Neural Prosthetics:A Review of Empirical vs. Systems Engineering Strategies

Abstract

Implantable electrical interfaces with the nervous system were first enabled by cardiac pacemaker technology over 50 years ago and have since diverged into almost all of the physiological functions controlled by the nervous system. There have been a few major clinical and commercial successes, many contentious claims, and some outright failures. These tend to be reviewed within each clinical subspecialty, obscuring the many commonalities of neural control, biophysics, interface materials, electronic technologies, and medical device regulation that they share. This review cites a selection of foundational and recent journal articles and reviews for all major applications of neural prosthetic interfaces in clinical use, trials, or development. The hard-won knowledge and experience across all of these fields can now be amalgamated and distilled into more systematic processes for development of clinical products instead of the often empirical (trial and error) approaches to date. These include a frank assessment of a specific clinical problem, the state of its underlying science, the identification of feasible targets, the availability of suitable technologies, and the path to regulatory and reimbursement approval. Increasing commercial interest and investment facilitates this systematic approach, but it also motivates projects and products whose claims are dubious.

Implantable Direct Current Neural Modulation: Theory, Feasibility, and Efficacy

“…In the nervous system, pulsatile stimulation was in principle confined to evoking an action potential (AP) in response to a pulse. However, due to the gross spatiotemporal spike rate coding method of the peripheral nervous system, pulsatile stimulation offered such a broad realm of applications that IPG technology dominated the field of neuromodulation for many years and it is still the primary commercial technology for neuromodulation therapies (Loeb, 2018).…”

Flourishing energy harvesters for future body sensor network: from single to multiple energy sources

“…(Jayathilaka et al, 2019). Besides, the sensing masks would contribute an extended degree of freedom for health care assessment, by providing respiration diagnosis regarding the respiration rate and the exhaled gases (Su et al, 2020a;2018;2017;Wang et al, 2019e). Implanted bioelectronics, on the other hand, provides new feasibilities in detecting biological signals and stimulating nervous systems or organs (Lee and Lee, 2018).…”

“…Implanted bioelectronics, on the other hand, provides new feasibilities in detecting biological signals and stimulating nervous systems or organs ( Lee and Lee, 2018 ). Besides, neural prostheses can assist patients by enhancing their sensory, cognitive, and motor modalities ( Loeb, 2018 ; Wang et al., 2020a ). The eventual realization of the exhaustive bodyNET will provide insightful information for disease diagnosis, preventive health care, rehabilitation, and even prompt treatment with the aid of surging drug delivery systems.…”

Combined ionic direct current and pulse frequency modulation improves the dynamic range of vestibular canal stimulation

“…Most neural prostheses including vestibular prostheses rely on biphasic charge-balanced pulses to stimulate the neural tissue [15]. It has previously been shown that the application of anodal direct current (DC) to the vestibular system can inhibit baseline activity in the vestibular nerve [9].…”