Adaptive self-healing electronic epineurium for chronic bidirectional neural interfaces

Softening implantable bioelectronics: Material designs, applications, and future directions

Implantable bioelectronics, integrated directly within the body, represent a potent biomedical solution for monitoring and treating a range of medical conditions, including chronic diseases, neural disorders, and cardiac conditions, through personalized medical interventions. Nevertheless, contemporary implantable bioelectronics rely heavily on rigid materials (e.g., inorganic materials and metals), leading to inflammatory responses and tissue damage due to a mechanical mismatch with biological tissues. Recently, soft electronics with mechanical properties comparable to those of biological tissues have been introduced to alleviate fatal immune responses and improve tissue conformity. Despite their myriad advantages, substantial challenges persist in surgical handling and precise positioning due to their high compliance. To surmount these obstacles, softening implantable bioelectronics has garnered significant attention as it embraces the benefits of both rigid and soft bioelectronics. These devices are rigid for easy standalone implantation, transitioning to a soft state in vivo in response to environmental stimuli, which effectively overcomes functional/biological problems inherent in the static mechanical properties of conventional implants. This article reviews recent research and development in softening materials and designs for implantable bioelectronics. Examples featuring tissue-penetrating and conformal softening devices highlight the promising potential of these approaches in biomedical applications. A concluding section delves into current challenges and outlines future directions for softening implantable device technologies, underscoring their pivotal role in propelling the evolution of next-generation bioelectronics.

Stretchable Functional Nanocomposites for Soft Implantable Bioelectronics

Material advances in soft bioelectronics, particularly those based on stretchable nanocomposites─functional nanomaterials embedded in viscoelastic polymers with irreversible or reversible bonds─have driven significant progress in translational medical device research. The unique mechanical properties inherent in the stretchable nanocomposites enable stiffness matching between tissue and device, as well as its spontaneous mechanical adaptation to in vivo environments, minimizing undesired mechanical stress and inflammation responses. Furthermore, these properties allow percolative networks of conducting fillers in the nanocomposites to be sustained even under repetitive tensile/compressive stresses, leading to stable tissue-device interfacing. Here, we present an in-depth review of materials strategies, fabrication/integration techniques, device designs, applications, and translational opportunities of nanocomposite-based soft bioelectronics, which feature intrinsic stretchability, self-healability, tissue adhesion, and/or syringe injectability. Among many, applications to brain, heart, and peripheral nerves are predominantly discussed, and translational studies in certain domains such as neuromuscular and cardiovascular engineering are particularly highlighted.

Flexible silk-fibroin-based microelectrode arrays for high-resolution neural recording

High-precision neural recording plays a pivotal role in unraveling the intricate mechanisms that underlie information transmission of the nervous system, raising increasing interest in the development of implantable microelectrode arrays (MEAs). The challenge lies in providing a truly soft, highly conductive and low-impedance neural interface for precise recording of the electrophysiological signals of individual neurons or neural networks. Herein, by implementing a novel topological regulation strategy of silk fibroin (SF) crosslinking, we prepared a flexible, hydrophilic, and biocompatible MEA substrate, facilitating a biocompatible neural interface that minimizes mechanical mismatch with biological tissues. Additionally, we established a strategy involving screen-printing combined with post-coating to prepare MEAs with high conductivity, low impedance and high capacitance, by coating PEDOT:PSS on titanium carbide (Ti3C2) microarrays. The Ti3C2 nanosheets, as the conductive track of the MEAs, avoided the charge drifting associated with metals and facilitated the processing of the MEAs. Further coating PEDOT:PSS on the electrode points reduced the impedance 100-fold, from 105 to 103 Ω. Experimental validation confirmed the superior electrophysiological signal recording capabilities of the SF-based MEA (SMEA) in peripheral and cerebral nerves with a much higher signal-to-noise ratio (SNR) of 20. In particular, we achieved high-precision recording of the action potential (AP) induced by flash visual stimulation, demonstrating high performance in weak signal recording. In summary, the development of SMEA provides a robust foundation for future investigations into the mechanisms and principles of neural circuit information transmission in complex nervous systems.

Synthesis of shape-programmable elastomer for a bioresorbable, wireless nerve stimulator

Materials that have the ability to manipulate shapes in response to stimuli such as heat, light, humidity and magnetism offer a means for versatile, sophisticated functions in soft robotics or biomedical implants, while such a reactive transformation has certain drawbacks including high operating temperatures, inherent rigidity and biological hazard. Herein, we introduce biodegradable, self-adhesive, shape-transformable poly (L-lactide-co-ε-caprolactone) (BSS-PLCL) that can be triggered via thermal stimulation near physiological temperature (∼38 °C). Chemical inspections confirm the fundamental properties of the synthetic materials in diverse aspects, and study on mechanical and biochemical characteristics validates exceptional stretchability up to 800 % and tunable dissolution behaviors under biological conditions. The integration of the functional polymer with a bioresorbable electronic system highlights potential for a wide range of biomedical applications.

Flexible Peripheral Nerve Interfacing Electrode for Joint Position Control in Closed-Loop Neuromuscular Stimulation

Addressing peripheral nerve disorders with electronic medicine poses significant challenges, especially in replicating the dynamic mechanical properties of nerves and understanding their functionality. In the field of electronic medicine, it is crucial to design a system that thoroughly understands the functions of the nervous system and ensures a stable interface with nervous tissue, facilitating autonomous neural adaptation. Herein, we present a novel neural interface platform that modulates the peripheral nervous system using flexible nerve electrodes and advanced neuromodulation techniques. Specifically, we have developed a surface-based inverse recruitment model for effective joint position control via direct electrical nerve stimulation. Utilizing barycentric coordinates, this model constructs a three-dimensional framework that accurately interpolates inverse isometric recruitment values across various joint positions, thereby enhancing control stability during stimulation. Experimental results from rabbit ankle joint control trials demonstrate our model's effectiveness. In combination with a proportional-integral-derivative (PID) controller, it shows superior performance by achieving reduced settling time (less than 1.63 s), faster rising time (less than 0.39 s), and smaller steady-state error (less than 3 degrees) compared to the legacy model. Moreover, the model's compatibility with recent advances in flexible interfacing technologies and its integration into a closed-loop controlled functional neuromuscular stimulation (FNS) system highlight its potential for precise neuroprosthetic applications in joint position control. This approach marks a significant advancement in the management of neurological disorders with advanced neuroprosthetic solutions.

Sticky and Strain-Gradient Artificial Epineurium for Sutureless Nerve Repair in Rodents and Nonhuman Primates

The need for the development of soft materials capable of stably adhering to nerve tissues without any suturing followed by additional damages is at the fore at a time when success in postoperative recovery depends largely on the surgical experience and/or specialized microsuturing skills of the surgeon. Despite fully recognizing such prerequisite conditions, designing the materials with robust adhesion to wet nerves as well as acute/chronic anti-inflammation remains to be resolved. Herein, a sticky and strain-gradient artificial epineurium (SSGAE) that overcomes the most critically challenging aspect for realizing sutureless repair of severely injured nerves is presented. In this regard, the SSGAE with a skin-inspired hierarchical structure entailing strain-gradient layers, anisotropic Janus layers including hydrophobic top and hydrophilic bottom surfaces, and synergistic self-healing capabilities enables immediate and stable neurorrhaphy in both rodent and nonhuman primate models, indicating that the bioinspired materials strategy significantly contributes to translational medicine for effective peripheral nerve repair.

Practical Applications of Self-Healing Polymers Beyond Mechanical and Electrical Recovery

Self-healing polymeric materials, which can repair physical damage, offer promising prospects for protective applications across various industries. Although prolonged durability and resource conservation are key advantages, focusing solely on mechanical recovery may limit the market potential of these materials. The unique physical properties of self-healing polymers, such as interfacial reduction, seamless connection lines, temperature/pressure responses, and phase transitions, enable a multitude of innovative applications. In this perspective, the diverse applications of self-healing polymers beyond their traditional mechanical strength are emphasized and their potential in various sectors such as food packaging, damage-reporting, radiation shielding, acoustic conservation, biomedical monitoring, and tissue regeneration is explored. With regards to the commercialization challenges, including scalability, robustness, and performance degradation under extreme conditions, strategies to overcome these limitations and promote successful industrialization are discussed. Furthermore, the potential impacts of self-healing materials on future research directions, encompassing environmental sustainability, advanced computational techniques, integration with emerging technologies, and tailoring materials for specific applications are examined. This perspective aims to inspire interdisciplinary approaches and foster the adoption of self-healing materials in various real-life settings, ultimately contributing to the development of next-generation materials.

Recent Advances in Implantable Neural Interfaces for Multimodal Electrical Neuromodulation

Electrical neuromodulation plays a pivotal role in enhancing patient outcomes among individuals suffering from neurological disorders. Implantable neural interfaces are vital components of the electrical neuromodulation system to ensure desirable performance; However, conventional devices are limited to a single function and are constructed with bulky and rigid materials, which often leads to mechanical incompatibility with soft tissue and an inability to adapt to the dynamic and complex 3D structures of biological systems. In addition, current implantable neural interfaces utilized in clinical settings primarily rely on wire-based techniques, which are associated with complications such as increased risk of infection, limited positioning options, and movement restrictions. Here, the state-of-art applications of electrical neuromodulation are presented. Material schemes and device structures that can be employed to develop robust and multifunctional neural interfaces, including flexibility, stretchability, biodegradability, self-healing, self-rolling, or morphing are discussed. Furthermore, multimodal wireless neuromodulation techniques, including optoelectronics, mechano-electrics, magnetoelectrics, inductive coupling, and electrochemically based self-powered devices are reviewed. In the end, future perspectives are given.

Bionic artificial skin with a fully implantable wireless tactile sensory system for wound healing and restoring skin tactile function

Tactile function is essential for human life as it enables us to recognize texture and respond to external stimuli, including potential threats with sharp objects that may result in punctures or lacerations. Severe skin damage caused by severe burns, skin cancer, chemical accidents, and industrial accidents damage the structure of the skin tissue as well as the nerve system, resulting in permanent tactile sensory dysfunction, which significantly impacts an individual's daily life. Here, we introduce a fully-implantable wireless powered tactile sensory system embedded artificial skin (WTSA), with stable operation, to restore permanently damaged tactile function and promote wound healing for regenerating severely damaged skin. The fabricated WTSA facilitates (i) replacement of severely damaged tactile sensory with broad biocompatibility, (ii) promoting of skin wound healing and regeneration through collagen and fibrin-based artificial skin (CFAS), and (iii) minimization of foreign body reaction via hydrogel coating on neural interface electrodes. Furthermore, the WTSA shows a stable operation as a sensory system as evidenced by the quantitative analysis of leg movement angle and electromyogram (EMG) signals in response to varying intensities of applied pressures.

Water-Responsive 3D Electronics for Smart Biological Interfaces

Three-dimensional (3D) electronic systems with their potential for enhanced functionalities often require complex fabrication processes. This paper presents a water-based, stimuli-responsive approach for creating self-assembled 3D electronic systems, particularly suited for biorelated applications. We utilize laser scribing to programmatically shape a water-responsive bilayer, resulting in smart 3D electronic substrates. Control over the deformation direction, actuation time, and surface curvature of rolling structures is achieved by adjusting laser-scribing parameters, as validated through experiments and numerical simulations. Additionally, self-locking structures maintain the integrity of the 3D systems. This methodology enables the implementation of spiral twining electrodes for electrophysiological signal monitoring in plants. Furthermore, the integration of self-rolling electrodes onto peripheral nerves in a rodent model allows for stimulation and recording of in vivo neural activities with excellent biocompatibility. These innovations provide viable paths to next-generation 3D biointegrated electronic systems for life science studies and medical applications.

Doping-induced assembly interface for noninvasive in vivo local and systemic immunomodulation

Peripheral neural interfaces, potent in modulating local and systemic immune responses for disease treatment, face significant challenges due to the peripheral nerves' broad distribution in tissues like the fascia, periosteum, and skin. The incongruity between static electronic components and the dynamic, complex organization of the peripheral nervous system often leads to interface failure, stalling circuit research and clinical applications. To overcome these, we developed a self-assembling, tissue-adaptive electrode composed of a single-component cocktail nanosheet colloid, including dopants, conducting polymers, stabilizers, and an MXene catalyst. Delivered via a jet injector to designated nerve terminals, this assembly utilizes reactive oxygen species to catalytically dope poly (3,4-ethylenedioxythiophene), enhancing π-π interactions between nanosheets, and yielding a conductive, biodegradable interface. This interface effectively regulates local immune activity and promotes sensory and motor nerve functional restoration in nerve-injured mice, while engaging the vagal-adrenal axis in freely moving mice, eliciting catecholamine neurotransmitter release, and suppressing systemic cytokine storms. This innovative strategy specifically targets nerve substructures, bolstering local and systemic immune modulation, and paving the way for the development of self-adaptive dynamic neural interfaces.

Water-responsive supercontractile polymer films for bioelectronic interfaces

Connecting different electronic devices is usually straightforward because they have paired, standardized interfaces, in which the shapes and sizes match each other perfectly. Tissue-electronics interfaces, however, cannot be standardized, because tissues are soft1-3 and have arbitrary shapes and sizes4-6. Shape-adaptive wrapping and covering around irregularly sized and shaped objects have been achieved using heat-shrink films because they can contract largely and rapidly when heated7. However, these materials are unsuitable for biological applications because they are usually much harder than tissues and contract at temperatures higher than 90 °C (refs. 8,9). Therefore, it is challenging to prepare stimuli-responsive films with large and rapid contractions for which the stimuli and mechanical properties are compatible with vulnerable tissues and electronic integration processes. Here, inspired by spider silk10-12, we designed water-responsive supercontractile polymer films composed of poly(ethylene oxide) and poly(ethylene glycol)-α-cyclodextrin inclusion complex, which are initially dry, flexible and stable under ambient conditions, contract by more than 50% of their original length within seconds (about 30% per second) after wetting and become soft (about 100 kPa) and stretchable (around 600%) hydrogel thin films thereafter. This supercontraction is attributed to the aligned microporous hierarchical structures of the films, which also facilitate electronic integration. We used this film to fabricate shape-adaptive electrode arrays that simplify the implantation procedure through supercontraction and conformally wrap around nerves, muscles and hearts of different sizes when wetted for in vivo nerve stimulation and electrophysiological signal recording. This study demonstrates that this water-responsive material can play an important part in shaping the next-generation tissue-electronics interfaces as well as broadening the biomedical application of shape-adaptive materials.

Injectable tissue prosthesis for instantaneous closed-loop rehabilitation

To construct tissue-like prosthetic materials, soft electroactive hydrogels are the best candidate owing to their physiological mechanical modulus, low electrical resistance and bidirectional stimulating and recording capability of electrophysiological signals from biological tissues1,2. Nevertheless, until now, bioelectronic devices for such prostheses have been patch type, which cannot be applied onto rough, narrow or deep tissue surfaces3-5. Here we present an injectable tissue prosthesis with instantaneous bidirectional electrical conduction in the neuromuscular system. The soft and injectable prosthesis is composed of a biocompatible hydrogel with unique phenylborate-mediated multiple crosslinking, such as irreversible yet freely rearrangeable biphenyl bonds and reversible coordinate bonds with conductive gold nanoparticles formed in situ by cross-coupling. Closed-loop robot-assisted rehabilitation by injecting this prosthetic material is successfully demonstrated in the early stage of severe muscle injury in rats, and accelerated tissue repair is achieved in the later stage.

A Water-Resistant, Self-Healing Encapsulation Layer for a Stable, Implantable Wireless Antenna

Polymers for implantable devices are desirable for biomedical engineering applications. This study introduces a water-resistant, self-healing fluoroelastomer (SHFE) as an encapsulation material for antennas. The SHFE exhibits a tissue-like modulus (approximately 0.4 MPa), stretchability (at least 450%, even after self-healing in an underwater environment), self-healability, and water resistance (WVTR result: 17.8610 g m-2 day-1). Further, the SHFE is self-healing in underwater environments via dipole-dipole interactions, such that devices can be protected from the penetration of biofluids and withstand external damage. With the combination of the SHFE and antennas designed to operate inside the body, we fabricated implantable, wireless antennas that can transmit information from inside the body to a reader coil that is outside. For antennas designed considering the dielectric constant, the uniformity of the encapsulation layer is crucial. A uniform and homogeneous interface is formed by simply overlapping two films. This study demonstrated the possibility of wireless communication in vivo through experiments on rodents for 4 weeks, maintaining the maximum communication distance (15 mm) without chemical or physical deformation in the SHFE layer. This study illustrates the applicability of fluoroelastomers in vivo and is expected to contribute to realizing the stable operation of high-performance implantable devices.

Neuromorphic sensorimotor loop embodied by monolithically integrated, low-voltage, soft e-skin

Artificial skin that simultaneously mimics sensory feedback and mechanical properties of natural skin holds substantial promise for next-generation robotic and medical devices. However, achieving such a biomimetic system that can seamlessly integrate with the human body remains a challenge. Through rational design and engineering of material properties, device structures, and system architectures, we realized a monolithic soft prosthetic electronic skin (e-skin). It is capable of multimodal perception, neuromorphic pulse-train signal generation, and closed-loop actuation. With a trilayer, high-permittivity elastomeric dielectric, we achieved a low subthreshold swing comparable to that of polycrystalline silicon transistors, a low operation voltage, low power consumption, and medium-scale circuit integration complexity for stretchable organic devices. Our e-skin mimics the biological sensorimotor loop, whereby a solid-state synaptic transistor elicits stronger actuation when a stimulus of increasing pressure is applied.

Perspectives on tissue-like bioelectronics for neural modulation

Advances in bioelectronic implants have been offering valuable chances to interface and modulate neural systems. Potential mismatches between bioelectronics and targeted neural tissues require devices to exhibit "tissue-like" properties for better implant-bio integration. In particular, mechanical mismatches pose a significant challenge. In the past years, efforts were made in both materials synthesis and device design to achieve bioelectronics mechanically and biochemically mimicking biological tissues. In this perspective, we mainly summarized recent progress of developing "tissue-like" bioelectronics and categorized them into different strategies. We also discussed how these "tissue-like" bioelectronics were utilized for modulating in vivo nervous systems and neural organoids. We concluded the perspective by proposing further directions including personalized bioelectronics, novel materials design and the involvement of artificial intelligence and robotic techniques.

Recent developments in multifunctional neural probes for simultaneous neural recording and modulation

Neural probes are among the most widely applied tools for studying neural circuit functions and treating neurological disorders. Given the complexity of the nervous system, it is highly desirable to monitor and modulate neural activities simultaneously at the cellular scale. In this review, we provide an overview of recent developments in multifunctional neural probes that allow simultaneous neural activity recording and modulation through different modalities, including chemical, electrical, and optical stimulation. We will focus on the material and structural design of multifunctional neural probes and their interfaces with neural tissues. Finally, future challenges and prospects of multifunctional neural probes will be discussed.

Electroconductive, Adhesive, Non-Swelling, and Viscoelastic Hydrogels for Bioelectronics

As a new class of materials, implantable flexible electrical conductors have recently been developed and applied to bioelectronics. An ideal electrical conductor requires high conductivity, tissue-like mechanical properties, low toxicity, reliable adhesion to biological tissues, and the ability to maintain its shape in wet physiological environments. Despite significant advances, electrical conductors that satisfy all these requirements are insufficient. Herein, a facile method for manufacturing a new conductive hydrogels through the simultaneous exfoliation of graphite and polymerization of zwitterionic monomers triggered by microwave irradiation is introduced. The mechanical properties of the obtained conductive hydrogel are similar to those of living tissue, which is ideal as a bionic adhesive for minimizing contact damage due to mechanical mismatches between hard electronics and soft tissues. Furthermore, it exhibits excellent adhesion performance, electrical conductivity, non-swelling, and high conformability in water. Excellent biocompatibility of the hydrogel is confirmed through a cytotoxicity test using C2C12 cells, a biocompatibility test on rat tissues, and their histological analysis. The hydrogel is then implanted into the sciatic nerve of a rat and neuromodulation is demonstrated through low-current electrical stimulation. This hydrogel demonstrates a tissue-like extraneuronal electrode, which possesses high conformability to improve the tissue-electronics interfaces, promising next-generation bioelectronics applications.

Balanced Coexistence of Reversible and Irreversible Covalent Bonds in a Conductive Triple Polymeric Network Enables Stretchable Hydrogels with High Toughness and Adhesiveness

The application of soft hydrogels to stretchable devices has attracted increasing attention in deformable bioelectronics owing to their unique characteristic, "modulus matching between materials and organs". Despite considerable progress, their low toughness, low conductivity, and absence of tissue adhesiveness remain substantial challenges associated with unstable skin-interfacing, where body movements undesirably disturb electrical signal acquisitions. Herein, we report a material design of a highly tough strain-dissipative and skin-adhesive conducting hydrogel fabricated through a facile one-step sol-gel transition and its application to an interactive human-machine interface. The hydrogel comprises a triple polymeric network where irreversible amide linkage of polyacrylamide with alginate and dynamic covalent bonds entailing conjugated polymer chains of poly(3,4-ethylenedioxythiophene)-co-(3-thienylboronic acid) are simultaneously capable of high stretchability (1300% strain), efficient strain dissipation (36,209 J/m²), low electrical resistance (590 Ω), and even robust skin adhesiveness (35.0 ± 5.6 kPa). Based on such decent characteristics, the hydrogel was utilized as a multifunctional layer for successfully performing either electrophysiological cardiac/muscular on-skin sensors or an interactive stretchable human-machine interface.

Totally Organic Hydrogel-Based Self-Closing Cuff Electrode for Vagus Nerve Stimulation

An intrinsically soft organic electrode consisting of poly(3,4-ethylenedioxythiophene)-modified polyurethane (PEDOT-PU) is embedded into a bilayer film of polyvinyl alcohol (PVA) hydrogels for developing a self-closing cuff electrode for neuromodulation. The curled form of the PVA hydrogel is prepared by releasing internal stress in the bilayer structure. The inner diameter of the cuff electrode is set to less than 2 mm for immobilization to the vagus nerve (VN) of humans and pigs. The stability of the immobilization is examined, while the pressure applied to a nerve bundle is at a harmless level (≈200 Pa). Since the electrode is totally organic, MRI measurements can be conducted without image artifacts. The large electric capacitance of the PEDOT-PU (≈27 mF cm^-2 ) ensures a safe stimulation of living tissues without Faradaic reactions. The practical performance of the cuff electrode for VN stimulation is demonstrated by observation of bradycardia induction in a pig.

Ultra-Thin Flexible Encapsulating Materials for Soft Bio-Integrated Electronics

Recently, bioelectronic devices extensively researched and developed through the convergence of flexible biocompatible materials and electronics design that enables  more precise diagnostics and therapeutics in human health care and opens up the potential to expand into various fields, such as clinical medicine and biomedical research. To establish an accurate and stable bidirectional bio-interface, protection against the external environment and high mechanical deformation is essential for wearable bioelectronic devices. In the case of implantable bioelectronics, special encapsulation materials and optimized mechanical designs and configurations that provide electronic stability and functionality are required for accommodating various organ properties, lifespans, and functions in the biofluid environment. Here, this study introduces recent developments of ultra-thin encapsulations with novel materials that can preserve or even improve the electrical performance of wearable and implantable bio-integrated electronics by supporting safety and stability for protection from destruction and contamination as well as optimizing the use of bioelectronic systems in physiological environments. In addition, a summary of the materials, methods, and characteristics of the most widely used encapsulation technologies is introduced, thereby providing a strategic selection of appropriate choices of recently developed flexible bioelectronics.

Wireless charging-mediated angiogenesis and nerve repair by adaptable microporous hydrogels from conductive building blocks

Traumatic brain injury causes inflammation and glial scarring that impede brain tissue repair, so stimulating angiogenesis and recovery of brain function remain challenging. Here we present an adaptable conductive microporous hydrogel consisting of gold nanoyarn balls-coated injectable building blocks possessing interconnected pores to improve angiogenesis and recovery of brain function in traumatic brain injury. We show that following minimally invasive implantation, the adaptable hydrogel is able to fill defects with complex shapes and regulate the traumatic brain injury environment in a mouse model. We find that placement of this injectable hydrogel at peri-trauma regions enhances mature brain-derived neurotrophic factor by 180% and improves angiogenesis by 250% in vivo within 2 weeks after electromagnetized stimulation, and that these effects facilitate neuron survival and motor function recovery by 50%. We use blood oxygenation level-dependent functional neuroimaging to reveal the successful restoration of functional brain connectivity in the corticostriatal and corticolimbic circuits.

Soft Liquid Metal-Based Conducting Composite with Robust Electrical Durability for a Wearable Electrocardiogram Sensor

Liquid metals not only have the electrical property of conductivity, but they also have a unique characteristic of existing in a liquid state at room temperature, unlike ordinary stiff solid metals. However, in bioelectronics, the modulus matching well between a device and skin or tissue is considered very advantageous, because high-quality biological signals can be recorded. Therefore, it is possible to implement soft electronics with stable and robust electrical characteristics by using LM as a conductive liquid-state filler. In this study, we changed a type of liquid metal, Eutectic Gallium Indium (EGaIn), into a particle form via tip sonication and mixed it with a solution that dissolved Styrene-Ethylene-Butylene-Styrene (SEBS) in toluene to fabricate a composite. The EGaIn-SEBS composite has high conductivity, excellent electrical durability under mechanically harsh conditions, and a degree of modulus similar to that of bare SEBS, which is lower than that of solid-filler-based SEBS composite. Finally, we demonstrated electrocardiogram signal monitoring using an EGaIn-Alginate two-layer electrode (EATE) that was fabricated by simply coating the surface of the composite with alginate hydrogel, which demonstrates excellent performance in bioelectronics.

A low-power stretchable neuromorphic nerve with proprioceptive feedback

By relaying neural signals from the motor cortex to muscles, devices for neurorehabilitation can enhance the movement of limbs in which nerves have been damaged as a consequence of injuries affecting the spinal cord or the lower motor neurons. However, conventional neuroprosthetic devices are rigid and power-hungry. Here we report a stretchable neuromorphic implant that restores coordinated and smooth motions in the legs of mice with neurological motor disorders, enabling the animals to kick a ball, walk or run. The neuromorphic implant acts as an artificial efferent nerve by generating electrophysiological signals from excitatory post-synaptic signals and by providing proprioceptive feedback. The device operates at low power (~1/150 that of a typical microprocessor system), and consists of hydrogel electrodes connected to a stretchable transistor incorporating an organic semiconducting nanowire (acting as an artificial synapse), connected via an ion gel to an artificial proprioceptor incorporating a carbon nanotube strain sensor (acting as an artificial muscle spindle). Stretchable electronics with proprioceptive feedback may inspire the further development of advanced neuromorphic devices for neurorehabilitation.

2D MXene interfaces preserve the basal electrophysiology of targeted neural circuits

Neural interfaces enable the monitoring of the state of the brain and its composite cell networks, as well as stimulate them to treat nervous disorders. In addition to their highly efficient charge transduction and stability during operation, the neural electrodes should avoid altering the physiological properties of targeted neuronal tissues. Two-dimensional (2D) MXene materials integrate the advantages of metallic conductivity, high specific-surface area and surface functionality in aqueous dispersions, showing promising potential in neural interface applications. Here, we apply uncoated Ti₃C₂T_x MXene to interface neuronal development. The impacts of the uncoated Ti₃C₂T_x MXene interface on neuronal development and neuronal microcircuit activity were tested for the first time. Compared to the standard neuronal culture with a poly-L-ornithine coated coverslip, uncoated Ti₃C₂T_x MXene surfaces did not affect the cell morphology, density, neuron ratios, maturation or the compositions of the neuronal network. Moreover, calcium imaging, spontaneous postsynaptic currents (sPSCs) and also miniature postsynaptic currents (mPSCs) were recorded to demonstrate that Ti₃C₂T_x MXene interfaces preserved the basal physiology of neuronal activity. The ability to interface neuronal circuit development without altering neuronal signaling properties enables the construction of MXene-based neural prosthetic devices for neuroscience research, diagnosis, and therapies.

A mechanically adaptive hydrogel neural interface based on silk fibroin for high-efficiency neural activity recording

A flexible non-transient electrical platform that can realize bidirectional neural communication from living tissues is of great interest in neuroscience to better understand basic neuroscience and the nondrug therapy of diseases or disorders. The development of soft, biocompatible, and conductive neural interface with mechanical coupling and efficient electrical exchange is a new trend but remains a challenge. Herein, we designed a multifunctional neural electrical communication platform in the form of a mechanically compliant, electrically conductive, and biocompatible hydrogel electrode. Silk fibroin (SF) obtained from Bombyx Mori cocoons was compounded with aldehyde-hyaluronic acid (HA-CHO) with a dynamic network to delay or interrupt the β-sheet-induced hardening of SF chains, resulting in the fabrication of a hydrogel matrix that is mechanically matched to biological tissues. Moreover, the incorporation of functionalized carbon nanotubes (CNTs) facilitated interaction and dispersion and enabled the formation of a hydrogel electrode with a high-current percolation network, thus contributing toward improving the electrical properties in terms of conductivity, impedance, and charge storage capabilities. These advances allow high-efficiency stimulation and the recording of neural signals during in vivo implantation. Overall, a wide range of animal experiments demonstrate that the platform exhibits minimal foreign body responses, thus showing it to be a promising electrophysiology interface for potential applications in neuroscience.

Highly Thermally Conductive Polymer/Graphene Composites with Rapid Room-Temperature Self-Healing Capacity

Composites that can rapidly self-healing their structure and function at room temperature have broad application prospects. However, in view of the complexity of composite structure and composition, its self-heal is facing challenges. In this article, supramolecular effect is proposed to repair the multistage structure, mechanical and thermal properties of composite materials. A stiff and tough supramolecular frameworks of 2-[[(butylamino)carbonyl]oxy]ethyl ester (PBA)-polydimethylsiloxane (PDMS) were established using a chain extender with double amide bonds in a side chain to extend prepolymers through copolymerization. Then, by introducing the copolymer into a folded graphene film (FGf), a highly thermally conductive composite of PBA-PDMS/FGf with self-healing capacity was fabricated. The ratio of crosslinking and hydrogen bonding was optimized to ensure that PBA-PDMS could completely self-heal at room temperature in 10 min. Additionally, PBA-PDMS/FGf exhibits a high tensile strength of 2.23 ± 0.15 MPa at break and high thermal conductivity of 13 ± 0.2 W m^-1 K^-1; of which the self-healing efficiencies were 100% and 98.65% at room temperature for tensile strength and thermal conductivity, respectively. The excellent self-healing performance comes from the efficient supramolecular interaction between polymer molecules, as well as polymer molecule and graphene. This kind of thermal conductive self-healing composite has important application prospects in the heat dissipation field of next generation electronic devices in the future.

Materials for Implantable Surface Electrode Arrays: Current Status and Future Directions

Surface electrode arrays are mainly fabricated from rigid or elastic materials, and precisely manipulated ductile metal films, which offer limited stretchability. However, the living tissues to which they are applied are nonlinear viscoelastic materials, which can undergo significant mechanical deformation in dynamic biological environments. Further, the same arrays and compositions are often repurposed for vastly different tissues rather than optimizing the materials and mechanical properties of the implant for the target application. By first characterizing the desired biological environment, and then designing a technology for a particular organ, surface electrode arrays may be more conformable, and offer better interfaces to tissues while causing less damage. Here, the various materials used in each component of a surface electrode array are first reviewed, and then electrically active implants in three specific biological systems, the nervous system, the muscular system, and skin, are described. Finally, the fabrication of next-generation surface arrays that overcome current limitations is discussed.

Advanced Implantable Biomedical Devices Enabled by Triboelectric Nanogenerators

Implantable biomedical devices (IMDs) play essential roles in healthcare. Subject to the limited battery life, IMDs cannot achieve long-term in situ monitoring, diagnosis, and treatment. The proposal and rapid development of triboelectric nanogenerators free IMDs from the shackles of batteries and spawn a self-powered healthcare system. This review aims to overview the development of IMDs based on triboelectric nanogenerators, divided into self-powered biosensors, in vivo energy harvesting devices, and direct electrical stimulation therapy devices. Meanwhile, future challenges and opportunities are discussed according to the development requirements of current-level self-powered IMDs to enhance output performance, develop advanced triboelectric nanogenerators with multifunctional materials, and self-driven close-looped diagnosis and treatment systems.

Flexible Electronics and Devices as Human-Machine Interfaces for Medical Robotics

Medical robots are invaluable players in non-pharmaceutical treatment of disabilities. Particularly, using prosthetic and rehabilitation devices with human-machine interfaces can greatly improve the quality of life for impaired patients. In recent years, flexible electronic interfaces and soft robotics have attracted tremendous attention in this field due to their high biocompatibility, functionality, conformability, and low-cost. Flexible human-machine interfaces on soft robotics will make a promising alternative to conventional rigid devices, which can potentially revolutionize the paradigm and future direction of medical robotics in terms of rehabilitation feedback and user experience. In this review, the fundamental components of the materials, structures, and mechanisms in flexible human-machine interfaces are summarized by recent and renowned applications in five primary areas: physical and chemical sensing, physiological recording, information processing and communication, soft robotic actuation, and feedback stimulation. This review further concludes by discussing the outlook and current challenges of these technologies as a human-machine interface in medical robotics.

Recent Progress in Materials Chemistry to Advance Flexible Bioelectronics in Medicine

Designing bioelectronic devices that seamlessly integrate with the human body is a technological pursuit of great importance. Bioelectronic medical devices that reliably and chronically interface with the body can advance neuroscience, health monitoring, diagnostics, and therapeutics. Recent major efforts focus on investigating strategies to fabricate flexible, stretchable, and soft electronic devices, and advances in materials chemistry have emerged as fundamental to the creation of the next generation of bioelectronics. This review summarizes contemporary advances and forthcoming technical challenges related to three principal components of bioelectronic devices: i) substrates and structural materials, ii) barrier and encapsulation materials, and iii) conductive materials. Through notable illustrations from the literature, integration and device fabrication strategies and associated challenges for each material class are highlighted.

Soft Stretchable Conductive Carboxymethylcellulose Hydrogels for Wearable Sensors

Hydrogels that have a capability to provide mechanical modulus matching between time-dynamic curvilinear tissues and bioelectronic devices have been considered tissue-interfacing ionic materials for stably sensing physiological signals and delivering feedback actuation in skin-inspired healthcare systems. These functionalities are totally different from those of elastomers with low ionic conductivity and higher stiffness. Despite such remarkable progress, their low conductivity remains limited in transporting electrical charges to internal or external terminals without undesired information loss, potentially leading to an unstable biotic-abiotic interfaces in the wearable electronics. Here, we report a soft stretchable conductive hydrogel composite consisting of alginate, carboxymethyl cellulose, polyacrylamide, and silver flakes. This composite was fabricated via sol-gel transition. In particular, the phase stability and low dynamic modulus rates of the conductive hydrogel were confirmed through an oscillatory rheological characterization. In addition, our conductive hydrogel showed maximal tensile strain (≈400%), a low deformations of cyclic loading (over 100 times), low resistance (≈8.4 Ω), and a high gauge factor (≈241). These stable electrical and mechanical properties allowed our composite hydrogel to fully support the operation of a light-emitting diode demonstration under mechanical deformation. Based on such durable performance, we successfully measured the electromyogram signals without electrical malfunction even in various motions.

Electrostatic-Mechanical Synergistic In Situ Multiscale Tissue Adhesion for Sustainable Residue-Free Bioelectronics Interfaces

Recent studies on soft adhesives have sought to deeply understand how their chemical or mechanical structures interact strongly with living tissues. The aim is to optimally address the unmet needs of patients with acute or chronic diseases. Synergistic adhesion involving both electrostatic (hydrogen bonds) and mechanical interactions (capillarity-assisted suction stress) seems to be effective in overcoming the challenges associated with long-term unstable coupling to tissues. Here, an electrostatically and mechanically synergistic mechanism of residue-free, sustainable, in situ tissue adhesion by implementing hybrid multiscale architectonics. To deduce the mechanism, a thermodynamic model based on a tailored multiscale combinatory adhesive is proposed. The model supports the experimental results that the thermodynamically controlled swelling of the nanoporous hydrogel embedded in the hierarchical elastomeric structure enhances biofluid-insensitive, sustainable, in situ adhesion to diverse soft, slippery, and wet organ surfaces, as well as clean detachment in the peeling direction. Based on the robust tissue adhesion capability, universal reliable measurements of electrophysiological signals generated by various tissues, ranging from rodent sciatic nerve, the muscle, brain, and human skin, are successfully demonstrated.

A Microclip Peripheral Nerve Interface (μcPNI) for Bioelectronic Interfacing with Small Nerves

Peripheral nerves carry sensory (afferent) and motor (efferent) signals between the central nervous system and other parts of the body. The peripheral nervous system (PNS) is therefore rich in targets for therapeutic neuromodulation, bioelectronic medicine, and neuroprosthetics. Peripheral nerve interfaces (PNIs) generally suffer from a tradeoff between selectivity and invasiveness. This work describes the fabrication, evaluation, and chronic implantation in zebra finches of a novel PNI that breaks this tradeoff by interfacing with small nerves. This PNI integrates a soft, stretchable microelectrode array with a 2-photon 3D printed microclip (μcPNI). The advantages of this μcPNI compared to other designs are: a) increased spatial resolution due to bi-layer wiring of the electrode leads, b) reduced mismatch in biomechanical properties with the nerve, c) reduced disturbance to the host tissue due to the small size, d) elimination of sutures or adhesives, e) high circumferential contact with small nerves, f) functionality under considerable strain, and g) graded neuromodulation in a low-threshold stimulation regime. Results demonstrate that the μcPNIs are electromechanically robust, and are capable of reliably recording and stimulating neural activity in vivo in small nerves. The μcPNI may also inform the development of new optical, thermal, ultrasonic, or chemical PNIs as well.

Lead-Sealed Stretchable Underwater Perovskite-Based Optoelectronics via Self-Recovering Polymeric Nanomaterials

To harness the full potential of halide perovskite based optoelectronics, biological safety, compatibility with flexible/stretchable platforms, and operational stability must be guaranteed. Despite substantial efforts, none has come close to providing a solution that encompasses all of these requirements. To address these issues, we devise a multifunctional encapsulation scheme utilizing hydrogen bond-based self-recovering polymeric nanomaterials as an alternative for conventional glass-based encapsulation. We show that Pb in physically damaged halide perovskite solar cells can be completely contained within the self-recovering encapsulation upon submersion in a simulated rain bath, as indicated by in vitro cytotoxicity tests. In addition, self-recovering encapsulation accommodates stable device operation upon casual bending and even stretching, which is in stark contrast to conventional glass-based encapsulation schemes. We also demonstrate the concept of assembling user-defined scalable modular optoelectronics based on halide perovskite solar cells and light emitting diodes through the use of self-recovering conductive nanocomposites. Finally, long-term operational stability of over 1000 h was achieved under harsh accelerated conditions (50 °C/50% RH and 85 °C/0% RH) with the incorporation of an ultrathin atomic layer deposited TiO₂ barrier underneath the multifunctional encapsulation. In light of these merits, the encapsulation scheme based on self-recovering polymeric nanomaterials is proposed as a simple, but practical solution to a multifaceted challenge in the field of halide perovskites.

Recent advances in recording and modulation technologies for next-generation neural interfaces

Along with the advancement in neural engineering techniques, unprecedented progress in the development of neural interfaces has been made over the past few decades. However, despite these achievements, there is still room for further improvements especially toward the possibility of monitoring and modulating neural activities with high resolution and specificity in our daily lives. In an effort of taking a step toward the next-generation neural interfaces, we want to highlight the recent progress in neural technologies. We will cover a wide scope of such developments ranging from novel platforms for highly specific recording and modulation to system integration for practical applications of novel interfaces.

Materials Chemistry of Neural Interface Technologies and Recent Advances in Three-Dimensional Systems

Advances in materials chemistry and engineering serve as the basis for multifunctional neural interfaces that span length scales from individual neurons to neural networks, neural tissues, and complete neural systems. Such technologies exploit electrical, electrochemical, optical, and/or pharmacological modalities in sensing and neuromodulation for fundamental studies in neuroscience research, with additional potential to serve as routes for monitoring and treating neurodegenerative diseases and for rehabilitating patients. This review summarizes the essential role of chemistry in this field of research, with an emphasis on recently published results and developing trends. The focus is on enabling materials in diverse device constructs, including their latest utilization in 3D bioelectronic frameworks formed by 3D printing, self-folding, and mechanically guided assembly. A concluding section highlights key challenges and future directions.

Flexible and biodegradable electronic implants for diagnosis and treatment of brain diseases

In the diagnosis and treatment of brain diseases, implantable devices have immense potential for intracranial sensing of brain activity and application of controlled therapy for providing feedback to the sensing. Flexible materials are preferred for implantable devices, as they can minimise implanted device-brain tissue mechanical mismatch. Moreover, biodegradable implantable devices can reduce potential immunological side-effects. Biodegradability also helps avoid the burdensome secondary surgery for retrieving the implanted device. In this study, we reviewed recent advancements related to the use of flexible and biodegradable type of implantable devices for the diagnosis and treatment of brain diseases. Representative cases of intracranial sensing and feedback therapy are introduced, and then a brief discussion concludes the review.

Transparent, Conductive Hydrogels with High Mechanical Strength and Toughness

Transparent, conductive hydrogels with good mechanical strength and toughness are in great demand of the fields of biomedical and future wearable smart electronics. We reported a carboxymethyl chitosan (CMCS)-calcium chloride (CaCl2)/polyacrylamide (PAAm)/poly(N-methylol acrylamide (PNMA) transparent, tough and conductive hydrogel containing a bi-physical crosslinking network through in situ free radical polymerization. It showed excellent light transmittance (>90%), excellent toughness (10.72 MJ/m3), good tensile strength (at break, 2.65 MPa), breaking strain (707%), and high elastic modulus (0.30 MPa). The strain sensing performance is found with high sensitivity (maximum gauge factor 9.18, 0.5% detection limit), wide strain response range, fast response and recovery time, nearly zero hysteresis and good repeatability. This study extends the transparent, tough, conductive hydrogels to provide body-surface wearable devices that can accurately and repeatedly monitor the movement of body joints, including the movements of wrists, elbows and knee joints. This study provided a broad development potential for tough, transparent and conductive hydrogels as body-surface intelligent health monitoring systems and implantable soft electronics.

Durable and Fatigue-Resistant Soft Peripheral Neuroprosthetics for In Vivo Bidirectional Signaling

Soft neuroprosthetics that monitor signals from sensory neurons and deliver motor information can potentially replace damaged nerves. However, achieving long-term stability of devices interfacing peripheral nerves is challenging, since dynamic mechanical deformations in peripheral nerves cause material degradation in devices. Here, a durable and fatigue-resistant soft neuroprosthetic device is reported for bidirectional signaling on peripheral nerves. The neuroprosthetic device is made of a nanocomposite of gold nanoshell (AuNS)-coated silver (Ag) flakes dispersed in a tough, stretchable, and self-healing polymer (SHP). The dynamic self-healing property of the nanocomposite allows the percolation network of AuNS-coated flakes to rebuild after degradation. Therefore, its degraded electrical and mechanical performance by repetitive, irregular, and intense deformations at the device-nerve interface can be spontaneously self-recovered. When the device is implanted on a rat sciatic nerve, stable bidirectional signaling is obtained for over 5 weeks. Neural signals collected from a live walking rat using these neuroprosthetics are analyzed by a deep neural network to predict the joint position precisely. This result demonstrates that durable soft neuroprosthetics can facilitate collection and analysis of large-sized in vivo data for solving challenges in neurological disorders.

Self-Healing, Stretchable, Biocompatible, and Conductive Alginate Hydrogels through Dynamic Covalent Bonds for Implantable Electronics

Implantable electronics have recently been attracting attention because of the promising advances in personalized healthcare. They can be used to diagnose and treat chronic diseases by monitoring and applying bioelectrical signals to various organs. However, there are challenges regarding the rigidity and hardness of typical electronic devices that can trigger inflammatory reactions in tissues. In an effort to improve the physicochemical properties of conventional implantable electronics, soft hydrogel-based platforms have emerged as components of implantable electronics. It is important that they meet functional criteria, such as stretchability, biocompatibility, and self-healing. Herein, plant-inspired conductive alginate hydrogels composed of “boronic acid modified alginate” and “oligomerized epigallocatechin gallate,” which are extracted from plant compounds, are proposed. The conductive hydrogels show great stretchability up to 500% and self-healing properties because of the boronic acid-cis-diol dynamic covalent bonds. In addition, as a simple strategy to increase the electrical conductivity of the hydrogels, ionically crosslinked shells with cations (e.g., sodium) were generated on the hydrogel under physiological salt conditions. This decreased the resistance of the conductive hydrogel down to 900 ohm without trading off the original properties of stretchability and self-healing. The hydrogels were used for “electrophysiological bridging” to transfer electromyographic signals in an ex vivo muscle defect model, showing a great bridging effect comparable to that of a muscle-to-muscle contact model. The use of plant-inspired ionically conductive hydrogels is a promising strategy for designing implantable and self-healable bioelectronics.

From Diagnosis to Treatment: Recent Advances in Patient-Friendly Biosensors and Implantable Devices

Patient-friendly medical diagnostics and treatments have been receiving a great deal of interest due to their rapid and cost-effective health care applications with minimized risk of infection, which has the potential to replace conventional hospital-based medical procedures. In particular, the integration of recently developed materials into health care devices allows the rapid development of point-of-care (POC) sensing platforms and implantable devices with special functionalities. In this review, the recent advances in biosensors for patient-friendly diagnosis and implantable devices for patient-friendly treatment are discussed. Comprehensive analysis of portable and wearable biosensing platforms for patient-friendly health monitoring and disease diagnosis is provided, including topics such as materials selection, device structure and integration, and biomarker detection strategies. Moreover, specific challenges related to each biological fluid for wearable biosensor-based POC applications are presented. Also, advances in implantable devices, including recent materials development and wireless communication strategies, are discussed. Furthermore, various patient-friendly surgical and treatment approaches are reviewed, such as minimally invasive insertion and mounting, in vivo electrical and optical modulations, and post-operation health monitoring. Finally, the challenges and future perspectives toward the development of the patient-friendly diagnosis and treatment are provided.