Miniaturised Wireless Power Transfer Systems for Neurostimulation: A Review

A Frequency-Switching Inductive Power Transfer System for Wireless, Miniaturised and Large-Scale Neural Interfaces

Three-coil inductive power transfer is the state-of-the-art solution to power multiple miniaturised neural implants. However, the maximum delivered power is limited by the efficiency of the powering link and safety constrains. Here we propose a frequency-switching inductive link, where the passive resonator normally used in a three-coil link is replaced by an active resonator. It receives power from the external transmitter via a two-coil inductive link at the low frequency of 13.56 MHz. Then, it switches the operating frequency to the higher frequency of 433.92 MHz through a dedicated circuitry. Last, it transmits power to 1024 miniaturised implants via a three-coil inductive link using an array of 37 focusing resonators for a brain coverage of 163.84 mm 2. Our simulations reported a power transfer efficiency of 0.013 % and a maximum power delivered to the load of 1970 μW under safety-constrains, which are respectively two orders of magnitude and more than six decades higher compared to an equivalent passive three-coil link. The frequency-switching inductive system is a scalable and highly versatile solution for wireless, miniaturised and large-scale neural interfaces.

A Wearable Real-Time System for Simultaneous Wireless Power and Data Transmission to Cortical Visual Prosthesis

Wireless, miniaturised and distributed neural interfaces are emerging neurotechnologies. Although extensive research efforts contribute to their technological advancement, the need for real-time systems enabling simultaneous wireless information and power transfer toward distributed neural implants remains crucial. Here we present a complete wearable system including a software for real-time image capturing, processing and digital data transfer; an hardware for high radiofrequency generation and modulation via amplitude shift keying; and a 3-coil inductive link adapt to operate with multiple miniaturised receivers. The system operates in real-time with a maximum frame rate of 20 Hz, reconstructing each frame with a matrix of 32 × 32 pixels. The device generates a carrier frequency of 433.92 MHz. It transmits the highest power of 32 dBm with a data rate of 6 Mbps and a variable modulation index as low as 8 %, thus potentially enabling wireless communication with 1024 miniaturised and distributed intracortical microstimulators. The system is primarily conceived as an external wearable device for distributed cortical visual prosthesis covering a visual field of 20 °. At the same time, it is modular and versatile, being suitable for multiple applications requiring simultaneous wireless information and power transfer to large-scale neural interfaces.

A Miniaturized, Low-Frequency Magnetoelectric Wireless Power Transfer System for Powering Biomedical Implants

This work experimentally demonstrates the operation of a miniaturized magnetoelectric (ME) wireless power transfer (WPT) system by incorporating a ME transducer and a suitable interface power management circuit (PMC) for potentially powering implantable medical devices (IMD) wirelessly. A ME heterostructure is micromachined to obtain desired device dimensions of 3.5 × 5 mm 2 and to restrict the operating frequency at a clinically approved frequency of 50 kHz. The proposed work also aims to address the trade-off between the device miniaturization, power attenuation and limiting the specific absorption rate (SAR) in the human tissue. By limiting the operating frequency to 50 kHz, the SAR is reduced to less than 1 μW/kg. The fabricated device is characterized with low-intensity AC magnetic field up to 40 μT without using any DC bias, resulting in 0.4 V output voltage and 6.6 μW power across 8 k Ω load. Alignment misorientation between the Tx and Rx is studied for in-plane and out-of-plane angular rotations to confirm the device's reliability against angular misalignment. By eliminating the bulky biasing magnets, the proposed device achieves a significant size reduction compared to the previously reported works. In addition, a self-powered interface PMC is incorporated with the ME system. The PMC generates 3.5 V regulated DC voltage from the input AC voltage range 0.7 V to 3.3 V. The PMC is fabricated on a 2-layered PCB and the over all ME WPT system consumes 12 × 12 mm 2 area. The overall PMC has intrinsic current consumption less than 550 nA with peak power conversion efficiency higher than 85 %. The in vitro cytotoxicity analysis in the human hepatic cell line WRL-68 confirmed the biocompatibility of the Parylene-C encapsulated ME device for up to 7 days, suggesting its potential use in implantable electronic devices for biomedical and clinical applications.

Wireless Stimulation of Motor Cortex Through a Collagen Dura Substitute Using an Ultra-Thin Implant Fabricated on Parylene/PDMS

We present the design, fabrication, and in vivo testing of an ultra-thin (100 μm) wireless and battery-free implant for stimulation of the brain's cortex. The implant is fabricated on a flexible and transparent parylene/PDMS substrate, and it is miniaturized to dimensions of 15.6 × 6.6 mm 2. The frequency and pulse width of the monophasic voltage pulses are determined through On-Off keying (OOK) modulation of a wireless transmission at 2.45 GHz. Furthermore, the implant triggered a motor response in vivo when tested in 6 rodents. Limb response was observed by wireless stimulation of the brain's motor cortex through an FDA-approved collagen dura substitute that was placed on the dura in the craniotomy site, with no direct contact between the implant's electrodes and the brain's cortical surface. Therefore, the wireless stimulation method reported herein enables the concept of an e-dura substitute, where wireless electronics can be integrated onto a conventional dura substitute to augment its therapeutic function and administer any desired stimulation protocol without the need for post-surgical intervention for battery replacement or reprogramming stimulation parameters.

Janus microparticles-based targeted and spatially-controlled piezoelectric neural stimulation via low-intensity focused ultrasound

Electrical stimulation is a fundamental tool in studying neural circuits, treating neurological diseases, and advancing regenerative medicine. Injectable, free-standing piezoelectric particle systems have emerged as non-genetic and wireless alternatives for electrode-based tethered stimulation systems. However, achieving cell-specific and high-frequency piezoelectric neural stimulation remains challenging due to high-intensity thresholds, non-specific diffusion, and internalization of particles. Here, we develop cell-sized 20 μm-diameter silica-based piezoelectric magnetic Janus microparticles (PEMPs), enabling clinically-relevant high-frequency neural stimulation of primary neurons under low-intensity focused ultrasound. Owing to its functionally anisotropic design, half of the PEMP acts as a piezoelectric electrode via conjugated barium titanate nanoparticles to induce electrical stimulation, while the nickel-gold nanofilm-coated magnetic half provides spatial and orientational control on neural stimulation via external uniform rotating magnetic fields. Furthermore, surface functionalization with targeting antibodies enables cell-specific binding/targeting and stimulation of dopaminergic neurons. Taking advantage of such functionalities, the PEMP design offers unique features towards wireless neural stimulation for minimally invasive treatment of neurological diseases.

Advancements in non-invasive microwave brain stimulation: A comprehensive survey

This survey provides a comprehensive insight into the world of non-invasive brain stimulation and focuses on the evolving landscape of deep brain stimulation through microwave research. Non-invasive brain stimulation techniques provide new prospects for comprehending and treating neurological disorders. We investigate the methods shaping the future of deep brain stimulation, emphasizing the role of microwave technology in this transformative journey. Specifically, we explore antenna structures and optimization strategies to enhance the efficiency of high-frequency microwave stimulation. These advancements can potentially revolutionize the field by providing a safer and more precise means of modulating neural activity. Furthermore, we address the challenges that researchers currently face in the realm of microwave brain stimulation. From safety concerns to methodological intricacies, this survey outlines the barriers that must be overcome to fully unlock the potential of this technology. This survey serves as a roadmap for advancing research in microwave brain stimulation, pointing out potential directions and innovations that promise to reshape the field.

First-in-human demonstration of floating EMG sensors and stimulators wirelessly powered and operated by volume conduction

BACKGROUND

Recently we reported the design and evaluation of floating semi-implantable devices that receive power from and bidirectionally communicate with an external system using coupling by volume conduction. The approach, of which the semi-implantable devices are proof-of-concept prototypes, may overcome some limitations presented by existing neuroprostheses, especially those related to implant size and deployment, as the implants avoid bulky components and can be developed as threadlike devices. Here, it is reported the first-in-human acute demonstration of these devices for electromyography (EMG) sensing and electrical stimulation.

METHODS

A proof-of-concept device, consisting of implantable thin-film electrodes and a nonimplantable miniature electronic circuit connected to them, was deployed in the upper or lower limb of six healthy participants. Two external electrodes were strapped around the limb and were connected to the external system which delivered high frequency current bursts. Within these bursts, 13 commands were modulated to communicate with the implant.

RESULTS

Four devices were deployed in the biceps brachii and the gastrocnemius medialis muscles, and the external system was able to power and communicate with them. Limitations regarding insertion and communication speed are reported. Sensing and stimulation parameters were configured from the external system. In one participant, electrical stimulation and EMG acquisition assays were performed, demonstrating the feasibility of the approach to power and communicate with the floating device.

CONCLUSIONS

This is the first-in-human demonstration of EMG sensors and electrical stimulators powered and operated by volume conduction. These proof-of-concept devices can be miniaturized using current microelectronic technologies, enabling fully implantable networked neuroprosthetics.

Miniature battery-free bioelectronics

Miniature wireless bioelectronic implants that can operate for extended periods of time can transform how we treat disorders by acting rapidly on precise nerves and organs in a way that drugs cannot. To reach this goal, materials and methods are needed to wirelessly transfer energy through the body or harvest energy from the body itself. We review some of the capabilities of emerging energy transfer methods to identify the performance envelope for existing technology and discover where opportunities lie to improve how much-and how efficiently-we can deliver energy to the tiny bioelectronic implants that can support emerging medical technologies.

Magnetoelectrics enables large power delivery to mm-sized wireless bioelectronics

To maximize the capabilities of minimally invasive implantable bioelectronic devices, we must deliver large amounts of power to small implants; however, as devices are made smaller, it becomes more difficult to transfer large amounts of power without a wired connection. Indeed, recent work has explored creative wireless power transfer (WPT) approaches to maximize power density [the amount of power transferred divided by receiver footprint area (length × width)]. Here, we analyzed a model for WPT using magnetoelectric (ME) materials that convert an alternating magnetic field into an alternating voltage. With this model, we identify the parameters that impact WPT efficiency and optimize the power density. We find that improvements in adhesion between the laminated ME layers, clamping, and selection of material thicknesses lead to a power density of 3.1 mW/mm2, which is over four times larger than previously reported for mm-sized wireless bioelectronic implants at a depth of 1 cm or more in tissue. This improved power density allows us to deliver 31 and 56 mW to 10 and 27-mm2 ME receivers, respectively. This total power delivery is over five times larger than similarly sized bioelectronic devices powered by radiofrequency electromagnetic waves, inductive coupling, ultrasound, light, capacitive coupling, or previously reported magnetoelectrics. This increased power density opens the door to more power-intensive bioelectronic applications that have previously been inaccessible using mm-sized battery-free devices.

Magnetoelectrics Enables Large Power Delivery to mm-Sized Wireless Bioelectronics

To maximize the capabilities of minimally invasive implantable bioelectronic devices, we must deliver large amounts of power to small implants; however, as devices are made smaller, it becomes more difficult to transfer large amounts of power without a wired connection. Indeed, recent work has explored creative wireless power transfer (WPT) approaches to maximize power density (the amount of power transferred divided by receiver footprint area (length × width)). Here, we analyzed a model for WPT using magnetoelectric (ME) materials that convert an alternating magnetic field into an alternating voltage. With this model, we identify the parameters that impact WPT efficiency and optimize the power density. We find that improvements in adhesion between the laminated ME layers, clamping, and selection of material thicknesses lead to a power density of 3.1 mW/mm 2 , which is over 4 times larger than previously reported for mm-sized wireless bioelectronic implants at a depth of 1 cm or more in tissue. This improved power density allows us to deliver 31 mW and 56 mW to 10-mm 2 and 27-mm 2 ME receivers, respectively. This total power delivery is over 5 times larger than similarly sized bioelectronic devices powered by radiofrequency electromagnetic waves, inductive coupling, ultrasound, light, capacitive coupling, or previously reported magnetoelectrics. This increased power density opens the door to more power-intensive bioelectronic applications that have previously been inaccessible using mm-sized battery-free devices.

A Fully Wireless and Batteryless Localization System With 50 Micrometre Motion Detection Capability and Adaptive Transmitter Power Control for Point-of-Care Biomedical Applications

Localization has varied applications in biomedicine, such as wireless capsule endoscopy (WCE), detection of cancerous tissue, drug delivery, robotic surgeries, and brain mapping. Currently, most localization systems are battery-powered and suffer from issues regarding battery leakage and limited battery life, resulting in potential health hazards and inconveniences when using them for continuous health monitoring applications. This article proposes an entirely wireless and battery-less 2D localization system consisting of an integrated circuit (IC) that is wirelessly powered at a distance of 4 cm by a 40.68 MHz radio frequency (RF) power of only 2 W. The proposed localization system wirelessly transmits a locked sub-harmonic 13.56 MHz signal generated from the wirelessly received 40.68 MHz RF power signal, eliminating the need for a power-hungry oscillator. Additionally, the system, having a measurement latency of 11.3 ms, has also been verified to sense motion as small as 50 [Formula: see text] as well as measure the rate of motion up to 10 beats per minute, therefore extending its application to the detection of physiological motions such as diaphragm motion during breathing. The localizer has a small form factor of 17 mm × 12 mm × 0.2 mm and consumes an average power of 6 μW. Ex vivo measurements using the localizer inside the porcine intestine demonstrate a localization accuracy of less than 5 mm.

Wireless-controlled cubic neural stimulator for free-moving animals

An electrical stimulator transmitting information into selected neural circuits is a promising approach for neural prostheses or animal robots. However, traditional stimulators are based on rigid printed circuit board (PCB) technology; technological limitations hindered the development of stimulators, especially for experiments involving free-moving subjects. Here we described a small (1.6 × 1.8 × 1.6 cm), lightweight (4 g, including a 100 mA h lithium battery) and multi-channel (eight unipolar or four bipolar biphasic channels) cubic wireless electrical stimulator exploiting flexible PCB technology. In comparison with the traditional stimulator, an appliance of both flexible PCB and cube structure makes it smaller and lighter, and enhances its stability. Stimulation sequences can be constructed with 100 selectable current levels, 40 selectable frequency levels and 20 selectable pulse-width-ratio levels. Moreover, the distance of wireless communication can reach approximately 150 m. Both in vitro and in vivo results have demonstrated functionality of the stimulator. The feasibility of remote pigeon's navigation using the proposed stimulator was successfully verified.

Trends in volumetric-energy efficiency of implantable neurostimulators: a review from a circuits and systems perspective

This paper presents a comprehensive review of state-of-the-art, commercially available neurostimulators. We analyse key design parameters and performance metrics of 45 implantable medical devices across six neural target categories: deep brain, vagus nerve, spinal cord, phrenic nerve, sacral nerve and hypoglossal nerve. We then benchmark these alongside modern cardiac pacemaker devices that represent a more established market. This work studies trends in device size, electrode number, battery technology (i.e., primary and secondary use and chemistry), power consumption and longevity. This information is analysed to show the course of design decisions adopted by industry and identifying opportunity for further innovation. We identify fundamental limits in power consumption, longevity and size as well as the interdependencies and trade-offs. We propose a figure of merit to quantify volumetric efficiency within specific therapeutic targets, battery technologies/capacities, charging capabilities and electrode count. Finally, we compare commercially available implantable medical devices with recently developed systems in the research community. We envisage this analysis to aid circuit and system designers in system optimisation and identifying innovation opportunities, particularly those related to low power circuit design techniques.

An Out-of-Phase Wireless Power Transfer System for Implantable Medical Devices to Reduce Human Exposure to Electromagnetic Field and Increase Power Transfer Efficiency

For the wireless power transfer (WPT) system in implantable medical devices (IMDs), human tissue is positioned between the transmitting and receiving coils which are different from general WPT systems. Because this space is where the strongest electromagnetic field (EMF) occurs, it is essential to reduce the EMF at the interspace to reduce human exposure to the EMF. In this paper, an out-of-phase coupled WPT system for IMDs is proposed to reduce human exposure to EMF. Considering the EMF exposure and power transfer efficiency (PTE) of the proposed system, a design procedure for determining the phase difference of each capacitor is analyzed and presented. Based on the equivalent circuit model analysis of the proposed system, the EMF and PTE characteristics of the WPT system depending on the design variables are comprehensively analyzed. The proposed system is compared with conventional systems through simulation and measurements. It is verified that the proposed system can reduce the EMF by 41.05% and increase the PTE by 9.62% compared to the conventional system. In addition, through simulation, human exposure to EMFs is assessed considering the exposure environment and electrical properties of human tissues. As a result, the current density, induced electric field, and specific absorption rate were reduced by 44.10%, 38.90%, and 63.82%, respectively.

A Multilevel Synchronized Optical Pulsed Modulation for High Efficiency Biotelemetry

The paper describes the design, implementation, and characterization of a novel multilevel synchronized pulse position modulation paradigm for high efficiency optical biotelemetry links. The entire optoelectronic architecture has been designed with the aim to improve the efficiency of the data transmission and decrease the overall power consumption that are key factors for the fabrication of implantable and wearable medical devices. By employing specially designed digital architectures, the proposed modulation technique automatically transmits more than one bit per symbol together with the reference clock signal enabling the decoding process of the received coded data. In the present case, the paper demonstrates the capability of the modulation technique to transmit symbols composed by 3 and 4 bits. This has been achieved by developing a prototype of an optical biotelemetry system implemented on an FPGA board that, making use of 500 ps laser pulses, operates under the following two working conditions: (i) 40 MHz clock signal corresponding to a baud rate of 40 Mega symbol per second for symbols composed by 3 bits; (ii) 30 MHz clock signal corresponding to a baud rate of 30 Mega symbol per second for symbols composed by 4 bits. Thus, for both these two configurations the transmission data rate is 120 Mbps and the measured BER was lower than 10^-10. Finally, the power consumption was found to be 1.95 and 1.8 mW and the resulting energy efficiencies were 16.25 and 15 pJ/bit for transmitted symbols composed by 3 and 4 bits/symbol, respectively.

Recent Advancements in Emerging Technologies for Healthcare Management Systems: A Survey

In recent times, the growth of the Internet of Things (IoT), artificial intelligence (AI), and Blockchain technologies have quickly gained pace as a new study niche in numerous collegiate and industrial sectors, notably in the healthcare sector. Recent advancements in healthcare delivery have given many patients access to advanced personalized healthcare, which has improved their well-being. The subsequent phase in healthcare is to seamlessly consolidate these emerging technologies such as IoT-assisted wearable sensor devices, AI, and Blockchain collectively. Surprisingly, owing to the rapid use of smart wearable sensors, IoT and AI-enabled technology are shifting healthcare from a conventional hub-based system to a more personalized healthcare management system (HMS). However, implementing smart sensors, advanced IoT, AI, and Blockchain technologies synchronously in HMS remains a significant challenge. Prominent and reoccurring issues such as scarcity of cost-effective and accurate smart medical sensors, unstandardized IoT system architectures, heterogeneity of connected wearable devices, the multidimensionality of data generated, and high demand for interoperability are vivid problems affecting the advancement of HMS. Hence, this survey paper presents a detailed evaluation of the application of these emerging technologies (Smart Sensor, IoT, AI, Blockchain) in HMS to better understand the progress thus far. Specifically, current studies and findings on the deployment of these emerging technologies in healthcare are investigated, as well as key enabling factors, noteworthy use cases, and successful deployments. This survey also examined essential issues that are frequently encountered by IoT-assisted wearable sensor systems, AI, and Blockchain, as well as the critical concerns that must be addressed to enhance the application of these emerging technologies in the HMS.

An Ultrasonic Energy Harvesting IC Providing Adjustable Bias Voltage for Pre-Charged CMUT

Ultrasonic wireless power transmission (WPT) using pre-charged capacitive micromachined ultrasonic transducers (CMUT) is drawing great attention due to the easy integration of CMUT with CMOS techniques. Here, we present an integrated circuit (IC) that interfaces with a pre-charged CMUT device for ultrasonic energy harvesting. We implemented an adaptive high voltage charge pump (HVCP) in the proposed IC, which features low power, overvoltage stress (OVS) robustness, and a wide output range. The ultrasonic energy harvesting IC is fabricated in the 180 nm HV BCD process and occupies a 2 × 2.5 mm² silicon area. The adaptive HVCP offers a 2× - 12× voltage conversion ratio (VCR), thereby providing a wide bias voltage range of 4 V-44 V for the pre-charged CMUT. Moreover, a VCR tunning finite state machine (FSM) implemented in the proposed IC can dynamically adjust the VCR to stabilize the HVCP output (i.e., the pre-charged CMUT bias voltage) to a target voltage in a closed-loop manner. Such a closed-loop control mechanism improves the tolerance of the proposed IC to the received power variation caused by misalignments, amount of transmitted power change, and/or load variation. Besides, the proposed ultrasonic energy harvesting IC has an average power consumption of 35 μW-554 μW corresponding to the HVCP output from 4 V-44 V. The CMUT device with a local surface acoustic intensity of 3.78 mW/mm², which is well below the FDA limit for power flux (7.2 mW/mm²), can deliver sufficient power to the IC.

An ultrasound-induced wireless power supply based on AlN piezoelectric micromachined ultrasonic transducers

Wireless power transfer is one of the enabling technologies for powering implantable biomedical devices. Biocompatibility and CMOS compatibility of wireless power transfer devices are highly desired due to safety and footprint concerns. Toward implantable applications, this paper presents an ultrasound-induced wireless power supply based on AlN piezoelectric micromachined ultrasonic transducer (PMUT). The wireless power supply integrates wireless power transfer, power management and energy storage functions. The PMUT array is used as a passive wireless power receiver, followed by electrical impedance matching networks and a voltage multiplier for efficient power transmission and rectification. The output power intensity of the wireless receiver reaches 7.36 μW/mm² with an incident ultrasound power below the FDA safety limit. The output power of the wireless power supply reaches 18.8 μW and a 100-μF capacitor is fully charged to 3.19 V after power management, which are sufficient to power many low-power implantable biomedical devices such as for neural electrical stimulation, biosensors and intrabody communication applications. The wireless power supply is implemented in a PCB with a diameter of 1 cm. With biocompatibility and CMOS compatibility of AlN thin film compared to commonly used PZT, the proposed solution paves the way for safer and ultraminiaturized wireless power supplies with further development incorporating all the functions on a monolithic chip in the future.

Wireless networks of injectable microelectronic stimulators based on rectification of volume conducted high frequency currents

OBJECTIVE

To develop and in vivo demonstrate threadlike wireless implantable neuromuscular microstimulators that are digitally addressable.

APPROACH

These devices perform, through its two electrodes, electronic rectification of innocuous high frequency current bursts delivered by volume conduction via epidermal textile electrodes. By avoiding the need of large components to obtain electrical energy, this approach allows the development of thin devices that can be intramuscularly implanted by minimally invasive procedures such as injection. For compliance with electrical safety standards, this approach requires a minimum distance, in the order of millimeters or a very few centimeters, between the implant electrodes. Additionally, the devices must cause minimal mechanical damage to tissues, avoid dislocation and be adequate for long-term implantation. Considering these requirements, the implants were conceived as tubular and flexible devices with two electrodes at opposite ends and, at the middle section, a hermetic metallic capsule housing the electronics.

MAIN RESULTS

The developed implants have a submillimetric diameter (0.97 mm diameter, 35 mm length) and consist of a microcircuit, which contains a single custom-developed integrated circuit, housed within a titanium capsule (0.7 mm diameter, 6.5 mm length), and two platinum-iridium coils that form two electrodes (3 mm length) located at opposite ends of a silicone body. These neuromuscular stimulators are addressable, allowing to establish a network of microstimulators that can be controlled independently. Their operation was demonstrated in an acute study by injecting a few of them in the hind limb of anesthetized rabbits and inducing controlled and independent contractions.

SIGNIFICANCE

These results show the feasibility of manufacturing threadlike wireless addressable neuromuscular stimulators by using fabrication techniques and materials well established for chronic electronic implants. Although long-term operation still must be demonstrated, the obtained results pave the way to the clinical development of advanced motor neuroprostheses formed by dense networks of such wireless devices.

Self-Sustainable Biomedical Devices Powered by RF Energy: A Review

Wearable and implantable medical devices (IMDs) have come a long way in the past few decades and have contributed to the development of many personalized health monitoring and therapeutic applications. Sustaining these devices with reliable and long-term power supply is still an ongoing challenge. This review discusses the challenges and milestones in energizing wearable and IMDs using the RF energy harvesting (RFEH) technique. The review highlights the main integrating frontend blocks such as the wearable and implantable antenna design, matching network, and rectifier topologies. The advantages and bottlenecks of adopting RFEH technology in wearable and IMDs are reviewed, along with the system elements and characteristics that enable these devices to operate in an optimized manner. The applications of RFEH in wearable and IMDs medical devices are elaborated in the final section of this review. This article summarizes the recent developments in RFEH, highlights the gaps, and explores future research opportunities.

Evolution of Biotelemetry in Medical Devices: From Radio Pills to mm-Scale Implants

The advent of semiconductor technology in the mid-20th century created unprecedented opportunities to develop a new generation of small-scale wireless medical sensing devices that can support remote monitoring of patients' vital signs. The first radio pills were developed as early as the 1950's using only a few transistors. These swallowable capsules could sense and wirelessly transmit vital parameters from inside the human body. Since then we have witnessed the rapid progress of medical devices driven by the evolution of semiconductor technology, from single-transistor oscillators to complex mixed-signal multi-channel and multi-modal systems. This paper retraces the evolution of biotelemetry devices from their very early inception to the smart miniaturized systems of modern days, focusing on semiconductor-enabled sensing methods and circuits developed over the last six decades. The paper also includes the author's perspective on current and future trends in the development of CMOS-based biotelemeters, focusing on concepts of implant modularity, miniaturization and hybrid energy harvesting solutions.

An implantable ultrasound-powered device for the treatment of brain cancer using electromagnetic fields

Brain tumors have been proved challenging to treat. Here, we present a promising alternative by developing an implantable ultrasound-powered tumor treating device (UP-TTD) that electromagnetically disrupts the rapid division of cancer cells without any adverse effects on normal neurons, thereby safely inhibiting brain cancer recurrence. In vitro and in vivo experiments confirmed the significant therapeutic effect of the UP-TTD, with ~58% inhibition on growth rate of clinical tumor cells and ~78% reduction of cancer area in tumor-bearing rats. This UP-TTD is wireless ultrasound-powered, chip-sized, lightweight, and easy to operate on complex surfaces, with a largely boosting therapeutic efficiency and reducing energy consumption. Meanwhile, various treatment parameters could be tuned from the UP-TTD without increasing its size or adding circuits on the integrated chip. The tuning process was simulated and discussed, showing an excellent agreement with the experimental data. The encouraging results of the UP-TTD raise the possibility of a new modality for brain cancer treatment.

Floating EMG sensors and stimulators wirelessly powered and operated by volume conduction for networked neuroprosthetics

Background

Implantable neuroprostheses consisting of a central electronic unit wired to electrodes benefit thousands of patients worldwide. However, they present limitations that restrict their use. Those limitations, which are more adverse in motor neuroprostheses, mostly arise from their bulkiness and the need to perform complex surgical implantation procedures. Alternatively, it has been proposed the development of distributed networks of intramuscular wireless microsensors and microstimulators that communicate with external systems for analyzing neuromuscular activity and performing stimulation or controlling external devices. This paradigm requires the development of miniaturized implants that can be wirelessly powered and operated by an external system. To accomplish this, we propose a wireless power transfer (WPT) and communications approach based on volume conduction of innocuous high frequency (HF) current bursts. The currents are applied through external textile electrodes and are collected by the wireless devices through two electrodes for powering and bidirectional digital communications. As these devices do not require bulky components for obtaining power, they may have a flexible threadlike conformation, facilitating deep implantation by injection.

Methods

We report the design and evaluation of advanced prototypes based on the above approach. The system consists of an external unit, floating semi-implantable devices for sensing and stimulation, and a bidirectional communications protocol. The devices are intended for their future use in acute human trials to demonstrate the distributed paradigm. The technology is assayed in vitro using an agar phantom, and in vivo in hindlimbs of anesthetized rabbits.

Results

The semi-implantable devices were able to power and bidirectionally communicate with the external unit. Using 13 commands modulated in innocuous 3 MHz HF current bursts, the external unit configured the sensing and stimulation parameters, and controlled their execution. Raw EMG was successfully acquired by the wireless devices at 1 ksps.

Conclusions

The demonstrated approach overcomes key limitations of existing neuroprostheses, paving the way to the development of distributed flexible threadlike sensors and stimulators. To the best of our knowledge, these devices are the first based on WPT by volume conduction that can work as EMG sensors and as electrical stimulators in a network of wireless devices.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12984-022-01033-3.

A 28 nm Bulk CMOS Fully Digital BPSK Demodulator for US-Powered IMDs Downlink Communications

Low-invasive and battery-less implantable medical devices (IMDs) have been increasingly emerging in recent years. The developed solutions in the literature often concentrate on the Bidirectional Data-Link for long-term monitoring devices. Indeed, their ability to collect data and communicate them to the external world, namely Data Up-Link, has revealed a promising solution for bioelectronic medicine. Furthermore, the capacity to control organs such as the brain, nerves, heart-beat and gastrointestinal activities, made up through the manipulation of electrical transducers, could optimise therapeutic protocols and help patients’ pain relief. These kinds of stimulations come from the modulation of a powering signal generated from an externally placed unit coupled to the implanted receivers for power/data exchanging. The established communication is also defined as a Data Down-Link. In this framework, a new solution of the Binary Phase-Shift Keying (BPSK) demodulator is presented in this paper in order to design a robust, low-area, and low-power Down-Link for ultrasound (US)-powered IMDs. The implemented system is fully digital and PLL-free, thus reducing area occupation and making it fully synthesizable. Post-layout simulation results are reported using a 28 nm Bulk CMOS technology provided by TSMC. Using a 2 MHz carrier input signal and an implant depth of 1 cm, the data rate is up to 1.33 Mbit/s with a 50% duty cycle, while the minimum average power consumption is cut-down to 3.3 μW in the typical corner.

Injectable wireless microdevices: challenges and opportunities

In the past three decades, we have witnessed unprecedented progress in wireless implantable medical devices that can monitor physiological parameters and interface with the nervous system. These devices are beginning to transform healthcare. To provide an even more stable, safe, effective, and distributed interface, a new class of implantable devices is being developed; injectable wireless microdevices. Thanks to recent advances in micro/nanofabrication techniques and powering/communication methodologies, some wireless implantable devices are now on the scale of dust (< 0.5 mm), enabling their full injection with minimal insertion damage. Here we review state-of-the-art fully injectable microdevices, discuss their injection techniques, and address the current challenges and opportunities for future developments.

Tracking the Migration of Injectable Microdevices in the Rodent Brain Using a 9.4T Magnetic Resonance Imaging Scanner

Wirelessly powered microdevices are being miniaturized to improve safety, longevity, and spatial resolution in a wide range of biomedical applications. Some wireless microdevices have reached a point where they can be injected whole into the central nervous system. However, the state-of-the-art floating microdevices have not yet been tested in chronic brain applications, and there is a growing concern that the implants might migrate through neural tissue over time. Using a 9.4T MRI scanner, we attempt to address the migration question by tracking ultra-small devices injected in different areas of the brain (cortico-subcortical) of rats over 5 months. We demonstrate that injectable microdevices smaller than 0.01 mm³ remain anchored in the brain at the targeted injection site over this time period. Based on CD68 (microglia) and GFAP (astrocytes) immunoreactivity to the microdevice, we hypothesize that glial scar formation is preventing the migration of chronically implanted microdevices in the brain over time.

Ultrasound-Powered Implants: A Critical Review of Piezoelectric Material Selection and Applications

Ultrasound-powered implants (UPIs) represent cutting edge power sources for implantable medical devices (IMDs), as their powering strategy allows for extended functional lifetime, decreased size, increased implant depth, and improved biocompatibility. IMDs are limited by their reliance on batteries. While batteries proved a stable power supply, batteries feature relatively large sizes, limited life spans, and toxic material compositions. Accordingly, energy harvesting and wireless power transfer (WPT) strategies are attracting increasing attention by researchers as alternative reliable power sources. Piezoelectric energy scavenging has shown promise for low power applications. However, energy scavenging devices need be located near sources of movement, and the power stream may suffer from occasional interruptions. WPT overcomes such challenges by more stable, on-demand power to IMDs. Among the various forms of WPT, ultrasound powering offers distinct advantages such as low tissue-mediated attenuation, a higher approved safe dose (720 mW cm^-2 ), and improved efficiency at smaller device sizes. This study presents and discusses the state-of-the-art in UPIs by reviewing piezoelectric materials and harvesting devices including lead-based inorganic, lead-free inorganic, and organic polymers. A comparative discussion is also presented of the functional material properties, architecture, and performance metrics, together with an overview of the applications where UPIs are being deployed.

Wireless Power Delivery Techniques for Miniature Implantable Bioelectronics

Progress in implanted bioelectronic technology offers the opportunity to develop more effective tools for personalized electronic medicine. While there are numerous clinical and pre-clinical applications for these devices, power delivery to these systems can be challenging. Wireless battery-free devices offer advantages such as a smaller and lighter device footprint and reduced failures and infections by eliminating lead wires. However, with the development of wireless technologies, there are fundamental tradeoffs between five essential factors: power, miniaturization, depth, alignment tolerance, and transmitter distance, while still allowing devices to work within safety limits. These tradeoffs mean that multiple forms of wireless power transfer are necessary for different devices to best meet the needs for a given biological target. Here six different types of wireless power transfer technologies used in bioelectronic implants-inductive coupling, radio frequency, mid-field, ultrasound, magnetoelectrics, and light-are reviewed in context of the five tradeoffs listed above. This core group of wireless power modalities is then used to suggest possible future bioelectronic technologies and their biological applications.

Wireless Power Transfer and Telemetry for Implantable Bioelectronics

Implantable bioelectronic devices are becoming useful and prospective solutions for various diseases owing to their ability to monitor or manipulate body functions. However, conventional implantable devices (e.g., pacemaker and neurostimulator) are still bulky and rigid, which is mostly due to the energy storage component. In addition to mechanical mismatch between the bulky and rigid implantable device and the soft human tissue, another significant drawback is that the entire device should be surgically replaced once the initially stored energy is exhausted. Besides, retrieving physiological information across a closed epidermis is a tricky procedure. However, wireless interfaces for power and data transfer utilizing radio frequency (RF) microwave offer a promising solution for resolving such issues. While the RF interfacing devices for power and data transfer are extensively investigated and developed using conventional electronics, their application to implantable bioelectronics is still a challenge owing to the constraints and requirements of in vivo environments, such as mechanical softness, small module size, tissue attenuation, and biocompatibility. This work elucidates the recent advances in RF-based power transfer and telemetry for implantable bioelectronics to tackle such challenges.

Wireless Addressable Cortical Microstimulators Powered by Near-Infrared Harvesting

Ensembles of autonomous, spatially distributed wireless stimulators can offer a versatile approach to patterned microstimulation of biological circuits such as the cortex. Here, we demonstrate the concept of a distributed, untethered, and addressable microstimulator, integrating an ultraminiaturized ASIC with a custom-designed GaAs photovoltaic (PV) microscale energy harvester, dubbed as an "optical neurograin (ONG)". An on-board Manchester-encoded near-infrared downlink delivers incident IR power and provides a synchronous clock across an ensemble of microdevices, triggering stimulus events by remote command. Each ONG has a unique device address and, when an incoming downlink bit sequence matches with this device identification (ID), the implant delivers a charge-balanced current stimulus to the target cortex. Present devices use 7-bit metal fuses fabricated during the CMOS process for their device ID, laser-scribed in post-processing, allowing in principle for a stimulator network of up to 128 nodes. We have characterized small ensembles of ONGs and shown a proof of concept of the system both on benchtop and in vivo rat rodent model.

A Review of Power Management Integrated Circuits for Ultrasound-Based Energy Harvesting in Implantable Medical Devices

This paper aims to review the recent architectures of power management units for ultrasound-based energy harvesting, while focusing on battery-less implantable medical devices. In such systems, energy sustainability is based on piezoelectric devices and a power management circuit, which represents a key building block since it maximizes the power extracted from the piezoelectric devices and delivers it to the other building blocks of the implanted device. Since the power budget is strongly constrained by the dimension of the piezoelectric energy harvester, complexity of topologies have been increased bit by bit in order to achieve improved power efficiency also in difficult operative conditions. With this in mind, the introduced work consists of a comprehensive presentation of the main blocks of a generic power management unit for ultrasound-based energy harvesting and its operative principles, a review of the prior art and a comparative study of the performance achieved by the considered solutions. Finally, design guidelines are provided, allowing the designer to choose the best topology according to the given design specifications and technology adopted.