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Apollo NV, Murphy B, Prezelski K, Driscoll N, Richardson AG, Lucas TH, Vitale F. Gels, jets, mosquitoes, and magnets: a review of implantation strategies for soft neural probes. J Neural Eng 2020; 17:041002. [PMID: 32759476 PMCID: PMC8152109 DOI: 10.1088/1741-2552/abacd7] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Implantable neuroelectronic interfaces have enabled breakthrough advances in the clinical diagnosis and treatment of neurological disorders, as well as in fundamental studies of brain function, behavior, and disease. Intracranial electroencephalography (EEG) mapping with stereo-EEG (sEEG) depth electrodes is routinely adopted for precise epilepsy diagnostics and surgical treatment, while deep brain stimulation has become the standard of care for managing movement disorders. Intracortical microelectrode arrays for high-fidelity recordings of neural spiking activity have led to impressive demonstrations of the power of brain-machine interfaces for motor and sensory functional recovery. Yet, despite the rapid pace of technology development, the issue of establishing a safe, long-term, stable, and functional interface between neuroelectronic devices and the host brain tissue still remains largely unresolved. A body of work spanning at least the last 15 years suggests that safe, chronic integration between invasive electrodes and the brain requires a close match between the mechanical properties of man-made components and the neural tissue. In other words, the next generation of invasive electrodes should be soft and compliant, without sacrificing biological and chemical stability. Soft neuroelectronic interfaces, however, pose a new and significant surgical challenge: bending and buckling during implantation that can preclude accurate and safe device placement. In this topical review, we describe the next generation of soft electrodes and the surgical implantation methods for safe and precise insertion into brain structures. We provide an overview of the most recent innovations in the field of insertion strategies for flexible neural electrodes such as dissolvable or biodegradable carriers, microactuators, biologically-inspired support structures, and electromagnetic drives. In our analysis, we also highlight approaches developed in different fields, such as robotic surgery, which could be potentially adapted and translated to the insertion of flexible neural probes.
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Affiliation(s)
- Nicholas V Apollo
- Department of Bioengineering, University of Pennsylvania, Philadelphia, Pennsylvania 19104, United States of America
- Center for Neuroengineering and Therapeutics, University of Pennsylvania, Philadelphia, Pennsylvania 19104, United States of America
- Center for Neurotrauma, Neurodegeneration, and Restoration, Corporal Michael J. Crescenz Veterans Affairs Medical Center, Philadelphia, Pennsylvania, 19104, United States of America
| | - Brendan Murphy
- Department of Bioengineering, University of Pennsylvania, Philadelphia, Pennsylvania 19104, United States of America
- Center for Neuroengineering and Therapeutics, University of Pennsylvania, Philadelphia, Pennsylvania 19104, United States of America
- Center for Neurotrauma, Neurodegeneration, and Restoration, Corporal Michael J. Crescenz Veterans Affairs Medical Center, Philadelphia, Pennsylvania, 19104, United States of America
- These authors contributed equally
| | - Kayla Prezelski
- Department of Bioengineering, University of Pennsylvania, Philadelphia, Pennsylvania 19104, United States of America
- Center for Neuroengineering and Therapeutics, University of Pennsylvania, Philadelphia, Pennsylvania 19104, United States of America
- Center for Neurotrauma, Neurodegeneration, and Restoration, Corporal Michael J. Crescenz Veterans Affairs Medical Center, Philadelphia, Pennsylvania, 19104, United States of America
- These authors contributed equally
| | - Nicolette Driscoll
- Department of Bioengineering, University of Pennsylvania, Philadelphia, Pennsylvania 19104, United States of America
- Center for Neuroengineering and Therapeutics, University of Pennsylvania, Philadelphia, Pennsylvania 19104, United States of America
- Center for Neurotrauma, Neurodegeneration, and Restoration, Corporal Michael J. Crescenz Veterans Affairs Medical Center, Philadelphia, Pennsylvania, 19104, United States of America
| | - Andrew G Richardson
- Center for Neuroengineering and Therapeutics, University of Pennsylvania, Philadelphia, Pennsylvania 19104, United States of America
- Department of Neurosurgery, University of Pennsylvania, Philadelphia, Pennsylvania 19104, United States of America
| | - Timothy H Lucas
- Center for Neuroengineering and Therapeutics, University of Pennsylvania, Philadelphia, Pennsylvania 19104, United States of America
- Department of Neurosurgery, University of Pennsylvania, Philadelphia, Pennsylvania 19104, United States of America
| | - Flavia Vitale
- Department of Bioengineering, University of Pennsylvania, Philadelphia, Pennsylvania 19104, United States of America
- Center for Neuroengineering and Therapeutics, University of Pennsylvania, Philadelphia, Pennsylvania 19104, United States of America
- Center for Neurotrauma, Neurodegeneration, and Restoration, Corporal Michael J. Crescenz Veterans Affairs Medical Center, Philadelphia, Pennsylvania, 19104, United States of America
- These authors contributed equally
- Department of Neurology, University of Pennsylvania, Philadelphia, Pennsylvania 19104, United States of America
- Department of Physical Medicine & Rehabilitation, University of Pennsylvania, Philadelphia, Pennsylvania, 19104, United States of America
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Orozco GA, Smith JH, García JJ. Three-dimensional nonlinear finite element model to estimate backflow during flow-controlled infusions into the brain. Proc Inst Mech Eng H 2020; 234:1018-1028. [DOI: 10.1177/0954411920937220] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Convection-enhanced delivery is a technique to bypass the blood–brain barrier and deliver therapeutic drugs into the brain tissue. However, animal investigations and preliminary clinical trials have reported reduced efficacy to transport the infused drug in specific zones, attributed mainly to backflow, in which an annular gap is formed outside the catheter and the fluid preferentially flows toward the surface of the brain rather than through the tissue in front of the cannula tip. In this study, a three-dimensional human brain finite element model of backflow was developed to study the influence of anatomical structures during flow-controlled infusions. Predictions of backflow length were compared under the influence of ventricular pressure and the distance between the cannula and the ventricles. Simulations with zero relative ventricle pressure displayed similar backflow length predictions for larger cannula-ventricle distances. In addition, infusions near the ventricles revealed smaller backflow length and the liquid was observed to escape to the longitudinal fissure and ventricular cavities. Simulations with larger cannula-ventricle distances and nonzero relative ventricular pressure showed an increase of fluid flow through the tissue and away from the ventricles. These results reveal the importance of considering both the subject-specific anatomical details and the nonlinear effects in models focused on analyzing current and potential treatment options associated with convection-enhanced delivery optimization for future clinical trials.
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Affiliation(s)
- Gustavo A Orozco
- Department of Applied Physics, University of Eastern Finland, Kuopio, Finland
| | - Joshua H Smith
- Department of Mechanical Engineering, Lafayette College, Easton, PA, USA
| | - José J García
- Escuela de Ingeniería Civil y Geomática, Universidad del Valle, Cali, Colombia
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