Resorbable conductive materials for optimally interfacing medical devices with the living

Implantable and wearable bioelectronic systems are arising growing interest in the medical field. Linking the microelectronic (electronic conductivity) and biological (ionic conductivity) worlds, the biocompatible conductive materials at the electrode/tissue interface are key components in these systems. We herein focus more particularly on resorbable bioelectronic systems, which can safely degrade in the biological environment once they have completed their purpose, namely, stimulating or sensing biological activity in the tissues. Resorbable conductive materials are also explored in the fields of tissue engineering and 3D cell culture. After a short description of polymer-based substrates and scaffolds, and resorbable electrical conductors, we review how they can be combined to design resorbable conductive materials. Although these materials are still emerging, various medical and biomedical applications are already taking shape that can profoundly modify post-operative and wound healing follow-up. Future challenges and perspectives in the field are proposed.

Walking naturally after spinal cord injury using a brain-spine interface

A spinal cord injury interrupts the communication between the brain and the region of the spinal cord that produces walking, leading to paralysis^1,2. Here, we restored this communication with a digital bridge between the brain and spinal cord that enabled an individual with chronic tetraplegia to stand and walk naturally in community settings. This brain-spine interface (BSI) consists of fully implanted recording and stimulation systems that establish a direct link between cortical signals³ and the analogue modulation of epidural electrical stimulation targeting the spinal cord regions involved in the production of walking^4-6. A highly reliable BSI is calibrated within a few minutes. This reliability has remained stable over one year, including during independent use at home. The participant reports that the BSI enables natural control over the movements of his legs to stand, walk, climb stairs and even traverse complex terrains. Moreover, neurorehabilitation supported by the BSI improved neurological recovery. The participant regained the ability to walk with crutches overground even when the BSI was switched off. This digital bridge establishes a framework to restore natural control of movement after paralysis.

Insights into the mechanical interaction between an active cranial implant and the skull subjected to moderate impact loadings

In the context of cochlear implants, which are now widely used, and innovative active devices, the cranial implantation of electronic devices raises new questions about the mechanical interactions between the implant and the skull. The aim of this study was to build a methodology using experimental data and numerical simulations to evaluate the mechanical interactions between the skull and the WIMAGINE® active cranial implant intended for use for tetraplegic patients. A finite element model of the implant housing and a simplified model of the three-layered skull were developed. 2.5 J-hammer impact tests were performed on implant housings and ovine cadaver heads for model calibration. The two models were then combined to analyze the interactions between the skull and the implant and compared against impact tests. The implant dissipates a certain amount of the impact energy which could be a parameter to include in implant design in addition to the implant integrity, tending to increase the implant stiffness. The non-implanted as well as the implanted lamb heads demonstrated an overall good resistance to the impact tests. The models correlated well with the experimental data, and improvements of the model through more realistic geometry (CT-scans) and more complex material behavior could now be implemented. Such a model could then be used with human head geometries and help for future implant design optimizations using numerical models of the implant-skull and even implant-head complex.

Long-term stability of the chronic epidural wireless recorder WIMAGINE in tetraplegic patients

Objective.The evaluation of the long-term stability of ElectroCorticoGram (ECoG) signals is an important scientific question as new implantable recording devices can be used for medical purposes such as Brain-Computer Interface (BCI) or brain monitoring.Approach.The long-term clinical validation of wireless implantable multi-channel acquisition system for generic interface with neurons (WIMAGINE), a wireless 64-channel epidural ECoG recorder was investigated. The WIMAGINE device was implanted in two quadriplegic patients within the context of a BCI protocol. This study focused on the ECoG signal stability in two patients bilaterally implanted in June 2017 (P1) and in November 2019 (P2).Methods. The ECoG signal was recorded at rest prior to each BCI session resulting in a 32 month and in a 14 month follow-up for P1 and P2 respectively. State-of-the-art signal evaluation metrics such as root mean square (RMS), the band power (BP), the signal to noise ratio (SNR), the effective bandwidth (EBW) and the spectral edge frequency (SEF) were used to evaluate stability of signal over the implantation time course. The time-frequency maps obtained from task-related motor activations were also studied to investigate the long-term selectivity of the electrodes.Mainresults.Based on temporal linear regressions, we report a limited decrease of the signal average level (RMS), spectral distribution (BP) and SNR, and a remarkable steadiness of the EBW and SEF. Time-frequency maps obtained during motor imagery, showed a high level of discrimination 1 month after surgery and also after 2 years.Conclusions.The WIMAGINE epidural device showed high stability over time. The signal evaluation metrics of two quadriplegic patients during 32 months and 14 months respectively provide strong evidence that this wireless implant is well-suited for long-term ECoG recording.Significance.These findings are relevant for the future of implantable BCIs, and could benefit other patients with spinal cord injury, amyotrophic lateral sclerosis, neuromuscular diseases or drug-resistant epilepsy.

Johnson-Cook Parameter Identification for Commercially Pure Titanium at Room Temperature under Quasi-Static Strain Rates

BACKGROUND

To simulate mechanical shocks on an intracranial implant called WIMAGINE®, Clinatec chose a Johnson-Cook model to account for the viscoplastic behavior of grade 2 titanium in a dynamic study using Radioss©.

METHODS

Thirty tensile specimens were subjected to tensile tests at room temperature, and the influence of the strain rate (8 × 10-3 and 8 × 10-2 s-1) and sandblasting was analyzed. Relaxations were included in the tests to analyze viscosity phenomena.

RESULTS

A whole set of parameters was identified for the elastic and plastic parts. Strain rate influence on stress was negligible at these strain rates. As expected, the sandblasting hardened the material during the tests by decreasing the hardening parameters, while local necking occurred at an earlier strain.

CONCLUSIONS

This article provides the parameters of a Johnson-Cook model to simulate the elastoplastic behavior of pure titanium (T40, grade 2) in Finite Element Model (FEM) software.

Reliability of parylene-based multi-electrode arrays chronically implanted in adult rat brains, and evidence of electrical stimulation on contact impedance

OBJECTIVE

The goal of this study was to evaluate the long-term behavior of the surface electrode through electrochemical characterization and follow-up of implanted parylene/platinum microelectrodes.

APPROACH

To this aim, we designed and manufactured specific planar electrodes for cortical implantation for a rat model. This work was included in the INTENSE^® project, one of the goals of which was to prove the feasibility of selective neural recording or stimulation with cuff electrodes around the vagus nerve.

MAIN RESULTS

After a 12-week implantation in a rat model, we can report that these microelectrodes have withstood in vivo use. Regarding the biocompatibility of the electrodes (materials and manufacturing process), no adverse effect was reported. Indeed, after the three-month implantation, we characterized limited tissue reaction beneath the electrodes and showed an increase and a stabilization of their impedance. Interestingly, the follow-up of the electrochemical impedance combined with electrical stimulation highlighted a drop in the impedance up to 60% at 1 kHz after ten minutes of electrical stimulation at 110 Hz.

SIGNIFICANCE

This study gives evidence of the biocompatibility of the parylene platinum contact array designed for the project and confirms the effect of stimulation on the contact impedance.

Long-Term Sheep Implantation of WIMAGINE®, a Wireless 64-Channel Electrocorticogram Recorder

This article deals with the long-term preclinical validation of WIMAGINE^® (Wireless Implantable Multi-channel Acquisition system for Generic Interface with Neurons), a 64-channel wireless implantable recorder that measures the electrical activity at the cortical surface (electrocorticography, ECoG). The WIMAGINE^® implant was designed for chronic wireless neuronal signal acquisition, to be used e.g., as an intracranial Brain–Computer Interface (BCI) for severely motor-impaired patients. Due to the size and shape of WIMAGINE^®, sheep appeared to be the best animal model on which to carry out long-term in vivo validation. The devices were implanted in two sheep for a follow-up period of 10 months, including idle state cortical recordings and Somato-Sensory Evoked Potential (SSEP) sessions. ECoG and SSEP demonstrated relatively stable behavior during the 10-month observation period. Information recorded from the SensoriMotor Cortex (SMC) showed an SSEP phase reversal, indicating the cortical site of the sensorimotor activity was retained after 10 months of contact. Based on weekly recordings of raw ECoG signals, the effective bandwidth was in the range of 230 Hz for both animals and remarkably stable over time, meaning preservation of the high frequency bands valuable for decoding of the brain activity using BCIs. The power spectral density (in dB/Hz), on a log scale, was of the order of 2.2, –4.5 and –18 for the frequency bands (10–40), (40–100), and (100–200) Hz, respectively. The outcome of this preclinical work is the first long-term in vivo validation of the WIMAGINE^® implant, highlighting its ability to record the brain electrical activity through the dura mater and to send wireless digitized data to the external base station. Apart from local adhesion of the dura to the skull, the neurosurgeon did not face any difficulty in the implantation of the WIMAGINE^® device and post-mortem analysis of the brain revealed no side effect related to the implantation. We also report on the reliability of the system; including the implantable device, the antennas module and the external base station.

WIMAGINE(®): 64-channel ECoG recording implant for human applications

A wireless 64-channel ElectroCorticoGram (ECoG) recording implant named WIMAGINE(®) has been designed for clinical applications. This active implantable medical device is able to record ECoG on 64 electrodes with selectable gain and sampling frequency, with less than 0.7 µVRMS input referred noise in the [0.5 Hz - 300 Hz] band. It is powered remotely through an inductive link at 13.56 MHz, communicates wirelessly on the MICS band at 402-405 MHz with a custom designed base station connected to a PC and complies with the regulations applicable to class III AIMD. The design of the housing and the antenna have been optimized to ease the surgery and to take into account all the requirements of a clinical trial in particular patient safety and comfort. The main features of this WIMAGINE(®) implantable device and its architecture will be presented, as well as its performances and in vivo validations.

WIMAGINE: wireless 64-channel ECoG recording implant for long term clinical applications

A wireless 64-channel ElectroCorticoGram (ECoG) recording implant named WIMAGINE has been designed for various clinical applications. The device is aimed at interfacing a cortical electrode array to an external computer for neural recording and control applications. This active implantable medical device is able to record neural activity on 64 electrodes with selectable gain and sampling frequency, with less than 1 μV(RMS) input referred noise in the [0.5 Hz - 300 Hz] band. It is powered remotely through an inductive link at 13.56 MHz which provides up to 100 mW. The digitized data is transmitted wirelessly to a custom designed base station connected to a PC. The hermetic housing and the antennae have been designed and optimized to ease the surgery. The design of this implant takes into account all the requirements of a clinical trial, in particular safety, reliability, and compliance with the regulations applicable to class III AIMD. The main features of this WIMAGINE implantable device and its architecture are presented, as well as its functional performances and long-term biocompatibility results.

Electrochemically induced maskless metal deposition on micropore wall

By applying an external electric field across a micropore via an electrolyte, metal ions in the electrolyte can be reduced locally onto the inner wall of the micropore, which was fabricated in a silica-covered silicon membrane. This maskless metal deposition on the silica surface is a result of the pore membrane polarization in the electric field.

Polarization-induced local pore-wall functionalization for biosensing: from micropore to nanopore

The use of biological-probe-modified solid-state pores in biosensing is currently hindered by difficulties in pore-wall functionalization. The surface to be functionalized is small and difficult to target and is usually chemically similar to the bulk membrane. Herein, we demonstrate the contactless electrofunctionalization (CLEF) approach and its mechanism. This technique enables the one-step local functionalization of the single pore wall fabricated in a silica-covered silicon membrane. CLEF is induced by polarization of the pore membrane in an electric field and requires a sandwich-like composition and a conducting or semiconducting core for the pore membrane. The defects in the silica layer of the micropore wall enable the creation of an electric pathway through the silica layer, which allows electrochemical reactions to take place locally on the pore wall. The pore diameter is not a limiting factor for local wall modification using CLEF. Nanopores with a diameter of 200 nm fabricated in a silicon membrane and covered with native silica layer have been successfully functionalized with this method, and localized pore-wall modification was obtained. Furthermore, through proof-of-concept experiments using ODN-modified nanopores, we show that functionalized nanopores are suitable for translocation-based biosensing.

Control of neuronal network organization by chemical surface functionalization of multi-walled carbon nanotube arrays

Carbon nanotube substrates are promising candidates for biological applications and devices. Interfacing of these carbon nanotubes with neurons can be controlled by chemical modifications. In this study, we investigated how chemical surface functionalization of multi-walled carbon nanotube arrays (MWNT-A) influences neuronal adhesion and network organization. Functionalization of MWNT-A dramatically modifies the length of neurite fascicles, cluster inter-connection success rate, and the percentage of neurites that escape from the clusters. We propose that chemical functionalization represents a method of choice for developing applications in which neuronal patterning on MWNT-A substrates is required.

Influence of glass and polymer coatings on CHO cell morphology and adhesion

Successful development of cell-on-chip microsystems where living cells are deposited and grown in microfabricated structures is highly dependent on the control of cell/substrate interactions. In this study, several materials of interest were tested for CHO cell growth and morphology: (i) glass, fibronectin-, poly-L-lysine- and 3-aminopropyltriethoxysilane (APTES)--treated glass and UV/O(3)-modified PDMS coating on glass as well as (ii) silicon, poly-L-lysine-, APTES-, O(2) plasma-treated and oxide-coated silicon. In addition, we quantitatively characterized cell adhesion to these substrates using a radial flow detachment assay. Lack of correlation between cell adhesion and cell morphology was systematically observed for all substrates. In particular, we show that PDMS coatings on glass can be finely tuned by UV/O(3) treatment to enhance cell adhesion and induce elongated morphology. Moreover, we observed a low shear stress cell detachment mechanism on silicon oxide coatings on silicon wafers. It is therefore possible with these coatings to selectively influence either cell adhesion or morphology.