of extracellular fluid revealed a significant dependence on the electrolyte, with more than a factor of 4 difference under some pulsing conditions, emphasizing the need to select an electrolyte model that closely matches the conductivity and ionic composition of the in vivo environment.

A floating metal microelectrode array for chronic implantation

Implantation of multi-electrode arrays is becoming increasingly more prevalent within the neuroscience research community and has become important for clinical applications. Many of these studies have been directed towards the development of sensory and motor prosthesis. Here, we present a multi-electrode system made from biocompatible material that is electrically and mechanically stable, and employs design features allowing flexibility in the geometric layout and length of the individual electrodes within the array. We also employ recent advances in laser machining of thin ceramic substrates, application of ultra-fine line gold conductors to ceramic, fabrication of extremely flexible cables, and fine wire management techniques associated with juxtaposing metal microelectrodes within a few hundred microns of each other in the development of a floating multi-electrode array (FMA). We implanted the FMA in rats and show that the FMA is capable of recording both spikes and local field potentials.

Potential-biased, asymmetric waveforms for charge-injection with activated iridium oxide (AIROF) neural stimulation electrodes

The use of potential biasing and biphasic, asymmetric current pulse waveforms to maximize the charge-injection capacity of activated iridium oxide (AIROF) microelectrodes used for neural stimulation is described. The waveforms retain overall zero net charge for the biphasic pulse, but employ an asymmetry in the current and pulse widths of each phase, with the second phase delivered at a lower current density for a longer period of time than the leading phase. This strategy minimizes polarization of the AIROF by the charge-balancing second phase and permits the use of a more positive anodic bias for cathodal-first pulsing or a more negative cathodic bias for anodal-first pulsing to maximize charge injection. Using 0.4-ms cathodal-first pulses, a maximum charge-injection capacity of 3.3 mC/cm2 was obtained with an 0.6-V bias (versus Ag/AgCl) and a pulse asymmetry of 1:8 in the cathodal and anodal pulse widths. For anodal-first pulsing, a maximum charge capacity of 9.6 mC/cm2 was obtained with an asymmetry of 1:3 at an 0.1-V bias. These measurements were made in vitro in carbonate-buffered saline using microelectrodes with a 2000 microm2 surface area.

A LabVIEW based experiment system for the efficient collection and analysis of cyclic voltametry and electrode charge capacity measurements

Cyclic voltametry and recording of stimulation electrode voltage excursions are two critical methods of measurement for understanding the performance of implantable electrodes. Because implanted electrodes cannot easily be replaced, it is necessary to have an a-priori understanding of an electrode's implanted performance and capabilities. In-vitro exhaustive tests are often needed to quantify an electrodes performance. Using commonly available equipment, the human labor cost to conduct this work is immense. Presented is an automated experiment system that is highly configurable that can efficiently conduct a battery of repeatable CV and stimulation recording measurements. Results of preparing 96 electrodes prior to an animal implantation are also discussed.

Analysis of capacitive coupling within microelectrode array

Capacitive coupling within high-density microelectrode arrays can degrade neural recording signal or disperse neural stimulation current. Material deterioration in a chronically implanted neural stimulation/recording system can cause such an undesired effect. We present a simple method with an iterative algorithm to quantify the cross-coupling capacitance, in-situ.

An implantable myoelectric sensor based prosthesis control system

We present progress on the design and testing of an upper-extremity prosthesis control system based on implantable myoelectric sensors. The implant consists of a single silicon chip packaged with transmit and receive coils. Forward control telemetry to, and reverse EMG data telemetry from multiple implants has been demonstrated.

In Vitro Comparison of the Charge-Injection Limits of Activated Iridium Oxide (AIROF) and Platinum-Iridium Microelectrodes

The charge-injection limits of activated iridium oxide electrodes (AIROF) and PtIr microelectrodes with similar geometric area and shape have been compared in vitro using a stimulation waveform that delivers cathodal current pulses with current-limited control of the electrode bias potential in the interpulse period. Charge-injection limits were compared over a bias range of 0.1-0.7 V (versus Ag/AgCl) and pulse frequencies of 20, 50, and 100 Hz. The AIROF was capable of injecting between 4 and 10 times the charge of the PtIr electrode, with a maximum value of 3.9 mC/cm2 obtained at a 0.7 V bias and 20 Hz frequency.

Visuotopic mapping through a multichannel stimulating implant in primate V1

We report on our efforts to establish an animal model for the development and testing of a cortical visual prostheses. One-hundred-fifty-two electrodes were implanted in the primary visual cortex of a rhesus monkey. The electrodes were made from iridium with an activated iridium oxide film, which has a large charge capacity for a given surface area, and insulated with parylene-C. One-hundred-fourteen electrodes were functional after implantation. The activity of small (2-3) neuronal clusters was first recorded to map the visually responsive region corresponding to each electrode. The animal was then trained in a memory (delayed) saccade task, first with a visual target, then to a target defined by direct cortical stimulation with coordinates specified by the stimulating electrode's mapped receptive field. The SD of saccade endpoints was approximately 2.5 larger for electrically stimulated versus visual saccades; nevertheless, when trial-to-trial scatter was averaged out, the correlation between saccade end points and receptive field locations was highly significant and approached unity after several months of training. Five electrodes were left unused until the monkey was fully trained; when these were introduced, the receptive field-saccade correlations were high on the first day of use (R = 0.85, P = 0.03 for angle, R = 0.98, P < 0.001 for eccentricity), indicating that the monkey had not learned to perform the task empirically by memorizing reward zones. The results of this experiment suggest the potential for rigorous behavioral testing of cortical visual prostheses in the macaque.

Injectable electronic identification, monitoring, and stimulation systems

Historically, electronic devices such as pacemakers and neuromuscular stimulators have been surgically implanted into animals and humans. A new class of implants made possible by advances in monolithic electronic design and implant packaging is small enough to be implanted by percutaneous injection through large-gauge hypodermic needles and does not require surgical implantation. Among these, commercially available implants, known as radio frequency identification (RFID) tags, are used for livestock, pet, laboratory animal, and endangered-species identification. The RFID tag is a subminiature glass capsule containing a solenoidal coil and an integrated circuit. Acting as the implanted half of a transcutaneous magnetic link, the RFID tag is powered by and communicates with an extracorporeal magnetic reader. The tag transmits a unique identification code that serves the function of identifying the animal. Millions of RFID tags have been sold since the early 1980s. Based on the success of the RFID tags, research laboratories have developed injectable medical implants, known as micromodules. One type of micromodule, the microstimulator, is designed for use in functional-neuromuscular stimulation. Each microstimulator is uniquely addressable and could comprise one channel of a multichannel functional-neuromuscular stimulation system. Using bidirectional telemetry and commands, from a single extracorporeal transmitter, as many as 256 microstimulators could form the hardware basis for a complex functional-neuromuscular stimulation feedback-control system. Uses include stimulation of paralyzed muscle, therapeutic functional-neuromuscular stimulation, and neuromodulatory functions such as laryngeal stimulation and sleep apnea.

Micromodular implants to provide electrical stimulation of paralyzed muscles and limbs

We describe the design, fabrication, and output capabilities of a microminiature electrical stimulator that can be injected in or near nerves and muscles. Each single-channel microstimulator consists of a cylindrical glass capsule with hermetically sealed electrodes in either end (2-mm diameter x 13-mm overall length). Power and digital control data can be transmitted to multiple implants (256 unique addresses) via a 2-MHz RF field created by an external AM oscillator and inductive coil. In vitro testing demonstrated accurate control of output pulsewidth (3-258 microseconds in 1-microseconds steps) and current (0-30 mA in two linear ranges of 16 steps each, up to 8.5 V available compliance voltage). Microstimulators were used successfully for chronic stimulation in hindlimb muscles of cats. Design and fabrication issues affecting yield and reliability of the packaging and electronics are discussed.

Closed-loop class E transcutaneous power and data link for microimplants

Magnetic transcutaneous coupling is frequently used for power and data transfer to implanted electronic devices. The proposed development of MicroImplants, small enough to be injected through a hypodermic needle suggest the need for a high-efficiency magnetic transcutaneous link. This paper describes the use of a multifrequency transmitter coil driver based upon the Class E topology. The development of a "high-Q approximation" which simplifies the design procedure is presented. A closed-loop controller to compensate for transmitter and receiver variations, and a method of data modulation, using synchronous frequency shifting are described. The closed-loop Class E circuit shows great promise, especially for circuits with unusually low coefficients of coupling. Currents of several amperes, at radio frequencies, can easily and efficiently be obtained.

Class E driver for transcutaneous power and data link for implanted electronic devices

Magnetic transcutaneous coupling is frequently used for power and data transfer to implanted electronic devices. The paper describes a transmitter/coil driver based on the class E topology. The development of a 'high-Q approximation' simplifies the design procedure. A method of data modulation using synchronous frequency shifting is described. The class E circuit shows great promise, especially for circuits with unusually low coefficients of coupling. Transmitter coil currents of several amperes, at radio frequencies, with relatively low active device power dissipation, can easily be obtained.

Injectable microstimulator for functional electrical stimulation

A family of digitally controlled devices is constructed for functional electrical stimulation in which each module is an hermetically sealed glass capsule that is small enough to be injected through the lumen of a hypodermic needle. The overall design and component characteristics of microstimulators that receive power and command signals by inductive coupling from a single, externally worn coil are described. Each device stores power between stimulus pulses by charging an electrolytic capacitor formed by its two electrodes, made of sintered, anodised tantalum and electrochemically activated iridium, respectively. Externally, a highly efficient class E amplifier provides power and digitally encoded command signals to control the amplitude, duration and timing of pulses from up to 256 such microstimulators.