Biomaterials. Electronic dura mater for long-term multimodal neural interfaces

Advances in drug delivery technology for the treatment of glioblastoma multiforme

Glioblastoma multiforme (GBM) is a particularly aggressive and malignant type of brain tumor, notorious for its high recurrence rate and low survival rate. The treatment of GBM is challenging mainly because several issues associated with the GBM microenvironment have not yet been resolved. These obstacles originate from a variety of factors such as genetics, anatomy, and cytology, all of which collectively hinder the treatment of GBM. Recent advances in materials and device engineering have presented new perspectives with regard to unconventional drug administration methods for GBM treatment. Such novel drug delivery approaches, based on the clear understanding of the intrinsic properties of GBM, have shown promise in overcoming some of the obstacles. In this review, we first recapitulate the first-line therapy and clinical challenges in the current treatment of GBM. Afterwards, we introduce the latest technological advances in drug delivery strategies to improve the efficiency for GBM treatment, mainly focusing on materials and devices. We describe such efforts by classifying them into two categories, systemic and local drug delivery. Finally, we discuss unmet challenges and prospects for the clinical translation of these drug delivery technologies.

Opto-E-Dura: A Soft, Stretchable ECoG Array for Multimodal, Multiscale Neuroscience

Soft, stretchable materials hold great promise for the fabrication of biomedical devices due to their capacity to integrate gracefully with and conform to biological tissues. Conformal devices are of particular interest in the development of brain interfaces where rigid structures can lead to tissue damage and loss of signal quality over the lifetime of the implant. Interfaces to study brain function and dysfunction increasingly require multimodal access in order to facilitate measurement of diverse physiological signals that span the disparate temporal and spatial scales of brain dynamics. Here the Opto-e-Dura, a soft, stretchable, 16-channel electrocorticography array that is optically transparent is presented. Its compatibility with diverse optical and electrical readouts is demonstrated enabling multimodal studies that bridge spatial and temporal scales. The device is chronically stable for weeks, compatible with wide-field and 2-photon calcium imaging and permits the repeated insertion of penetrating multielectrode arrays. As the variety of sensors and effectors realizable on soft, stretchable substrates expands, similar devices that provide large-scale, multimodal access to the brain will continue to improve fundamental understanding of brain function.

Devising Materials Manufacturing Toward Lab-to-Fab Translation of Flexible Electronics

Flexible electronics have witnessed exciting progress in academia over the past decade, but most of the research outcomes have yet to be translated into products or gain much market share. For mass production and commercialization, industrial adoption of newly developed functional materials and fabrication techniques is a prerequisite. However, due to the disparate features of academic laboratories and industrial plants, translating materials and manufacturing technologies from labs to fabs is notoriously difficult. Therefore, herein, key challenges in the materials manufacturing of flexible electronics are identified and discussed for its lab-to-fab translation, along the four stages in product manufacturing: design, materials supply, processing, and integration. Perspectives on industry-oriented strategies to overcome some of these obstacles are also proposed. Priorities for action are outlined, including standardization, iteration between basic and applied research, and adoption of smart manufacturing. With concerted efforts from academia and industry, flexible electronics will bring a bigger impact to society as promised.

Printable microscale interfaces for long-term peripheral nerve mapping and precision control

The nascent field of bioelectronic medicine seeks to decode and modulate peripheral nervous system signals to obtain therapeutic control of targeted end organs and effectors. Current approaches rely heavily on electrode-based devices, but size scalability, material and microfabrication challenges, limited surgical accessibility, and the biomechanically dynamic implantation environment are significant impediments to developing and deploying peripheral interfacing technologies. Here, we present a microscale implantable device - the nanoclip - for chronic interfacing with fine peripheral nerves in small animal models that begins to meet these constraints. We demonstrate the capability to make stable, high signal-to-noise ratio recordings of behaviorally-linked nerve activity over multi-week timescales. In addition, we show that multi-channel, current-steering-based stimulation within the confines of the small device can achieve multi-dimensional control of a small nerve. These results highlight the potential of new microscale design and fabrication techniques for realizing viable devices for long-term peripheral interfacing.

Adaptive self-healing electronic epineurium for chronic bidirectional neural interfaces

Realizing a clinical-grade electronic medicine for peripheral nerve disorders is challenging owing to the lack of rational material design that mimics the dynamic mechanical nature of peripheral nerves. Electronic medicine should be soft and stretchable, to feasibly allow autonomous mechanical nerve adaptation. Herein, we report a new type of neural interface platform, an adaptive self-healing electronic epineurium (A-SEE), which can form compressive stress-free and strain-insensitive electronics-nerve interfaces and enable facile biofluid-resistant self-locking owing to dynamic stress relaxation and water-proof self-bonding properties of intrinsically stretchable and self-healable insulating/conducting materials, respectively. Specifically, the A-SEE does not need to be sutured or glued when implanted, thereby significantly reducing complexity and the operation time of microneurosurgery. In addition, the autonomous mechanical adaptability of the A-SEE to peripheral nerves can significantly reduce the mechanical mismatch at electronics-nerve interfaces, which minimizes nerve compression-induced immune responses and device failure. Though a small amount of Ag leaked from the A-SEE is observed in vivo (17.03 ppm after 32 weeks of implantation), we successfully achieved a bidirectional neural signal recording and stimulation in a rat sciatic nerve model for 14 weeks. In view of our materials strategy and in vivo feasibility, the mechanically adaptive self-healing neural interface would be considered a new implantable platform for a wide range application of electronic medicine for neurological disorders in the human nervous system.

Electronic implantable devices should be soft and stretchable, such that nerves can adapt mechanically and autonomously. Here, the authors present an adaptive self-healing electronic epineurium which can form compressive stress-free and strain-insensitive electronics-nerve interfaces.

Flexible Multiplexed In2O3 Nanoribbon Aptamer-Field-Effect Transistors for Biosensing

Flexible sensors are essential for advancing implantable and wearable bioelectronics toward monitoring chemical signals within and on the body. Developing biosensors for monitoring multiple neurotransmitters in real time represents a key in vivo application that will increase understanding of information encoded in brain neurochemical fluxes. Here, arrays of devices having multiple In₂O₃ nanoribbon field-effect transistors (FETs) were fabricated on 1.4-μm-thick polyethylene terephthalate (PET) substrates using shadow mask patterning techniques. Thin PET-FET devices withstood crumpling and bending such that stable transistor performance with high mobility was maintained over >100 bending cycles. Real-time detection of the small-molecule neurotransmitters serotonin and dopamine was achieved by immobilizing recently identified high-affinity nucleic-acid aptamers on individual In₂O₃ nanoribbon devices. Limits of detection were 10 fM for serotonin and dopamine with detection ranges spanning eight orders of magnitude. Simultaneous sensing of temperature, pH, serotonin, and dopamine enabled integration of physiological and neurochemical data from individual bioelectronic devices.

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We fabricated flexible In₂O₃ nanoribbon transistors using cleanroom-free processes

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Flexible In₂O₃ transistors withstood crumpling and bending with stable performance

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Flexible aptamer biosensors detect neurotransmitters in real time

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Multiplexed sensors monitor temperature, pH, serotonin, and dopamine simultaneously

Stretchable hydrogels with low hysteresis and anti-fatigue fracture based on polyprotein cross-linkers

Hydrogel-based devices are widely used as flexible electronics, biosensors, soft robots, and intelligent human-machine interfaces. In these applications, high stretchability, low hysteresis, and anti-fatigue fracture are essential but can be rarely met in the same hydrogels simultaneously. Here, we demonstrate a hydrogel design using tandem-repeat proteins as the cross-linkers and random coiled polymers as the percolating network. Such a design allows the polyprotein cross-linkers only to experience considerable forces at the fracture zone and unfold to prevent crack propagation. Thus, we are able to decouple the hysteresis-toughness correlation and create hydrogels of high stretchability (~1100%), low hysteresis (< 5%), and high fracture toughness (~900 J m-2). Moreover, the hydrogels show a high fatigue threshold of ~126 J m-2 and can undergo 5000 load-unload cycles up to 500% strain without noticeable mechanical changes. Our study provides a general route to decouple network elasticity and local mechanical response in synthetic hydrogels.

Interfacing Neurons with Nanostructured Electrodes Modulates Synaptic Circuit Features

Understanding neural physiopathology requires advances in nanotechnology-based interfaces, engineered to monitor the functional state of mammalian nervous cells. Such interfaces typically contain nanometer-size features for stimulation and recording as in cell-non-invasive extracellular microelectrode arrays. In such devices, it turns crucial to understand specific interactions of neural cells with physicochemical features of electrodes, which could be designed to optimize performance. Herein, versatile flexible nanostructured electrodes covered by arrays of metallic nanowires are fabricated and used to investigate the role of chemical composition and nanotopography on rat brain cells in vitro. By using Au and Ni as exemplary materials, nanostructure and chemical composition are demonstrated to play major roles in the interaction of neural cells with electrodes. Nanostructured devices are interfaced to rat embryonic cortical cells and postnatal hippocampal neurons forming synaptic circuits. It is shown that Au-based electrodes behave similarly to controls. Contrarily, Ni-based nanostructured electrodes increase cell survival, boost neuronal differentiation, and reduce glial cells with respect to flat counterparts. Nonetheless, Au-based electrodes perform superiorly compared to Ni-based ones. Under electrical stimulation, Au-based nanostructured substrates evoke intracellular calcium dynamics compatible with neural networks activation. These studies highlight the opportunity for these electrodes to excite a silent neural network by direct neuronal membranes depolarization.

Recent advances in neural interfaces-Materials chemistry to clinical translation

Implantable neural interfaces are important tools to accelerate neuroscience research and translate clinical neurotechnologies. The promise of a bidirectional communication link between the nervous system of humans and computers is compelling, yet important materials challenges must be first addressed to improve the reliability of implantable neural interfaces. This perspective highlights recent progress and challenges related to arguably two of the most common failure modes for implantable neural interfaces: (1) compromised barrier layers and packaging leading to failure of electronic components; (2) encapsulation and rejection of the implant due to injurious tissue-biomaterials interactions, which erode the quality and bandwidth of signals across the biology-technology interface. Innovative materials and device design concepts could address these failure modes to improve device performance and broaden the translational prospects of neural interfaces. A brief overview of contemporary neural interfaces is presented and followed by recent progress in chemistry, materials, and fabrication techniques to improve in vivo reliability, including novel barrier materials and harmonizing the various incongruences of the tissue-device interface. Challenges and opportunities related to the clinical translation of neural interfaces are also discussed.

Flexible Electrocorticography Electrode Array for Epileptiform Electrical Activity Recording under Glutamate and GABA Modulation on the Primary Somatosensory Cortex of Rats

Epilepsy is a common neurological disorder. There is still a lack of methods to accurately detect cortical activity and locate lesions. In this work, a flexible electrocorticography (ECoG) electrode array based on polydimethylsiloxane (PDMS)-parylene was fabricated to detect epileptiform activity under glutamate (Glu) and gamma-aminobutyric acid (GABA) modulation on primary somatosensory cortex of rats. The electrode with a thickness of 20 μm has good flexibility to establish reliable contact with the cortex. Fourteen recording sites with a diameter of 60 μm are modified by electroplating platinum black nanoparticles, which effectively improve the performance with lower impedance, obtaining a sensitive sensing interface. The electrode enables real-time capturing changes in neural activity under drug modulation. Under Glu modulation, neuronal populations showed abnormal excitability, manifested as hypsarrhythmia rhythm and continuous or periodic spike wave epileptiform activity, with power increasing significantly. Under GABA modulation, the excitement was inhibited, with amplitude and power reduced to normal. The flexible ECoG electrode array could monitor cortical activity, providing us with an effective tool for further studying epilepsy and locating lesions.

Conformable bioelectronic interfaces: Mapping the road ahead

Translating conformable bioelectronic interface research into clinical reality foretells a promising future for an aging society.

Site-Specific Neuromodulation of Detrusor and External Urethral Sphincter by Epidural Spinal Cord Stimulation

Impairments of the lower urinary tract function including urine storage and voiding are widely spread among patients with spinal cord injuries. The management of such patients includes bladder catheterization, surgical and pharmacological approaches, which reduce the morbidity from urinary tract-related complications. However, to date, there is no effective treatment of neurogenic bladder and restoration of urinary function. In the present study, we examined neuromodulation of detrusor (Detr) and external urethral sphincter by epidural electrical stimulation (EES) of lumbar and sacral regions of the spinal cord in chronic rats. To our knowledge, it is the first chronic study where detrusor and external urethral sphincter signals were recorded simultaneously to monitor their neuromodulation by site-specific spinal cord stimulation (SCS). The data obtained demonstrate that activation of detrusor muscle mainly occurs during the stimulation of the upper lumbar (L1) and lower lumbar (L5-L6) spinal segments whereas external urethral sphincter was activated predominantly by sacral stimulation. These findings can be used for the development of neurorehabilitation strategies based on spinal cord epidural stimulation for autonomic function recovery after severe spinal cord injury (SCI).

Skin-Integrated Wearable Systems and Implantable Biosensors: A Comprehensive Review

Biosensors devices have attracted the attention of many researchers across the world. They have the capability to solve a large number of analytical problems and challenges. They are future ubiquitous devices for disease diagnosis, monitoring, treatment and health management. This review presents an overview of the biosensors field, highlighting the current research and development of bio-integrated and implanted biosensors. These devices are micro- and nano-fabricated, according to numerous techniques that are adapted in order to offer a suitable mechanical match of the biosensor to the surrounding tissue, and therefore decrease the body’s biological response. For this, most of the skin-integrated and implanted biosensors use a polymer layer as a versatile and flexible structural support, combined with a functional/active material, to generate, transmit and process the obtained signal. A few challenging issues of implantable biosensor devices, as well as strategies to overcome them, are also discussed in this review, including biological response, power supply, and data communication.

Tailoring the Morphology and Fractal Dimension of 2D Mesh-like Gold Gels

As there is a great demand of 2D metal networks, especially out of gold for a plethora of applications we show a universal synthetic method via phase boundary gelation which allows the fabrication of networks displaying areas of up to 2 cm². They are transferred to many different substrates: glass, glassy carbon, silicon, or polymers such as PDMS. In addition to the standardly used web thickness, the networks are parametrized by their fractal dimension. By variation of experimental conditions, we produced web thicknesses between 4.1 nm and 14.7 nm and fractal dimensions in the span of 1.56 to 1.76 which allows to tailor the structures to fit for various applications. Furthermore, the morphology can be tailored by stacking sheets of the networks. For each different metal network, we determined its optical transmission and sheet resistance. The obtained values of up to 97 % transparency and sheet resistances as low as 55.9 Ω/sq highlight the great potential of the obtained materials.

Fully stretchable active-matrix organic light-emitting electrochemical cell array

Intrinsically and fully stretchable active-matrix-driven displays are an important element to skin electronics that can be applied to many emerging fields, such as wearable electronics, consumer electronics and biomedical devices. Here, we show for the first time a fully stretchable active-matrix-driven organic light-emitting electrochemical cell array. Briefly, it is comprised of a stretchable light-emitting electrochemical cell array driven by a solution-processed, vertically integrated stretchable organic thin-film transistor active-matrix, which is enabled by the development of chemically-orthogonal and intrinsically stretchable dielectric materials. Our resulting active-matrix-driven organic light-emitting electrochemical cell array can be readily bent, twisted and stretched without affecting its device performance. When mounted on skin, the array can tolerate to repeated cycles at 30% strain. This work demonstrates the feasibility of skin-applicable displays and lays the foundation for further materials development.

To realize a skin-like display for human-electronics interfaces, intrinsically stretchable light-emitting, transistor and device interconnect components are needed. Here, the authors report a fully stretchable transistor driven active-matrix organic light-emitting electrochemical cell array.

Optimizing the neuron-electrode interface for chronic bioelectronic interfacing

Engineering approaches have vast potential to improve the treatment of disease. Brain-machine interfaces have become a well-established means of treating some otherwise medically refractory neurological diseases, and they have shown promise in many more areas. More widespread use of implanted stimulating and recording electrodes for long-term intervention is, however, limited by the difficulty in maintaining a stable interface between implanted electrodes and the local tissue for reliable recording and stimulation.This loss of performance at the neuron-electrode interface is due to a combination of inflammation and glial scar formation in response to the implanted material, as well as electrical factors contributing to a reduction in function over time. An increasing understanding of the factors at play at the neural interface has led to greater focus on the optimization of this neuron-electrode interface in order to maintain long-term implant viability.A wide variety of approaches to improving device interfacing have emerged, targeting the mechanical, electrical, and biological interactions between implanted electrodes and the neural tissue. These approaches are aimed at reducing the initial trauma and long-term tissue reaction through device coatings, optimization of mechanical characteristics for maximal biocompatibility, and implantation techniques. Improved electrode features, optimized stimulation parameters, and novel electrode materials further aim to stabilize the electrical interface, while the integration of biological interventions to reduce inflammation and improve tissue integration has also shown promise.Optimization of the neuron-electrode interface allows the use of long-term, high-resolution stimulation and recording, opening the door to responsive closed-loop systems with highly selective modulation. These new approaches and technologies offer a broad range of options for neural interfacing, representing the possibility of developing specific implant technologies tailor-made to a given task, allowing truly personalized, optimized implant technology for chronic neural interfacing.

Stiffness-matched biomaterial implants for cell delivery: clinical, intraoperative ultrasound elastography provides a 'target' stiffness for hydrogel synthesis in spinal cord injury

Safe hydrogel delivery requires stiffness-matching with host tissues to avoid iatrogenic damage and reduce inflammatory reactions. Hydrogel-encapsulated cell delivery is a promising combinatorial approach to spinal cord injury therapy, but a lack of in vivo clinical spinal cord injury stiffness measurements is a barrier to their use in clinics. We demonstrate that ultrasound elastography – a non-invasive, clinically established tool – can be used to measure spinal cord stiffness intraoperatively in canines with spontaneous spinal cord injury. In line with recent experimental reports, our data show that injured spinal cord has lower stiffness than uninjured cord. We show that the stiffness of hydrogels encapsulating a clinically relevant transplant population (olfactory ensheathing cells) can also be measured by ultrasound elastography, enabling synthesis of hydrogels with comparable stiffness to canine spinal cord injury. We therefore demonstrate proof-of-principle of a novel approach to stiffness-matching hydrogel-olfactory ensheathing cell implants to ‘real-life’ spinal cord injury values; an approach applicable to multiple biomaterial implants for regenerative therapies.

PDMS-Parylene Adhesion Improvement via Ceramic Interlayers to Strengthen the Encapsulation of Active Neural Implants

Parylene-C has been used as a substrate and encapsulation material for many implantable medical devices. However, to ensure the flexibility required in some applications, minimize tissue reaction, and protect parylene from degradation in vivo an additional outmost layer of polydimethylsiloxane (PDMS) is desired. In such a scenario, the adhesion of PDMS to parylene is of critical importance to prevent early failure caused by delamination in the harsh environment of the human body. Towards this goal, we propose a method based on creating chemical covalent bonds using intermediate ceramic layers as adhesion promoters between PDMS and parylene.To evaluate our concept, we prepared three different sets of samples with PDMS on parylene without and with oxygen plasma treatment (the most commonly employed method to increase adhesion), and samples with our proposed ceramic intermediate layers of silicon carbide (SiC) and silicon dioxide (SiO₂). The samples were soaked in phosphate-buffered saline (PBS) solution at room temperature and were inspected under an optical microscope. To investigate the adhesion property, cross-cut tape tests and peel tests were performed. The results showed a significant improvement of the adhesion and in-soak long-term performance of our proposed encapsulation stack compared with PDMS on parylene and PDMS on plasma-treated parylene. We aim to use the proposed solution to package bare silicon chips on active implants.

Light-Based Neuronal Activation: The Future of Cranial Nerve Stimulation

Despite advances in implant hardware, neuroprosthetic devices in otolaryngology have sustained evolutionary rather than revolutionary changes over the past half century. Although electrical stimulation has the capacity for facile activation of neurons and high temporal resolution, it has limited spatial selectivity. Alternative strategies for neuronal stimulation are being investigated to improve spatial resolution. In particular, light-based neuronal stimulation is a viable alternative and complement to electrical stimulation. This article provides a broad overview of light-based neuronal stimulation technologies. Specific examples of active research on light-based prostheses, including cochlear implants, auditory brainstem implants, retinal implants, and facial nerve implants, are reviewed.

Hofmeister-Effect-Guided Ionohydrogel Design as Printable Bioelectronic Devices

Bioelectronic platforms convert biological signals into electrical signals by utilizing biocatalysts that provide tools to monitor the activity of cells and tissues. Traditional conducting materials such as solid conductors and conducting polymers are confronted with a great challenge in sophisticated production processes and mismatch at biological tissues-machine interfaces. Furthermore, the biocatalyst, the key functional component in the electron-transfer reaction for bio-signal detection denatures easily in an ionic conductive solution. Herein, a bionic strategy is elaborately developed to synthesize an ionohydrogel bioelectronic platform that possesses extracellular-matrix-like habitat by employing hydrated ionic liquids (HILs) as ionic solvent and bioprotectant. This strategy realizes an integration of ionic and enzymatic electronic circuits and minimization of the disparities between tissues and artificial machines. The Hofmeister effect of HILs on enzyme proteins and polymer chains ensures the high bioactivity of the enzymes and greatly improves the mechanical properties of the ionohydrogels. Moreover, hydrogen bonds formed by ILs, water, and polymer chains greatly improve the water-retention of the ionohydrogel and give it more practical significance. Consequently, the promising ionohydrogel is partly printed and fabricated into wearable devices as a pain-free humoral components monitor and a wireless motion-sensor.

Transparent Nano Thin-Film Transistors for Medical Sensors, OLED and Display Applications

Background

Transparent thin-film transistors (TFTs) have received a great deal of attention for medical sensors, OLED and medical display applications. Moreover, ultrathin nanomaterial layers are favored due to their more compact design architectures.

Methods

Here, transparent TFTs are proposed and were investigated under different stress conditions such as temperature and biases.

Results

Key electrical characteristics of the sensors, such as threshold voltage changes, illustrate their linear dependence on temperature with a suitable recovery, suggesting the potential of the devices to serve as medical temperature sensors. The temperature conditions changed in the range of 28°C to 40°C, which is within the standard human temperature testing range. The thickness of the indium-gallium-zinc oxide semiconductor layer was as thin as only 5–6 nm, deposited by mature radio-frequency sputtering which also showed good repeatability. Optimal bending durability caused by mechanical deformation was demonstrated via suitable electrical properties after up to 600 bending cycles, and by testing the flexible device at a different bending radii ranging from 48 mm to 18 mm.

Conclusion

In summary, this study suggests that the present transparent nano TFTs are promising candidates for medical sensors, OLED and displays which require transparency and stability.

Conformable polyimide-based μECoGs: Bringing the electrodes closer to the signal source

Structural biocompatibility is a fundamental requirement for chronically stable bioelectronic devices. Newest neurotechnologies are increasingly focused on minimizing the foreign body response through the development of devices that match the mechanical properties of the implanted tissue and mimic its surface composition, often compromising on their robustness. In this study, an analytical approach is proposed to determine the threshold of conformability for polyimide-based electrocorticography devices. A finite element model was used to quantify the depression of the cortex following the application of devices mechanically above or below conformability threshold. Findings were validated in vivo on rat animal models. Impedance measurements were performed for 40 days after implantation to monitor the status of the biotic/abiotic interface with both conformable and non-conformable implants. Multi-unit activity was then recorded for 12 weeks after implantation using the most compliant device type. It can therefore be concluded that conformability is an essential prerequisite for steady and reliable implants which does not only depend on the Young's modulus of the device material: it strongly relies on the relation between tissue curvature at the implantation site and corresponding device's thickness and geometry, which eventually define the moment of inertia and the interactions at the material-tissue interface.

Intrinsically stretchable electrode array enabled in vivo electrophysiological mapping of atrial fibrillation at cellular resolution

Electrophysiological mapping of chronic atrial fibrillation (AF) at high throughput and high resolution is critical for understanding its underlying mechanism and guiding definitive treatment such as cardiac ablation, but current electrophysiological tools are limited by either low spatial resolution or electromechanical uncoupling of the beating heart. To overcome this limitation, we herein introduce a scalable method for fabricating a tissue-like, high-density, fully elastic electrode (elastrode) array capable of achieving real-time, stable, cellular level-resolution electrophysiological mapping in vivo. Testing with acute rabbit and porcine models, the device is proven to have robust and intimate tissue coupling while maintaining its chemical, mechanical, and electrical properties during the cardiac cycle. The elastrode array records epicardial atrial signals with comparable efficacy to currently available endocardial-mapping techniques but with 2 times higher atrial-to-ventricular signal ratio and >100 times higher spatial resolution and can reliably identify electrical local heterogeneity within an area of simultaneously identified rotor-like electrical patterns in a porcine model of chronic AF.

Materials for flexible bioelectronic systems as chronic neural interfaces

Engineered systems that can serve as chronically stable, high-performance electronic recording and stimulation interfaces to the brain and other parts of the nervous system, with cellular-level resolution across macroscopic areas, are of broad interest to the neuroscience and biomedical communities. Challenges remain in the development of biocompatible materials and the design of flexible implants for these purposes, where ulimate goals are for performance attributes approaching those of conventional wafer-based technologies and for operational timescales reaching the human lifespan. This Review summarizes recent advances in this field, with emphasis on active and passive constituent materials, design architectures and integration methods that support necessary levels of biocompatibility, electronic functionality, long-term stable operation in biofluids and reliability for use in vivo. Bioelectronic systems that enable multiplexed electrophysiological mapping across large areas at high spatiotemporal resolution are surveyed, with a particular focus on those with proven chronic stability in live animal models and scalability to thousands of channels over human-brain-scale dimensions. Research in materials science will continue to underpin progress in this field of study.

Towards the clinical translation of optogenetic skeletal muscle stimulation

Paralysis is a frequent phenomenon in many diseases, and to date, only functional electrical stimulation (FES) mediated via the innervating nerve can be employed to restore skeletal muscle function in patients. Despite recent progress, FES has several technical limitations and significant side effects. Optogenetic stimulation has been proposed as an alternative, as it may circumvent some of the disadvantages of FES enabling cell type–specific, spatially and temporally precise stimulation of cells expressing light-gated ion channels, commonly Channelrhodopsin2. Two distinct approaches for the restoration of skeletal muscle function with optogenetics have been demonstrated: indirect optogenetic stimulation through the innervating nerve similar to FES and direct optogenetic stimulation of the skeletal muscle. Although both approaches show great promise, both have their limitations and there are several general hurdles that need to be overcome for their translation into clinics. These include successful gene transfer, sustained optogenetic protein expression, and the creation of optically active implantable devices. Herein, a comprehensive summary of the underlying mechanisms of electrical and optogenetic approaches is provided. With this knowledge in mind, we substantiate a detailed discussion of the advantages and limitations of each method. Furthermore, the obstacles in the way of clinical translation of optogenetic stimulation are discussed, and suggestions on how they could be overcome are provided. Finally, four specific examples of pathologies demanding novel therapeutic measures are discussed with a focus on the likelihood of direct versus indirect optogenetic stimulation.

Morphing electronics enable neuromodulation in growing tissue

Bioelectronics for modulating the nervous system have shown promise in treating neurological diseases^1-3. However, their fixed dimensions cannot accommodate rapid tissue growth^4,5 and may impair development⁶. For infants, children and adolescents, once implanted devices are outgrown, additional surgeries are often needed for device replacement, leading to repeated interventions and complications^6-8. Here, we address this limitation with morphing electronics, which adapt to in vivo nerve tissue growth with minimal mechanical constraint. We design and fabricate multilayered morphing electronics, consisting of viscoplastic electrodes and a strain sensor that eliminate the stress at the interface between the electronics and growing tissue. The ability of morphing electronics to self-heal during implantation surgery allows a reconfigurable and seamless neural interface. During the fastest growth period in rats, morphing electronics caused minimal damage to the rat nerve, which grows 2.4-fold in diameter, and allowed chronic electrical stimulation and monitoring for 2 months without disruption of functional behavior. Morphing electronics offers a path toward growth-adaptive pediatric electronic medicine.

Shape Morphable Hydrogel/Elastomer Bilayer for Implanted Retinal Electronics

Direct fabrication of a three-dimensional (3D) structure using soft materials has been challenging. The hybrid bilayer is a promising approach to address this challenge because of its programable shape-transformation ability when responding to various stimuli. The goals of this study are to experimentally and theoretically establish a rational design principle of a hydrogel/elastomer bilayer system and further optimize the programed 3D structures that can serve as substrates for multi-electrode arrays. The hydrogel/elastomer bilayer consists of a hygroscopic polyacrylamide (PAAm) layer cofacially laminated with a water-insensitive polydimethylsiloxane (PDMS) layer. The asymmetric volume change in the PAAm hydrogel can bend the bilayer into a curvature. We manipulate the initial monomer concentrations of the pre-gel solutions of PAAm to experimentally and theoretically investigate the effect of intrinsic mechanical properties of the hydrogel on the resulting curvature. By using the obtained results as a design guideline, we demonstrated stimuli-responsive transformation of a PAAm/PDMS flower-shaped bilayer from a flat bilayer film to a curved 3D structure that can serve as a substrate for a wide-field retinal electrode array.

Injectable Biomedical Devices for Sensing and Stimulating Internal Body Organs

The rapid pace of progress in implantable electronics driven by novel technology has created devices with unconventional designs and features to reduce invasiveness and establish new sensing and stimulating techniques. Among the designs, injectable forms of biomedical electronics are explored for accurate and safe targeting of deep-seated body organs. Here, the classes of biomedical electronics and tools that have high aspect ratio structures designed to be injected or inserted into internal organs for minimally invasive monitoring and therapy are reviewed. Compared with devices in bulky or planar formats, the long shaft-like forms of implantable devices are easily placed in the organs with minimized outward protrusions via injection or insertion processes. Adding flexibility to the devices also enables effortless insertions through complex biological cavities, such as the cochlea, and enhances chronic reliability by complying with natural body movements, such as the heartbeat. Diverse types of such injectable implants developed for different organs are reviewed and the electronic, optoelectronic, piezoelectric, and microfluidic devices that enable stimulations and measurements of site-specific regions in the body are discussed. Noninvasive penetration strategies to deliver the miniscule devices are also considered. Finally, the challenges and future directions associated with deep body biomedical electronics are explained.

Soft, Implantable Bioelectronic Interfaces for Translational Research

The convergence of materials science, electronics, and biology, namely bioelectronic interfaces, leads novel and precise communication with biological tissue, particularly with the nervous system. However, the translation of lab-based innovation toward clinical use calls for further advances in materials, manufacturing and characterization paradigms, and design rules. Herein, a translational framework engineered to accelerate the deployment of microfabricated interfaces for translational research is proposed and applied to the soft neurotechnology called electronic dura mater, e-dura. Anatomy, implant function, and surgical procedure guide the system design. A high-yield, silicone-on-silicon wafer process is developed to ensure reproducible characteristics of the electrodes. A biomimetic multimodal platform that replicates surgical insertion in an anatomy-based model applies physiological movement, emulates therapeutic use of the electrodes, and enables advanced validation and rapid optimization in vitro of the implants. Functionality of scaled e-dura is confirmed in nonhuman primates, where epidural neuromodulation of the spinal cord activates selective groups of muscles in the upper limbs with unmet precision. Performance stability is controlled over 6 weeks in vivo. The synergistic steps of design, fabrication, and biomimetic in vitro validation and in vivo evaluation in translational animal models are of general applicability and answer needs in multiple bioelectronic designs and medical technologies.

Conformable Hybrid Systems for Implantable Bioelectronic Interfaces

Conformable bioelectronic systems are promising tools that may aid the understanding of diseases, alleviate pathological symptoms such as chronic pain, heart arrhythmia, and dysfunctions, and assist in reversing conditions such as deafness, blindness, and paralysis. Combining reduced invasiveness with advanced electronic functions, hybrid bioelectronic systems have evolved tremendously in the last decade, pushed by progress in materials science, micro- and nanofabrication, system assembly and packaging, and biomedical engineering. Hybrid integration refers here to a technological approach to embed within mechanically compliant carrier substrates electronic components and circuits prepared with traditional electronic materials. This combination leverages mechanical and electronic performance of polymer substrates and device materials, respectively, and offers many opportunities for man-made systems to communicate with the body with unmet precision. However, trade-offs between materials selection, manufacturing processes, resolution, electrical function, mechanical integrity, biointegration, and reliability should be considered. Herein, prominent trends in manufacturing conformable hybrid systems are analyzed and key design, function, and validation principles are outlined together with the remaining challenges to produce reliable conformable, hybrid bioelectronic systems.

When Bio Meets Technology: Biohybrid Neural Interfaces

The development of electronics capable of interfacing with the nervous system is a rapidly advancing field with applications in basic science and clinical translation. Devices containing arrays of electrodes can be used in the study of cells grown in culture or can be implanted into damaged or dysfunctional tissue to restore normal function. While devices are typically designed and used exclusively for one of these two purposes, there have been increasing efforts in developing implantable electrode arrays capable of housing cultured cells, referred to as biohybrid implants. Once implanted, the cells within these implants integrate into the tissue, serving as a mediator of the electrode-tissue interface. This biological component offers unique advantages to these implant designs, providing better tissue integration and potentially long-term stability. Herein, an overview of current research into biohybrid devices, as well as the historical background that led to their development are provided, based on the host anatomical location for which they are designed (CNS, PNS, or special senses). Finally, a summary of the key challenges of this technology and potential future research directions are presented.

NanoPt-A Nanostructured Electrode Coating for Neural Recording and Microstimulation

Bioelectronic devices, interfacing neural tissue for therapeutic, diagnostic, or rehabilitation purposes, rely on small electrode contacts in order to achieve highly sophisticated communication at the neural interface. Reliable recording and safe stimulation with small electrodes, however, are limited when conventional electrode metallizations are used, demanding the development of new materials to enable future progress within bioelectronics. In this study, we present a versatile process for the realization of nanostructured platinum (nanoPt) coatings with a high electrochemically active surface area, showing promising biocompatibility and providing low impedance, high charge injection capacity, and outstanding long-term stability both for recording and stimulation. The proposed electrochemical fabrication process offers exceptional control over the nanoPt deposition, allowing the realization of specific coating morphologies such as small grains, pyramids, or nanoflakes, and can moreover be scaled up to wafer level or batch fabrication under economic process conditions. The suitability of nanoPt as a coating for neural interfaces is here demonstrated, in vitro and in vivo, revealing superior stimulation performance under chronic conditions. Thus, nanoPt offers promising qualities as an advanced neural interface coating which moreover extends to the numerous application fields where a large (electro)chemically active surface area contributes to increased efficiency.

Wireless Monitoring Using a Stretchable and Transparent Sensor Sheet Containing Metal Nanowires

Mechanically and visually imperceptible sensor sheets integrated with lightweight wireless loggers are employed in ultimate flexible hybrid electronics (FHE) to reduce vital stress/nervousness and monitor natural biosignal responses. The key technologies and applications for conceptual sensor system fabrication are reported, as exemplified by the use of a stretchable sensor sheet completely conforming to an individual's body surface to realize a low-noise wireless monitoring system (<1 µV) that can be attached to the human forehead for recording electroencephalograms. The above system can discriminate between Alzheimer's disease and the healthy state, thus offering a rapid in-home brain diagnosis possibility. Moreover, the introduction of metal nanowires to improve the transparency of the biocompatible sensor sheet allows one to wirelessly acquire electrocorticograms of nonhuman primates and simultaneously offers optogenetic stimulation such as toward-the-brain-machine interface under free movement. Also discussed are effective methods of improving electrical reliability, biocompatibility, miniaturization, etc., for metal nanowire based tracks and exploring the use of an organic amplifier as an important component to realize a flexible active probe with a high signal-to-noise ratio. Overall, ultimate FHE technologies are demonstrated to achieve efficient closed-loop systems for healthcare management, medical diagnostics, and preclinical studies in neuroscience and neuroengineering.

Flexible Hybrid Electronics for Digital Healthcare

Recent advances in material innovation and structural design provide routes to flexible hybrid electronics that can combine the high-performance electrical properties of conventional wafer-based electronics with the ability to be stretched, bent, and twisted to arbitrary shapes, revolutionizing the transformation of traditional healthcare to digital healthcare. Here, material innovation and structural design for the preparation of flexible hybrid electronics are reviewed, a brief chronology of these advances is given, and biomedical applications in bioelectrical monitoring and stimulation, optical monitoring and treatment, acoustic imitation and monitoring, bionic touch, and body-fluid testing are described. In conclusion, some remarks on the challenges for future research of flexible hybrid electronics are presented.

Three-Dimensional Surface Reconstruction of the Human Cochlear Nucleus: Implications for Auditory Brain Stem Implant Design

Objective  The auditory brain stem implant (ABI) is a neuroprosthesis placed on the surface of the cochlear nucleus (CN) to provide hearing sensations in children and adults who are not candidates for cochlear implantation. Contemporary ABI arrays are stiff and do not conform to the curved brain stem surface. Recent advancements in microfabrication techniques have enabled the development of flexible surface arrays, but these have only been applied in animal models. Herein, we measure the surface curvature of the human CN and adjoining regions to assist in the design and placement of next-generation conformable clinical ABI arrays. Three-dimensional (3D) reconstructions from ultrahigh T1-weighted brain magnetic resonance imaging (MRI) sequences and histologic reconstructions based on postmortem adult human brain stem specimens were used. Design  This is a retrospective review of radiologic data and postmortem histologic axial sections. Setting  This is set at the tertiary referral center. Participants  Data were acquired from healthy adults. Main Outcome Measures  The main outcome measures are principal curvature values (Kmin and Kmax) and global radius of curvature. Results  The CN was successfully extracted and rendered as a 3D surface in all cases. Significant curvatures of the CN in both histologic and radiographic reconstructions were found with global radius of curvature ranging from 2.08 to 8.5 mm. In addition, local curvature analysis revealed that the surface is highly complex. Conclusion  Detailed rendering of the human CN is feasible using histology and 3D MRI reconstruction and highlights complex surface topography that is not recapitulated by contemporary stiff ABI arrays.

Elastic conducting polymer composites in thermoelectric modules

The rapid growth of wearables has created a demand for lightweight, elastic and conformal energy harvesting and storage devices. The conducting polymer poly(3,4-ethylenedioxythiophene) has shown great promise for thermoelectric generators, however, the thick layers of pristine poly(3,4-ethylenedioxythiophene) required for effective energy harvesting are too hard and brittle for seamless integration into wearables. Poly(3,4-ethylenedioxythiophene)-elastomer composites have been developed to improve its mechanical properties, although so far without simultaneously achieving softness, high electrical conductivity, and stretchability. Here we report an aqueously processed poly(3,4-ethylenedioxythiophene)-polyurethane-ionic liquid composite, which combines high conductivity (>140 S cm⁻¹) with superior stretchability (>600%), elasticity, and low Young’s modulus (<7 MPa). The outstanding performance of this organic nanocomposite is the result of favorable percolation networks on the nano- and micro-scale and the plasticizing effect of the ionic liquid. The elastic thermoelectric material is implemented in the first reported intrinsically stretchable organic thermoelectric module.

Though deformable thermoelectric materials are desirable for integrating thermoelectric devices into wearable electronics, typical thermoelectric materials are too brittle for practical application. Here, the authors report a high-performance elastic composite for stretchable thermoelectric modules.

Biomarkers and neuromodulation techniques in substance use disorders

Addictive disorders are a severe health concern. Conventional therapies have just moderate success and the probability of relapse after treatment remains high. Brain stimulation techniques, such as transcranial Direct Current Stimulation (tDCS) and Deep Brain Stimulation (DBS), have been shown to be effective in reducing subjectively rated substance craving. However, there are few objective and measurable parameters that reflect neural mechanisms of addictive disorders and relapse. Key electrophysiological features that characterize substance related changes in neural processing are Event-Related Potentials (ERP). These high temporal resolution measurements of brain activity are able to identify neurocognitive correlates of addictive behaviours. Moreover, ERP have shown utility as biomarkers to predict treatment outcome and relapse probability. A future direction for the treatment of addiction might include neural interfaces able to detect addiction-related neurophysiological parameters and deploy neuromodulation adapted to the identified pathological features in a closed-loop fashion. Such systems may go beyond electrical recording and stimulation to employ sensing and neuromodulation in the pharmacological domain as well as advanced signal analysis and machine learning algorithms. In this review, we describe the state-of-the-art in the treatment of addictive disorders with electrical brain stimulation and its effect on addiction-related neurophysiological markers. We discuss advanced signal processing approaches and multi-modal neural interfaces as building blocks in future bioelectronics systems for treatment of addictive disorders.

Evaluation of a conducting elastomeric composite material for intramuscular electrode application

Electrical stimulation of the muscle has been proven efficacious in preventing atrophy and/or reanimating paralyzed muscles. Intramuscular electrodes made from metals have significantly higher Young's Moduli than the muscle tissues, which has the potential to cause chronic inflammation and decrease device performance. Here, we present an intramuscular electrode made from an elastomeric conducting polymer composite consisting of PEDOT-PEG copolymer, silicone and carbon nanotubes (CNT) with fluorosilicone insulation. The electrode wire has a Young's modulus of 804 (±99) kPa, which better mimics the muscle tissue modulus than conventional stainless steel (SS) electrodes. Additionally, the non-metallic composition enables metal-artifact free CT and MR imaging. These soft wire (SW) electrodes present comparable electrical impedance to SS electrodes of similar geometric surface area, activate muscle at a lower threshold, and maintain stable electrical properties in vivo up to 4 weeks. Histologically, the SW electrodes elicited significantly less fibrotic encapsulation and less IBA-1 positive macrophage accumulation than the SS electrodes at one and three months. Further phenotyping the macrophages with the iNOS (pro-inflammatory) and ARG-1 (pro-healing) markers revealed significantly less presence of pro-inflammatory macrophage around SW implants at one month. By three months, there was a significant increase in pro-healing macrophages (ARG-1) around the SW implants but not around the SS implants. Furthermore, a larger number of AchR clusters closer to SW implants were found at both time points compared to SS implants. These results suggest that a softer implant encourages a more intimate and healthier electrode-tissue interface. STATEMENT OF SIGNIFICANCE: Intramuscular electrodes made from metals have significantly higher Young's Moduli than the muscle tissues, which has the potential to cause chronic inflammation and decrease device performance. Here, we present an intramuscular electrode made from an elastomeric conducting polymer composite consisting of PEDOT-PEG copolymer, silicone and carbon nanotubes with fluorosilicone insulation. This elastomeric composite results in an electrode wire with a Young's modulus mimicking that of the muscle tissue, which elicits significantly less foreign body response compared to stainless steel wires. The lack of metal in this composite also enables metal-artifact free MRI and CT imaging.

Cyber-Physiochemical Interfaces

Living things rely on various physical, chemical, and biological interfaces, e.g., somatosensation, olfactory/gustatory perception, and nervous system response. They help organisms to perceive the world, adapt to their surroundings, and maintain internal and external balance. Interfacial information exchanges are complicated but efficient, delicate but precise, and multimodal but unisonous, which has driven researchers to study the science of such interfaces and develop techniques with potential applications in health monitoring, smart robotics, future wearable devices, and cyber physical/human systems. To understand better the issues in these interfaces, a cyber-physiochemical interface (CPI) that is capable of extracting biophysical and biochemical signals, and closely relating them to electronic, communication, and computing technology, to provide the core for aforementioned applications, is proposed. The scientific and technical progress in CPI is summarized, and the challenges to and strategies for building stable interfaces, including materials, sensor development, system integration, and data processing techniques are discussed. It is hoped that this will result in an unprecedented multi-disciplinary network of scientific collaboration in CPI to explore much uncharted territory for progress, providing technical inspiration-to the development of the next-generation personal healthcare technology, smart sports-technology, adaptive prosthetics and augmentation of human capability, etc.

A Microfluidic Ion Sensor Array

A balanced concentration of ions is essential for biological processes to occur. For example, [H⁺ ] gradients power adenosine triphosphate synthesis, dynamic changes in [K⁺ ] and [Na⁺ ] create action potentials in neuronal communication, and [Cl^- ] contributes to maintaining appropriate cell membrane voltage. Sensing ionic concentration is thus important for monitoring and regulating many biological processes. This work demonstrates an ion-selective microelectrode array that simultaneously and independently senses [K⁺ ], [Na⁺ ], and [Cl^- ] in electrolyte solutions. To obtain ion specificity, the required ion-selective membranes are patterned using microfluidics. As a proof of concept, the change in ionic concentration is monitored during cell proliferation in a cell culture medium. This microelectrode array can easily be integrated in lab-on-a-chip approaches to physiology and biological research and applications.

Supramolecular Peptide Hydrogel-Based Soft Neural Interface Augments Brain Signals through a Three-Dimensional Electrical Network

Recording neural activity from the living brain is of great interest in neuroscience for interpreting cognitive processing or neurological disorders. Despite recent advances in neural technologies, development of a soft neural interface that integrates with neural tissues, increases recording sensitivity, and prevents signal dissipation still remains a major challenge. Here, we introduce a biocompatible, conductive, and biostable neural interface, a supramolecular β-peptide-based hydrogel that allows signal amplification via tight neural/hydrogel contact without neuroinflammation. The non-biodegradable β-peptide forms a multihierarchical structure with conductive nanomaterial, creating a three-dimensional electrical network, which can augment brain signal efficiently. By achieving seamless integration in brain tissue with increased contact area and tight neural tissue coupling, the epidural and intracortical neural signals recorded with the hydrogel were augmented, especially in the high frequency range. Overall, our tissuelike chronic neural interface will facilitate a deeper understanding of brain oscillation in broad brain states and further lead to more efficient brain-computer interfaces.