Implantable neural electrical stimulator for external control of gastrointestinal motility

Jalilian, Ehsan; Onen, Denis; Neshev, Emil; Mintchev, Martin P.

doi:10.1016/j.medengphy.2006.03.009

Cited by 31 publications

(22 citation statements)

References 68 publications

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“…The Enterra device uses a stimulation pulse train of 14 Hz frequency with 5 mA amplitude of current, less than 1% duty cycle, 0.1 second in on-time and 5 seconds off-time electrogastrogram signal frequencies and mean amplitudes varied at different stimulation settings. 13,14 Recorded frequency-to-amplitude ratios indicated significant changes in gastric activities during stimulation as compared with control measurements. Amplitude activity became more unequal during baseline measurement than during stimulation.…”

Section: Resultsmentioning

confidence: 91%

Development of innovative techniques for the endoscopic implantation and securing of a novel, wireless, miniature gastrostimulator (with videos)

Deb

Tang

Abell

et al. 2012

Gastrointestinal Endoscopy

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Background Gastric stimulation via high-frequency, low-energy pulses can provide an effective treatment for gastric dysmotility; however, the current commercially available device requires surgical implantation for long-term stimulation and is powered by a nonrechargeable battery. Objective To test and describe endoscopic implantation techniques and testing of stimulation of a novel, wireless, batteryless, gastric electrical stimulation (GES) device. Design Endoscopic gastric implantation techniques were implemented, and in vivo gastric signals were recorded and measured in a non-survival swine model (n = 2; 50-kg animals). Intervention Five novel endoscopic gastric implantation techniques and stimulation of a novel, wireless, batteryless, GES device were tested on a non-survival swine model. Main Outcome Measurements Feasibility of 5 new endoscopic gastric implantation techniques of the novel, miniature, batteryless, wireless GES device while recording and measurement of in vivo gastric signals. Results All 5 of the novel endoscopic techniques permitted insertion and securing of the miniaturized gastrostimulator. By the help of these methods and miniaturization of the gastrostimulator, successful GES could be provided without any surgery. The metallic clip attachment was restricted to the mucosal surface, whereas the prototype tacks, prototype spring coils, percutaneous endoscopic gastrostomy wires/T-tag fasteners, and submucosal pocket endoscopic implantation methods attach the stimulator near transmurally or transmurally to the stomach. They allow more secure device attachment with optimal stimulation depth. Limitations Non-survival pig studies. Conclusion These 5 techniques have the potential to augment the utility of GES as a treatment alternative, to provide an important prototype for other dysmotility treatment paradigms, and to yield insights for new technological interfaces between non-invasiveness and surgery.

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Section: Resultsmentioning

confidence: 91%

Development of innovative techniques for the endoscopic implantation and securing of a novel, wireless, miniature gastrostimulator (with videos)

Deb

Tang

Abell

et al. 2012

Gastrointestinal Endoscopy

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“…Both heavier devices (3,8) have more emphasis on the recording of neural signals than this system, which is not necessary for chronic safety testing. The fully implantable device by Jalilian et al (9) offers an impressive set of features including wireless control, although were it to be continuously active, the battery would last less than a day. Because all pulse parameters must be included in the controller's firmware, this system is not capable of real-time stimulation with arbitrary pulses, as is the case in other systems.…”

Section: Discussionmentioning

confidence: 99%

A Flexible Wireless System for Preclinical Evaluation of Retinal Prosthesis

Thien¹,

Millard²,

Epp³

et al. 2018

Sensors and Materials

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In this paper, we present a novel stimulation controller and monitoring system for evaluating the safety and efficacy of implantable neuroprosthetic devices in a preclinical setting. It features a programmable controller designed to be worn in a custom backpack by freely moving feline subjects. A custom controller powered two, modified, 22-channel clinical stimulators simultaneously. The controller and stimulators together weighed 140 g and measured 85 × 70 × 35 mm 3 . Power was supplied from a 3350 mAh lithium-ion battery. A Bluetooth-enabled laptop-PC base station managed up to six systems and allowed the remote adjustment of the stimulation amplitude and automated collection of stimulator telemetry data. The initial application was for the chronic safety testing of a 44-channel retinal prosthesis. Thirteen feline subjects were implanted with a suprachoroidal electrode array, which was then stimulated or monitored continuously for an average of 54.5 d. Batteries were changed twice weekly and electrode impedances were recorded hourly. This allowed broken electrodes and other issues to be quickly identified and addressed. The ability to remotely control the stimulation amplitude minimised the amount of subject handling that was required, likely reducing subject stress. Existing preclinical evaluation systems are either designed for short-term experiments and have many features but limited battery life, or for long-term static stimulation and are long-lived, but with restricted stimulation parameters and channel counts. Here, we have described a system designed to improve the chronic safety testing of electrode arrays. While it was used here with a suprachoroidal retinal implant, it could be readily adapted for other preclinical models requiring continuous, deterministic stimulation over a prolonged period.

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“…Essentially, the method employs sets of electrode arrangements transverse to the gastric axis, which can be entirely or partially circumferential. When stimulated with high-frequency trains (>20 Hz, for durations >2 seconds), the smooth muscle tissue responds with strong circumferential contraction, which can be even lumen-occluding if amplitudes greater than 10 V (peak-to-peak) are utilized (in case of voltage-based stimulation [122]). The inclusion of multiple circumferential electrode set locations andthe synchronization of the administration of the pulse trains insequential fashion between these locations can propel gastric contentdistally, move it retrogradely, or simply shake it around on demandunder microprocessor control.…”

Section: Types Of Gastric Electrical Stimulation For the Treatmentmentioning

confidence: 99%

Gastric Electrical Stimulation for the Treatment of Obesity: From Entrainment to Bezoars—A Functional Review

Mintchev

2013

ISRN Gastroenterology

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Growing worldwide obesity epidemic has prompted the development of two main treatment streams: (a) conservative approaches and (b) invasive techniques. However, only invasive surgical methods have delivered significant and sustainable benefits. Therefore, contemporary research exploration has focused on the development of minimally invasive gastric manipulation methods featuring a safe but reliable and long-term sustainable weight loss effect similar to the one delivered by bariatric surgeries. This antiobesity approach is based on placing external devices in the stomach ranging from electrodes for gastric electrical stimulation to temporary intraluminal bezoars for gastric volume displacement for a predetermined amount of time. The present paper examines the evolution of these techniques from invasively implantable units to completely noninvasive patient-controllable implements, from a functional, rather than from the traditional, parametric point of view. Comparative discussion over the available pilot and clinical studies related to gastric electrical stimulation outlines the promises and the fallacies of this concept as a reliable alternative anti-obesity strategy.

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Implantable neural electrical stimulator for external control of gastrointestinal motility

Cited by 31 publications

References 68 publications

Development of innovative techniques for the endoscopic implantation and securing of a novel, wireless, miniature gastrostimulator (with videos)

Development of innovative techniques for the endoscopic implantation and securing of a novel, wireless, miniature gastrostimulator (with videos)

A Flexible Wireless System for Preclinical Evaluation of Retinal Prosthesis

Gastric Electrical Stimulation for the Treatment of Obesity: From Entrainment to Bezoars—A Functional Review

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