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Dong C, Carnicer-Lombarte A, Bonafè F, Huang B, Middya S, Jin A, Tao X, Han S, Bance M, Barone DG, Fraboni B, Malliaras GG. Electrochemically actuated microelectrodes for minimally invasive peripheral nerve interfaces. NATURE MATERIALS 2024; 23:969-976. [PMID: 38671159 PMCID: PMC11230894 DOI: 10.1038/s41563-024-01886-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 03/31/2024] [Indexed: 04/28/2024]
Abstract
Electrode arrays that interface with peripheral nerves are used in the diagnosis and treatment of neurological disorders; however, they require complex placement surgeries that carry a high risk of nerve injury. Here we leverage recent advances in soft robotic actuators and flexible electronics to develop highly conformable nerve cuffs that combine electrochemically driven conducting-polymer-based soft actuators with low-impedance microelectrodes. Driven with applied voltages as small as a few hundreds of millivolts, these cuffs allow active grasping or wrapping around delicate nerves. We validate this technology using in vivo rat models, showing that the cuffs form and maintain a self-closing and reliable bioelectronic interface with the sciatic nerve of rats without the use of surgical sutures or glues. This seamless integration of soft electrochemical actuators with neurotechnology offers a path towards minimally invasive intraoperative monitoring of nerve activity and high-quality bioelectronic interfaces.
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Affiliation(s)
- Chaoqun Dong
- Electrical Engineering Division, Department of Engineering, University of Cambridge, Cambridge, UK
| | | | - Filippo Bonafè
- Electrical Engineering Division, Department of Engineering, University of Cambridge, Cambridge, UK
- Department of Physics and Astronomy, University of Bologna, Bologna, Italy
| | - Botian Huang
- Electrical Engineering Division, Department of Engineering, University of Cambridge, Cambridge, UK
- Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK
| | - Sagnik Middya
- Electrical Engineering Division, Department of Engineering, University of Cambridge, Cambridge, UK
| | - Amy Jin
- Electrical Engineering Division, Department of Engineering, University of Cambridge, Cambridge, UK
| | - Xudong Tao
- Electrical Engineering Division, Department of Engineering, University of Cambridge, Cambridge, UK
| | - Sanggil Han
- Electrical Engineering Division, Department of Engineering, University of Cambridge, Cambridge, UK
- Department of Nano-Bioengineering, Incheon National University, Incheon, Republic of Korea
| | - Manohar Bance
- Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK
| | - Damiano G Barone
- Electrical Engineering Division, Department of Engineering, University of Cambridge, Cambridge, UK
- Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK
| | - Beatrice Fraboni
- Department of Physics and Astronomy, University of Bologna, Bologna, Italy
| | - George G Malliaras
- Electrical Engineering Division, Department of Engineering, University of Cambridge, Cambridge, UK.
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2
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Seufert L, Elmahmoudy M, Theunis C, Lienemann S, Li Y, Mohammadi M, Boda U, Carnicer-Lombarte A, Kroon R, Persson POÅ, Rahmanudin A, Donahue MJ, Farnebo S, Tybrandt K. Stretchable Tissue-Like Gold Nanowire Composites with Long-Term Stability for Neural Interfaces. SMALL (WEINHEIM AN DER BERGSTRASSE, GERMANY) 2024:e2402214. [PMID: 38944890 DOI: 10.1002/smll.202402214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/28/2024] [Revised: 06/20/2024] [Indexed: 07/02/2024]
Abstract
Soft and stretchable nanocomposites can match the mechanical properties of neural tissue, thereby minimizing foreign body reactions to provide optimal stimulation and recording specificity. Soft materials for neural interfaces should simultaneously fulfill a wide range of requirements, including low Young's modulus (<<1 MPa), stretchability (≥30%), high conductivity (>> 1000 S cm-1), biocompatibility, and chronic stability (>> 1 year). Current nanocomposites do not fulfill the above requirements, in particular not the combination of softness and high conductivity. Here, this challenge is addressed by developing a scalable and robust synthesis route based on polymeric reducing agents for smooth, high-aspect ratio gold nanowires (AuNWs) of controllable dimensions with excellent biocompatibility. AuNW-silicone composites show outstanding performance with nerve-like softness (250 kPa), high conductivity (16 000 S cm-1), and reversible stretchability. Soft multielectrode cuffs based on the composite achieve selective functional stimulation, recordings of sensory stimuli in rat sciatic nerves, and show an accelerated lifetime stability of >3 years. The scalable synthesis method provides a chemically stable alternative to the widely used AgNWs, thereby enabling new applications within electronics, biomedical devices, and electrochemistry.
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Affiliation(s)
- Laura Seufert
- Laboratory of Organic Electronics, Department of Science and Technology, Linköping University, Norrköping, 602 21, Sweden
| | - Mohammed Elmahmoudy
- Laboratory of Organic Electronics, Department of Science and Technology, Linköping University, Norrköping, 602 21, Sweden
| | - Charlotte Theunis
- Laboratory of Organic Electronics, Department of Science and Technology, Linköping University, Norrköping, 602 21, Sweden
| | - Samuel Lienemann
- Laboratory of Organic Electronics, Department of Science and Technology, Linköping University, Norrköping, 602 21, Sweden
| | - Yuyang Li
- Laboratory of Organic Electronics, Department of Science and Technology, Linköping University, Norrköping, 602 21, Sweden
| | - Mohsen Mohammadi
- Laboratory of Organic Electronics, Department of Science and Technology, Linköping University, Norrköping, 602 21, Sweden
| | - Ulrika Boda
- RISE Research Institutes of Sweden, Digital Systems, Smart Hardware, Printed, Bio- and Organic Electronics, Södra Grytsgatan 4, Norrköping, SE-602 33, Sweden
| | | | - Renee Kroon
- Laboratory of Organic Electronics, Department of Science and Technology, Linköping University, Norrköping, 602 21, Sweden
| | - Per O Å Persson
- Department of Physics, Chemistry and Biology, Linköping University, Linköping, 581 83, Sweden
| | - Aiman Rahmanudin
- Laboratory of Organic Electronics, Department of Science and Technology, Linköping University, Norrköping, 602 21, Sweden
| | - Mary J Donahue
- Laboratory of Organic Electronics, Department of Science and Technology, Linköping University, Norrköping, 602 21, Sweden
| | - Simon Farnebo
- Department of Hand Surgery, Plastic Surgery and Burns, Linköping University Hospital, Linköping, 581 85, Sweden
- Department of Biomedical and Clinical Sciences, Linköping University, Linköping, 581 85, Sweden
| | - Klas Tybrandt
- Laboratory of Organic Electronics, Department of Science and Technology, Linköping University, Norrköping, 602 21, Sweden
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Reddy RS, Alshahrani MS, ALMohiza MA, Alkhamis BA, Tedla JS, Kakaraparthi VN, Koura GM, Mukherjee D, Alnakhli HH, Ghulam HSH, Alqhtani RS. Shoulder muscle weakness and proprioceptive impairments in type 2 diabetes mellitus: exploring correlations for improved clinical management. PeerJ 2024; 12:e17630. [PMID: 38948217 PMCID: PMC11212628 DOI: 10.7717/peerj.17630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Accepted: 06/03/2024] [Indexed: 07/02/2024] Open
Abstract
Background Type 2 diabetes mellitus (T2DM) is a prevalent metabolic disorder with systemic implications, potentially affecting musculoskeletal health. This study aimed to assess shoulder muscle strength and joint repositioning accuracy in individuals with T2DM, exploring potential correlations and shedding light on the musculoskeletal consequences of the condition. The objectives were two-fold: (1) to assess and compare shoulder strength and joint repositioning accuracy between individuals with T2DM and asymptomatic counterparts, and (2) to examine the correlation between shoulder strength and joint repositioning accuracy in individuals with T2DM. Methods A cross-sectional study enrolled 172 participants using the convenience sampling method, including 86 individuals with T2DM and an age-matched asymptomatic group (n = 86). Shoulder strength was assessed using a handheld dynamometer, while joint repositioning accuracy was evaluated with an electronic digital inclinometer. Results Individuals with T2DM exhibited reduced shoulder muscle strength compared to asymptomatic individuals (p < 0.001). Additionally, joint repositioning accuracy was significantly lower in the T2DM group (p < 0.001). Negative correlations were observed between shoulder strength and joint repositioning accuracy in various directions (ranging from -0.29 to -0.46, p < 0.001), indicating that higher muscle strength was associated with improved joint repositioning accuracy in individuals with T2DM. Conclusion This study highlights the significant impact of T2DM on shoulder muscle strength and joint repositioning accuracy. Reduced strength and impaired accuracy are evident in individuals with T2DM, emphasizing the importance of addressing musculoskeletal aspects in diabetes management. The negative correlations suggest that enhancing shoulder muscle strength may lead to improved joint repositioning accuracy, potentially contributing to enhanced physical functioning in this population.
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Affiliation(s)
- Ravi Shankar Reddy
- Medical Rehabilitation Sciences, King Khalid University, Abha, Aseer, Saudi Arabia
| | | | - Mohammad A. ALMohiza
- Department of Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Riyadh, Saudi Arabia
| | | | - Jaya Shanker Tedla
- Medical Rehabilitation Sciences, King Khalid University, Abha, Aseer, Saudi Arabia
| | | | - Ghada Mohamed Koura
- Medical Rehabilitation Sciences, King Khalid University, Abha, Aseer, Saudi Arabia
| | - Debjani Mukherjee
- Medical Rehabilitation Sciences, King Khalid University, Abha, Aseer, Saudi Arabia
| | - Hani Hassan Alnakhli
- Medical Rehabilitation Sciences, King Khalid University, Abha, Aseer, Saudi Arabia
| | | | - Raee S. Alqhtani
- Department of Physical Therapy, Najran University, Najran, Saudi Arabia
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Conde SV, Sacramento JF, Zinno C, Mazzoni A, Micera S, Guarino MP. Bioelectronic modulation of carotid sinus nerve to treat type 2 diabetes: current knowledge and future perspectives. Front Neurosci 2024; 18:1378473. [PMID: 38646610 PMCID: PMC11026613 DOI: 10.3389/fnins.2024.1378473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Accepted: 03/26/2024] [Indexed: 04/23/2024] Open
Abstract
Bioelectronic medicine are an emerging class of treatments aiming to modulate body nervous activity to correct pathological conditions and restore health. Recently, it was shown that the high frequency electrical neuromodulation of the carotid sinus nerve (CSN), a small branch of the glossopharyngeal nerve that connects the carotid body (CB) to the brain, restores metabolic function in type 2 diabetes (T2D) animal models highlighting its potential as a new therapeutic modality to treat metabolic diseases in humans. In this manuscript, we review the current knowledge supporting the use of neuromodulation of the CSN to treat T2D and discuss the future perspectives for its clinical application. Firstly, we review in a concise manner the role of CB chemoreceptors and of CSN in the pathogenesis of metabolic diseases. Secondly, we describe the findings supporting the potential therapeutic use of the neuromodulation of CSN to treat T2D, as well as the feasibility and reversibility of this approach. A third section is devoted to point up the advances in the neural decoding of CSN activity, in particular in metabolic disease states, that will allow the development of closed-loop approaches to deliver personalized and adjustable treatments with minimal side effects. And finally, we discuss the findings supporting the assessment of CB activity in metabolic disease patients to screen the individuals that will benefit therapeutically from this bioelectronic approach in the future.
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Affiliation(s)
- Silvia V. Conde
- iNOVA4Health, NOVA Medical School, Faculdade de Ciências Médicas, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - Joana F. Sacramento
- iNOVA4Health, NOVA Medical School, Faculdade de Ciências Médicas, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - Ciro Zinno
- The BioRobotics Institute Scuola Superiore Sant’Anna, Pontedera, Italy
| | - Alberto Mazzoni
- The BioRobotics Institute Scuola Superiore Sant’Anna, Pontedera, Italy
| | - Silvestro Micera
- The BioRobotics Institute Scuola Superiore Sant’Anna, Pontedera, Italy
| | - Maria P. Guarino
- ciTechCare, School of Health Sciences Polytechnic of Leiria, Leiria, Portugal
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5
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Zhong Y, Luo P, Wen X, Wang B, Zhong C, Zhu S. Mathematical definition and rules of the splitting/merging patterns in bundles of human peripheral nerve segment. Ann Anat 2024; 253:152231. [PMID: 38387822 DOI: 10.1016/j.aanat.2024.152231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Revised: 01/28/2024] [Accepted: 02/19/2024] [Indexed: 02/24/2024]
Abstract
Accurately measuring the spatial extension distance of nerve bundles in completing a split/merge is impossible because no clear mathematical definition exists for the starting and ending positions in nerve-bundle splitting/merging. We manually count the number of nerve-bundle splits/merges in long nerve segments, which is labor-intensive, inefficient, and prone to counting errors. Currently, the mathematics are unclear for the nerve-bundle diameter before and after splitting/merging. This paper explores these problems and proposes nerve-bundle splitting/merging rules. Based on the method of defining the beginning and ending positions of nerve-bundle splitting/merging, we explored the mathematical law of equivalent diameter of nerve bundles before and after splitting/merging. The experimental results revealed that the moving average of circularity of nerve bundle accurately defines the beginning and ending positions of nerve-bundle splitting/merging. The diameter of the nerve bundles before and after split/merge approximately conforms to the principles of the Da Vinci formula. The proposed automatic counting algorithm based on centroid offset matching obtains the number of split/merged nerve bundles in the sequence scan images with 100 % accuracy. The mathematical definition of the starting and ending positions of nerve-bundle splitting/merging proposed in this paper is accurate and strict and is the foundation of subsequent research. The proposed automatic counting algorithm based on centroid offset matching (ACA-COM) can accurately and efficiently count the number of times the nerve bundles split and merge in sequential images. The mathematical law satisfied by the diameter of the nerve bundles before and after splitting/merging reflects that the nerve bundles tend to have better capability to resist breaking.
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Affiliation(s)
- Yingchun Zhong
- School of Automation, Guangdong University of Technology, Guangzhou 510006, China
| | - Peng Luo
- Department of Orthopedics, Shenzhen Sixth People's Hospital, Shenzhen 518052, China
| | - Xiaoyue Wen
- Department of Joint Surgery and Traumatic Orthopedics of the Third Affiliated Hospital of Sun Yat sen University, Guangzhou 510630, China
| | - Biao Wang
- School of Automation, Guangdong University of Technology, Guangzhou 510006, China
| | - Chengfan Zhong
- Joint and Orthopedic Department, the People's Hospital of Gaozhou, Gaozhou 525200, China.
| | - Shuang Zhu
- Department of Joint and Orthopedics, Zhujiang Hospital, Southern Medical University, Guangzhou 510280, China.
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6
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Thota AK, Jung R. Accelerating neurotechnology development using an Agile methodology. Front Neurosci 2024; 18:1328540. [PMID: 38435056 PMCID: PMC10904481 DOI: 10.3389/fnins.2024.1328540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Accepted: 01/18/2024] [Indexed: 03/05/2024] Open
Abstract
Novel bioelectronic medical devices that target neural control of visceral organs (e.g., liver, gut, spleen) or inflammatory reflex pathways are innovative class III medical devices like implantable cardiac pacemakers that are lifesaving and life-sustaining medical devices. Bringing innovative neurotechnologies early into the market and the hands of treatment providers would benefit a large population of patients inflicted with autonomic and chronic immune disorders. Medical device manufacturers and software developers widely use the Waterfall methodology to implement design controls through verification and validation. In the Waterfall methodology, after identifying user needs, a functional unit is fabricated following the verification loop (design, build, and verify) and then validated against user needs. Considerable time can lapse in building, verifying, and validating the product because this methodology has limitations for adjusting to unanticipated changes. The time lost in device development can cause significant delays in final production, increase costs, and may even result in the abandonment of the device development. Software developers have successfully implemented an Agile methodology that overcomes these limitations in developing medical software. However, Agile methodology is not routinely used to develop medical devices with implantable hardware because of the increased regulatory burden of the need to conduct animal and human studies. Here, we provide the pros and cons of the Waterfall methodology and make a case for adopting the Agile methodology in developing medical devices with physical components. We utilize a peripheral nerve interface as an example device to illustrate the use of the Agile approach to develop neurotechnologies.
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Affiliation(s)
- Anil Kumar Thota
- Adaptive Neural Systems Group, The Institute for Integrative and Innovative Research, University of Arkansas, Fayetteville, AR, United States
| | - Ranu Jung
- Adaptive Neural Systems Group, The Institute for Integrative and Innovative Research, University of Arkansas, Fayetteville, AR, United States
- Biomedical Engineering Department, University of Arkansas, Fayetteville, AR, United States
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7
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Paggi V, Fallegger F, Serex L, Rizzo O, Galan K, Giannotti A, Furfaro I, Zinno C, Bernini F, Micera S, Lacour SP. A soft, scalable and adaptable multi-contact cuff electrode for targeted peripheral nerve modulation. Bioelectron Med 2024; 10:6. [PMID: 38350988 PMCID: PMC10865708 DOI: 10.1186/s42234-023-00137-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Accepted: 12/10/2023] [Indexed: 02/15/2024] Open
Abstract
BACKGROUND Cuff electrodes target various nerves throughout the body, providing neuromodulation therapies for motor, sensory, or autonomic disorders. However, when using standard, thick silicone cuffs, fabricated in discrete circular sizes, complications may arise, namely cuff displacement or nerve compression, due to a poor adaptability to variable nerve shapes and sizes encountered in vivo. Improvements in cuff design, materials, closing mechanism and surgical approach are necessary to overcome these issues. METHODS In this work, we propose a microfabricated multi-channel silicone-based soft cuff electrode with a novel easy-to-implant and size-adaptable design and evaluate a number of essential features such as nerve-cuff contact, nerve compression, cuff locking stability, long-term integration and stimulation selectivity. We also compared performance to that of standard fixed-size cuffs. RESULTS The belt-like cuff made of 150 μm thick silicone membranes provides a stable and pressure-free conformal contact, independently of nerve size variability, combined with a straightforward implantation procedure. The adaptable design and use of soft materials lead to limited scarring and demyelination after 6-week implantation. In addition, multi-contact designs, ranging from 6 to 16 electrodes, allow for selective stimulation in models of rat and pig sciatic nerve, achieving targeted activation of up to 5 hindlimb muscles. CONCLUSION These results suggest a promising alternative to classic fixed-diameter cuffs and may facilitate the adoption of soft, adaptable cuffs in clinical settings.
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Affiliation(s)
- Valentina Paggi
- Laboratory for Soft Bioelectronic Interfaces, Neuro-X Institute, Ecole Polytechnique Fédérale de Lausanne (EPFL), Geneva, Switzerland
| | - Florian Fallegger
- Laboratory for Soft Bioelectronic Interfaces, Neuro-X Institute, Ecole Polytechnique Fédérale de Lausanne (EPFL), Geneva, Switzerland
| | | | - Olivier Rizzo
- Laboratory for Soft Bioelectronic Interfaces, Neuro-X Institute, Ecole Polytechnique Fédérale de Lausanne (EPFL), Geneva, Switzerland
- Bertarelli Foundation Chair in Translational NeuroEngineering, Neuro-X Institute, École Polytechnique Fédérale de Lausanne (EPFL), Geneva, Switzerland
| | - Katia Galan
- Laboratory for Soft Bioelectronic Interfaces, Neuro-X Institute, Ecole Polytechnique Fédérale de Lausanne (EPFL), Geneva, Switzerland
| | - Alice Giannotti
- The BioRobotics Institute and Department of Excellence in Robotics and AI, Scuola Superiore Sant'Anna, Pisa, Italy
| | - Ivan Furfaro
- Laboratory for Soft Bioelectronic Interfaces, Neuro-X Institute, Ecole Polytechnique Fédérale de Lausanne (EPFL), Geneva, Switzerland
| | - Ciro Zinno
- The BioRobotics Institute and Department of Excellence in Robotics and AI, Scuola Superiore Sant'Anna, Pisa, Italy
| | - Fabio Bernini
- The BioRobotics Institute and Department of Excellence in Robotics and AI, Scuola Superiore Sant'Anna, Pisa, Italy
| | - Silvestro Micera
- Bertarelli Foundation Chair in Translational NeuroEngineering, Neuro-X Institute, École Polytechnique Fédérale de Lausanne (EPFL), Geneva, Switzerland
- The BioRobotics Institute and Department of Excellence in Robotics and AI, Scuola Superiore Sant'Anna, Pisa, Italy
| | - Stéphanie P Lacour
- Laboratory for Soft Bioelectronic Interfaces, Neuro-X Institute, Ecole Polytechnique Fédérale de Lausanne (EPFL), Geneva, Switzerland.
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8
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Cabral AM, Lora-Millán JS, Pereira AA, Rocon E, Andrade ADO. On the Effect of Vibrotactile Stimulation in Essential Tremor. Healthcare (Basel) 2024; 12:448. [PMID: 38391822 PMCID: PMC10888095 DOI: 10.3390/healthcare12040448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2023] [Revised: 01/24/2024] [Accepted: 02/05/2024] [Indexed: 02/24/2024] Open
Abstract
(1) Background: Vibrotactile stimulation has been studied for tremor, but there is little evidence for Essential Tremor (ET). (2) Methods: This research employed a dataset from a previous study, with data collected from 18 individuals subjected to four vibratory stimuli. To characterise tremor changes before, during, and after stimuli, time and frequency domain features were estimated from the signals. Correlation and regression analyses verified the relationship between features and clinical tremor scores. (3) Results: Individuals responded differently to vibrotactile stimulation. The 250 Hz stimulus was the only one that reduced tremor amplitude after stimulation. Compared to the baseline, the 250 Hz and random frequency stimulation reduced tremor peak power. The clinical scores and amplitude-based features were highly correlated, yielding accurate regression models (mean squared error of 0.09). (4) Conclusions: The stimulation frequency of 250 Hz has the greatest potential to reduce tremors in ET. The accurate regression model and high correlation between estimated features and clinical scales suggest that prediction models can automatically evaluate and control stimulus-induced tremor. A limitation of this research is the relatively reduced sample size.
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Affiliation(s)
- Ariana Moura Cabral
- Centre for Innovation and Technology Assessment in Health, Postgraduate Program in Electrical and Biomedical Engineering, Faculty of Electrical Engineering, Federal University of Uberlândia, Uberlândia 38400-902, Brazil
| | | | - Adriano Alves Pereira
- Centre for Innovation and Technology Assessment in Health, Postgraduate Program in Electrical and Biomedical Engineering, Faculty of Electrical Engineering, Federal University of Uberlândia, Uberlândia 38400-902, Brazil
| | - Eduardo Rocon
- BioRobotics Group, Centre for Automation and Robotics (CAR), CSIC-UPM, 28500 Madrid, Spain
| | - Adriano de Oliveira Andrade
- Centre for Innovation and Technology Assessment in Health, Postgraduate Program in Electrical and Biomedical Engineering, Faculty of Electrical Engineering, Federal University of Uberlândia, Uberlândia 38400-902, Brazil
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9
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Quinn KN, Tian Y, Budde R, Irazoqui PP, Tuffaha S, Thakor NV. Neuromuscular implants: Interfacing with skeletal muscle for improved clinical translation of prosthetic limbs. Muscle Nerve 2024; 69:134-147. [PMID: 38126120 DOI: 10.1002/mus.28029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 11/27/2023] [Accepted: 12/10/2023] [Indexed: 12/23/2023]
Abstract
After an amputation, advanced prosthetic limbs can be used to interface with the nervous system and restore motor function. Despite numerous breakthroughs in the field, many of the recent research advancements have not been widely integrated into clinical practice. This review highlights recent innovations in neuromuscular implants-specifically those that interface with skeletal muscle-which could improve the clinical translation of prosthetic technologies. Skeletal muscle provides a physiologic gateway to harness and amplify signals from the nervous system. Recent surgical advancements in muscle reinnervation surgeries leverage the "bio-amplification" capabilities of muscle, enabling more intuitive control over a greater number of degrees of freedom in prosthetic limbs than previously achieved. We anticipate that state-of-the-art implantable neuromuscular interfaces that integrate well with skeletal muscle and novel surgical interventions will provide a long-term solution for controlling advanced prostheses. Flexible electrodes are expected to play a crucial role in reducing foreign body responses and improving the longevity of the interface. Additionally, innovations in device miniaturization and ongoing exploration of shape memory polymers could simplify surgical procedures for implanting such interfaces. Once implanted, wireless strategies for powering and transferring data from the interface can eliminate bulky external wires, reduce infection risk, and enhance day-to-day usability. By outlining the current limitations of neuromuscular interfaces along with potential future directions, this review aims to guide continued research efforts and future collaborations between engineers and specialists in the field of neuromuscular and musculoskeletal medicine.
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Affiliation(s)
- Kiara N Quinn
- Department of Biomedical Engineering, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Yucheng Tian
- Department of Biomedical Engineering, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Ryan Budde
- Department of Biomedical Engineering, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Pedro P Irazoqui
- Department of Electrical and Computer Engineering, Johns Hopkins University, Baltimore, Maryland, USA
| | - Sami Tuffaha
- Department of Plastic and Reconstructive Surgery, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Nitish V Thakor
- Department of Biomedical Engineering, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
- Department of Electrical and Computer Engineering, Johns Hopkins University, Baltimore, Maryland, USA
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10
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Taghlabi KM, Cruz-Garza JG, Hassan T, Potnis O, Bhenderu LS, Guerrero JR, Whitehead RE, Wu Y, Luan L, Xie C, Robinson JT, Faraji AH. Clinical outcomes of peripheral nerve interfaces for rehabilitation in paralysis and amputation: a literature review. J Neural Eng 2024; 21:011001. [PMID: 38237175 DOI: 10.1088/1741-2552/ad200f] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 01/18/2024] [Indexed: 02/02/2024]
Abstract
Peripheral nerve interfaces (PNIs) are electrical systems designed to integrate with peripheral nerves in patients, such as following central nervous system (CNS) injuries to augment or replace CNS control and restore function. We review the literature for clinical trials and studies containing clinical outcome measures to explore the utility of human applications of PNIs. We discuss the various types of electrodes currently used for PNI systems and their functionalities and limitations. We discuss important design characteristics of PNI systems, including biocompatibility, resolution and specificity, efficacy, and longevity, to highlight their importance in the current and future development of PNIs. The clinical outcomes of PNI systems are also discussed. Finally, we review relevant PNI clinical trials that were conducted, up to the present date, to restore the sensory and motor function of upper or lower limbs in amputees, spinal cord injury patients, or intact individuals and describe their significant findings. This review highlights the current progress in the field of PNIs and serves as a foundation for future development and application of PNI systems.
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Affiliation(s)
- Khaled M Taghlabi
- Department of Neurological Surgery, Houston Methodist Hospital, Houston, TX 77030, United States of America
- Center for Neural Systems Restoration, Houston Methodist Research Institute, Houston, TX 77030, United States of America
- Clinical Innovations Laboratory, Houston Methodist Research Institute, Houston, TX 77030, United States of America
| | - Jesus G Cruz-Garza
- Department of Neurological Surgery, Houston Methodist Hospital, Houston, TX 77030, United States of America
- Center for Neural Systems Restoration, Houston Methodist Research Institute, Houston, TX 77030, United States of America
- Clinical Innovations Laboratory, Houston Methodist Research Institute, Houston, TX 77030, United States of America
| | - Taimur Hassan
- Department of Neurological Surgery, Houston Methodist Hospital, Houston, TX 77030, United States of America
- Center for Neural Systems Restoration, Houston Methodist Research Institute, Houston, TX 77030, United States of America
- Clinical Innovations Laboratory, Houston Methodist Research Institute, Houston, TX 77030, United States of America
- School of Medicine, Texas A&M University, Bryan, TX 77807, United States of America
| | - Ojas Potnis
- Department of Neurological Surgery, Houston Methodist Hospital, Houston, TX 77030, United States of America
- Center for Neural Systems Restoration, Houston Methodist Research Institute, Houston, TX 77030, United States of America
- Clinical Innovations Laboratory, Houston Methodist Research Institute, Houston, TX 77030, United States of America
- School of Engineering Medicine, Texas A&M University, Houston, TX 77030, United States of America
| | - Lokeshwar S Bhenderu
- Department of Neurological Surgery, Houston Methodist Hospital, Houston, TX 77030, United States of America
- Center for Neural Systems Restoration, Houston Methodist Research Institute, Houston, TX 77030, United States of America
- Clinical Innovations Laboratory, Houston Methodist Research Institute, Houston, TX 77030, United States of America
- School of Medicine, Texas A&M University, Bryan, TX 77807, United States of America
| | - Jaime R Guerrero
- Department of Neurological Surgery, Houston Methodist Hospital, Houston, TX 77030, United States of America
- Center for Neural Systems Restoration, Houston Methodist Research Institute, Houston, TX 77030, United States of America
- Clinical Innovations Laboratory, Houston Methodist Research Institute, Houston, TX 77030, United States of America
| | - Rachael E Whitehead
- Department of Academic Affairs, Houston Methodist Academic Institute, Houston, TX 77030, United States of America
| | - Yu Wu
- Rice Neuroengineering Initiative, Rice University, Houston, TX 77005, United States of America
- Department of Electrical and Computer Engineering, Rice University, Houston, TX 77005, United States of America
| | - Lan Luan
- Rice Neuroengineering Initiative, Rice University, Houston, TX 77005, United States of America
- Department of Electrical and Computer Engineering, Rice University, Houston, TX 77005, United States of America
| | - Chong Xie
- Rice Neuroengineering Initiative, Rice University, Houston, TX 77005, United States of America
- Department of Electrical and Computer Engineering, Rice University, Houston, TX 77005, United States of America
| | - Jacob T Robinson
- Rice Neuroengineering Initiative, Rice University, Houston, TX 77005, United States of America
- Department of Electrical and Computer Engineering, Rice University, Houston, TX 77005, United States of America
| | - Amir H Faraji
- Department of Neurological Surgery, Houston Methodist Hospital, Houston, TX 77030, United States of America
- Center for Neural Systems Restoration, Houston Methodist Research Institute, Houston, TX 77030, United States of America
- Clinical Innovations Laboratory, Houston Methodist Research Institute, Houston, TX 77030, United States of America
- Rice Neuroengineering Initiative, Rice University, Houston, TX 77005, United States of America
- Department of Electrical and Computer Engineering, Rice University, Houston, TX 77005, United States of America
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11
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Wu SJ, Zhao X. Bioadhesive Technology Platforms. Chem Rev 2023; 123:14084-14118. [PMID: 37972301 DOI: 10.1021/acs.chemrev.3c00380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2023]
Abstract
Bioadhesives have emerged as transformative and versatile tools in healthcare, offering the ability to attach tissues with ease and minimal damage. These materials present numerous opportunities for tissue repair and biomedical device integration, creating a broad landscape of applications that have captivated clinical and scientific interest alike. However, fully unlocking their potential requires multifaceted design strategies involving optimal adhesion, suitable biological interactions, and efficient signal communication. In this Review, we delve into these pivotal aspects of bioadhesive design, highlight the latest advances in their biomedical applications, and identify potential opportunities that lie ahead for bioadhesives as multifunctional technology platforms.
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Affiliation(s)
- Sarah J Wu
- Department of Mechanical Engineering, Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, United States
| | - Xuanhe Zhao
- Department of Mechanical Engineering, Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, United States
- Department of Civil and Environmental Engineering, Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, United States
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12
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Payne SC, Osborne PB, Thompson A, Eiber CD, Keast JR, Fallon JB. Selective recording of physiologically evoked neural activity in a mixed autonomic nerve using a minimally invasive array. APL Bioeng 2023; 7:046110. [PMID: 37928642 PMCID: PMC10625482 DOI: 10.1063/5.0164951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Accepted: 10/16/2023] [Indexed: 11/07/2023] Open
Abstract
Real-time closed-loop control of neuromodulation devices requires long-term monitoring of neural activity in the peripheral nervous system. Although many signal extraction methods exist, few are both clinically viable and designed for extracting small signals from fragile peripheral visceral nerves. Here, we report that our minimally invasive recording and analysis technology extracts low to negative signal to noise ratio (SNR) neural activity from a visceral nerve with a high degree of specificity for fiber type and class. Complex activity was recorded from the rat pelvic nerve that was physiologically evoked during controlled bladder filling and voiding, in an extensively characterized in vivo model that provided an excellent test bed to validate our technology. Urethane-anesthetized male rats (n = 12) were implanted with a four-electrode planar array and the bladder instrumented for continuous-flow cystometry, which measures urodynamic function by recording bladder pressure changes during constant infusion of saline. We demonstrated that differential bipolar recordings and cross-correlation analyses extracts afferent and efferent activity, and discriminated between subpopulations of fibers based on conduction velocity. Integrated Aδ afferent fiber activity correlated with bladder pressure during voiding (r2: 0.66 ± 0.06) and was not affected by activating nociceptive afferents with intravesical capsaicin (r2: 0.59 ± 0.14, P = 0.54, and n = 3). Collectively, these results demonstrate our minimally invasive recording and analysis technology is selective in extracting mixed neural activity with low/negative SNR. Furthermore, integrated afferent activity reliably correlates with bladder pressure and is a promising first step in developing closed-loop technology for bladder control.
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Affiliation(s)
| | - Peregrine B. Osborne
- Department of Anatomy and Physiology, University of Melbourne, Victoria 3010, Australia
| | | | - Calvin D. Eiber
- Department of Anatomy and Physiology, University of Melbourne, Victoria 3010, Australia
| | - Janet R. Keast
- Department of Anatomy and Physiology, University of Melbourne, Victoria 3010, Australia
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13
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Abstract
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.
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Affiliation(s)
- Changxu Sun
- Pritzker School of Molecular Engineering, University of Chicago, Chicago, IL 60637, USA
| | - Zhe Cheng
- Department of Chemistry, University of Chicago, Chicago, IL 60637, USA
| | - Jj Abu-Halimah
- Department of Chemistry, University of Chicago, Chicago, IL 60637, USA
| | - Bozhi Tian
- Department of Chemistry, University of Chicago, Chicago, IL 60637, USA
- The James Franck Institute, University of Chicago, Chicago, IL 60637, USA
- The Institute for Biophysical Dynamics, University of Chicago, Chicago, IL 60637, USA
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14
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Farina D, Vujaklija I, Brånemark R, Bull AMJ, Dietl H, Graimann B, Hargrove LJ, Hoffmann KP, Huang HH, Ingvarsson T, Janusson HB, Kristjánsson K, Kuiken T, Micera S, Stieglitz T, Sturma A, Tyler D, Weir RFF, Aszmann OC. Toward higher-performance bionic limbs for wider clinical use. Nat Biomed Eng 2023; 7:473-485. [PMID: 34059810 DOI: 10.1038/s41551-021-00732-x] [Citation(s) in RCA: 87] [Impact Index Per Article: 87.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Accepted: 04/01/2021] [Indexed: 12/19/2022]
Abstract
Most prosthetic limbs can autonomously move with dexterity, yet they are not perceived by the user as belonging to their own body. Robotic limbs can convey information about the environment with higher precision than biological limbs, but their actual performance is substantially limited by current technologies for the interfacing of the robotic devices with the body and for transferring motor and sensory information bidirectionally between the prosthesis and the user. In this Perspective, we argue that direct skeletal attachment of bionic devices via osseointegration, the amplification of neural signals by targeted muscle innervation, improved prosthesis control via implanted muscle sensors and advanced algorithms, and the provision of sensory feedback by means of electrodes implanted in peripheral nerves, should all be leveraged towards the creation of a new generation of high-performance bionic limbs. These technologies have been clinically tested in humans, and alongside mechanical redesigns and adequate rehabilitation training should facilitate the wider clinical use of bionic limbs.
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Affiliation(s)
- Dario Farina
- Department of Bioengineering, Imperial College London, London, UK.
| | - Ivan Vujaklija
- Department of Electrical Engineering and Automation, Aalto University, Espoo, Finland
| | - Rickard Brånemark
- Center for Extreme Bionics, Biomechatronics Group, MIT Media Lab, Massachusetts Institute of Technology, Cambridge, MA, USA
- Department of Orthopaedics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Anthony M J Bull
- Department of Bioengineering, Imperial College London, London, UK
| | - Hans Dietl
- Ottobock Products SE & Co. KGaA, Vienna, Austria
| | | | - Levi J Hargrove
- Center for Bionic Medicine, Shirley Ryan AbilityLab, Chicago, IL, USA
- Department of Physical Medicine & Rehabilitation, Northwestern University, Chicago, IL, USA
- Department of Biomedical Engineering, Northwestern University, Chicago, IL, USA
| | - Klaus-Peter Hoffmann
- Department of Medical Engineering & Neuroprosthetics, Fraunhofer-Institut für Biomedizinische Technik, Sulzbach, Germany
| | - He Helen Huang
- NCSU/UNC Joint Department of Biomedical Engineering, North Carolina State University, Raleigh, NC, USA
- University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Thorvaldur Ingvarsson
- Department of Research and Development, Össur Iceland, Reykjavík, Iceland
- Faculty of Medicine, University of Iceland, Reykjavík, Iceland
| | - Hilmar Bragi Janusson
- School of Engineering and Natural Sciences, University of Iceland, Reykjavík, Iceland
| | | | - Todd Kuiken
- Center for Bionic Medicine, Shirley Ryan AbilityLab, Chicago, IL, USA
- Department of Physical Medicine & Rehabilitation, Northwestern University, Chicago, IL, USA
- Department of Biomedical Engineering, Northwestern University, Chicago, IL, USA
| | - Silvestro Micera
- The Biorobotics Institute and Department of Excellence in Robotics and AI, Scuola Superiore Sant'Anna, Pontedera, Italy
- Department of Excellence in Robotics and AI, Scuola Superiore Sant'Anna, Pontedera, Italy
- Bertarelli Foundation Chair in Translational NeuroEngineering, Center for Neuroprosthetics and Institute of Bioengineering, School of Engineering, Ecole Polytechnique Federale de Lausanne, Lausanne, Switzerland
| | - Thomas Stieglitz
- Laboratory for Biomedical Microtechnology, Department of Microsystems Engineering-IMTEK, BrainLinks-BrainTools Center and Bernstein Center Freiburg, University of Freiburg, Freiburg, Germany
| | - Agnes Sturma
- Department of Bioengineering, Imperial College London, London, UK
- Clinical Laboratory for Bionic Extremity Reconstruction, Department of Plastic and Reconstructive Surgery, Medical University of Vienna, Vienna, Austria
| | - Dustin Tyler
- Case School of Engineering, Case Western Reserve University, Cleveland, OH, USA
- Louis Stokes Veterans Affairs Medical Centre, Cleveland, OH, USA
| | - Richard F Ff Weir
- Biomechatronics Development Laboratory, Bioengineering Department, University of Colorado Denver and VA Eastern Colorado Healthcare System, Aurora, CO, USA
| | - Oskar C Aszmann
- Clinical Laboratory for Bionic Extremity Reconstruction, Department of Plastic and Reconstructive Surgery, Medical University of Vienna, Vienna, Austria
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15
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Hiendlmeier L, Zurita F, Vogel J, Del Duca F, Al Boustani G, Peng H, Kopic I, Nikić M, F Teshima T, Wolfrum B. 4D-Printed Soft and Stretchable Self-Folding Cuff Electrodes for Small-Nerve Interfacing. ADVANCED MATERIALS (DEERFIELD BEACH, FLA.) 2023; 35:e2210206. [PMID: 36594106 DOI: 10.1002/adma.202210206] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Revised: 12/19/2022] [Indexed: 06/17/2023]
Abstract
Peripheral nerve interfacing (PNI) has a high clinical potential for treating various diseases, such as obesity or diabetes. However, currently existing electrodes present challenges to the interfacing procedure, which limit their clinical application, in particular, when targeting small peripheral nerves (<200 µm). To improve the electrode handling and implantation, a nerve interface that can fold itself to a cuff around a small nerve, triggered by the body moisture during insertion, is fabricated. This folding is achieved by printing a bilayer of a flexible polyurethane printing resin and a highly swelling sodium acrylate hydrogel using photopolymerization. When immersed in an aqueous liquid, the hydrogel swells and folds the electrode softly around the nerve. Furthermore, the electrodes are robust, can be stretched (>20%), and bent to facilitate the implantation due to the use of soft and stretchable printing resins as substrates and a microcracked gold film as conductive layer. The straightforward implantation and extraction of the electrode as well as stimulation and recording capabilities on a small peripheral nerve in vivo are demonstrated. It is believed that such simple and robust to use self-folding electrodes will pave the way for bringing PNI to a broader clinical application.
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Affiliation(s)
- Lukas Hiendlmeier
- Neuroelectronics, Munich Institute of Biomedical Engineering, School of Computation, Informatics and Technology, Technical University of Munich, Hans-Piloty-Str. 1, 85748, Garching, Germany
- Medical & Health Informatics Laboratories, NTT Research Incorporated, 940 Stewart Dr, Sunnyvale, CA, 94085, USA
| | - Francisco Zurita
- Neuroelectronics, Munich Institute of Biomedical Engineering, School of Computation, Informatics and Technology, Technical University of Munich, Hans-Piloty-Str. 1, 85748, Garching, Germany
- Medical & Health Informatics Laboratories, NTT Research Incorporated, 940 Stewart Dr, Sunnyvale, CA, 94085, USA
| | - Jonas Vogel
- Neuroelectronics, Munich Institute of Biomedical Engineering, School of Computation, Informatics and Technology, Technical University of Munich, Hans-Piloty-Str. 1, 85748, Garching, Germany
| | - Fulvia Del Duca
- Neuroelectronics, Munich Institute of Biomedical Engineering, School of Computation, Informatics and Technology, Technical University of Munich, Hans-Piloty-Str. 1, 85748, Garching, Germany
- Medical & Health Informatics Laboratories, NTT Research Incorporated, 940 Stewart Dr, Sunnyvale, CA, 94085, USA
| | - George Al Boustani
- Neuroelectronics, Munich Institute of Biomedical Engineering, School of Computation, Informatics and Technology, Technical University of Munich, Hans-Piloty-Str. 1, 85748, Garching, Germany
- Medical & Health Informatics Laboratories, NTT Research Incorporated, 940 Stewart Dr, Sunnyvale, CA, 94085, USA
| | - Hu Peng
- Neuroelectronics, Munich Institute of Biomedical Engineering, School of Computation, Informatics and Technology, Technical University of Munich, Hans-Piloty-Str. 1, 85748, Garching, Germany
| | - Inola Kopic
- Neuroelectronics, Munich Institute of Biomedical Engineering, School of Computation, Informatics and Technology, Technical University of Munich, Hans-Piloty-Str. 1, 85748, Garching, Germany
| | - Marta Nikić
- Neuroelectronics, Munich Institute of Biomedical Engineering, School of Computation, Informatics and Technology, Technical University of Munich, Hans-Piloty-Str. 1, 85748, Garching, Germany
| | - Tetsuhiko F Teshima
- Neuroelectronics, Munich Institute of Biomedical Engineering, School of Computation, Informatics and Technology, Technical University of Munich, Hans-Piloty-Str. 1, 85748, Garching, Germany
- Medical & Health Informatics Laboratories, NTT Research Incorporated, 940 Stewart Dr, Sunnyvale, CA, 94085, USA
| | - Bernhard Wolfrum
- Neuroelectronics, Munich Institute of Biomedical Engineering, School of Computation, Informatics and Technology, Technical University of Munich, Hans-Piloty-Str. 1, 85748, Garching, Germany
- Medical & Health Informatics Laboratories, NTT Research Incorporated, 940 Stewart Dr, Sunnyvale, CA, 94085, USA
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16
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Borda E, Medagoda DI, Airaghi Leccardi MJI, Zollinger EG, Ghezzi D. Conformable neural interface based on off-stoichiometry thiol-ene-epoxy thermosets. Biomaterials 2023; 293:121979. [PMID: 36586146 DOI: 10.1016/j.biomaterials.2022.121979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Revised: 11/29/2022] [Accepted: 12/21/2022] [Indexed: 12/28/2022]
Abstract
Off-stoichiometry thiol-ene-epoxy (OSTE+) thermosets show low permeability to gases and little absorption of dissolved molecules, allow direct low-temperature dry bonding without surface treatments, have a low Young's modulus, and can be manufactured via UV polymerisation. For these reasons, OSTE+ thermosets have recently gained attention for the rapid prototyping of microfluidic chips. Moreover, their compatibility with standard clean-room processes and outstanding mechanical properties make OSTE+ an excellent candidate as a novel material for neural implants. Here we exploit OSTE+ to manufacture a conformable multilayer micro-electrocorticography array with 16 platinum electrodes coated with platinum black. The mechanical properties allow conformability to curved surfaces such as the brain. The low permeability and strong adhesion between layers improve the stability of the device. Acute experiments in mice show the multimodal capacity of the array to record and stimulate the neural tissue by smoothly conforming to the mouse cortex. Devices are not cytotoxic, and immunohistochemistry stainings reveal only modest foreign body reaction after two and six weeks of chronic implantation. This work introduces OSTE+ as a promising material for implantable neural interfaces.
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Affiliation(s)
- Eleonora Borda
- Medtronic Chair in Neuroengineering, Center for Neuroprosthetics and Institute of Bioengineering, School of Engineering, École Polytechnique Fédérale de Lausanne, Switzerland
| | - Danashi Imani Medagoda
- Medtronic Chair in Neuroengineering, Center for Neuroprosthetics and Institute of Bioengineering, School of Engineering, École Polytechnique Fédérale de Lausanne, Switzerland
| | - Marta Jole Ildelfonsa Airaghi Leccardi
- Medtronic Chair in Neuroengineering, Center for Neuroprosthetics and Institute of Bioengineering, School of Engineering, École Polytechnique Fédérale de Lausanne, Switzerland
| | - Elodie Geneviève Zollinger
- Medtronic Chair in Neuroengineering, Center for Neuroprosthetics and Institute of Bioengineering, School of Engineering, École Polytechnique Fédérale de Lausanne, Switzerland
| | - Diego Ghezzi
- Medtronic Chair in Neuroengineering, Center for Neuroprosthetics and Institute of Bioengineering, School of Engineering, École Polytechnique Fédérale de Lausanne, Switzerland.
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17
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Yang M, Chen P, Qu X, Zhang F, Ning S, Ma L, Yang K, Su Y, Zang J, Jiang W, Yu T, Dong X, Luo Z. Robust Neural Interfaces with Photopatternable, Bioadhesive, and Highly Conductive Hydrogels for Stable Chronic Neuromodulation. ACS NANO 2023; 17:885-895. [PMID: 36629747 DOI: 10.1021/acsnano.2c04606] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
A robust neural interface with intimate electrical coupling between neural electrodes and neural tissues is critical for stable chronic neuromodulation. The development of bioadhesive hydrogel neural electrodes is a potential approach for tightly fixing the neural electrodes on the epineurium surface to construct a robust neural interface. Herein, we construct a photopatternable, antifouling, conductive (∼6 S cm-1), bioadhesive (interfacial toughness ∼100 J m-2), soft, and elastic (∼290% strain, Young's modulus of 7.25 kPa) hydrogel to establish a robust neural interface for bioelectronics. The UV-sensitive zwitterionic monomer can facilitate the formation of an electrostatic-assembled conductive polymer PEDOT:PSS network, and it can be further photo-cross-linked into elastic polymer network. Such a semi-interpenetrating network endows the hydrogel electrodes with good conductivity. Especially, the photopatternable feature enables the facile microfabrication processes of multifunctional hydrogel (MH) interface with a characteristic size of 50 μm. The MH neural electrodes, which show improved performance of impedance, charge storage capacity, and charge injection capability, can produce effective electrical stimulation with high current density (1 mA cm-2) at ultralow voltages (±25 mV). The MH interface could realize high-efficient electrical communication at the chronic neural interface for stable recording and stimulation of a sciatic nerve in the rat model.
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Affiliation(s)
- Ming Yang
- National Engineering Research Center for Nanomedicine, College of Life Science and Technology, Huazhong University of Science and Technology, Wuhan430074, China
| | - Ping Chen
- National Engineering Research Center for Nanomedicine, College of Life Science and Technology, Huazhong University of Science and Technology, Wuhan430074, China
| | - Xinyu Qu
- Key Laboratory of Flexible Electronics (KLOFE) and Institute of Advanced Materials (IAM), Nanjing Tech University (NanjingTech), Nanjing211816, China
| | - Fuchi Zhang
- Department of Neurosurgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan430030, China
| | - Shan Ning
- School of Optical and Electronic Information and Wuhan National Laboratory for Optoelectronics, Huazhong University of Science and Technology, Wuhan430074, China
| | - Li Ma
- School of Physics and Technology, Wuhan University, Wuhan430072, China
| | - Kun Yang
- National Engineering Research Center for Nanomedicine, College of Life Science and Technology, Huazhong University of Science and Technology, Wuhan430074, China
| | - Yuming Su
- National Engineering Research Center for Nanomedicine, College of Life Science and Technology, Huazhong University of Science and Technology, Wuhan430074, China
| | - Jianfeng Zang
- School of Optical and Electronic Information and Wuhan National Laboratory for Optoelectronics, Huazhong University of Science and Technology, Wuhan430074, China
| | - Wei Jiang
- Department of Neurosurgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan430030, China
| | - Ting Yu
- School of Physics and Technology, Wuhan University, Wuhan430072, China
| | - Xiaochen Dong
- Key Laboratory of Flexible Electronics (KLOFE) and Institute of Advanced Materials (IAM), Nanjing Tech University (NanjingTech), Nanjing211816, China
- School of Chemistry and Materials Science, Jiangsu Normal University, Xuzhou221116, China
| | - Zhiqiang Luo
- National Engineering Research Center for Nanomedicine, College of Life Science and Technology, Huazhong University of Science and Technology, Wuhan430074, China
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18
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Silveira C, Khushaba RN, Brunton E, Nazarpour K. Spatio-temporal feature extraction in sensory electroneurographic signals. PHILOSOPHICAL TRANSACTIONS. SERIES A, MATHEMATICAL, PHYSICAL, AND ENGINEERING SCIENCES 2022; 380:20210268. [PMID: 35658682 PMCID: PMC9289791 DOI: 10.1098/rsta.2021.0268] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/24/2021] [Accepted: 11/08/2021] [Indexed: 06/15/2023]
Abstract
The recording and analysis of peripheral neural signal can provide insight for various prosthetic and bioelectronics medicine applications. However, there are few studies that investigate how informative features can be extracted from population activity electroneurographic (ENG) signals. In this study, five feature extraction frameworks were implemented on sensory ENG datasets and their classification performance was compared. The datasets were collected in acute rat experiments where multi-channel nerve cuffs recorded from the sciatic nerve in response to proprioceptive stimulation of the hindlimb. A novel feature extraction framework, which incorporates spatio-temporal focus and dynamic time warping, achieved classification accuracies above 90% while keeping a low computational cost. This framework outperformed the remaining frameworks tested in this study and has improved the discrimination accuracy of the sensory signals. Thus, this study has extended the tools available to extract features from sensory population activity ENG signals. This article is part of the theme issue 'Advanced neurotechnologies: translating innovation for health and well-being'.
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Affiliation(s)
- C. Silveira
- School of Engineering, Newcastle University, Newcastle upon Tyne NE1 7RU, UK
| | - R. N. Khushaba
- Australian Center for Field Robotics, The University of Sydney, New South Wales 2006, Australia
| | - E. Brunton
- National Vision Research Institute, Australian College of Optometry, Carlton, Victoria 3053, Australia
- Department of Optometry and Vision Sciences, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, Victoria 3010, Australia
| | - K. Nazarpour
- Edinburgh Neuroprosthetics Laboratory, School of Informatics, University of Edinburgh, Edinburgh EH8 9AB, UK
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19
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Akouissi O, Lacour SP, Micera S, DeSimone A. A finite element model of the mechanical interactions between peripheral nerves and intrafascicular implants. J Neural Eng 2022; 19. [PMID: 35861557 DOI: 10.1088/1741-2552/ac7d0e] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Accepted: 06/29/2022] [Indexed: 11/11/2022]
Abstract
Objective.Intrafascicular peripheral nerve implants are key components in the development of bidirectional neuroprostheses such as touch-enabled bionic limbs for amputees. However, the durability of such interfaces is hindered by the immune response following the implantation. Among the causes linked to such reaction, the mechanical mismatch between host nerve and implant is thought to play a decisive role, especially in chronic settings.Approach.Here we focus on modeling mechanical stresses induced on the peripheral nerve by the implant's micromotion using finite element analysis. Through multiple parametric sweeps, we analyze the role of the implant's material, geometry (aspect-ratio and shape), and surface coating, deriving a set of parameters for the design of better-integrated implants.Main results.Our results indicate that peripheral nerve implants should be designed and manufactured with smooth edges, using materials at most three orders of magnitude stiffer than the nerve, and with innovative geometries to redistribute micromotion-associated loads to less delicate parts of the nerve such as the epineurium.Significance.Overall, our model is a useful tool for the peripheral nerve implant designer that is mindful of the importance of implant mechanics for long term applications.
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Affiliation(s)
- Outman Akouissi
- Bertarelli Foundation Chair in Neuroprosthetic Technology, Laboratory for Soft Bioelectronic Interfaces, Neuro-X Institute, Ecole Polytechnique Fédérale de Lausanne (EPFL), Geneva, 1202, Switzerland.,Bertarelli Foundation Chair in Translational Neuroengineering, Translational Neural Engineering Laboratory, Neuro-X Institute, Ecole Polytechnique Fédérale de Lausanne (EPFL), Geneva, 1202, Switzerland
| | - Stéphanie P Lacour
- Bertarelli Foundation Chair in Neuroprosthetic Technology, Laboratory for Soft Bioelectronic Interfaces, Neuro-X Institute, Ecole Polytechnique Fédérale de Lausanne (EPFL), Geneva, 1202, Switzerland
| | - Silvestro Micera
- Bertarelli Foundation Chair in Translational Neuroengineering, Translational Neural Engineering Laboratory, Neuro-X Institute, Ecole Polytechnique Fédérale de Lausanne (EPFL), Geneva, 1202, Switzerland.,The Biorobotics Institute and Department of Excellence in Robotics & AI, Health Science Interdisciplinary Center, Scuola Superiore Sant'Anna, Pisa, Italy
| | - Antonio DeSimone
- The Biorobotics Institute and Department of Excellence in Robotics & AI, Health Science Interdisciplinary Center, Scuola Superiore Sant'Anna, Pisa, Italy.,SISSA-International School for Advanced Studies, 34136 Trieste, Italy
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20
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Gregory E, Baek IH, Ala-Kokko N, Dugan R, Pinzon-Herrera L, Almodóvar J, Song YH. Peripheral Nerve Decellularization for In Vitro Extracellular Matrix Hydrogel Use: A Comparative Study. ACS Biomater Sci Eng 2022; 8:2574-2588. [PMID: 35649243 PMCID: PMC9983633 DOI: 10.1021/acsbiomaterials.2c00034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
The rise of tissue-engineered biomaterials has introduced more clinically translatable models of disease, including three-dimensional (3D) decellularized extracellular matrix (dECM) hydrogels. Specifically, decellularized nerve hydrogels have been utilized to model peripheral nerve injuries and disorders in vitro; however, there lacks standardization in decellularization methods. Here, rat sciatic nerves of varying preparations were decellularized using previously established methods: sodium deoxycholate (SD)-based, 3-((3-cholamidopropyl)dimethylammonio)-1-propanesulfonate (CHAPS)-based, and apoptosis-mediated. These nerves were characterized for cellular debris removal, ECM retention, and low cytotoxicity with cultured Schwann cells. The best preparations of each decellularization method were digested into dECM hydrogels, and rheological characterization, gelation kinetics, and confocal reflectance imaging of collagen fibril assembly were performed. It was determined that the SD-based method with nerve epineurial removal best maintained the overall ECM composition and mechanical properties of physiological peripheral nerves while efficiently stripping the scaffolds of tissue-specific cells and debris. This method was then utilized as a culture platform for quiescent Schwann cells and cancer-nerve crosstalk. Hydrogel-embedded Schwann cells were found to have high viability and act in a more physiologically relevant manner than those cultured in monolayers, and the hydrogel platform allowed for the activation of Schwann cells following treatment with cancer secreted factors. These findings establish a standard for peripheral nerve decellularization for usage as a dECM hydrogel testbed for in vitro peripheral nerve disease modeling and may facilitate the development of treatments for peripheral nerve disease and injury.
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Affiliation(s)
- Emory Gregory
- Department of Biomedical Engineering, University of Arkansas, Fayetteville, Arkansas 72701, United States
| | - In Ha Baek
- Department of Biomedical Engineering, University of Arkansas, Fayetteville, Arkansas 72701, United States
| | - Nikolas Ala-Kokko
- Department of Biomedical Engineering, University of Arkansas, Fayetteville, Arkansas 72701, United States
| | - Reagan Dugan
- Department of Biomedical Engineering, University of Arkansas, Fayetteville, Arkansas 72701, United States
| | - Luis Pinzon-Herrera
- Ralph E. Martin Department of Chemical Engineering, University of Arkansas, Fayetteville, Arkansas 72701, United States
| | - Jorge Almodóvar
- Ralph E. Martin Department of Chemical Engineering, University of Arkansas, Fayetteville, Arkansas 72701, United States
| | - Young Hye Song
- Department of Biomedical Engineering, University of Arkansas, Fayetteville, Arkansas 72701, United States
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21
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Sevcencu C. Single-interface bioelectronic medicines - concept, clinical applications and preclinical data. J Neural Eng 2022; 19. [PMID: 35533654 DOI: 10.1088/1741-2552/ac6e08] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Accepted: 05/08/2022] [Indexed: 11/12/2022]
Abstract
Presently, large groups of patients with various diseases are either intolerant, or irresponsive to drug therapies and also intractable by surgery. For several diseases, one option which is available for such patients is the implantable neurostimulation therapy. However, lacking closed-loop control and selective stimulation capabilities, the present neurostimulation therapies are not optimal and are therefore used as only "third" therapeutic options when a disease cannot be treated by drugs or surgery. Addressing those limitations, a next generation class of closed-loop controlled and selective neurostimulators generically named bioelectronic medicines seems within reach. A sub-class of such devices is meant to monitor and treat impaired functions by intercepting, analyzing and modulating neural signals involved in the regulation of such functions using just one neural interface for those purposes. The primary objective of this review is to provide a first broad perspective on this type of single-interface devices for bioelectronic therapies. For this purpose, the concept, clinical applications and preclinical studies for further developments with such devices are here analyzed in a narrative manner.
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Affiliation(s)
- Cristian Sevcencu
- National Institute for Research and Development of Isotopic and Molecular Technologies, 67-103 Donat Street, Cluj-Napoca, 400293, ROMANIA
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22
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Borda E, Gaillet V, Airaghi Leccardi MJI, Zollinger EG, Moreira RC, Ghezzi D. Three-dimensional multilayer concentric bipolar electrodes restrict spatial activation in optic nerve stimulation. J Neural Eng 2022; 19. [PMID: 35523152 DOI: 10.1088/1741-2552/ac6d7e] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2021] [Accepted: 05/06/2022] [Indexed: 11/12/2022]
Abstract
OBJECTIVE Intraneural nerve interfaces often operate in a monopolar configuration with a common and distant ground electrode. This configuration leads to a wide spreading of the electric field. Therefore, this approach is suboptimal for intraneural nerve interfaces when selective stimulation is required. APPROACH We designed a multilayer electrode array embedding three-dimensional concentric bipolar electrodes. First, we validated the higher stimulation selectivity of this new electrode array compared to classical monopolar stimulation using simulations. Next, we compared them in-vivo by intraneural stimulation of the rabbit optic nerve and recording evoked potentials in the primary visual cortex. MAIN RESULTS Simulations showed that three-dimensional concentric bipolar electrodes provide a high localisation of the electric field in the tissue so that electrodes are electrically independent even for high electrode density. Experiments in-vivo highlighted that this configuration restricts spatial activation in the visual cortex due to the fewer fibres activated by the electric stimulus in the nerve. SIGNIFICANCE Highly focused electric stimulation is crucial to achieving high selectivity in fibre activation. The multilayer array embedding three-dimensional concentric bipolar electrodes improves selectivity in optic nerve stimulation. This approach is suitable for other neural applications, including bioelectronic medicine.
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Affiliation(s)
- Eleonora Borda
- Medtronic Chair in Neuroengineering, Ecole Polytechnique Federale de Lausanne, EPFL STI IBI LNE, Geneva, 1012, SWITZERLAND
| | - Vivien Gaillet
- Medtronic Chair in Neuroengineering, Ecole Polytechnique Federale de Lausanne, EPFL STI IBI LNE, Geneva, 1012, SWITZERLAND
| | | | - Elodie Geneviève Zollinger
- Medtronic Chair in Neuroengineering, Ecole Polytechnique Federale de Lausanne, EPFL STI IBI LNE, Geneva, 1012, SWITZERLAND
| | | | - Diego Ghezzi
- École Polytechnique Fédérale de Lausanne, Chemin des Mines 9, Geneva, 1202, SWITZERLAND
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23
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Koppaka S, Hess-Dunning A, Tyler DJ. Biomechanical characterization of isolated epineurial and perineurial membranes of rabbit sciatic nerve. J Biomech 2022; 136:111058. [DOI: 10.1016/j.jbiomech.2022.111058] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Revised: 01/31/2022] [Accepted: 03/21/2022] [Indexed: 01/31/2023]
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24
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Sanchez Rezza A, Kulahci Y, Gorantla VS, Zor F, Drzeniek NM. Implantable Biomaterials for Peripheral Nerve Regeneration–Technology Trends and Translational Tribulations. Front Bioeng Biotechnol 2022; 10:863969. [PMID: 35573254 PMCID: PMC9092979 DOI: 10.3389/fbioe.2022.863969] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Accepted: 04/05/2022] [Indexed: 02/01/2023] Open
Abstract
The use of autografted nerve in surgical repair of peripheral nerve injuries (PNI) is severely limited due to donor site morbidity and restricted tissue availability. As an alternative, synthetic nerve guidance channels (NGCs) are available on the market for surgical nerve repair, but they fail to promote nerve regeneration across larger critical gap nerve injuries. Therefore, such injuries remain unaddressed, result in poor healing outcomes and are a limiting factor in limb reconstruction and transplantation. On the other hand, a myriad of advanced biomaterial strategies to address critical nerve injuries are proposed in preclinical literature but only few of those have found their way into clinical practice. The design of synthetic nerve grafts should follow rational criteria and make use of a combination of bioinstructive cues to actively promote nerve regeneration. To identify the most promising NGC designs for translation into applicable products, thorough mode of action studies, standardized readouts and validation in large animals are needed. We identify design criteria for NGC fabrication according to the current state of research, give a broad overview of bioactive and functionalized biomaterials and highlight emerging composite implant strategies using therapeutic cells, soluble factors, structural features and intrinsically conductive substrates. Finally, we discuss translational progress in bioartificial conduits for nerve repair from the surgeon’s perspective and give an outlook toward future challenges in the field.
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Affiliation(s)
- Angela Sanchez Rezza
- Charité— Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt–Universität zu Berlin, Institute of Medical Immunology, Berlin, Germany
| | - Yalcin Kulahci
- Wake Forest School of Medicine, Department of Surgery, Wake Forest Institute for Regenerative Medicine, Winston-Salem, NC, United States
| | - Vijay S. Gorantla
- Wake Forest School of Medicine, Department of Surgery, Wake Forest Institute for Regenerative Medicine, Winston-Salem, NC, United States
| | - Fatih Zor
- Wake Forest School of Medicine, Department of Surgery, Wake Forest Institute for Regenerative Medicine, Winston-Salem, NC, United States
- *Correspondence: Fatih Zor, ; Norman M. Drzeniek,
| | - Norman M. Drzeniek
- Charité— Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt–Universität zu Berlin, Institute of Medical Immunology, Berlin, Germany
- Berlin Institute of Health at Charité—Universitätsmedizin Berlin, BIH Center for Regenerative Therapies (BCRT), Berlin, Germany
- Charité — Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt- Universität zu Berlin, Berlin-Brandenburg School for Regenerative Therapies (BSRT), Berlin, Germany
- *Correspondence: Fatih Zor, ; Norman M. Drzeniek,
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25
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Pascual-Valdunciel A, Rajagopal A, Pons JL, Delp S. Non-invasive electrical stimulation of peripheral nerves for the management of tremor. J Neurol Sci 2022; 435:120195. [PMID: 35220113 PMCID: PMC9590374 DOI: 10.1016/j.jns.2022.120195] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Revised: 12/06/2021] [Accepted: 02/17/2022] [Indexed: 12/22/2022]
Abstract
Pathological tremor in patients with essential tremor and Parkinsons disease is typically treated using medication or neurosurgical interventions. There is a widely recognized need for new treatments that avoid the side effects of current medications and do not carry the risks of surgical interventions. Building on decades of research and engineering development, non-invasive electrical stimulation of peripheral nerves has emerged as a safe and effective strategy for reducing pathologic tremor in essential tremor. This review surveys the peripheral electrical stimulation (PES) literature and summarizes effectiveness, safety, clinical translatability, and hypothesized tremor-reduction mechanisms of various PES approaches. The review also proposes guidelines for assessing tremor in the context of evaluating new therapies that combine the strengths of clinician assessments, patient evaluations, and novel motion sensing technology. The review concludes with a summary of future directions for PES, including expanding clinical access for patients with Parkinson's disease and leveraging large, at-home datasets to learn more about tremor physiology and treatment effect that will better characterize the state of tremor management and accelerate discovery of new therapies. Growing evidence suggests that non-invasive electrical stimulation of afferent neural pathways provides a viable new option for management of pathological tremor, with one specific PES therapy cleared for prescription and home use, suggesting that PES be considered along with medication and neurosurgical interventions for treatment of tremor. This article is part of the Special Issue "Tremor" edited by Daniel D. Truong, Mark Hallett, and Aasef Shaikh.
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Affiliation(s)
- Alejandro Pascual-Valdunciel
- Northwestern University, Evanston, IL, USA; E.T.S. Ingenieros de Telecomunicación, Universidad Politécnica de Madrid, Spain
| | | | - Jose L Pons
- Northwestern University, Evanston, IL, USA; Shirley Ryan AbilityLab, Chicago, IL, USA.
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26
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Vázquez-Guardado A, Yang Y, Rogers JA. OUP accepted manuscript. Natl Sci Rev 2022; 9:nwac016. [PMID: 36196123 PMCID: PMC9522382 DOI: 10.1093/nsr/nwac016] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Revised: 12/06/2021] [Accepted: 01/27/2022] [Indexed: 11/13/2022] Open
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27
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Andreis FR, Metcalfe B, Janjua TAM, Jensen W, Meijs S, dos Santos Nielsen TGN. The Use of the Velocity Selective Recording Technique to Reveal the Excitation Properties of the Ulnar Nerve in Pigs. SENSORS (BASEL, SWITZERLAND) 2021; 22:58. [PMID: 35009601 PMCID: PMC8747393 DOI: 10.3390/s22010058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Revised: 12/02/2021] [Accepted: 12/16/2021] [Indexed: 06/14/2023]
Abstract
Decoding information from the peripheral nervous system via implantable neural interfaces remains a significant challenge, considerably limiting the advancement of neuromodulation and neuroprosthetic devices. The velocity selective recording (VSR) technique has been proposed to improve the classification of neural traffic by combining temporal and spatial information through a multi-electrode cuff (MEC). Therefore, this study investigates the feasibility of using the VSR technique to characterise fibre type based on the electrically evoked compound action potentials (eCAP) propagating along the ulnar nerve of pigs in vivo. A range of electrical stimulation parameters (amplitudes of 50 μA-10 mA and pulse durations of 100 μs, 500 μs, 1000 μs, and 5000 μs) was applied on a cutaneous and a motor branch of the ulnar nerve in nine Danish landrace pigs. Recordings were made with a 14 ring MEC and a delay-and-add algorithm was used to convert the eCAPs into the velocity domain. The results revealed two fibre populations propagating along the cutaneous branch of the ulnar nerve, with mean velocities of 55 m/s and 21 m/s, while only one dominant fibre population was found for the motor branch, with a mean velocity of 63 m/s. Because of its simplicity to provide information on the fibre selectivity and direction of propagation of nerve fibres, VSR can be implemented to advance the performance of the bidirectional control of neural prostheses and bioelectronic medicine applications.
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Affiliation(s)
- Felipe Rettore Andreis
- Center for Neuroplasticity and Pain (CNAP), Department of Health Science and Technology, Aalborg University, 9220 Aalborg, Denmark; (T.A.M.J.); (W.J.); (S.M.); (T.G.N.d.S.N.)
| | - Benjamin Metcalfe
- Center for Biosensors, Bioelectronics and Biodevices (C3Bio), Department of Electronic & Electrical Engineering, University of Bath, Bath BA2 7AY, UK;
| | - Taha Al Muhammadee Janjua
- Center for Neuroplasticity and Pain (CNAP), Department of Health Science and Technology, Aalborg University, 9220 Aalborg, Denmark; (T.A.M.J.); (W.J.); (S.M.); (T.G.N.d.S.N.)
| | - Winnie Jensen
- Center for Neuroplasticity and Pain (CNAP), Department of Health Science and Technology, Aalborg University, 9220 Aalborg, Denmark; (T.A.M.J.); (W.J.); (S.M.); (T.G.N.d.S.N.)
| | - Suzan Meijs
- Center for Neuroplasticity and Pain (CNAP), Department of Health Science and Technology, Aalborg University, 9220 Aalborg, Denmark; (T.A.M.J.); (W.J.); (S.M.); (T.G.N.d.S.N.)
| | - Thomas Gomes Nørgaard dos Santos Nielsen
- Center for Neuroplasticity and Pain (CNAP), Department of Health Science and Technology, Aalborg University, 9220 Aalborg, Denmark; (T.A.M.J.); (W.J.); (S.M.); (T.G.N.d.S.N.)
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28
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Koppaka S, Hess-Dunning A, Tyler DJ. Directed stimulation with interfascicular interfaces for peripheral nerve stimulation. J Neural Eng 2021; 18. [PMID: 34706351 DOI: 10.1088/1741-2552/ac33e8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2021] [Accepted: 10/27/2021] [Indexed: 01/10/2023]
Abstract
Objective.Computational models have shown that directional electrical contacts placed within the epineurium, between the fascicles, and not penetrating the perineurium, can achieve selectivity levels similar to point source contacts placed within the fascicle. The objective of this study is to test, in a murine model, the hypothesis that directed interfascicular contacts are selective.Approach.Multiple interfascicular electrodes with directional contacts, exposed on a single face, were implanted in the sciatic nerves of 32 rabbits. Fine-wire intramuscular wire electrodes were implanted to measure electromyographic (EMG) activity from medial and lateral gastrocnemius, soleus, and tibialis anterior muscles.Main results.The recruitment data demonstrated that directed interfascicular interfaces, which do not penetrate the perineurium, selectively activate different axon populations.Significance.Interfascicular interfaces that are inside the nerve, but do not penetrate the perineurium are an alternative to intrafascicular interfaces and may offer additional selectivity compared to extraneural approaches.
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Affiliation(s)
- Smruta Koppaka
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH, United States of America.,Louis Stokes Cleveland VA Medical Center, Rehabilitation R&D, Cleveland, OH, United States of America.,Advanced Platform Technology (APT) Center, Cleveland, OH, United States of America
| | - Allison Hess-Dunning
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH, United States of America.,Louis Stokes Cleveland VA Medical Center, Rehabilitation R&D, Cleveland, OH, United States of America.,Advanced Platform Technology (APT) Center, Cleveland, OH, United States of America
| | - Dustin J Tyler
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH, United States of America.,Louis Stokes Cleveland VA Medical Center, Rehabilitation R&D, Cleveland, OH, United States of America.,Advanced Platform Technology (APT) Center, Cleveland, OH, United States of America
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29
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Lienemann S, Zötterman J, Farnebo S, Tybrandt K. Stretchable gold nanowire-based cuff electrodes for low-voltage peripheral nerve stimulation. J Neural Eng 2021; 18. [PMID: 33957608 DOI: 10.1088/1741-2552/abfebb] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Accepted: 05/06/2021] [Indexed: 12/29/2022]
Abstract
Objective. Electrical stimulation of the peripheral nervous system (PNS) can treat various diseases and disorders, including the healing process after nerve injury. A major challenge when designing electrodes for PNS stimulation is the mechanical mismatch between the nerve and the device, which can lead to non-conformal contact, tissue damage and inefficient stimulation due to current leakage. Soft and stretchable cuff electrodes promise to tackle these challenges but often have limited performance and rely on unconventional materials. The aim of this study is to develop a high performance soft and stretchable cuff electrode based on inert materials for low-voltage nerve stimulation.Approach. We developed 50µm thick stretchable cuff electrodes based on silicone rubber, gold nanowire conductors and platinum coated nanowire electrodes. The electrode performance was characterized under strain cycling to assess the durability of the electrodes. The stimulation capability of the cuff electrodes was evaluated in anin vivosciatic nerve rat model by measuring the electromyography response to various stimulation pulses.Main results. The stretchable cuff electrodes showed excellent stability for 50% strain cycling and one million stimulation pulses. Saturated homogeneous stimulation of the sciatic nerve was achieved at only 200 mV due to the excellent conformability of the electrodes, the low conductor resistance (0.3 Ohm sq-1), and the low electrode impedance.Significance. The developed stretchable cuff electrode combines favourable mechanical properties and good electrode performance with inert and stable materials, making it ideal for low power supply applications within bioelectronic medicine.
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Affiliation(s)
- Samuel Lienemann
- Laboratory of Organic Electronics, Department of Science and Technology, Linköping University, 601 74 Norrköping, Sweden
| | - Johan Zötterman
- Department of Hand Surgery, Plastic Surgery and Burns, Linköping University Hospital, Linköping, Sweden.,Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Simon Farnebo
- Department of Hand Surgery, Plastic Surgery and Burns, Linköping University Hospital, Linköping, Sweden.,Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Klas Tybrandt
- Laboratory of Organic Electronics, Department of Science and Technology, Linköping University, 601 74 Norrköping, Sweden
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