Regeneration microelectrode array for peripheral nerve recording and stimulation

A Haptic Sleeve as a Method of Mechanotactile Feedback Restoration for Myoelectric Hand Prosthesis Users

Current myoelectric upper limb prostheses do not restore sensory feedback, impairing fine motor control. Mechanotactile feedback restoration with a haptic sleeve may rectify this problem. This randomised crossover within-participant controlled study aimed to assess a prototype haptic sleeve's effect on routine grasping tasks performed by eight able-bodied participants. Each participant completed 15 repetitions of the three tasks: Task 1—normal grasp, Task 2—strong grasp and Task 3—weak grasp, using visual, haptic, or combined feedback All data were collected in April 2021 in the Scottish Microelectronics Centre, Edinburgh, UK. Combined feedback correlated with significantly higher grasp success rates compared to the vision alone in Task 1 (p < 0.0001), Task 2 (p = 0.0057), and Task 3 (p = 0.0170). Similarly, haptic feedback was associated with significantly higher grasp success rates compared to vision in Task 1 (p < 0.0001) and Task 2 (p = 0.0015). Combined feedback correlated with significantly lower energy expenditure compared to visual feedback in Task 1 (p < 0.0001) and Task 3 (p = 0.0003). Likewise, haptic feedback was associated with significantly lower energy expenditure compared to the visual feedback in Task 1 (p < 0.0001), Task 2 (p < 0.0001), and Task 3 (p < 0.0001). These results suggest that mechanotactile feedback provided by the haptic sleeve effectively augments grasping and reduces its energy expenditure.

A review for the peripheral nerve interface designer

Informational density and relative accessibility of the peripheral nervous system make it an attractive site for therapeutic intervention. Electrode-based electrophysiological interfaces with peripheral nerves have been under development since the 1960s and, for several applications, have seen widespread clinical implementation. However, many applications require a combination of neural target resolution and stability which has thus far eluded existing peripheral nerve interfaces (PNIs). With the goal of aiding PNI designers in development of devices that meet the demands of next-generation applications, this review seeks to collect and present practical considerations and best practices which emerge from the literature, including both lessons learned during early PNI development and recent ideas. Fundamental and practical principles guiding PNI design are reviewed, followed by an updated and critical account of existing PNI designs and strategies. Finally, a brief survey of in vitro and in vivo PNI characterization methods is presented.

Modelling the impact of altered axonal morphometry on the response of regenerative nervous tissue to electrical stimulation through macro-sieve electrodes

OBJECTIVE

Regenerated peripheral nervous tissue possesses different morphometric properties compared to undisrupted nerve. It is poorly understood how these morphometric differences alter the response of the regenerated nerve to electrical stimulation. In this work, we use computational modeling to explore the electrophysiological response of regenerated and undisrupted nerve axons to electrical stimulation delivered by macro-sieve electrodes (MSEs).

APPROACH

A 3D finite element model of a peripheral nerve segment populated with mammalian myelinated axons and implanted with a macro-sieve electrode has been developed. Fiber diameters and morphometric characteristics representative of undisrupted or regenerated peripheral nervous tissue were assigned to core conductor models to simulate the two tissue types. Simulations were carried out to quantify differences in thresholds and chronaxie between undisrupted and regenerated fiber populations. The model was also used to determine the influence of axonal caliber on recruitment thresholds for the two tissue types. Model accuracy was assessed through comparisons with in vivo recruitment data from chronically implanted MSEs.

MAIN RESULTS

Recruitment thresholds of individual regenerated fibers with diameters  >2 µm were found to be lower compared to same caliber undisrupted fibers at electrode to fiber distances of less than about 90-140 µm but roughly equal or higher for larger distances. Caliber redistributions observed in regenerated nerve resulted in an overall increase in average recruitment thresholds and chronaxie during whole nerve stimulation. Modeling results also suggest that large diameter undisrupted fibers located close to a longitudinally restricted current source such as the MSE have higher average recruitment thresholds compared to small diameter fibers. In contrast, large diameter regenerated nerve fibers located in close proximity of MSE sites have, on average, lower recruitment thresholds compared to small fibers. Utilizing regenerated fiber morphometry and caliber distributions resulted in accurate predictions of in vivo recruitment data.

SIGNIFICANCE

Our work uses computational modeling to show how morphometric differences between regenerated and undisrupted tissue results in recruitment threshold discrepancies, quantifies these differences, and illustrates how large undisrupted nerve fibers close to longitudinally restricted current sources have higher recruitment thresholds compared to adjacently positioned smaller fibers while the opposite is true for large regenerated fibers.

Multifunctional Freestanding Microprobes for Potential Biological Applications

Deep-level sensors for detecting the local temperatures of inner organs and tissues of an animal are rarely reported. In this paper, we present a method to fabricate multifunctional micro-probes with standard cleanroom procedures, using a piece of stainless-steel foil as the substrate. On each of the as-fabricated micro-probes, arrays of thermocouples made of Pd-Cr thin-film stripes with reliable thermal sensing functions were built, together with Pd electrode openings for detecting electrical signals. The as-fabricated sword-shaped freestanding microprobes with length up to 30 mm showed excellent mechanical strength and elastic properties when they were inserted into the brain and muscle tissues of live rats, as well as suitable electrochemical properties and, therefore, are promising for potential biological applications.

Mechanical fatigue resistance of an implantable branched lead system for a distributed set of longitudinal intrafascicular electrodes

OBJECTIVE

A neural interface system has been developed that consists of an implantable stimulator/recorder can with a 15-electrode lead that trifurcates into three bundles of five individual wire longitudinal intrafascicular electrodes. This work evaluated the mechanical fatigue resistance of the branched lead and distributed electrode system under conditions designed to mimic anticipated strain profiles that would be observed after implantation in the human upper arm.

APPROACH

Custom test setups and procedures were developed to apply linear or angular strain at four critical stress riser points on the lead and electrode system. Each test was performed to evaluate fatigue under a high repetition/low amplitude paradigm designed to test the effects of arm movement on the leads during activities such as walking, or under a low repetition/high amplitude paradigm designed to test the effects of more strenuous upper arm activities. The tests were performed on representative samples of the implantable lead system for human use. The specimens were fabricated using procedures equivalent to those that will be used during production of human-use implants. Electrical and visual inspections of all test specimens were performed before and after the testing procedures to assess lead integrity.

MAIN RESULTS

Measurements obtained before and after applying repetitive strain indicated that all test specimens retained electrical continuity and that electrical impedance remained well below pre-specified thresholds for detection of breakage. Visual inspection under a microscope at 10×  magnification did not reveal any signs of damage to the wires or silicone sheathing at the stress riser points.

SIGNIFICANCE

These results demonstrate that the branched lead of this implantable neural interface system has sufficient mechanical fatigue resistance to withstand strain profiles anticipated when the system is implanted in an arm. The novel test setups and paradigms may be useful in testing other lead systems.

Tissue-Engineered Peripheral Nerve Interfaces

Research on neural interfaces has historically concentrated on development of systems for the brain; however, there is increasing interest in peripheral nerve interfaces (PNIs) that could provide benefit when peripheral nerve function is compromised, such as for amputees. Efforts focus on designing scalable and high-performance sensory and motor peripheral nervous system interfaces. Current PNIs face several design challenges such as undersampling of signals from the thousands of axons, nerve-fiber selectivity, and device-tissue integration. To improve PNIs, several researchers have turned to tissue engineering. Peripheral nerve tissue engineering has focused on designing regeneration scaffolds that mimic normal nerve extracellular matrix composition, provide advanced microarchitecture to stimulate cell migration, and have mechanical properties like the native nerve. By combining PNIs with tissue engineering, the goal is to promote natural axon regeneration into the devices to facilitate close contact with electrodes; in contrast, traditional PNIs rely on insertion or placement of electrodes into or around existing nerves, or do not utilize materials to actively facilitate axon regeneration. This review presents the state-of-the-art of PNIs and nerve tissue engineering, highlights recent approaches to combine neural-interface technology and tissue engineering, and addresses the remaining challenges with foreign-body response.

Regenerated Sciatic Nerve Axons Stimulated through a Chronically Implanted Macro-Sieve Electrode

Sieve electrodes provide a chronic interface for stimulating peripheral nerve axons. Yet, successful utilization requires robust axonal regeneration through the implanted electrode. The present study determined the effect of large transit zones in enhancing axonal regeneration and revealed an intimate neural interface with an implanted sieve electrode. Fabrication of the polyimide sieve electrodes employed sacrificial photolithography. The manufactured macro-sieve electrode (MSE) contained nine large transit zones with areas of ~0.285 mm² surrounded by eight Pt-Ir metallized electrode sites. Prior to implantation, saline, or glial derived neurotropic factor (GDNF) was injected into nerve guidance silicone-conduits with or without a MSE. The MSE assembly or a nerve guidance conduit was implanted between transected ends of the sciatic nerve in adult male Lewis rats. At 3 months post-operation, fiber counts were similar through both implant types. Likewise, stimulation of nerves regenerated through a MSE or an open silicone conduit evoked comparable muscle forces. These results showed that nerve regeneration was comparable through MSE transit zones and an open conduit. GDNF had a minimal positive effect on the quality and morphology of fibers regenerating through the MSE; thus, the MSE may reduce reliance on GDNF to augment axonal regeneration. Selective stimulation of several individual muscles was achieved through monopolar stimulation of individual electrodes sites suggesting that the MSE might be an optimal platform for functional neuromuscular stimulation.

Mapping of Small Nerve Trunks and Branches Using Adaptive Flexible Electrodes

Selective stimulation is delivered to the sciatic nerve using different paris of contacts on a split-ring electrode, while simulatneous recordings are acquired by the neural ribbon electrodes on three different branches. Two hook electrodes are also implanted in the muscle to monitor the activated muscle responses. It shows that the high precision implantation of electrodes, increases the efficacy and reduces the incidence of side effects.

Approaches to Peripheral Nerve Repair: Generations of Biomaterial Conduits Yielding to Replacing Autologous Nerve Grafts in Craniomaxillofacial Surgery

Peripheral nerve injury is a common clinical entity, which may arise due to traumatic, tumorous, or even iatrogenic injury in craniomaxillofacial surgery. Despite advances in biomaterials and techniques over the past several decades, reconstruction of nerve gaps remains a challenge. Autografts are the gold standard for nerve reconstruction. Using autografts, there is donor site morbidity, subsequent sensory deficit, and potential for neuroma development and infection. Moreover, the need for a second surgical site and limited availability of donor nerves remain a challenge. Thus, increasing efforts have been directed to develop artificial nerve guidance conduits (ANCs) as new methods to replace autografts in the future. Various synthetic conduit materials have been tested in vitro and in vivo, and several first- and second-generation conduits are FDA approved and available for purchase, while third-generation conduits still remain in experimental stages. This paper reviews the current treatment options, summarizes the published literature, and assesses future prospects for the repair of peripheral nerve injury in craniomaxillofacial surgery with a particular focus on facial nerve regeneration.

Suppression of scarring in peripheral nerve implants by drug elution

OBJECTIVE

Medical implants made of non-biological materials provoke a chronic inflammatory response, resulting in the deposition of a collagenous scar tissue (ST) layer on their surface, that gradually thickens over time. This is a critical problem for neural interfaces. Scar build-up on electrodes results in a progressive decline in signal level because the scar tissue gradually separates axons away from the recording contacts. In regenerative sieves and microchannel electrodes, progressive scar deposition will constrict and may eventually choke off the sieve hole or channel lumen. Interface designs need to address this issue if they are to be fit for long term use. This study examines a novel method of inhibiting the formation and thickening of the fibrous scar.

APPROACH

Research to date has mainly focused on methods of preventing stimulation of the foreign body response by implant surface modification. In this paper a pharmacological approach using drug elution to suppress chronic inflammation is introduced. Microchannel implants made of silicone doped with the steroid drug dexamethasone were implanted in the rat sciatic nerve for periods of up to a year. Tissue from within the microchannels was compared to that from control devices that did not release any drug.

MAIN RESULTS

In the drug eluting implants the scar layer was significantly thinner at all timepoints, and unlike the controls it did not continue to thicken after 6 months. Control implants supported axon regeneration well initially, but axon counts fell rapidly at later timepoints as scar thickened. Axon counts in drug eluting devices were initially much lower, but increased rather than declined and by one year were significantly higher than in controls.

SIGNIFICANCE

Drug elution offers a potential long term solution to the problem of performance degradation due to scarring around neural implants.

Nanostructured cavity devices for extracellular stimulation of HL-1 cells

Microelectrode arrays (MEAs) are state-of-the-art devices for extracellular recording and stimulation on biological tissue. Furthermore, they are a relevant tool for the development of biomedical applications like retina, cochlear and motor prostheses, cardiac pacemakers and drug screening. Hence, research on functional cell-sensor interfaces, as well as the development of new surface structures and modifications for improved electrode characteristics, is a vivid and well established field. However, combining single-cell resolution with sufficient signal coupling remains challenging due to poor cell-electrode sealing. Furthermore, electrodes with diameters below 20 µm often suffer from a high electrical impedance affecting the noise during voltage recordings. In this study, we report on a nanocavity sensor array for voltage-controlled stimulation and extracellular action potential recordings on cellular networks. Nanocavity devices combine the advantages of low-impedance electrodes with small cell-chip interfaces, preserving a high spatial resolution for recording and stimulation. A reservoir between opening aperture and electrode is provided, allowing the cell to access the structure for a tight cell-sensor sealing. We present the well-controlled fabrication process and the effect of cavity formation and electrode patterning on the sensor's impedance. Further, we demonstrate reliable voltage-controlled stimulation using nanostructured cavity devices by capturing the pacemaker of an HL-1 cell network.

In vivo testing of a 3D bifurcating microchannel scaffold inducing separation of regenerating axon bundles in peripheral nerves

Artificial nerve guidance channels enhance the regenerative effectiveness in an injured peripheral nerve but the existing design so far has been limited to basic straight tubes simply guiding the growth to bridge the gap. Hence, one of the goals in development of more effective neuroprostheses is to create bidirectional highly selective neuro-electronic interface between a prosthetic device and the severed nerve. A step towards improving selectivity for both recording and stimulation have been made with some recent in vitro studies which showed that three-dimensional (3D) bifurcating microchannels can separate neurites growing on a planar surface and bring them into contact with individual electrodes. Since the growing axons in vivo have the innate tendency to group in bundles surrounded by connective tissue, one of the big challenges in neuro-prosthetic interface design is how to overcome it. Therefore, we performed experiments with 3D bifurcating guidance scaffolds implanted in the sciatic nerve of rats to test if this new channel architecture could trigger separation pattern of ingrowth also in vivo. Our results showed that this new method enabled the re-growth of neurites into channels with gradually diminished width (80, 40 and 20 µm) and facilitated the separation of the axonal bundles with 91% success. It seems that the 3D bifurcating scaffold might contribute towards conveying detailed neural control and sensory feedback to users of prosthetic devices, and thus could improve the quality of their daily life.

Implantable FES Stimulation Systems: What is Needed?

Since their initial development, the performance gains in functional electrical stimulation (FES) systems have been modest. Conceptually, the replacement of normal neural function by artificial electronic systems is attractive, considering the continued technologic advancements in electronics, communication, and control. It is likely that efficacious FES systems will require complete implantation and activation of large numbers of motor units. One approach is to develop a neural interface that has a one-to-one relationship between stimulating electrodes and lower motor neurons. While technology may offer solutions to the design of miniaturized implantable stimulators, the high-density neural interface remains more elusive. During the past 20 years, research in the stimulation of peripheral motor systems has been primarily constrained by progress in two areas of research: strategies for the control of paralyzed muscle and sophistication of implantable stimulation systems. Often, a debate concerning which of these two areas is a "critical path" element yields no strategic ideas. It has been stated that a need must be demonstrated for a specific number of electrode channels before it is warranted to invest effort into the engineering of implantable systems that are capable of driving large numbers of electrodes. Indeed it is a logical approach to problem solving that the need should drive the development of function. Even study sections, in review of FES grant applications, often resort to this logic. In our opinion, when applied to FES, this argument is often fallacious and ignores the reality that research frequently requires that a threshold of experimental methodology be reached before any meaningful work can be accomplished. Practical trials of stimulation control strategies, long-term patient acceptance, and achievable function for FES systems cannot begin without the capability of stimulation. And, in order to determine whether or not stimulating large numbers of muscle groups can lead to more natural control of movement, suitable stimulation hardware must first exist, and be reliable. In the specific case of lower extremity FES research, it is likely that without a quantum advance in technologic capabilities, the practical utility of FES systems will continue to only be marginally close to normal function. To reach the level of being considered a routine treatment for spinal cord injury, FES systems should be able to offer improved functionality, ease of use, and near-equal reliability, compared to wheelchairs. At present, no FES systems attain this combination. The functional reliability of FES systems must approach 100%. As a trivial example, consider that for a standing, or walking, system, the perspectives of bioengineers and users may be quite different. While an engineer might be pleased to design a system that functions, as intended, 99% of the time, if a user falls down 1 time out of every 100, this is likely to be unacceptable. The minimal threshold of functional utility for FES systems is unclear, and will not be addressed here. Rather, we consider the issues of what features and capabilities are desirable for next generation implantable systems, and to what degree these desires approach engineering feasibility.

Regenerative scaffold electrodes for peripheral nerve interfacing

Advances in neural interfacing technology are required to enable natural, thought-driven control of a prosthetic limb. Here, we describe a regenerative electrode design in which a polymer-based thin-film electrode array is integrated within a thin-film sheet of aligned nanofibers, such that axons regenerating from a transected peripheral nerve are topographically guided across the electrode recording sites. Cultures of dorsal root ganglia were used to explore design parameters leading to cellular migration and neurite extension across the nanofiber/electrode array boundary. Regenerative scaffold electrodes (RSEs) were subsequently fabricated and implanted across rat tibial nerve gaps to evaluate device recording capabilities and influence on nerve regeneration. In 20 of these animals, regeneration was compared between a conventional nerve gap model and an amputation model. Characteristic shaping of regenerated nerve morphology around the embedded electrode array was observed in both groups, and regenerated axon profile counts were similar at the eight week end point. Implanted RSEs recorded evoked neural activity in all of these cases, and also in separate implantations lasting up to five months. These results demonstrate that nanofiber-based topographic cues within a regenerative electrode can influence nerve regeneration, to the potential benefit of a peripheral nerve interface suitable for limb amputees.

A regenerative microchannel neural interface for recording from and stimulating peripheral axons in vivo

Neural interfaces are implanted devices that couple the nervous system to electronic circuitry. They are intended for long term use to control assistive technologies such as muscle stimulators or prosthetics that compensate for loss of function due to injury. Here we present a novel design of interface for peripheral nerves. Recording from axons is complicated by the small size of extracellular potentials and the concentration of current flow at nodes of Ranvier. Confining axons to microchannels of ~100 µm diameter produces amplified potentials that are independent of node position. After implantation of microchannel arrays into rat sciatic nerve, axons regenerated through the channels forming 'mini-fascicles', each typically containing ~100 myelinated fibres and one or more blood vessels. Regenerated motor axons reconnected to distal muscles, as demonstrated by the recovery of an electromyogram and partial prevention of muscle atrophy. Efferent motor potentials and afferent signals evoked by muscle stretch or cutaneous stimulation were easily recorded from the mini-fascicles and were in the range of 35-170 µV. Individual motor units in distal musculature were activated from channels using stimulus currents in the microampere range. Microchannel interfaces are a potential solution for applications such as prosthetic limb control or enhancing recovery after nerve injury.

Insulating Biomaterials Research for Implantable Microelectronic Devices

Developments in the field of BioMEMS share many of the same issues encountered in the development of neural interface technology that has been underway for many decades. In addition to issues of function, other issues such as biocompatibility and bioresistance have also presented great challenges. The focus of this paper is on the development and testing of electrically insulating biomaterials for micro-devices that can be implanted in biological systems. A variety of accelerated degradation and accelerated detection of degradation techniques have been developed and are used to screen candidate materials. Direct tests of mechanical properties, adhesion, and chemical resistance are used for further assessment. Promising materials indicate what chemistry might be suitable for development of a Chemical Vapor Deposited (CVD) thin film coating. CVD coatings are under development that may be useful for insulation of very small, micromachined elements of an implantable device while only increasing the size of the device by a few micrometers. Materials passing in-vitro testing are then considered for in-vivo testing. Novel instrumentation for testing devices in-vivo has been developed.

Electrochemical properties and myocyte interaction of carbon nanotube microelectrodes

Arrays of carbon nanotube (CNT) microelectrodes (nominal geometric surface areas 20-200 μm(2)) were fabricated by photolithography with chemical vapor deposition of randomly oriented CNTs. Raman spectroscopy showed strong peak intensities in both G and D bands (G/D = 0.86), indicative of significant disorder in the graphitic layers of the randomly oriented CNTs. The impedance spectra of gold and CNT microelectrodes were compared using equivalent circuit models. Compared to planar gold surfaces, pristine nanotubes lowered the overall electrode impedance at 1 kHz by 75%, while nanotubes treated in O(2) plasma reduced the impedance by 95%. Cyclic voltammetry in potassium ferricyanide showed potential peak separations of 133 and 198 mV for gold and carbon nanotube electrodes, respectively. The interaction of cultured cardiac myocytes with randomly oriented and vertically aligned CNTs was investigated by the sectioning of myocytes using focused-ion-beam milling. Vertically aligned nanotubes deposited by plasma-enhanced chemical vapor deposition (PECVD) were observed to penetrate the membrane of neonatal-rat ventricular myocytes, while randomly oriented CNTs remained external to the cells. These results demonstrated that CNT electrodes can be leveraged to reduce impedance and enhance biological interfaces for microelectrodes of subcellular size.

Active pixel sensor array for high spatio-temporal resolution electrophysiological recordings from single cell to large scale neuronal networks

This paper presents a chip-based electrophysiological platform enabling the study of micro- and macro-circuitry in in-vitro neuronal preparations. The approach is based on a 64x64 microelectrode array device providing extracellular electrophysiological activity recordings with high spatial (21 microm of electrode separation) and temporal resolution (from 0.13 ms for 4096 microelectrodes down to 8 micros for 64 microelectrodes). Applied to in-vitro neuronal preparations, we show how this approach enables neuronal signals to be acquired for investigating neuronal activity from single cells and microcircuits to large scale neuronal networks. The main elements of the platform are the metallic microelectrode array (MEA) implemented in Complementary Metal Oxide Semiconductor (CMOS) technology similar to a light imager, the in-pixel integrated low-noise amplifiers (11 microVrms) and the high-speed random addressing logic. The chip is combined with a real-time acquisition system providing the capability to record at 7.8 kHz/electrode the whole array and to process the acquired signals.

BioMEMS -Advancing the Frontiers of Medicine

Biological and medical application of micro-electro-mechanical-systems (MEMS) is currently seen as an area of high potential impact. Integration of biology and microtechnology has resulted in the development of a number of platforms for improving biomedical and pharmaceutical technologies. This review provides a general overview of the applications and the opportunities presented by MEMS in medicine by classifying these platforms according to their applications in the medical field.

Selective extracellular stimulation of individual neurons in ganglia

Selective control of individual neurons could clarify neural functions and aid disease treatments. To target specific neurons, it may be useful to focus on ganglionic neuron clusters, which are found in the peripheral nervous system in vertebrates. Because neuron cell bodies are found primarily near the surface of invertebrate ganglia, and often found near the surface of vertebrate ganglia, we developed a technique for controlling individual neurons extracellularly using the buccal ganglia of the marine mollusc Aplysia californica as a model system. We experimentally demonstrated that anodic currents can selectively activate an individual neuron and cathodic currents can selectively inhibit an individual neuron using this technique. To define spatial specificity, we studied the minimum currents required for stimulation, and to define temporal specificity, we controlled firing frequencies up to 45 Hz. To understand the mechanisms of spatial and temporal specificity, we created models using the NEURON software package. To broadly predict the spatial specificity of arbitrary neurons in any ganglion sharing similar geometry, we created a steady-state analytical model. A NEURON model based on cat spinal motor neurons showed responses to extracellular stimulation qualitatively similar to those of the Aplysia NEURON model, suggesting that this technique could be widely applicable to vertebrate and human peripheral ganglia having similar geometry.

Improved long-term recording of nerve signal by modified intrafascicular electrodes in rabbits

Methods for long-term recording of peripheral nerve activity via intrafascicular electrodes have not been optimized. We compared the long-term functionality of custom-made 95%Pt/5%Ir intrafascicular electrodes containing a proximal spring-like structure to that of conventional straight electrodes. The modified electrode was implanted into the sciatic nerve fascicle of a random hind limb in 14 rabbits for 9 months. A conventional electrode was implanted in the opposite hind limb as a control. Orthodromic and antidromic nerve potentials were sampled and analyzed monthly. Latency, amplitude, and nerve conduction velocity of electrical signals were generally similar within the modified group and straight control group at different time intervals (P > 0.05). However, at the conclusion of the study period, the modified electrode group had a greater number of functioning electrodes (P < 0.05) and a greater total functioning electrode time (P = 0.006). Intrafascicular electrodes with a spring-like structure demonstrated superior potential for long-term electrophysiological monitoring over straight electrodes.

Microchannels as axonal amplifiers

An implantable neural interface capable of reliable long-term high-resolution recording from peripheral nerves has yet to be developed. Device design is challenging because extracellular axonal signals are very small, decay rapidly with distance from the axon, and in myelinated fibres are concentrated close to nodes of Ranvier, which are around 1 mum long and spaced several hundred micrometers apart. We present a finite element model examining the electrical behavior of axons in microchannels, and demonstrate that confining axons in such channels substantially amplifies the extracellular signal. For example, housing a 10-microm myelinated axon in a 1-cm-long channel with a 1000-microm(2) cross section is predicted to generate a peak extracellular voltage of over 10 mV. Furthermore, there is little radial signal decay within the channel, and a smooth axial variation of signal amplitude along the channel, irrespective of node location. Additional benefits include a greater extracellular voltage generated by large myelinated fibres compared to small unmyelinated axons, and the reduction of gain to unity at the end of the channel which ensures that there can be no crosstalk with electrodes in other channels nearby. A microchannel architecture seems well suited to the requirements of a peripheral nerve interface.

Neurobiological assessment of regenerative electrodes for bidirectional interfacing injured peripheral nerves

Regenerative electrodes are designed to interface regenerated axons from a sectioned peripheral nerve. Applicability of regenerative electrodes depends on biocompatibility, success of axonal regeneration, secondary nerve damage, and adequacy of interface electronics. Polyimide sieve electrodes with 281 holes were chronically implanted in the severed sciatic nerve of 30 rats. Regeneration was successful in all the animals, with increasing numbers of regenerated myelinated fibers from 2 to 6 mo. However, constrictive axonopathy affected a few cases from 6 to 12 mo. postimplantation. A second electrode design with 571 holes and 27 ring electrodes was developed. The number of regenerated axons increased thanks to the larger open area. Recordings were obtained from a low proportion of electrodes on the sieve in response to distal stimulation. Difficulties for recording impulses with regenerative electrodes include the small size of regenerated axons, changes in membrane excitability and in target reconnection.

Residual motor signal in long-term human severed peripheral nerves and feasibility of neural signal-controlled artificial limb

PURPOSE

The residual motor pathways after amputation have not been fully elucidated. We sampled potentials from peripheral nerve stumps with intrafascicular electrodes to study residual motor transmission and explore the feasibility of nerve signal-controlled artificial limbs.

METHODS

Six intrafascicular electrodes were inserted into the ulnar, radial, and median nerves in the stump of an amputee. An electrode was placed outside the fascicle as a reference. Potentials from 4 of the 6 electrodes per trial were monitored using a 4-channel electromyogram machine, and 32 groups of electrophysiologic tests were conducted under volitional control. Actions included finger extension and flexion, forearm pronation and supination, and wrist extension and flexion. Each action was carried out with light, intermediate, and full efforts. Then, 2 of 6 electrodes randomly chosen per trial were interfaced to a nerve signal-controlled artificial limb. Finger extension and flexion of the prosthesis were tested under volitional control.

RESULTS

The volitional motor nerve potentials uniquely associated with the missing limb were recorded successfully with intrafascicular electrodes. The signal amplitude from the radial nerve was 5.5 microV +/- 0.8 (mean +/- SD), which was greater than the amplitudes from the ulnar (2.5 microV +/- 0.4) and median (2.2 microV +/- 0.3) nerves. Under volitional control of the subject, finger extension of the artificial limb was triggered by the radial nerve signal, but the remaining actions were unsuccessful.

CONCLUSIONS

The long-term amputee was able to generate motor neuron activity related to phantom limb movement. Intrafascicular electrodes can be used to monitor residual motor nerve activity in the stump, and the amplitude may predict successful control of artificial limbs.

Neural machine interfaces for controlling multifunctional powered upper-limb prostheses

This article investigates various neural machine interfaces for voluntary control of externally powered upper-limb prostheses. Epidemiology of upper limb amputation, as well as prescription and follow-up studies of externally powered upper-limb prostheses are discussed. The use of electromyographic interfaces and peripheral nerve interfaces for prosthetic control, as well as brain machine interfaces suitable for prosthetic control, are examined in detail along with available clinical results. In addition, studies on interfaces using muscle acoustic and mechanical properties and the problem of interfacing sensory information to the nervous system are discussed.

Implantable microscale neural interfaces

Implantable neural microsystems provide an interface to the nervous system, giving cellular resolution to physiological processes unattainable today with non-invasive methods. Such implantable microelectrode arrays are being developed to simultaneously sample signals at many points in the tissue, providing insight into processes such as movement control, memory formation, and perception. These electrode arrays have been microfabricated on a variety of substrates, including silicon, using both surface and bulk micromachining techniques, and more recently, polymers. Current approaches to achieving a stable long-term tissue interface focus on engineering the surface properties of the implant, including coatings that discourage protein adsorption or release bioactive molecules. The implementation of a wireless interface requires consideration of the necessary data flow, amplification, signal processing, and packaging. In future, the realization of a fully implantable neural microsystem will contribute to both diagnostic and therapeutic applications, such as a neuroprosthetic interface to restore motor functions in paralyzed patients.

Implantable visual prostheses

Visual impairment and blindness is primarily caused by optic neuropathies like injuries and glaucomas, as well as retinopathies like agerelated macular degeneration (MD), systemic diseases like diabetes, hypertonia and hereditary retinitis pigmentosa (RP). These pathological conditions may affect retinal photoreceptors, or retinal pigment epithelium, or particular subsets of retinal neurons, and in particular retinal ganglion cells (RGCs). The RGCs which connect the retina with the brain are unique cells with extremely long axons bridging the distance from the retina to visual relays within the thalamus and midbrain, being therefore vulnerable to heterogeneous pathological conditions along this pathway. When becoming mature, RGCs loose the ability to divide and to regenerate their accidentally or experimentally injured axons. Consequently, any loss of RGCs is irreversible and results to loss of visual function. The advent of micro- and nanotechnology, and the construction of artificial implants prompted to create visual prostheses which aimed at compensating for the loss of visual function in particular cases. The purpose of the present contribution is to review the considerable engineering expertise that is essential to fabricate current visual prostheses in connection with their functional features and applicability to the animal and human eye. In this chapter, 1) Retinal and cortical implants are introduced, with particular emphasis given to the requirements they have to fulfil in order to replace very complex functions like vision. 2) Advanced work on material research is presented both from the technological and from the biocompatibility aspect as prerequisites of any perspectives for implantation. 3) Ultimately, experimental studies are presented showing the shaping of implants, the procedures of testing their biocompatibility and essential modifications to improve the interfaces between technical devices and the biological environment. The review ends by pointing to future perspectives in the rapidly accelerating process of visual prosthetics and in the increasing hope that restoration of the visual system becomes reality.

Brain-Controlled Interfaces: Movement Restoration with Neural Prosthetics

Brain-controlled interfaces are devices that capture brain transmissions involved in a subject's intention to act, with the potential to restore communication and movement to those who are immobilized. Current devices record electrical activity from the scalp, on the surface of the brain, and within the cerebral cortex. These signals are being translated to command signals driving prosthetic limbs and computer displays. Somatosensory feedback is being added to this control as generated behaviors become more complex. New technology to engineer the tissue-electrode interface, electrode design, and extraction algorithms to transform the recorded signal to movement will help translate exciting laboratory demonstrations to patient practice in the near future.

Design, in vitro and in vivo assessment of a multi-channel sieve electrode with integrated multiplexer

This paper reports on the design, in vitro and in vivo investigation of a flexible, lightweight, polyimide based implantable sieve electrode with a hybrid assembly of multiplexers and polymer encapsulation. The integration of multiplexers enables us to connect a large number of electrodes on the sieve using few input connections. The implant assembly of the sieve electrode with the electronic circuitry was verified by impedance measurement. The 27 platinum electrodes of the sieve were coated with platinum black to reduce the electrode impedance. The impedance magnitude of the electrode sites on the sieve (geometric surface area 2,200 microm(2)) was |Z(f=1kHz)| = 5.7 kOmega. The sieve electrodes, encased in silicone, have been implanted in the transected sciatic nerve of rats. Initial experiments showed that axons regenerated through the holes of the sieve and reinnervated distal target organs. Nerve signals were recorded in preliminary tests after 3-7 months post-implantation.

A critical review of interfaces with the peripheral nervous system for the control of neuroprostheses and hybrid bionic systems

Considerable scientific and technological efforts have been devoted to develop neuroprostheses and hybrid bionic systems that link the human nervous system with electronic or robotic prostheses, with the main aim of restoring motor and sensory functions in disabled patients. A number of neuroprostheses use interfaces with peripheral nerves or muscles for neuromuscular stimulation and signal recording. Herein, we provide a critical overview of the peripheral interfaces available and trace their use from research to clinical application in controlling artificial and robotic prostheses. The first section reviews the different types of non-invasive and invasive electrodes, which include surface and muscular electrodes that can record EMG signals from and stimulate the underlying or implanted muscles. Extraneural electrodes, such as cuff and epineurial electrodes, provide simultaneous interface with many axons in the nerve, whereas intrafascicular, penetrating, and regenerative electrodes may contact small groups of axons within a nerve fascicle. Biological, technological, and material science issues are also reviewed relative to the problems of electrode design and tissue injury. The last section reviews different strategies for the use of information recorded from peripheral interfaces and the current state of control neuroprostheses and hybrid bionic systems.

Retinal prosthesis

Retinal prostheses represent the best near-term hope for individuals with incurable, blinding diseases of the outer retina. On the basis of the electrical activation of nerves, prototype retinal prostheses have been tested in blind humans and have demonstrated the capability to elicit the sensation of light and to give test subjects the ability to detect motion. To improve the visual function in implant recipients, a more sophisticated device is required. Simulations suggest that 600-1000 pixels will be required to provide visual function such as face recognition and reading. State-of-the-art implantable stimulator technology cannot produce such a device, which mandates the advancement of the state of the art in areas such as analog microelectronics, wireless power and data transfer, packaging, and stimulating electrodes.

Long term assessment of axonal regeneration through polyimide regenerative electrodes to interface the peripheral nerve

Polyimide sieve electrodes were implanted between the severed ends of the sciatic nerve in rats. The degree of axonal regeneration through the electrode was examined by physiological and histological methods from 2 to 12 months postimplantation. Regeneration was successful in the 30 animals implanted. Functional reinnervation of hindlimb targets progressed to reach maximal levels at 6 months. Comparatively, the reinnervation of distal plantar muscles was lower than that of proximal muscles and of digital nerves. The number of regenerated myelinated fibers increased from 2 to 6 months, when it was similar to control values. The majority of myelinated fibers crossing the via holes and regenerated through the distal nerve had a normal appearance. However, in a few cases decline of target reinnervation and loss of regenerated nerve fibers was found from 6 to 12 months postimplantation. Motor axons labeled by ChAT immunoreactivity regenerated scattered within minifascicles, although they were found at higher density at the periphery of the regenerated nerve. The number of ChAT-positive axons was markedly lower distally than proximally to the sieve electrode.

Multielectrode Microprobes for Deep-Brain Stimulation Fabricated With a Customizable 3-D Electroplating Process

Although deep-brain stimulation (DBS) can be used to improve some of the severe symptoms of Parkinson's disease (e.g., Bradykinesia, rigidity, and tremors), the mechanisms by which the symptoms are eliminated are not well understood. Moreover, DBS does not prevent neurodegeneration that leads to dementia or death. In order to fully investigate DBS and to optimize its use, a comprehensive long-term stimulation study in an animal model is needed. However, since the brain region that must be stimulated, known as the subthalamic nucleus (STN), is extremely small (500 microm x 500 microm x 1 mm) and deep within the rat brain (10 mm), the stimulating probe must have geometric and mechanical properties that allow accurate positioning in the brain, while minimizing tissue damage. We have designed, fabricated, and tested a novel micromachined probe that is able to accurately stimulate the STN. The probe is designed to minimize damage to the surrounding tissue. The probe shank is coated with gold and the electrode interconnects are insulated with silicon nitride for biocompatibility. The probe has four platinum electrodes to provide a variety of spatially distributed stimuli, and is formed in a novel 3-D plating process that results in a microwire like geometry (i.e., smoothly tapering diameter) with a corresponding mechanically stable shank.

Effects of Short-Term Training on Sensory and Motor Function in Severed Nerves of Long-Term Human Amputees

Much has been studied and written about plastic changes in the CNS of humans triggered by events such as limb amputation. However, little is known about the extent to which the original pathways retain residual function after peripheral amputation. Our earlier, acute study on long-term amputees indicated that central pathways associated with amputated peripheral nerves retain at least some sensory and motor function. The purpose of the present study was to determine if these functional connections would be strengthened or improved with experience and training over several days time. To do this, electrodes were implanted within fascicles of severed nerves of long-term human amputees to evaluate the changes in electrically evoked sensations and volitional motor neuron activity associated with attempted phantom limb movements. Nerve stimulation consistently resulted in discrete, unitary, graded sensations of touch/pressure and joint-position sense. There was no significant change in the values of stimulation parameters required to produce these sensations over time. Similarly, while the amputees were able to improve volitional control of motor neuron activity, the rate and pattern of change was similar to that seen with practice in normal individuals on motor tasks. We conclude that the central plasticity seen after amputation is most likely primarily due to unmasking, rather than replacement, of existing synaptic connections. These results also have implications for neural control of prosthetic limbs.

Acute peripheral nerve recording characteristics of polymer-based longitudinal intrafascicular electrodes

We examined the recording characteristics of two different types of polymer-based longitudinal intrafascicular electrodes (LIFEs) in peripheral nerve: single-stranded (s-polyLIFEs) and multistranded (m-polyLIFEs). Recordings were also made from Pt-Ir wire-based electrodes (PtIrLIFEs) as a control. The electrodes were implanted in either tibial or medial gastrocnemius branches of the rabbit sciatic nerve, and in the sciatic nerve of rats. Recorded neural activity induced by manually elicited afferent neural activity showed that both polyLIFE versions performed comparably to PtIrLIFEs.

Residual function in peripheral nerve stumps of amputees: implications for neural control of artificial limbs

PURPOSE

It is not known whether motor and sensory pathways associated with a missing or denervated limb remain functionally intact over periods of many months or years after amputation or chronic peripheral nerve transection injury. We examined the extent to which activity on chronically severed motor nerve fibers could be controlled by human amputees and whether distally referred tactile and proprioceptive sensations could be induced by stimulation of sensory axons in the nerve stumps.

METHODS

Amputees undergoing elective stump procedures were invited to participate in this study. Longitudinal intrafascicular electrodes were threaded percutaneously and implanted in severed nerves of human amputees. The electrodes were interfaced to an amplifier and stimulator system controlled by a laptop computer. Electrophysiologic tests were conducted for 2 consecutive days after recovery from the surgery.

RESULTS

It was possible to record volitional motor nerve activity uniquely associated with missing limb movements. Electrical stimulation through the implanted electrodes elicited discrete, unitary, graded sensations of touch, joint movement, and position, referring to the missing limb.

CONCLUSIONS

These findings indicate that both central and peripheral motor and somatosensory pathways retain significant residual connectivity and function for many years after limb amputation. This implies that peripheral nerve interfaces could be used to provide amputees with prosthetic limbs that have more natural feel and control than is possible with current myoelectric and body-powered control systems.

Fabrication and characteristics of an implantable, polymer-based, intrafascicular electrode

We describe new manufacturing techniques and physical properties of an improved polymer-based longitudinal intrafascicular electrode (polyLIFE). Modifications were made to correct: (1) poor metal film adhesion and fatigue resistance, (2) inconsistent insulation adhesion and control over recording/stimulation zone length, and (3) insufficient tensile strength for clinical use. Metal adhesion was significantly improved by both plasma treatment and fiber rotation (about the long axis) during metal deposition. Fatigue resistance was improved by reduction in sputtering energy (time x power) combined with long axis rotation, resulting in thin metal films that were 250 times more resistant to cyclic bending fatigue. Insulation adhesion was enhanced with the application of an adhesion-promoting silicone (MED2-4013, Nusil), while the recording/stimulation zone length was controlled to 1 +/- 0.2mm (mean +/- S.D.). The polyLIFE was made more robust by the inclusion of three individually metallized fibers, improving its tensile strength by a factor of 4 while producing minimal changes to its overall stiffness. However, the metallized fiber redundancy did not significantly affect fatigue resistance. The manufacturing changes described in this study enable the construction of more mechanically robust polyLIFEs, which should provide greater success when chronically implanted in peripheral nerves.

Selective electrical interfaces with the nervous system

To achieve selective electrical interfacing to the neural system it is necessary to approach neuronal elements on a scale of micrometers. This necessitates microtechnology fabrication and introduces the interdisciplinary field of neurotechnology, lying at the juncture of neuroscience with microtechnology. The neuroelectronic interface occurs where the membrane of a cell soma or axon meets a metal microelectrode surface. The seal between these may be narrow or may be leaky. In the latter case the surrounding volume conductor becomes part of the interface. Electrode design for successful interfacing, either for stimulation or recording, requires good understanding of membrane phenomena, natural and evoked action potential generation, volume conduction, and electrode behavior. Penetrating multimicroelectrodes have been produced as one-, two-, and three-dimensional arrays, mainly in silicon, glass, and metal microtechnology. Cuff electrodes circumvent a nerve; their selectivity aims at fascicles more than at nerve fibers. Other types of electrodes are regenerating sieves and cone-ingrowth electrodes. The latter may play a role in brain-computer interfaces. Planar substrate-embedded electrode arrays with cultured neural cells on top are used to study the activity and plasticity of developing neural networks. They also serve as substrates for future so-called cultured probes.

A biohybrid system to interface peripheral nerves after traumatic lesions: design of a high channel sieve electrode

Peripheral nerve lesions lead to nerve degeneration and flaccid paralysis. The first objective in functional rehabilitation of these diseases should be the preservation of the neuro-muscular junction by biological means and following functional electrical stimulation (FES) may restore some function of the paralyzed limb. The combination of biological cells and technical microdevices to biohybrid systems might become a new approach in neural prosthetics research to preserve skeletal muscle function. In this paper, a microdevice for a biohybrid system to interface peripheral nerves after traumatic lesions is presented. The development of the microprobe design and the fabrication technology is described and first experimental results are given and afterwards discussed. The technical microprobe is designed in a way that meets the most important technical requirements: adaptation to the distal nerve stump, suitability to combine the microstructure with a containment for cells, and integrated microelectrodes as information transducers for cell stimulation and monitoring. Micromachining technologies were applied to fabricate a polyimide-based sieve-like microprobe with 19 substrate-integrated ring electrodes and a distributed counter electrode. Monolithic integration of fixation flaps and a three-dimensional shaping technology led to a device that might be adapted to nerve stumps with neurosurgical sutures in the epineurium. First experimental results of the durability of the shaping technology and electrochemical electrode properties were investigated. The three-dimensional shape remained quite stable after sterilization in an autoclave and chronic implantation. Electrode impedance was below 200 kOmega at 1 kHz which ought to permit recording of signals from nerves sprouting through the sieve holes.