MIT Media Lab, Massachusetts Institute of Technology, Cambridge, MA, 02139, USA.
Adv Mater. 2020 Apr;32(15):e1901482. doi: 10.1002/adma.201901482. Epub 2019 Jun 17.
The past two decades have seen unprecedented progress in the development of novel materials, form factors, and functionalities in neuroimplantable technologies, including electrocorticography (ECoG) systems, multielectrode arrays (MEAs), Stentrode, and deep brain probes. The key considerations for the development of such devices intended for acute implantation and chronic use, from the perspective of biocompatible hybrid materials incorporation, conformable device design, implantation procedures, and mechanical and biological risk factors, are highlighted. These topics are connected with the role that the U.S. Food and Drug Administration (FDA) plays in its regulation of neuroimplantable technologies based on the above parameters. Existing neuroimplantable devices and efforts to improve their materials and implantation protocols are first discussed in detail. The effects of device implantation with regards to biocompatibility and brain heterogeneity are then explored. Topics examined include brain-specific risk factors, such as bacterial infection, tissue scarring, inflammation, and vasculature damage, as well as efforts to manage these dangers through emerging hybrid, bioelectronic device architectures. The current challenges of gaining clinical approval by the FDA-in particular, with regards to biological, mechanical, and materials risk factors-are summarized. The available regulatory pathways to accelerate next-generation neuroimplantable devices to market are then discussed.
在过去的二十年中,神经植入技术在新型材料、形态因素和功能方面取得了前所未有的进展,包括脑皮层电图(ECoG)系统、多电极阵列(MEA)、Stentrode 和深部脑探针。从生物相容性混合材料结合、顺应性器件设计、植入程序以及机械和生物学风险因素的角度,强调了这些旨在急性植入和慢性使用的器件的开发的关键考虑因素。这些主题与美国食品和药物管理局(FDA)根据上述参数对神经植入技术的监管作用有关。首先详细讨论了现有的神经植入设备及其改进材料和植入方案的努力。然后探讨了设备植入对生物相容性和大脑异质性的影响。研究的主题包括大脑特定的风险因素,如细菌感染、组织瘢痕、炎症和血管损伤,以及通过新兴的混合、生物电子设备架构来管理这些危险的努力。总结了通过 FDA 获得临床批准的当前挑战,特别是在生物、机械和材料风险因素方面。然后讨论了加速下一代神经植入设备进入市场的可用监管途径。