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Technical specificities and challenges of neurological active implants
Keywords: Neuro-stimulators, Active implants, Encapsulation
Long term active implantable devices intended to treat neurological disorders are getting available for a large population. It is generally unknown of the public that, every year, more than hundred thousand active devices are implanted in patient suffering from diseases related to the brain, spinal cord, peripheral nerves, and senses (hearing and vision). Interfacing a pulse generator, a recorder, a computer, or any implanted electronic, with the nervous system is very challenging, due to the fragile nature of the tissues, to the immense complexity of the brain, to the capture of tiny signals on hundreds of electrodes, and to the large flow of information to be transferred in and out the body. In the cases where we want to have electrodes interfacing directly with the brain (subcutaneously, epi- or subdural, penetrating the cortex or deep brain stimulation), it will be appropriate to located the implanted electronics “above the neck”. With the exception of cochlear implants, current neurological stimulators, like Deep Brain Stimulation for Parkinson Disease, are still too big and have the pulse generator implanted in the pectoral area, with cables tunneled along the neck and under the scalp. Miniaturization and new encapsulation technologies make it possible to move the electronics in the head. The human head is a very special environment which requires an adaptation of the design of implants to specific constrains. We will describe the criteria to take in account to optimize the design of “above the neck” active implants, in the perspective of efficacy of the therapy, but also in the view of the patients’ and doctors’ needs. The presentation will cover a broad spectrum of the new challenges induced by moving the implant technology above the neck, especially in terms of energy, size, material, fixation, esthetics, reliability, connectivity, surgical insertion and wireless communication. Devices interfacing with the brain usually include many channels for either reading signals or stimulating specific areas of the brain. Having more than 100 channels or electrodes creates new challenges especially in terms of connections. Compared to active implants placed in the chest and abdomen, “above the neck” devices obey to different design rules. Several key building blocks, like hermetic feedthroughs or batteries, must be re-invented to meet the specificities of multi-channel wireless long term implanted brain interfaces. The technological review will be done at system level as well as subsystems level like electrodes, cables, connectors, implanted electronics, sources of energy and external accessories. We will be focusing on understanding the “environment”, including the physical specificities of the human head, but also the technologies used in the past, today and in the future. A careful analysis of advantages and drawbacks of existing active implants used for many therapies and diagnostics in various places in the body will show us the direction to take for neuro-stimulators of the future. The Wyss Center for Neuro-Engineering, based in Geneva Switzerland, is a non-for-profit foundation aiming to accelerate the development of neuro-technologies for human benefits.
Claude Clement, CTO
Wyss Center for Bio and Neuroengineering
Geneva, Not Applicable

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