Neimat Joseph S, Bina Robert W, Koenig Steven C, Demirors Emrecan, Guida Raffaele, Burke Ryan, Melodia Tommaso, Jimenez Jorge
Department of Neurological Surgery, University of Louisville, Louisville, KY, USA.
Department of Neurological Surgery, University of Louisville, Louisville, KY, USA.
Neuromodulation. 2025 Apr;28(3):455-463. doi: 10.1016/j.neurom.2024.02.008. Epub 2024 May 31.
This study aimed to indicate the feasibility of a prototype electrical neuromodulation system using a closed-loop energy-efficient ultrasound-based mechanism for communication, data transmission, and recharging.
Closed-loop deep brain stimulation (DBS) prototypes were designed and fabricated with ultrasonic wideband (UsWB) communication technology and miniaturized custom electronics. Two devices were implanted short term in anesthetized Göttingen minipigs (N = 2). Targeting was performed using preoperative magnetic resonance imaging, and locations were confirmed postoperatively by computerized tomography. DBS systems were tested over a wide range of stimulation settings to mimic minimal, typical, and/or aggressive clinical settings, and evaluated for their ability to transmit data through scalp tissue and to recharge the DBS system using UsWB.
Stimulation, communication, reprogramming, and recharging protocols were successfully achieved in both subjects for amplitude (1V-6V), frequency (50-250 Hz), and pulse width (60-200 μs) settings and maintained for ≥six hours. The precision of pulse settings was verified with <5% error. Communication rates of 64 kbit/s with an error rate of 0.05% were shown, with no meaningful throughput degradation observed. Time to recharge to 80% capacity was <9 minutes. Two DBS systems also were implanted in the second test animal, and independent bilateral stimulation was successfully shown.
The system performed at clinically relevant implant depths and settings. Independent bilateral stimulation for the duration of the study with a 4F energy storage and full rapid recharge were achieved. Continuous function extrapolates to six days of continuous stimulation in future design iterations implementing application specific integrated circuit level efficiency and 15F storage capacitance. UsWB increases energy efficiency, reducing storage requirements and thereby enabling device miniaturization. The device can enable intelligent closed-loop stimulation, remote system monitoring, and optimization and can serve as a power/data gateway to interconnect the intrabody network with the Internet of Medical Things.
本研究旨在表明一种原型电神经调节系统的可行性,该系统使用基于闭环节能超声的机制进行通信、数据传输和充电。
采用超声宽带(UsWB)通信技术和小型化定制电子设备设计并制造了闭环深部脑刺激(DBS)原型。将两个装置短期植入麻醉的哥廷根小型猪(N = 2)体内。术前使用磁共振成像进行靶向定位,术后通过计算机断层扫描确认位置。在广泛的刺激设置下测试DBS系统,以模拟最小、典型和/或激进的临床设置,并评估其通过头皮组织传输数据以及使用UsWB为DBS系统充电的能力。
在两名受试者中,对于幅度(1V - 6V)、频率(50 - 250Hz)和脉冲宽度(60 - 200μs)设置,刺激、通信、重新编程和充电协议均成功实现,并维持≥6小时。脉冲设置的精度经验证误差<5%。显示通信速率为64kbit/s,错误率为0.05%,未观察到有意义的吞吐量下降。充电至80%容量的时间<9分钟。在第二只实验动物中也植入了两个DBS系统,并成功展示了独立的双侧刺激。
该系统在临床相关的植入深度和设置下运行。在研究期间实现了独立的双侧刺激,具备4F能量存储和完全快速充电功能。在未来实施专用集成电路级效率和15F存储电容的设计迭代中,连续功能可外推至连续刺激六天。UsWB提高了能源效率,减少了存储需求,从而实现了设备小型化。该设备可实现智能闭环刺激、远程系统监测和优化,并可作为将体内网络与医疗物联网互连的电源/数据网关。