Cuff electrode implantation around the sciatic nerve is associated with an upregulation of TNF-alpha and TGF-beta 1

Polydimethylsiloxane as a more biocompatible alternative to glass in optogenetics

Optogenetics is highly useful to stimulate or inhibit defined neuronal populations and is often used together with electrophysiological recordings. Due to poor penetration of light in tissue, there is a need for biocompatible wave guides. Glass wave guides are relatively stiff and known to cause glia reaction that likely influence the activity in the remaining neurons. We developed highly flexible micro wave guides for optogenetics that can be used in combination with long-lasting electrophysiological recordings. We designed and evaluated polydimethylsiloxane (PDMS) mono-fibers, which use the tissue as cladding, with a diameter of 71 ± 10 µm and 126 ± 5 µm. We showed that micro PDMS fibers transmitted 9-33 mW/mm2 light energy enough to activate channelrhodopsin. This was confirmed in acute extracellular recordings in vivo in which optogenetic stimulation through the PDMS fibers generated action potentials in rat hippocampus with a short onset latency. PDMS fibers had significantly less microglia and astrocytic activation in the zone nearest to the implant as compared to glass. There was no obvious difference in number of adjacent neurons between size matched wave guides. Micro PDMS wave guide demonstrates in vivo functionality and improved biocompatibility as compared to glass. This enables the delivery of light with less tissue damage.

Highly conductive tissue-like hydrogel interface through template-directed assembly

Over the past decade, conductive hydrogels have received great attention as tissue-interfacing electrodes due to their soft and tissue-like mechanical properties. However, a trade-off between robust tissue-like mechanical properties and good electrical properties has prevented the fabrication of a tough, highly conductive hydrogel and limited its use in bioelectronics. Here, we report a synthetic method for the realization of highly conductive and mechanically tough hydrogels with tissue-like modulus. We employed a template-directed assembly method, enabling the arrangement of a disorder-free, highly-conductive nanofibrous conductive network inside a highly stretchable, hydrated network. The resultant hydrogel exhibits ideal electrical and mechanical properties as a tissue-interfacing material. Furthermore, it can provide tough adhesion (800 J/m²) with diverse dynamic wet tissue after chemical activation. This hydrogel enables suture-free and adhesive-free, high-performance hydrogel bioelectronics. We successfully demonstrated ultra-low voltage neuromodulation and high-quality epicardial electrocardiogram (ECG) signal recording based on in vivo animal models. This template-directed assembly method provides a platform for hydrogel interfaces for various bioelectronic applications.

A flexible implantable microelectrode array for recording electrocorticography signals from rodents

Electrocorticography signals, the intracranial recording of electrical signatures of the brain, are recorded by non-penetrating planar electrode arrays placed on the cortical surface. Flexible electrode arrays minimize the tissue damage upon implantation. This work shows the design and development of a 32-channel flexible microelectrode array to record electrocorticography signals from the rat's brain. The array was fabricated on a biocompatible flexible polyimide substrate. A titanium/gold layer was patterned as electrodes, and a thin polyimide layer was used for insulation. The fabricated microelectrode array was mounted on the exposed somatosensory cortex of the right hemisphere of a rat after craniotomy and incision of the dura. The signals were recorded using OpenBCI Cyton Daisy Biosensing Boards. The array faithfully recorded the baseline electrocorticography signals, the induced epileptic activities after applying a convulsant, and the recovered baseline signals after applying an antiepileptic drug. The signals recorded by such fabricated microelectrode array from anesthetized rats demonstrate its potential to monitor electrical signatures corresponding to epilepsy. Finally, the time-frequency analyses highlight the difference in spatiotemporal features of baseline and evoked epileptic discharges.

Harnessing the 2D Structure-Enabled Viscoelasticity of Graphene-Based Hydrogel Membranes for Chronic Neural Interfacing

Stiffness and viscoelasticity of neural implants regulate the foreign body response. Recent studies have suggested the use of elastic or viscoelastic materials with tissue-like stiffness for long-term neural electrical interfacing. Herein, the authors find that a viscoelastic multilayered graphene hydrogel (MGH) membrane, despite exhibiting a much higher Young's modulus than nerve tissues, shows little inflammatory response after 8-week implantation in rat sciatic nerves. The MGH membrane shows significant viscoelasticity due to the slippage between graphene nanosheets, facilitating its seamless yet minimally compressive interfacing with nerves to reduce the inflammation caused by the stiffness mismatch. When used as neural stimulation electrodes, the MGH membrane can offer abundant ion-accessible surfaces to bring a charge injection capacity 1-2 orders of magnitude higher than its traditional Pt counterpart, and further demonstrates chronic neural therapy potential in low-voltage modulation of rat blood pressure. This work suggests that the emergence of 2D nanomaterials and particularly their unique structural attributes can be harnessed to enable new bio-interfacing design strategies.

Foreign Body Reaction to Implanted Biomaterials and Its Impact in Nerve Neuroprosthetics

The implantation of any foreign material into the body leads to the development of an inflammatory and fibrotic process-the foreign body reaction (FBR). Upon implantation into a tissue, cells of the immune system become attracted to the foreign material and attempt to degrade it. If this degradation fails, fibroblasts envelop the material and form a physical barrier to isolate it from the rest of the body. Long-term implantation of medical devices faces a great challenge presented by FBR, as the cellular response disrupts the interface between implant and its target tissue. This is particularly true for nerve neuroprosthetic implants-devices implanted into nerves to address conditions such as sensory loss, muscle paralysis, chronic pain, and epilepsy. Nerve neuroprosthetics rely on tight interfacing between nerve tissue and electrodes to detect the tiny electrical signals carried by axons, and/or electrically stimulate small subsets of axons within a nerve. Moreover, as advances in microfabrication drive the field to increasingly miniaturized nerve implants, the need for a stable, intimate implant-tissue interface is likely to quickly become a limiting factor for the development of new neuroprosthetic implant technologies. Here, we provide an overview of the material-cell interactions leading to the development of FBR. We review current nerve neuroprosthetic technologies (cuff, penetrating, and regenerative interfaces) and how long-term function of these is limited by FBR. Finally, we discuss how material properties (such as stiffness and size), pharmacological therapies, or use of biodegradable materials may be exploited to minimize FBR to nerve neuroprosthetic implants and improve their long-term stability.

Bioresorbable Electrode Array for Electrophysiological and Pressure Signal Recording in the Brain

Medical implantation of an electrocorticography (ECoG) recording system for brain monitoring is an effective clinical tool for seizure focus location and brain disease diagnosis. Planar and flexible ECoG electrodes can minimize the risks of infection and serious inflammatory response, and their good shape adaptability allows the device to fit complex cortex shape and structure to record brain signals with high spatial and temporal resolution. However, these ECoG electrodes require an additional surgery to remove the implant, which imposes potential medical risks. Here, a novel flexible and bioresorbable ECoG device integrated with an intracortical pressure sensor for monitoring swelling of the cortex during operation is reported. The ECoG device is fabricated with poly(l-lactide) and polycaprolactone composite and transient metal molybdenum. In vivo tests on rats show that the ECoG system can record the dynamic changes in brain signals for the different epilepsy stages with high resolution, while the malleable pressure sensor shows a linear relationship between the pressure and resistance in in vitro tests. In vitro degradation experiments show that the ECoG system can work stably for about five days before loss of efficacy, and the whole ECoG system degrades completely in a phosphate buffer solution in about 100 days.

Thin Film Multi-Electrode Softening Cuffs for Selective Neuromodulation

Silicone nerve cuff electrodes are commonly implanted on relatively large and accessible somatic nerves as peripheral neural interfaces. While these cuff electrodes are soft (1–50 MPa), their self-closing mechanism requires of thick walls (200–600 µm), which in turn contribute to fibrotic tissue growth around and inside the device, compromising the neural interface. We report the use of thiol-ene/acrylate shape memory polymer (SMP) for the fabrication of thin film multi-electrode softening cuffs (MSC). We fabricated multi-size MSC with eight titanium nitride (TiN) electrodes ranging from 1.35 to 13.95 × 10⁻⁴ cm² (1–3 kΩ) and eight smaller gold (Au) electrodes (3.3 × 10⁻⁵ cm²; 750 kΩ), that soften at physiological conditions to a modulus of 550 MPa. While the SMP material is not as soft as silicone, the flexural forces of the SMP cuff are about 70–700 times lower in the MSC devices due to the 30 μm thick film compared to the 600 μm thick walls of the silicone cuffs. We demonstrated the efficacy of the MSC to record neural signals from rat sciatic and pelvic nerves (1000 µm and 200 µm diameter, respectively), and the selective fascicular stimulation by current steering. When implanted side-by-side and histologically compared 30 days thereafter, the MSC devices showed significantly less inflammation, indicated by a 70–80% reduction in ED1 positive macrophages, and 54–56% less fibrotic vimentin immunoreactivity. Together, the data supports the use of MSC as compliant and adaptable technology for the interfacing of somatic and autonomic peripheral nerves.

The foreign body response and morphometric changes associated with mesh-style peripheral nerve cuffs

Nerve cuffs have been used to anchor and protect penetrating electrodes in peripheral nerves and have been used as non-penetrating electrodes for neural recording and nerve stimulation. The material of choice for such applications is silicone, an inert synthetic biomaterial which elicits a minimal chronic foreign body response (FBR). While histological studies of solid silicone cuffs are available, to the best of our knowledge a comparison to other cuff designs is not well documented. Here, we describe the FBR and morphological changes that accompany nerve cuff implantation in the rat sciatic nerve by comparing a metallic mesh with and without a parylene coating to one made of silicone. Two months after implantation, we observed that such implants, irrespective of the cuff type, were associated with a persistent inflammatory response consisting of activated macrophages attached to the implant surfaces, which extended into the endoneurial space of the encapsulated nerve. We also observed foreign body giant cells in the epineurial space that were more prevalent in the mesh cohorts. The mesh cuff groups showed significant changes in several morphometric parameters that were not seen in the silicon group including reductions in nerve fiber packing density and a greater reduction of large diameter fibers. High magnification microscopy also showed greater evidence of foamy macrophages in the endoneurial space of the mesh implanted cohorts. Although the precise mechanisms are unknown, the results showed that mesh style nerve cuffs show a greater inflammatory response and had greater reductions in morphometric changes in the underlying nerve compared to silicone in the absence of a penetrating injury.

STATEMENT OF SIGNIFICANCE

While traditional silicone cuffs have been in use for decades, the inflammatory and morphometric effects of these cuffs on the underlying nerve have not been deeply studied. Further, manipulation of the foreign body response to nerve cuffs by using various materials and/or designs has not been well reported. Therefore, we report the inflammatory response around nerve cuffs of various materials and designs, as well as report morphometric parameters of the underlying nerve. These data provide important information regarding the potential for quantitative morphometric changes associated with the use of nerve cuffs, and, importantly, suggests that these changes are associated with the degree of inflammation associated with the cuff.

Biological assessments of multifunctional hydrogel-decorated implantable neural cuff electrode for clinical neurology application

The implantable cuff electrode is an effective neuroprosthetic device in current nerve tissue engineering. However, biocompatibility and stability are still a serious dispute in terms of in vivo function and continuous monitoring. In this regard, assessing the host's biological response to biomaterials is one of the key factors of chronic implantation. In this article, we analyzed the peripheral nerve specific-biological responses to the application of multi-functional hydrogel-coated electrodes. The surface of the cuff electrode was modified using a multifunctional hydrogel composed of PEG hydrogel, cyclosporin A(CsA)-microsphere(MS) and electrodeposited PEDOT:PSS. Through our approach, we have found that the multifunctional hydrogel coatings improve the neural electrode function, such as peak-to-peak amplitude increase. Additionally, the multifunctional hydrogel coated electrodes exhibited improved biocompatibility, such as reduced apoptotic properties and increased axonal myelination. Furthermore, 12 genes (BDNF, Gfra1, IL-6, Sox 10, S100B, P75 NTR , GAP43, MBP, MPZ, NrCAM, NE-FL, CB1) were upregulated at 5 weeks post-implant. Finally, double immunofluorescence revealed the effect of endocannabinoid system on neuroprotective properties and tissue remodeling of peripheral nerves during cuff electrode implantation. These results clearly confirmed that multifunctional hydrogel coatings could improve electrode function and biocompatibility by enhancing neuroprotective properties, which may provide a valuable paradigm for clinical neurology application.

Mechanical and Biological Interactions of Implants with the Brain and Their Impact on Implant Design

Neural prostheses have already a long history and yet the cochlear implant remains the only success story about a longterm sensory function restoration. On the other hand, neural implants for deep brain stimulation are gaining acceptance for variety of disorders including Parkinsons disease and obsessive-compulsive disorder. It is anticipated that the progress in the field has been hampered by a combination of technological and biological factors, such as the limited understanding of the longterm behavior of implants, unreliability of devices, biocompatibility of the implants among others. While the field's understanding of the cell biology of interactions at the biotic-abiotic interface has improved, relatively little attention has been paid on the mechanical factors (stress, strain), and hence on the geometry that can modulate it. This focused review summarizes the recent progress in the understanding of the mechanisms of mechanical interaction between the implants and the brain. The review gives an overview of the factors by which the implants interact acutely and chronically with the tissue: blood-brain barrier (BBB) breach, vascular damage, micromotions, diffusion etc. We propose some design constraints to be considered in future studies. Aspects of the chronic cell-implant interaction will be discussed in view of the chronic local inflammation and the ways of modulating it.

A flexible three-dimensional electrode mesh: An enabling technology for wireless brain-computer interface prostheses

The neural interface is a key component in wireless brain-computer prostheses. In this study, we demonstrate that a unique three-dimensional (3D) microneedle electrode on a flexible mesh substrate, which can be fabricated without complicated micromachining techniques, is conformal to the tissues with minimal invasiveness. Furthermore, we demonstrate that it can be applied to different functional layers in the nervous system without length limitation. The microneedle electrode is fabricated using drawing lithography technology from biocompatible materials. In this approach, the profile of a 3D microneedle electrode array is determined by the design of a two-dimensional (2D) pattern on the mask, which can be used to access different functional layers in different locations of the brain. Due to the sufficient stiffness of the electrode and the excellent flexibility of the mesh substrate, the electrode can penetrate into the tissue with its bottom layer fully conformal to the curved brain surface. Then, the exposed contact at the end of the microneedle electrode can successfully acquire neural signals from the brain.

Differences Exist in the Left and Right Sciatic Nerves of Naïve Rats and Cats

The sciatic nerve of rats and cats is commonly used in experimental models of peripheral nerve injury and repair, as well as experiments involving peripheral nerve electrode implantation. In such experiments, morphometric parameters from the implanted nerve are commonly evaluated and compared to control values obtained from the contralateral nerves. However, this may not be an appropriate approach as differences may naturally exist in the structure of the two nerves owing to developmental or behavioral asymmetry. Additionally, in the cat, baseline values for standard morphometric parameters are not well established. In this study, we characterized fascicle area, fiber count, fiber density, fiber packing, mean g-ratio, and fiber diameter distributions in the rat and cat, as well as investigated the potential for naturally occurring sided differences in these parameters in both species. We also investigated whether animal age or location along the nerve influenced these parameters. We found that sided or left/right leg differences exist in some parameters in both the rat and the cat, calling into question the validity of using the contralateral nerve as a control. We also found that animal age and location along the nerve can make significant differences in the parameters tested, establishing the importance of using control nerves from age- and behaviorally matched animals whose morphometric parameters are collected and compared from the same location.

Flexible and self-adaptive neural ribbon with three-dimensional electrodes for sciatic nerve recording

Various peripheral nerve interfaces have been developed in the last decades and transferred into neuroscientific researches or clinical applications. In this study, we present a novel flexible neural ribbon electrode that can achieve self-adaption to nerves in various diameters and have three dimensional (3D) contacts. Impedance spectroscopy of the neural ribbon electrode was carried out to determine its electrochemical characteristics during the recording. The recording capability of the neural ribbon on sciatic nerves with different diameter was demonstrated by successful signal acquisitions.

The foreign body response to the Utah Slant Electrode Array in the cat sciatic nerve

As the field of neuroprosthetic research continues to grow, studies describing the foreign body reaction surrounding chronic indwelling electrodes or microelectrode arrays will be critical for assessing biocompatibility. Of particular importance is the reaction surrounding penetrating microelectrodes that are used to stimulate and record from peripheral nerves used for prosthetic control, where such studies on axially penetrating electrodes are limited. Using the Utah Slant Electrode Array and a variety of histological methods, we investigated the foreign body response to the implanted array and its surrounding silicone cuff over long indwelling periods in the cat sciatic nerve. We observed that implanted nerves were associated with increased numbers of activated macrophages at the implant site, as well as distal to the implant, at all time points examined, with the longest observation being 350 days after implantation. We found that implanted cat sciatic nerves undergo a compensatory regenerative response after the initial injury that is accompanied by shifts in nerve fiber composition toward nerve fibers of smaller diameter and evidence of axons growing around microelectrode shafts. Nerve fibers located in fascicles that were not penetrated by the array or were located more than a few hundred microns from the implant appeared normal when examined over the course of a year-long indwelling period.

Laparoscopic placement of a tined lead electrode on the pudendal nerve with urodynamic monitoring of bladder function during electrical stimulation: an acute experimental study in healthy female pigs

Purpose

The aim of this study was to develop a method for standard laparoscopic access to the pudendal nerve in pigs to implant an electrode for chronic neuromodulation studies.

Methods

Using routine laparoscopic surgical techniques, the pudendal nerve was located in 10 female pigs using standardized anatomical landmarks. A tined lead electrode was placed in parallel to the exposed pudendal nerve, and acute unilateral electrical stimulation was performed consecutively on both pudendal nerves. Bladder pressure and perineal skeletal muscle response was monitored during stimulation.

Results

Standard access to the pudendal nerve was successfully established in the pig model with surgical times of approximately 45 minutes for bilateral electrode placement. Acute unilateral stimulation did not evoke bladder responses but resulted in reliable stimulation-dependent activity of the perineal skeletal muscles. The structural integrity of the pudendal nerves was confirmed in all cases.

Conclusions

These results illustrate the effectiveness of laparoscopy for standardised, safe nerve localisation and electrode implantation at the pudendal nerve in pigs. Laparoscopic implantation represents an alternative approach for performing electrode implantation under optical guidance versus the standard approach of percutaneous, neuro-physiological monitored implantation. In the future, pudendal neuromodulation may be used as a supplement to sacral neuromodulation or as a standalone therapeutic approach, depending on the underlying bladder dysfunction.

Biomechanical and functional variation in rat sciatic nerve following cuff electrode implantation

BACKGROUND

Nerve cuff electrodes are commonly and successfully used for stimulating peripheral nerves. On the other hand, they occasionally induce functional and morphological changes following chronic implantation, for reasons not always clear. We hypothesize that restriction of nerve mobility due to cuff implantation may alter nerve conduction.

METHODS

We quantified acute changes in nerve-muscle electrophysiology, using electromyography, and nerve kinematics in anesthetized Sprague Dawley rat sciatic nerves during controlled hindlimb joint movement. We compared electrophysiological and biomechanical response in uncuffed nerves and those secured within a cuff electrode using analysis of variance (ANOVA) and regression analysis.

RESULTS

Tethering resulting from cuff implantation resulted in altered nerve strain and a complex biomechanical environment during joint movement. Coincident with biomechanical changes, electromyography revealed significantly increased variability in the response of conduction latency and amplitude in cuffed, but not free, nerves following joint movement.

CONCLUSION

Our findings emphasize the importance of the mechanical interface between peripheral nerves and their devices on neurophysiological performance. This work has implications for nerve device design, implantation, and prediction of long-term efficacy.

Laparoscopic implantation of neural electrodes on pelvic nerves: an experimental study on the obturator nerve in a chronic minipig model

BACKGROUND

Laparoscopic exposure of pelvic nerves has opened a new area in the field of neuromodulation. However, electrode design and material deterioration remain issues that limit clinical application. The objective of this study was to evaluate experimentally the laparoscopic implantation of different types of neural electrodes in order to achieve functional and selective electrical stimulation of pelvic nerves.

METHODS

This was a prospective comparative study of the laparoscopic implantation and tolerance and efficacy of three monopolar cuff electrodes implanted on the obturator nerve in ten Göttingen minipigs (18-20 months old; 14.5-24 kg body weight). Animals were allocated to two groups. A 3-mm-diameter laparoscopic instrument was used during dissection of paravesical fossa and obturator nerve on both sides in order to minimize nerve damage. In all animals, a "split-cylinder" cuff electrode was implanted around the left obturator nerve. On the right side, a "lasso" cuff electrode was implanted in the first group and a "closed-cylinder" cuff was implanted in the second group. Electrical stimulation (0-5 V, 20 Hz) was performed for implanted electrodes on days 0, 7, 15, 30, 45, 60, and 90. Current intensity thresholds were identified by palpation of muscle contraction. Strength developed according to stimulation level and was measured using weight transducers.

RESULTS

All procedures were performed by laparoscopy. Mean operative times differed significantly among groups, the shortest being for split-cylinder electrodes (P = 0.0002). No electrical spread phenomena were observed. Initial thresholds were below 1.5 V (range = 0.5-1.3); however, a significant rise was observed, with time to a maximum of 2.7 V (P < 0.0001). Only split-cylinder electrodes remained functional after 3 months. The mean value of maximum strength remained stable during the study period (P = 0.21, NS).

CONCLUSIONS

The laparoscopic approach to implanting neuroprostheses seems to be very attractive. Furthermore, this approach could allow highly selective nerve stimulation to be achieved using simpler devices such as split-cylinder monopolar electrodes.

Oxidative stress in the thyroid gland: from harmlessness to hazard depending on the iodine content

In basal conditions, thyroid epithelial cells produce moderate amounts of reactive oxygen species (ROS) that are physiologically required for thyroid hormone synthesis. They are not necessarily toxic because they are continuously detoxified either in the process of hormone synthesis or by endogenous antioxidant systems. Using a rat model of goiter formation and iodine-induced involution, we found that compared with control thyroids, the oxidative stress, assessed by the detection of 4-hydroxynonenal, was strongly enhanced both in hyperplastic and involuting glands. The level of antioxidant defenses (glutathione peroxidases and peroxiredoxins) was also up-regulated in both groups, although somewhat less in the latter. Of note, increased oxidative stress came along with an inflammatory reaction, but only in involuting glands, suggesting that although antioxidant systems can adequately buffer a heavy load of ROS in goiter, it is not necessarily the case in involuting glands. The effects of 15-deoxy-Delta(12,14)-prostaglandin J2 (15dPGJ2), an endogenous ligand of peroxisome proliferated-activated receptor gamma (PPARgamma) with antiinflammatory properties, were then investigated in involuting glands. This drug strongly reduced both 4-hydroxynonenal staining and the inflammatory reaction, indicating that it can block iodine-induced cytotoxicity. When experiments were carried out with the PPARgamma antagonist, bisphenol A diglycidyl ether, 15dPGJ2-induced effects remained unchanged, suggesting that these effects were not mediated by PPARgamma. In conclusion, thyroid epithelial cells are well adapted to endogenously produced ROS in basal and goitrous conditions. In iodine-induced goiter involution, the increased oxidative stress is accompanied by inflammation that can be blocked by 15dPGJ2 through PPARgamma-independent protective effects.

Enhanced transmission at a spinal synapse triggered in vivo by an injury signal independent of altered synaptic activity

Peripheral nerve crush initiates a robust increase in transmission strength at spinal synapses made by axotomized group IA primary sensory neurons. To study the injury signal that initiates synaptic enhancement in vivo, we designed experiments to manipulate the enlargement of EPSPs produced in spinal motoneurons (MNs) by IA afferents 3 d after nerve crush in anesthetized adult rats. If nerve crush initiates IA EPSP enlargement as proposed by reducing impulse-evoked transmission in crushed IA afferents, then restoring synaptic activity should eliminate enlargement. Daily electrical stimulation of the nerve proximal to the crush site did, in fact, eliminate enlargement but was, surprisingly, just as effective when the action potentials evoked in crushed afferents were prevented from propagating into the spinal cord. Consistent with its independence from altered synaptic activity, we found that IA EPSP enlargement was also eliminated by colchicine blockade of axon transport in the crushed nerve. Together with the observation that colchicine treatment of intact nerves had no short-term effect on IA EPSPs, we conclude that enhancement of IA-MN transmission is initiated by some yet to be identified positive injury signal generated independent of altered synaptic activity. The results establish a new set of criteria that constrain candidate signaling molecules in vivo to ones that develop quickly at the peripheral injury site, move centrally by axon transport, and initiate enhanced transmission at the central synapses of crushed primary sensory afferents through a mechanism that can be modulated by action potential activity restricted to the axons of crushed afferents.

Two-way communication for programming and measurement in a miniature implantable stimulator

Implantable stimulators are needed for chronic electrical stimulation of nerves and muscles in experimental studies. The device described exploits the versatility of current microcontrollers for stimulation and communication in a miniature implant. Their standard outputs can provide the required selectable constant-current sources. In this device, pre-programmed stimulation paradigms were selected by transcutaneous light pulses. The potential of a programmable integrated circuit (PIC) was thus exploited. Implantable devices must be biocompatible. A novel encapsulation method that require no specialised equipment and that used two classical encapsulants, silicone and Teflon was developed. It was tested for implantation periods of up to four weeks. A novel way to estimate electrode impedance in awake animals is also presented. It was thus possible to follow the evolution of the nerve-electrode interface and, if necessary, to adjust the stimulation parameters. In practice, the electrode voltage at the end of a known constant-current pulse was measured by the PIC. The binary coded value was then indicated to the user as a series of muscle twitches that represented the binary value of the impedance measurement. This neurostimulator has been successfully tested in vitro and in vivo. Thresholds and impedance values were chronically monitored following implantation of a self-sizing spiral cuff electrode. Impedance variations in the first weeks could reflect morphological changes usually observed after the implantation of such electrodes.

Anti-TNF-α reduces the inflammatory reaction associated with cuff electrode implantation around the sciatic nerve

Extraneural cuff electrodes have been extensively used to investigate the nervous system. Their implantation is, however, associated with epineurial fibrosis, fiber loss, limited reproducibility of recordings and variability in stimulating conditions. It has recently been shown that TNF-alpha is involved in nerve alterations after electrode implantation. This study investigated whether a peri-operative anti-TNF-alpha treatment could modify the inflammation and fibrosis associated with cuff electrode implantation. Morphometrical and immunohistochemical methods were used to show that a single systemic injection of TNF-alpha neutralizing antibodies is sufficient to reduce the early inflammatory events, but not the long lasting fibrotic reaction.

Nitric oxide synthases II and III and vascular endothelial growth factor are up-regulated in sciatic nerve after spiral cuff electrode implantation

Nerve cuff electrodes, commonly used in functional electrical stimulation systems, induce local morphological changes that can affect nerve functionality. Nitric oxide (NO) and vascular endothelial growth factor (VEGF) have both neural and vascular effects. We investigated the time-dependent regulation of nitric oxide synthases (NOS) and of VEGF after implantation of spiral cuff electrode around rat sciatic nerve. NOSIII as well as VEGF were up-regulated in both epineurial and endoneurial compartments in cuff-implanted animals along with microvascular changes. Our results suggest that VEGF and NO are implied in morphological and functional alterations occurring in the early time after cuff implantation.