Lim Young-Soo, Kim Ji Hong, Kim Junho, Hoang MinhDuc, Kang Wonok, Koh Mattew, Choi Won Hyuk, Park Steve, Jeong Unyong, Kim Do Hwan, Park Sung-Min
Department of Convergence IT Engineering (CiTE), Pohang University of Science and Technology (POSTECH), Pohang, Republic of Korea.
Department of Chemical Engineering, Hanyang University, Seoul, Republic of Korea.
Nat Commun. 2025 May 2;16(1):4115. doi: 10.1038/s41467-025-59436-4.
Optimizing stimulation protocols for peripheral neuromodulation often depends on patient feedback, which can result in inconsistent clinical outcomes. Here we present a closed-loop control system for peripheral nerve stimulation (PNS) that utilizes evoked compound action potential (ECAP) feedback to regulate stimulation parameters, addressing the limitations of traditional methods. Unlike established closed-loop control techniques in the central nervous system, such as local field potential and spike analysis, a comparable approach for the peripheral nervous system remains underdeveloped. ECAPs can be consistently observed across peripheral nerves, providing a reliable measure of nerve activation. We developed a fully implantable device and neural interface for tibial nerve stimulation (TNS) that incorporates the proposed closed-loop system. This TNS system shows promise as a PNS treatment for alleviating overactive bladder symptoms. In a rat model, the system demonstrated longer micturition intervals and greater effectiveness compared to conventional motor response-based control.
优化用于外周神经调节的刺激方案通常依赖于患者反馈，这可能导致临床结果不一致。在此，我们提出一种用于外周神经刺激（PNS）的闭环控制系统，该系统利用诱发复合动作电位（ECAP）反馈来调节刺激参数，解决了传统方法的局限性。与中枢神经系统中已确立的闭环控制技术（如局部场电位和尖峰分析）不同，外周神经系统的类似方法仍未得到充分发展。ECAP可以在外周神经中持续观察到，为神经激活提供了可靠的测量方法。我们开发了一种用于胫神经刺激（TNS）的完全可植入设备和神经接口，该设备结合了所提出的闭环系统。该TNS系统有望成为一种用于缓解膀胱过度活动症状的PNS治疗方法。在大鼠模型中，与传统的基于运动反应的控制相比，该系统表现出更长的排尿间隔和更高的有效性。
