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

Implantable Neural Interfaces and Wearable Tactile Systems for Bidirectional Neuroprosthetics Systems

Neuroprosthetics and neuromodulation represent a promising field for several related applications in the central and peripheral nervous system, such as the treatment of neurological disorders, the control of external robotic devices, and the restoration of lost tactile functions. These actions are allowed by the neural interface, a miniaturized implantable device that most commonly exploits electrical energy to fulfill these operations. A neural interface must be biocompatible, stable over time, low invasive, and highly selective; the challenge is to develop a safe, compact, and reliable tool for clinical applications. In case of anatomical impairments, neuroprosthetics is bound to the need of exploring the surrounding environment by fast-responsive and highly sensitive artificial tactile sensors that mimic the natural sense of touch. Tactile sensors and neural interfaces are closely interconnected since the readouts from the first are required to convey information to the neural implantable apparatus. The role of these devices is pivotal hence technical improvements are essential to ensure a secure system to be eventually adopted in daily life. This review highlights the fundamental criteria for the design and microfabrication of neural interfaces and artificial tactile sensors, their use in clinical applications, and future enhancements for the release of a second generation of devices.

An Injectable Neural Stimulation Electrode Made from an In-Body Curing Polymer/Metal Composite

Implanted neural stimulation and recording devices hold vast potential to treat a variety of neurological conditions, but the invasiveness, complexity, and cost of the implantation procedure greatly reduce access to an otherwise promising therapeutic approach. To address this need, a novel electrode that begins as an uncured, flowable prepolymer that can be injected around a neuroanatomical target to minimize surgical manipulation is developed. Referred to as the Injectrode, the electrode conforms to target structures forming an electrically conductive interface which is orders of magnitude less stiff than conventional neuromodulation electrodes. To validate the Injectrode, detailed electrochemical and microscopy characterization of its material properties is performed and the feasibility of using it to stimulate the nervous system electrically in rats and swine is validated. The silicone-metal-particle composite performs very similarly to pure wire of the same metal (silver) in all measures, including exhibiting a favorable cathodic charge storage capacity (CSCC ) and charge injection limits compared to the clinical LivaNova stimulation electrode and silver wire electrodes. By virtue of its simplicity, the Injectrode has the potential to be less invasive, more robust, and more cost-effective than traditional electrode designs, which could increase the adoption of neuromodulation therapies for existing and new indications.

Flexible Microfluidics: Fundamentals, Recent Developments, and Applications

Miniaturization has been the driving force of scientific and technological advances over recent decades. Recently, flexibility has gained significant interest, particularly in miniaturization approaches for biomedical devices, wearable sensing technologies, and drug delivery. Flexible microfluidics is an emerging area that impacts upon a range of research areas including chemistry, electronics, biology, and medicine. Various materials with flexibility and stretchability have been used in flexible microfluidics. Flexible microchannels allow for strong fluid-structure interactions. Thus, they behave in a different way from rigid microchannels with fluid passing through them. This unique behaviour introduces new characteristics that can be deployed in microfluidic applications and functions such as valving, pumping, mixing, and separation. To date, a specialised review of flexible microfluidics that considers both the fundamentals and applications is missing in the literature. This review aims to provide a comprehensive summary including: (i) Materials used for fabrication of flexible microfluidics, (ii) basics and roles of flexibility on microfluidic functions, (iii) applications of flexible microfluidics in wearable electronics and biology, and (iv) future perspectives of flexible microfluidics. The review provides researchers and engineers with an extensive and updated understanding of the principles and applications of flexible microfluidics.

Nano-scale transistors for interfacing with brain: design criteria, progress and prospect

According to the World Health Organization, one quarter of the world's population suffers from various neurological disorders ranging from depression to Alzheimer's disease. Thus, understanding the operation mechanism of the brain enables us to help those who are suffering from these diseases. In addition, recent clinical medicine employs electronic brain implants, despite the fact of being invasive, to treat disorders ranging from severe coronary conditions to traumatic injuries. As a result, the deaf could hear, the blind could see, and the paralyzed could control robotic arms and legs. Due to the requirement of high data management capability with a power consumption as low as possible, designing nanoscale transistors as essential I/O electronics is a complex task. Herein, we review the essential design criteria for such nanoscale transistors, progress and prospect for implantable brain-machine-interface electronics. This article also discusses their technological challenges for practical implementation.

Mechanically transformative electronics, sensors, and implantable devices

Traditionally, electronics have been designed with static form factors to serve designated purposes. This approach has been an optimal direction for maintaining the overall device performance and reliability for targeted applications. However, electronics capable of changing their shape, flexibility, and stretchability will enable versatile and accommodating systems for more diverse applications. Here, we report design concepts, materials, physics, and manufacturing strategies that enable these reconfigurable electronic systems based on temperature-triggered tuning of mechanical characteristics of device platforms. We applied this technology to create personal electronics with variable stiffness and stretchability, a pressure sensor with tunable bandwidth and sensitivity, and a neural probe that softens upon integration with brain tissue. Together, these types of transformative electronics will substantially broaden the use of electronics for wearable and implantable applications.

Long-term functionality of a soft electrode array for epidural spinal cord stimulation in a minipig model

Long-term biointegration of man-made neural interfaces is influenced by the mechanical properties of the implant materials. Substantial experimental work currently aims at replacing conventional hard implant materials with soft alternatives that can favour a lower immune response. Here we assess the performance of a soft electrode array implanted in the spinal epidural space of a minipig model for a period of 6 months. The electrode array includes platinum-silicone electrode contacts and elastic thin-film gold interconnects embedded in silicone. textbfIn-vivo electrode impedance and voltage transients were monitored over time. Following implantation, epidural stimulation produced muscle-specific evoked potentials and visible muscle contractions. Over time, postoperative and stimulation induced changes in electrode impedance were observed. Such trends provide a basis for future technological improvements aiming at ensuring the stability of soft implantable electrodes for neural interfacing.

Battery-free, lightweight, injectable microsystem for in vivo wireless pharmacology and optogenetics

Pharmacology and optogenetics are widely used in neuroscience research to study the central and peripheral nervous systems. While both approaches allow for sophisticated studies of neural circuitry, continued advances are, in part, hampered by technology limitations associated with requirements for physical tethers that connect external equipment to rigid probes inserted into delicate regions of the brain. The results can lead to tissue damage and alterations in behavioral tasks and natural movements, with additional difficulties in use for studies that involve social interactions and/or motions in complex 3-dimensional environments. These disadvantages are particularly pronounced in research that demands combined optogenetic and pharmacological functions in a single experiment. Here, we present a lightweight, wireless, battery-free injectable microsystem that combines soft microfluidic and microscale inorganic light-emitting diode probes for programmable pharmacology and optogenetics, designed to offer the features of drug refillability and adjustable flow rates, together with programmable control over the temporal profiles. The technology has potential for large-scale manufacturing and broad distribution to the neuroscience community, with capabilities in targeting specific neuronal populations in freely moving animals. In addition, the same platform can easily be adapted for a wide range of other types of passive or active electronic functions, including electrical stimulation.

PEDOT:PSS for Flexible and Stretchable Electronics: Modifications, Strategies, and Applications

Substantial effort has been devoted to both scientific and technological developments of wearable, flexible, semitransparent, and sensing electronics (e.g., organic/perovskite photovoltaics, organic thin-film transistors, and medical sensors) in the past decade. The key to realizing those functionalities is essentially the fabrication of conductive electrodes with desirable mechanical properties. Conductive polymers (CPs) of poly(3,4-ethylenedioxythiophene):poly(styrenesulfonate) (PEDOT:PSS) have emerged to be the most promising flexible electrode materials over rigid metallic oxides and play a critical role in these unprecedented devices as transparent electrodes, hole transport layers, interconnectors, electroactive layers, or motion-sensing conductors. Here, the current status of research on PEDOT:PSS is summarized including various approaches to boosting the electrical conductivity and mechanical compliance and stability, directly linked to the underlying mechanism of the performance enhancements. Along with the basic principles, the most cutting edge-progresses in devices with PEDOT:PSS are highlighted. Meanwhile, the advantages and plausible problems of the CPs and as-fabricated devices are pointed out. Finally, new perspectives are given for CP modifications and device fabrications. This work stresses the importance of developing CP films and reveals their critical role in the evolution of these next-generation devices featuring wearable, deformable, printable, ultrathin, and see-through characteristics.

Ultracompliant Carbon Nanotube Direct Bladder Device

The bladder, stomach, intestines, heart, and lungs all move dynamically to achieve their purpose. A long-term implantable device that can attach onto an organ, sense its movement, and deliver current to modify the organ function would be useful in many therapeutic applications. The bladder, for example, can suffer from incomplete contractions that result in urinary retention with patients requiring catheterization. Those affected may benefit from a combination of a strain sensor and electrical stimulator to better control bladder emptying. The materials and design of such a device made from thin layer carbon nanotube (CNT) and Ecoflex 00-50 are described and demonstrate its function with in vivo feline bladders. During bench-top characterization, the resistive and capacitive sensors exhibit stability throughout 5000 stretching cycles under physiology conditions. In vivo measurements with piezoresistive devices show a high correlation between sensor resistance and volume. Stimulation driven from platinum-silicone composite electrodes successfully induce bladder contraction. A method for reliable connection and packaging of medical grade wire to the CNT device is also presented. This work is an important step toward the translation of low-durometer elastomers, stretchable CNT percolation, and platinum-silicone composite, which are ideal for large-strain bioelectric applications to sense or modulate dynamic organ states.

Advantages of soft subdural implants for the delivery of electrochemical neuromodulation therapies to the spinal cord

OBJECTIVE

We recently developed soft neural interfaces enabling the delivery of electrical and chemical stimulation to the spinal cord. These stimulations restored locomotion in animal models of paralysis. Soft interfaces can be placed either below or above the dura mater. Theoretically, the subdural location combines many advantages, including increased selectivity of electrical stimulation, lower stimulation thresholds, and targeted chemical stimulation through local drug delivery. However, these advantages have not been documented, nor have their functional impact been studied in silico or in a relevant animal model of neurological disorders using a multimodal neural interface.

APPROACH

We characterized the recruitment properties of subdural interfaces using a realistic computational model of the rat spinal cord that included explicit representation of the spinal roots. We then validated and complemented computer simulations with electrophysiological experiments in rats. We additionally performed behavioral experiments in rats that received a lateral spinal cord hemisection and were implanted with a soft interface.

MAIN RESULTS

In silico and in vivo experiments showed that the subdural location decreased stimulation thresholds compared to the epidural location while retaining high specificity. This feature reduces power consumption and risks of long-term damage in the tissues, thus increasing the clinical safety profile of this approach. The hemisection induced a transient paralysis of the leg ipsilateral to the injury. During this period, the delivery of electrical stimulation restricted to the injured side combined with local chemical modulation enabled coordinated locomotor movements of the paralyzed leg without affecting the non-impaired leg in all tested rats. Electrode properties remained stable over time, while anatomical examinations revealed excellent bio-integration properties.

SIGNIFICANCE

Soft neural interfaces inserted subdurally provide the opportunity to deliver electrical and chemical neuromodulation therapies using a single, bio-compatible and mechanically compliant device that effectively alleviates locomotor deficits after spinal cord injury.

Hydrogel-Based Organic Subdural Electrode with High Conformability to Brain Surface

A totally soft organic subdural electrode has been developed by embedding an array of poly(3,4-ethylenedioxythiophene)-modified carbon fabric (PEDOT-CF) into the polyvinyl alcohol (PVA) hydrogel substrate. The mesh structure of the stretchable PEDOT-CF allowed stable structural integration with the PVA substrate. The electrode performance for monitoring electrocorticography (ECoG) was evaluated in saline solution, on ex vivo brains, and in vivo animal experiments using rats and porcines. It was demonstrated that the large double-layer capacitance of the PEDOT-CF brings low impedance at the frequency of brain wave including epileptic seizures, and PVA hydrogel substrate minimized the contact impedance on the brain. The most important unique feature of the hydrogel-based ECoG electrode was its shape conformability to enable tight adhesion even to curved, grooved surface of brains by just being placed. In addition, since the hydrogel-based electrode is totally organic, the simultaneous ECoG-fMRI measurements could be conducted without image artifacts, avoiding problems induced by conventional metallic electrodes.

Next-generation interfaces for studying neural function

Monitoring and modulating the diversity of signals used by neurons and glia in a closed-loop fashion is necessary to establish causative links between biochemical processes within the nervous system and observed behaviors. As developments in neural-interface hardware strive to keep pace with rapid progress in genetically encoded and synthetic reporters and modulators of neural activity, the integration of multiple functional features becomes a key requirement and a pressing challenge in the field of neural engineering. Electrical, optical and chemical approaches have been used to manipulate and record neuronal activity in vivo, with a recent focus on technologies that both integrate multiple modes of interaction with neurons into a single device and enable bidirectional communication with neural circuits with enhanced spatiotemporal precision. These technologies not only are facilitating a greater understanding of the brain, spinal cord and peripheral circuits in the context of health and disease, but also are informing the development of future closed-loop therapies for neurological, neuro-immune and neuroendocrine conditions.

Monolayer Graphene Coating of Intracortical Probes for Long-Lasting Neural Activity Monitoring

The invasiveness of intracortical interfaces currently used today is responsible for the formation of an intense immunoresponse and inflammatory reaction from neural cells and tissues. This leads to a high concentration of reactive glial cells around the implant site, creating a physical barrier between the neurons and the recording channels. Such a rejection of foreign analog interfaces causes neural signals to fade from recordings which become flooded by background noise after a few weeks. Despite their invasiveness, those devices are required to track single neuron activity and decode fine sensory or motor commands. In particular, such quantitative and long-lasting recordings of individual neurons are crucial during a long time period (several months) to restore essential functions of the cortex, disrupted after injuries, stroke, or neurodegenerative diseases. To overcome this limitation, graphene and related materials have attracted numerous interests, as they gather in the same material many suitable properties for interfacing living matter, such as an exceptionally high neural affinity, diffusion barrier, and high physical robustness. In this work, the neural affinity of a graphene monolayer with numerous materials commonly used in neuroprostheses is compared, and its impact on the performance and durability of intracortical probes is investigated. For that purpose, an innovative coating method to wrap 3D intracortical probes with a continuous monolayer graphene is developed. Experimental evidence demonstrate the positive impact of graphene on the bioacceptance of conventional intracortical probes, in terms of detection efficiency and tissues responses, allowing real-time samplings of motor neuron activity during 5 weeks. Since continuous graphene coatings can easily be implemented on a wide range of 3D surfaces, this study further motivates the use of graphene and related materials as it could significantly contribute to reduce the current rejection of neural probes currently used in many research areas, from fundamental neurosciences to medicine and neuroprostheses.

Ultrastretchable and Wireless Bioelectronics Based on All-Hydrogel Microfluidics

Hydrogel bioelectronics that can interface biological tissues and flexible electronics is at the core of the growing field of healthcare monitoring, smart drug systems, and wearable and implantable devices. Here, a simple strategy is demonstrated to prototype all-hydrogel bioelectronics with embedded arbitrary conductive networks using tough hydrogels and liquid metal. Due to their excellent stretchability, the resultant all-hydrogel bioelectronics exhibits stable electrochemical properties at large tensile stretch and various modes of deformation. The potential of fabricated all-hydrogel bioelectronics is demonstrated as wearable strain sensors, cardiac patches, and near-field communication (NFC) devices for monitoring various physiological conditions wirelessly. The presented simple platform paves the way of implantable hydrogel electronics for Internet-of-Things and tissue-machine interfacing applications.

Soft Bioelectronic Stickers: Selection and Evaluation of Skin-Interfacing Electrodes

Surface biopotentials collected from the human epidermis contain important information about human physiology, such as muscular, heart, and brain activities. However, commercially available wearable biomonitoring devices are generally composed of rigid hardware incompatible with the mechanical compliance of soft human tissues. Thin-film stretchable e-skin circuits that can interface the human skin represent an excellent alternative for long-term wearable biomonitoring. Here, a series of soft and stretchable electrodes are evaluated for their applicability in biopotential sensing. This includes conductive composites made of polydimethylsiloxane (PDMS) as a base substrate and conductive particles, i.e., carbon (cPDMS), silver (AgPDMS), anisotropic z-axis conductors made with silver-coated nickel particles (zPDMS), as well as a combination of a conductive tough hydrogel with PDMS, and finally ultrathin tattoo-like adhesive poly(vinyl alcohol)-coated films with stretchable biphasic Ag-EGaIn electrodes. These electrodes are compared between themselves and against the gold-standard Ag/AgCl and stainless steel electrodes, in order to assess relative performance in signal-to-noise ratio (SNR) during electrocardiography, and electrode-skin impedance for a range of frequencies. Results show a direct relation between conformity of the electrode-skin interface and the SNR value. An all-integrated biomonitoring patch with embedded processing and communication electronics, hydrogel electrodes, and a multilayer liquid metal circuit is presented for electromyography.

Ultrasoft Silicone Gel as a Biomimetic Passivation Layer in Inkjet-Printed 3D MEA Devices

Multielectrode arrays (MEAs) are versatile tools that are used for chronic recording and stimulation of neural cells and tissues. Driven by the recent progress in understanding of how neuronal growth and function respond to scaffold stiffness, development of MEAs with a soft cell-to-device interface has gained importance not only for in vivo but also for in vitro applications. However, the passivation layer, which constitutes the majority of the cell-device interface, is typically prepared with stiff materials. Herein, a fabrication of an MEA device with an ultrasoft passivation layer is described, which takes advantage of inkjet printing and a polydimethylsiloxane (PDMS) gel with a stiffness comparable to that of the brain. The major challenge in using the PDMS gel is that it cannot be patterned to expose the sensing area of the electrode. This issue is resolved by printing 3D micropillars at the electrode tip. Primary cortical neurons are grown on the fabricated device, and effective stimulation of the culture confirms functional cell-device coupling. The 3D MEA device with an ultrasoft interface provides a novel platform for investigating evoked activity and drug responses of living neuronal networks cultured in a biomimetic environment for both fundamental research and pharmaceutical applications.

Control of neural probe shank flexibility by fluidic pressure in embedded microchannel using PDMS/PI hybrid substrate

Implantable neural probes are widely used to record and stimulate neural activities. These probes should be stiff enough for insertion. However, it should also be flexible to minimize tissue damage after insertion. Therefore, having dynamic control of the neural probe shank flexibility will be useful. For the first time, we have successfully fabricated flexible neural probes with embedded microfluidic channels for dynamic control of neural probe stiffness by controlling fluidic pressure in the channels. The present hybrid neural probes consisted of polydimethylsiloxane (PDMS) and polyimide (PI) layers could provide the required stiffness for insertion and flexibility during operation. The PDMS channels were fabricated by reversal imprint using a silicon mold and bonded to a PI layer to form the embedded channels in the neural probe. The probe shape was patterned using an oxygen plasma generated by an inductively coupled plasma etching system. The critical buckling force of PDMS/PI neural probes could be tuned from 0.25-1.25 mN depending on the applied fluidic pressure in the microchannels and these probes were successfully inserted into a 0.6% agarose gel that mimicked the stiffness of the brain tissue. Polymer-based neural probes are typically more flexible than conventional metal wire-based probes, and they could potentially provide less tissue damage after implantation.

Stretchable Low Impedance Electrodes for Bioelectronic Recording from Small Peripheral Nerves

Monitoring of bioelectric signals in peripheral sympathetic nerves of small animal models is crucial to gain understanding of how the autonomic nervous system controls specific body functions related to disease states. Advances in minimally-invasive electrodes for such recordings in chronic conditions rely on electrode materials that show low-impedance ionic/electronic interfaces and elastic mechanical properties compliant with the soft and fragile nerve strands. Here we report a highly stretchable low-impedance electrode realized by microcracked gold films as metallic conductors covered with stretchable conducting polymer composite to facilitate ion-to-electron exchange. The conducting polymer composite based on poly(3,4-ethylenedioxythiophene) polystyrene sulfonate (PEDOT:PSS) obtains its adhesive, low-impedance properties by controlling thickness, plasticizer content and deposition conditions. Atomic Force Microscopy measurements under strain show that the optimized conducting polymer coating is compliant with the micro-crack mechanics of the underlying Au-layer, necessary to absorb the tensile deformation when the electrodes are stretched. We demonstrate functionality of the stretchable electrodes by performing high quality recordings of renal sympathetic nerve activity under chronic conditions in rats.

Neurorestorative interventions involving bioelectronic implants after spinal cord injury

In the absence of approved treatments to repair damage to the central nervous system, the role of neurosurgeons after spinal cord injury (SCI) often remains confined to spinal cord decompression and vertebral fracture stabilization. However, recent advances in bioelectronic medicine are changing this landscape. Multiple neuromodulation therapies that target circuits located in the brain, midbrain, or spinal cord have been able to improve motor and autonomic functions. The spectrum of implantable brain-computer interface technologies is also expanding at a fast pace, and all these neurotechnologies are being progressively embedded within rehabilitation programs in order to augment plasticity of spared circuits and residual projections with training. Here, we summarize the impending arrival of bioelectronic medicine in the field of SCI. We also discuss the new role of functional neurosurgeons in neurorestorative interventional medicine, a new discipline at the intersection of neurosurgery, neuro-engineering, and neurorehabilitation.

Battery-free, fully implantable optofluidic cuff system for wireless optogenetic and pharmacological neuromodulation of peripheral nerves

Studies of the peripheral nervous system rely on controlled manipulation of neuronal function with pharmacologic and/or optogenetic techniques. Traditional hardware for these purposes can cause notable damage to fragile nerve tissues, create irritation at the biotic/abiotic interface, and alter the natural behaviors of animals. Here, we present a wireless, battery-free device that integrates a microscale inorganic light-emitting diode and an ultralow-power microfluidic system with an electrochemical pumping mechanism in a soft platform that can be mounted onto target peripheral nerves for programmed delivery of light and/or pharmacological agents in freely moving animals. Biocompliant designs lead to minimal effects on overall nerve health and function, even with chronic use in vivo. The small size and light weight construction allow for deployment as fully implantable devices in mice. These features create opportunities for studies of the peripheral nervous system outside of the scope of those possible with existing technologies.

Highly Conductive, Stretchable, and Cell-Adhesive Hydrogel by Nanoclay Doping

Electrically conductive materials that mimic physical and biological properties of tissues are urgently required for seamless brain-machine interfaces. Here, a multinetwork hydrogel combining electrical conductivity of 26 S m^-1 , stretchability of 800%, and tissue-like elastic modulus of 15 kPa with mimicry of the extracellular matrix is reported. Engineering this unique set of properties is enabled by a novel in-scaffold polymerization approach. Colloidal hydrogels of the nanoclay Laponite are employed as supports for the assembly of secondary polymer networks. Laponite dramatically increases the conductivity of in-scaffold polymerized poly(ethylene-3,4-diethoxy thiophene) in the absence of other dopants, while preserving excellent stretchability. The scaffold is coated with a layer containing adhesive peptide and polysaccharide dextran sulfate supporting the attachment, proliferation, and neuronal differentiation of human induced pluripotent stem cells directly on the surface of conductive hydrogels. Due to its compatibility with simple extrusion printing, this material promises to enable tissue-mimetic neurostimulating electrodes.

The use of intracranial recordings to decode human language: Challenges and opportunities

Decoding speech from intracranial recordings serves two main purposes: understanding the neural correlates of speech processing and decoding speech features for targeting speech neuroprosthetic devices. Intracranial recordings have high spatial and temporal resolution, and thus offer a unique opportunity to investigate and decode the electrophysiological dynamics underlying speech processing. In this review article, we describe current approaches to decoding different features of speech perception and production - such as spectrotemporal, phonetic, phonotactic, semantic, and articulatory components - using intracranial recordings. A specific section is devoted to the decoding of imagined speech, and potential applications to speech prosthetic devices. We outline the challenges in decoding human language, as well as the opportunities in scientific and neuroengineering applications.

Novel electrode technologies for neural recordings

Neural recording electrode technologies have contributed considerably to neuroscience by enabling the extracellular detection of low-frequency local field potential oscillations and high-frequency action potentials of single units. Nevertheless, several long-standing limitations exist, including low multiplexity, deleterious chronic immune responses and long-term recording instability. Driven by initiatives encouraging the generation of novel neurotechnologies and the maturation of technologies to fabricate high-density electronics, novel electrode technologies are emerging. Here, we provide an overview of recently developed neural recording electrode technologies with high spatial integration, long-term stability and multiple functionalities. We describe how these emergent neurotechnologies can approach the ultimate goal of illuminating chronic brain activity with minimal disruption of the neural environment, thereby providing unprecedented opportunities for neuroscience research in the future.

Spinal cord repair: advances in biology and technology

Individuals with spinal cord injury (SCI) can face decades with permanent disabilities. Advances in clinical management have decreased morbidity and improved outcomes, but no randomized clinical trial has demonstrated the efficacy of a repair strategy for improving recovery from SCI. Here, we summarize recent advances in biological and engineering strategies to augment neuroplasticity and/or functional recovery in animal models of SCI that are pushing toward clinical translation.

Integration of Electrochemical Microsupercapacitors with Thin Film Electronics for On-Chip Energy Storage

The development of self-powered electronic systems requires integration of on-chip energy-storage units to interface with various types of energy harvesters, which are intermittent by nature. Most studies have involved on-chip electrochemical microsupercapacitors that have been interfaced with energy harvesters through bulky Si-based rectifiers that are difficult to integrate. This study demonstrates transistor-level integration of electrochemical microsupercapacitors and thin film transistor rectifiers. In this approach, the thin film transistors, thin film rectifiers, and electrochemical microsupercapacitors share the same electrode material for all, which allows for a highly integrated electrochemical on-chip storage solution. The thin film rectifiers are shown to be capable of rectifying AC signal input from either triboelectric nanogenerators or standard function generators. In addition, electrochemical microsupercapacitors exhibit exceptionally slow self-discharge rate (≈18.75 mV h^-1 ) and sufficient power to drive various electronic devices. This study opens a new avenue for developing compact on-chip electrochemical micropower units integrated with thin film electronics.

Bioresorbable Electronic Implants: History, Materials, Fabrication, Devices, and Clinical Applications

Medical implants, either passive implants for structural support or implantable devices with active electronics, have been widely used for the diagnosis and treatment of various diseases and clinical issues. These implants offer various functions, including mechanical support of biological structures in orthopedic and dental applications, continuous electrophysiological monitoring and feedback of electrical stimulation in neuronal and cardiac applications, and controlled drug delivery while maintaining arterial structure in drug-eluting stents. Although these implants exhibit long-term biocompatibility, surgery for their retrieval is often required, which imposes physical, biological, and economical burdens on the patients. Therefore, as an alternative to such secondary surgeries, bioresorbable implants that disappear after a certain period of time inside the body, including bioresorbable active electronics, have been highlighted recently. This review first discusses the historical background of medical implants and briefly define related terminology. Representative examples of non-degradable medical implants for passive structural support and/or for diagnosis and therapy with active electronics are also provided. Then, recent progress in bioresorbable active implants composed of biosignal sensors, actuators for therapeutics, wireless power supply components, and their integrated systems are reviewed. Finally, clinical applications of these bioresorbable electronic implants are exemplified with brief conclusion and future outlook.

Polymer-based flexible bioelectronics

Due to the mechanical mismatch between conventional rigid electronic devices and soft tissues at nature, a lot of interests have been attracted to develop flexible bioelectronics that work well both in vitro and in vivo. To this end, polymers that can be used for both key components and substrates are indispensable to achieve high performances such as high sensitivity and long-term stability for sensing applications. Here we will summarize the recent advances on the synthesis of a variety of polymers, the design of typical architectures and the integration of different functions for the flexible bioelectronic devices. The remaining challenges and promising directions are highlighted to provide inspirations for the future study on the emerging flexible bioelectronics at end.

Printed nanofilms mechanically conforming to living bodies

It is anticipated that flexible wearable/implantable devices for biomedical applications will be established for the development of medical diagnostics and therapeutics. However, these devices need to be compatible with the physical and mechanical properties of the living body. In this minireview, we introduce free-standing polymer ultra-thin films (referred to as "polymer nanosheets"), for which a variety of polymers can be selected as building blocks (e.g., biodegradable polymers, conductive polymers, and elastomers), as a platform for flexible biomedical devices that are mechanically compatible with the living body, and then we demonstrate the use of "printed nanofilms" by combining nanosheets and printing technologies with a variety of inks represented by drugs, conductive nanomaterials, chemical dyes, bio-mimetic polymers, and cells. Owing to the low flexural rigidity (<10-2 nN m) of the polymer nanosheets, which is within the range of living brain slices (per unit width), the flexible printed nanofilms realize bio-integrated structure and display various functions with unique inks that continually monitor or detect biological activities, such as performing surface electromyography, measuring epidermal strain, imaging tissue temperature, organizing cells, and treating lesions in wounds and tumors.

Soft High-Resolution Neural Interfacing Probes: Materials and Design Approaches

Neural interfacing probes are located between the nervous system and the implanted electronic device in order to acquire information on the complex neuronal activity and to reconstruct impaired neural connectivity. Despite remarkable advancement in recent years, conventional neural interfacing is still unable to completely accomplish these goals, especially in long-term brain interfacing. The major limitation arises from physical and mechanical differences between neural interfacing probes and neural tissues that cause local immune responses and production of scar cells near the interface. Therefore, neural interfaces should ideally be extremely soft and have the physical scale of cells to mitigate the boundary between biotic and abiotic systems. Soft materials for neural interfaces have been intensively investigated to improve both interfacing and long-term signal transmission. The design and fabrication of micro and nanoscale devices have drastically decreased the stiffness of probes and enabled single-neuron measurement. In this Mini Review, we discuss materials and design approaches for developing soft high-resolution neural probes intended for long-term brain interfacing and outline existent challenges for achieving next-generation neural interfacing probes.

Conjugated Polymers in Bioelectronics: Addressing the Interface Challenge

Conjugated polymers are the material of choice for organic bioelectronic interfaces as they combine mechanical flexibility with electric and ionic conductivity. Their attractive properties are largely demonstrated in vitro, while the in vivo applications are limited to the coating of inorganic electrodes, where they are used to improve the intimate electronic contact between the device and the tissue. However, there has not been a commensurate rise in the in vivo applications of entirely organic implantable electronic devices based on conjugated polymers. To date, there is no comprehensive understanding of how these devices will interface with real biological systems. With the push toward increasingly thinner and more flexible next generation medical implants, this limitation remains a major detractor in the translation of conjugated polymers toward biological applications. This research news article examines the few reported in vivo studies and attempts to establish why there is such a dearth in the literature.

Long-Term Implantable, Flexible, and Transparent Neural Interface Based on Ag/Au Core-Shell Nanowires

Neural interfaces enabling light transmittance rely on optogenetics to control and monitor specific neural activity, thereby facilitating deeper understanding of intractable diseases. This study reports the material strategy underlying an optogenetic neural interface comprising stretchable and transparent conductive tracks and capable of demonstrating high biocompatibility after long-term (5-month) implantation. Ag/Au core-shell nanowires contribute toward improving track performance in terms of stretchability (<60% strain), transparency (<83%), and electrical resistance (15 Ω sq^-1 ). The neural interface integrated with gel-coated exterior microelectrodes preserves low impedance (1.1-3.2 Ω cm² ) in a saline solution over the evaluated 5-month period. Besides the use of efficient conductive materials, surface treatment using antithrombogenic polymer tends to prevent the growth of granulation tissue, thereby facilitating clear monitoring of electrocorticograms (ECoG) in a rodent during chronic implantation. The flexible and transparent neural interface pathologically exhibits noncytotoxicity and low inflammatory response while efficiently recording evoked ECoG in a nonhuman primate via optogenetic stimulation. The proposed highly reliable interface can be employed in multifaceted approaches for translational research based on chronic implants.

Bioinspired neuron-like electronics

As an important application of functional biomaterials, neural probes have contributed substantially to studying the brain. Bioinspired and biomimetic strategies have begun to be applied to the development of neural probes, although these and previous generations of probes have had structural and mechanical dissimilarities from their neuron targets that lead to neuronal loss, neuroinflammatory responses and measurement instabilities. Here, we present a bioinspired design for neural probes-neuron-like electronics (NeuE)-where the key building blocks mimic the subcellular structural features and mechanical properties of neurons. Full three-dimensional mapping of implanted NeuE-brain interfaces highlights the structural indistinguishability and intimate interpenetration of NeuE and neurons. Time-dependent histology and electrophysiology studies further reveal a structurally and functionally stable interface with the neuronal and glial networks shortly following implantation, thus opening opportunities for next-generation brain-machine interfaces. Finally, the NeuE subcellular structural features are shown to facilitate migration of endogenous neural progenitor cells, thus holding promise as an electrically active platform for transplantation-free regenerative medicine.

Ion Electron-Coupled Functionality in Materials and Devices Based on Conjugated Polymers

The coupling between charge accumulation in a conjugated polymer and the ionic charge compensation, provided from an electrolyte, defines the mode of operation in a vast array of different organic electrochemical devices. The most explored mixed organic ion-electron conductor, serving as the active electrode in these devices, is poly(3,4-ethyelenedioxythiophene) doped with polystyrelensulfonate (PEDOT:PSS). In this progress report, scientists of the Laboratory of Organic Electronics at Linköping University review some of the achievements derived over the last two decades in the field of organic electrochemical devices, in particular including PEDOT:PSS as the active material. The recently established understanding of the volumetric capacitance and the mixed ion-electron charge transport properties of PEDOT are described along with examples of various devices and phenomena utilizing this ion-electron coupling, such as the organic electrochemical transistor, ionic-electronic thermodiffusion, electrochromic devices, surface switches, and more. One of the pioneers in this exciting research field is Prof. Olle Inganäs and the authors of this progress report wish to celebrate and acknowledge all the fantastic achievements and inspiration accomplished by Prof. Inganäs all since 1981.

Flexible Micropillar Electrode Arrays for In Vivo Neural Activity Recordings

Flexible electronics that can form tight interfaces with neural tissues hold great promise for improving the diagnosis and treatment of neurological disorders and advancing brain/machine interfaces. Here, the facile fabrication of a novel flexible micropillar electrode array (µPEA) is described based on a biotemplate method. The flexible and compliant µPEA can readily integrate with the soft surface of a rat cerebral cortex. Moreover, the recording sites of the µPEA consist of protruding micropillars with nanoscale surface roughness that ensure tight interfacing and efficient electrical coupling with the nervous system. As a result, the flexible µPEA allows for in vivo multichannel recordings of epileptiform activity with a high signal-to-noise ratio of 252 ± 35. The ease of preparation, high flexibility, and biocompatibility make the µPEA an attractive tool for in vivo spatiotemporal mapping of neural activity.

Recent Advances in Transparent Electronics with Stretchable Forms

Advances in materials science and the desire for next-generation electronics have driven the development of stretchable and transparent electronics in the past decade. Novel applications, such as smart contact lenses and wearable sensors, have been introduced with stretchable and transparent form factors, requiring a deeper and wider exploration of materials and fabrication processes. In this regard, many research efforts have been dedicated to the development of mechanically stretchable, optically transparent materials and devices. Recent advances in stretchable and transparent electronics are discussed herein, with special emphasis on the development of stretchable and transparent materials, including substrates and electrodes. Several representative examples of applications enabled by stretchable and transparent electronics are presented, including sensors, smart contact lenses, heaters, and neural interfaces. The current challenges and opportunities for each type of stretchable and transparent electronics are also discussed.

Nongenetic optical neuromodulation with silicon-based materials

Optically controlled nongenetic neuromodulation represents a promising approach for the fundamental study of neural circuits and the clinical treatment of neurological disorders. Among the existing material candidates that can transduce light energy into biologically relevant cues, silicon (Si) is particularly advantageous due to its highly tunable electrical and optical properties, ease of fabrication into multiple forms, ability to absorb a broad spectrum of light, and biocompatibility. This protocol describes a rational design principle for Si-based structures, general procedures for material synthesis and device fabrication, a universal method for evaluating material photoresponses, detailed illustrations of all instrumentation used, and demonstrations of optically controlled nongenetic modulation of cellular calcium dynamics, neuronal excitability, neurotransmitter release from mouse brain slices, and brain activity in the mouse brain in vivo using the aforementioned Si materials. The entire procedure takes ~4-8 d in the hands of an experienced graduate student, depending on the specific biological targets. We anticipate that our approach can also be adapted in the future to study other systems, such as cardiovascular tissues and microbial communities.

Soft Conducting Elastomer for Peripheral Nerve Interface

State-of-the-art intraneural electrodes made from silicon or polyimide substrates have shown promise in selectively modulating efferent and afferent activity in the peripheral nervous system. However, when chronically implanted, these devices trigger a multiphase foreign body response ending in device encapsulation. The presence of encapsulation increases the distance between the electrode and the excitable tissue, which not only reduces the recordable signal amplitude but also requires increased current to activate nearby axons. Herein, this study reports a novel conducting polymer based intraneural electrode which has Young's moduli similar to that of nerve tissue. The study first describes material optimization of the soft wire conductive matrix and evaluates their mechanical and electrochemical properties. Second, the study demonstrates 3T3 cell survival when cultured with media eluted from the soft wires. Third, the study presents acute in vivo functionality for stimulation of peripheral nerves to evoke force and compound muscle action potential in a rat model. Furthermore, comprehensive histological analyses show that soft wires elicit significantly less scar tissue encapsulation, less changes to axon size, density and morphology, and reduced macrophage activation compared to polyimide implants in the sciatic nerves at 1 month postimplantation.

Flexible, multifunctional neural probe with liquid metal enabled, ultra-large tunable stiffness for deep-brain chemical sensing and agent delivery

Flexible neural probes have been pursued previously to minimize the mechanical mismatch between soft neural tissues and implants and thereby improve long-term performance. However, difficulties with insertion of such probes deep into the brain severely restricts their utility. We describe a solution to this problem using gallium (Ga) in probe construction, taking advantage of the solid-to-liquid phase change of the metal at body temperature and probe shape deformation to provide temperature-dependent control of stiffness over 5 orders of magnitude. Probes in the stiff state were successfully inserted 2 cm-deep into agarose gel "brain phantoms" and into rat brains under cooled conditions where, upon Ga melting, they became ultra soft, flexible, and stretchable in all directions. The current 30 μm-thick probes incorporated multilayer, deformable microfluidic channels for chemical agent delivery, electrical interconnects through Ga wires, and high-performance electrochemical glutamate sensing. These PDMS-based microprobes of ultra-large tunable stiffness (ULTS) should serve as an attractive platform for multifunctional chronic neural implants.

Configuration of electrical spinal cord stimulation through real-time processing of gait kinematics

Epidural electrical stimulation (EES) of the spinal cord and real-time processing of gait kinematics are powerful methods for the study of locomotion and the improvement of motor control after injury or in neurological disorders. Here, we describe equipment and surgical procedures that can be used to acquire chronic electromyographic (EMG) recordings from leg muscles and to implant targeted spinal cord stimulation systems that remain stable up to several months after implantation in rats and nonhuman primates. We also detail how to exploit these implants to configure electrical spinal cord stimulation policies that allow control over the degree of extension and flexion of each leg during locomotion. This protocol uses real-time processing of gait kinematics and locomotor performance, and can be configured within a few days. Once configured, stimulation bursts are delivered over specific spinal cord locations with precise timing that reproduces the natural spatiotemporal activation of motoneurons during locomotion. These protocols can also be easily adapted for the safe implantation of systems in the vicinity of the spinal cord and to conduct experiments involving real-time movement feedback and closed-loop controllers.

Flexible Sensors—From Materials to Applications

Flexible sensors have the potential to be seamlessly applied to soft and irregularly shaped surfaces such as the human skin or textile fabrics. This benefits conformability dependant applications including smart tattoos, artificial skins and soft robotics. Consequently, materials and structures for innovative flexible sensors, as well as their integration into systems, continue to be in the spotlight of research. This review outlines the current state of flexible sensor technologies and the impact of material developments on this field. Special attention is given to strain, temperature, chemical, light and electropotential sensors, as well as their respective applications.

Recent Progress in Aromatic Polyimide Dielectrics for Organic Electronic Devices and Circuits

Polymeric dielectrics play a key role in the realization of flexible organic electronics, especially for the fabrication of scalable device arrays and integrated circuits. Among a wide variety of polymeric dielectric materials, aromatic polyimides (PIs) are flexible, lightweight, and strongly resistant to high-temperature processing and corrosive etchants and, therefore, have become promising candidates as gate dielectrics with good feasibility in manufacturing organic electronic devices. More significantly, the characteristics of PIs can be conveniently modulated by the design of their chemical structures. Herein, from the perspective of structure optimization and interface engineering, a brief overview of recent progress in PI-based dielectrics for organic electronic devices and circuits is provided. Also, an outlook of future research directions and challenges for polyimide dielectric materials is presented.

Stretchable materials of high toughness and low hysteresis

In materials of all types, hysteresis and toughness are usually correlated. For example, a highly stretchable elastomer or hydrogel of a single polymer network has low hysteresis and low toughness. The single network is commonly toughened by introducing sacrificial bonds, but breaking and possibly reforming the sacrificial bonds causes pronounced hysteresis. In this paper, we describe a principle of stretchable materials that disrupt the toughness-hysteresis correlation, achieving both high toughness and low hysteresis. We demonstrate the principle by fabricating a composite of two constituents: a matrix of low elastic modulus, and fibers of high elastic modulus, with strong adhesion between the matrix and the fibers, but with no sacrificial bonds. Both constituents have low hysteresis (5%) and low toughness (300 J/m2), whereas the composite retains the low hysteresis but achieves high toughness (10,000 J/m2). Both constituents are prone to fatigue fracture, whereas the composite is highly fatigue resistant. We conduct experiment and computation to ascertain that the large modulus contrast alleviates stress concentration at the crack front, and that strong adhesion binds the fibers and the matrix and suppresses sliding between them. Stretchable materials of high toughness and low hysteresis provide opportunities to the creation of high-cycle and low-dissipation soft robots and soft human-machine interfaces.

Flexible fiber-based optoelectronics for neural interfaces

Neurological and psychiatric conditions pose an increasing socioeconomic burden on our aging society. Our ability to understand and treat these conditions relies on the development of reliable tools to study the dynamics of the underlying neural circuits. Despite significant progress in approaches and devices to sense and modulate neural activity, further refinement is required on the spatiotemporal resolution, cell-type selectivity, and long-term stability of neural interfaces. Guided by the principles of neural transduction and by the materials properties of the neural tissue, recent advances in neural interrogation approaches rely on flexible and multifunctional devices. Among these approaches, multimaterial fibers have emerged as integrated tools for sensing and delivering of multiple signals to and from the neural tissue. Fiber-based neural probes are produced by thermal drawing process, which is the manufacturing approach used in optical fiber fabrication. This technology allows straightforward incorporation of multiple functional components into microstructured fibers at the level of their macroscale models, preforms, with a wide range of geometries. Here we will introduce the multimaterial fiber technology, its applications in engineering fields, and its adoption for the design of multifunctional and flexible neural interfaces. We will discuss examples of fiber-based neural probes tailored to the electrophysiological recording, optical neuromodulation, and delivery of drugs and genes into the rodent brain and spinal cord, as well as their emerging use for studies of nerve growth and repair.

The Application of Omics Technologies to Study Axon Regeneration and CNS Repair

Traumatic brain and spinal cord injuries cause permanent disability. Although progress has been made in understanding the cellular and molecular mechanisms underlying the pathophysiological changes that affect both structure and function after injury to the brain or spinal cord, there are currently no cures for either condition. This may change with the development and application of multi-layer omics, new sophisticated bioinformatics tools, and cutting-edge imaging techniques. Already, these technical advances, when combined, are revealing an unprecedented number of novel cellular and molecular targets that could be manipulated alone or in combination to repair the injured central nervous system with precision. In this review, we highlight recent advances in applying these new technologies to the study of axon regeneration and rebuilding of injured neural circuitry. We then discuss the challenges ahead to translate results produced by these technologies into clinical application to help improve the lives of individuals who have a brain or spinal cord injury.

High-performance stretchable conductive nanocomposites: materials, processes, and device applications

Highly conductive and intrinsically stretchable electrodes are vital components of soft electronics such as stretchable transistors and circuits, sensors and actuators, light-emitting diode arrays, and energy harvesting devices. Many kinds of conducting nanomaterials with outstanding electrical and mechanical properties have been integrated with elastomers to produce stretchable conductive nanocomposites. Understanding the characteristics of these nanocomposites and assessing the feasibility of their fabrication are therefore critical for the development of high-performance stretchable conductors and electronic devices. We herein summarise the recent advances in stretchable conductors based on the percolation networks of nanoscale conductive fillers in elastomeric media. After discussing the material-, dimension-, and size-dependent properties of conductive fillers and their implications, we highlight various techniques that are used to reduce the contact resistance between the conductive filler materials. Furthermore, we categorize elastomer matrices with different stretchabilities and mechanical properties based on their polymeric chain structures. Then, we discuss the fabrication techniques of stretchable conductive nanocomposites toward their use in soft electronics. Finally, we provide representative examples of stretchable device applications and conclude the review with a brief outlook for future research.