Electrical Implants — small devices with huge potential


Since the introduction of the pacemaker in 1958, much has changed in the world of electrical stimulation. Whereas the first electrical implants targeted muscles, the implants of today are flexible and focus mainly on the nerves in our body. The concept, however, remains unchanged: electrical implants give control back to the body. Vasiliki Giagka, Assistant Professor of Bioelectronics at TU Delft, talks about the past, present and future of her field of research.

Electrical implants of today look nothing like the first pacemaker of sixty years ago. They are much smaller now and have a much longer battery life, while being much more versatile. Small active implants now help us to relieve the symptoms of Parkinson’s disease, alleviate pain in different parts of the body and treat incontinence. According to Vasiliki Giagka, personalised electronics will soon be part of the treatment plan of patients with rheumatoid arthritis, asthma and diabetes, and patients with spinal cord injury will be able to walk again in the foreseeable future. A pipe dream? Giagka: ‘There is huge potential. I am sure there are a lot of people who will benefit from this research.’

 

The plasticity of the spinal cord

‘Neurons in our body connect to form networks. The spinal cord therefore functions as a conduit for communication between muscles and the brain. For a person who suffers from spinal cord injury, some of these connections are interrupted. About thirty years ago, scientists discovered that networks can re-organise, and new connections can be formed. This phenomenon is called plasticity. We can encourage this process through physical training. In 2012, researchers succeeded in getting a paraplegic patient to support his own weight and even to take a step through a combination of electrical stimulation, medicines and training. Since then, more results have been published on a regular basis. I do not know whether we are going to be able to treat all paraplegic patients – that depends on lots of factors – but I believe there is huge potential. I am sure there are a lot of people who will benefit from this research.’

 

Signals

Electronic implants can be used to control three modalities in the body: to induce signals that are interrupted, to record signals coming from elsewhere in the body to feed them back to another system and to block unwanted signals. ‘Consider how our bladder works,’ explains Giagka. ‘It fills up, so we have to empty it. There needs to be a signal that instructs our body to do this. This is a signal we can induce with electronics at a time we want to. But then we want to know precisely when we want to induce this signal. So we need to record information that reveals how full our bladder is. We can then use this information to extract a signal that tells us that our bladder is full and needs to be emptied. Some people suffer from urinary incontinence: their bladder empties without them having instructed it to do so. We can use electronics to block that signal and restore the mechanism. This way we close the loop.’

Weak points

Closing such a loop with electrical stimulation can heal patients with a variety of conditions, such as spinal cord injury. Giagka: ‘Here in Delft, we are doing research into electronics that stimulate the spinal cord to restore locomotion in paraplegic patients. They can then learn to walk again in a more coordinated way.’ Giagka was already working on this line of research when she completed her PhD in England. ‘I fabricated a flexible electrical implant to stimulate the spinal cord. I wanted to avoid using wires to and from the electronics, because they cause inflammation around the spinal cord. We are currently working on minimising the size and power consumption.’

Local treatment

Giagka’s current activities focus on the next generation of active implantable devices: Bioelectronic Medicines. ‘They are even smaller than the current options and target the peripheral nervous system: smaller nerves that transmit signals of sensation and motor function through the whole body. A doctor must be able to inject the tiny implant around a nerve through a needle and program the device to give the patient personalised local treatment. That has a big advantage: only the immediate vicinity is treated, which avoids the possible side effects that come with medicine.’

Challenges

Giagka believes that before we are at a stage when a doctor can inject and program such an implant, we still face a number of challenges. ‘The devices must be biocompatible with the body and the anatomy, so that they do not cause any damage. They also need to last for decades and be able to run and communicate wirelessly.’ It is not yet known what these active implants will look like. ‘We want to concentrate all the technology in a small housing with a three-dimensional cuff-like form, which can be placed around the nerve. It would be really great if we could make an implant the size of one cubic centimetre.’ Since pharmaceutical company GlaxoSmithKline organised a competition to develop a wireless active implant a few years ago, many companies are now investing in the market. ‘Active implants have since become a hot topic,’ says Giagka. ‘I cannot say whether it is feasible, but GlaxoSmithKline hopes to be able to market these implants by 2023.’

About Vasiliki

Dr Vasiliki (Vasso) Giagka (Athens, 1984) studied Electronic and Computer Engineering at the Aristotle University in Thessaloniki, the second largest city in Greece. After graduating in 2009, she moved to London to do her PhD at University College at the Analogue and Biomedical Electronics and the Implantable Devices Groups . She participated as a post-doctoral researcher in the GlaxoSmithKline Bioelectronics Innovation Challenge. Since 2015, Giagka has been working at TU Delft as an Assistant Professor at the Bioelectronics Group, where she carries out research into new materials and approaches to the problems that come with bioelectronic medicines. She also teaches Master’s students.

 

Text: Koen Scheerders | Photo: Mark Prins | Illustration: Katarina Radovic (Stocksy) | November 2017

Will the Terminator come to life?

Humankind in 2050

Elon Musk recently launched his Neuralink company. What Musk aims to achieve is actually a good indication of what tomorrow’s technology could look like. He wants to make direct contact with our brains in order to connect people with each other. The exchange of information without any speech or typing. That technology, in which electronics are applied within our brains, is now being developed. 

Will humans become cyborgs by 2050? If they do, is that such a bad thing? Wouter Serdijn, Professor in Bio-Electronics at TU Delft, is thinking out loud.

Wouter Serdijn

What is going to happen actually makes logical sense from an evolutionary perspective. There will be further integration of humans and technology. Basically, people are large electrochemical machines. The slow process of information exchange within our bodies takes place by means of hormones and rapid exchange of information is achieved through electricity and neurotransmitters. It is possible to use electronics to influence the interaction between the two.
It is now already standard practice for people born deaf to be given a cochlear implant. By 2050, blind people will be fitted with retinal implants as a rule. It will look much better than it does today. Currently, it is still a type of camera and you can clearly tell that someone is disabled, but by then it will be fully integrated into the eyeball.
By 2050, we will have an even better understanding of how the human brain works. This will enable us to engage in improved interaction with the brain in order to offer even better treatments. Actually, the way we currently suppress medical disorders is quite cruel. This is why I hope to see a fully-fledged alternative for the chemical medicines that come with an arsenal of nasty side-effects. That is why we are, for example, working on injectable electronic medicines. That has to be the way forward.

My primary focus is on improving quality of life for people who are slightly disadvantaged from a medical perspective. The idea of using technology to improve ourselves, or even make ourselves bigger, is quite attractive. Even if there is no real medical need for it, as Elon Musk and others envisage. We will probably become integrated with the internet. What will the value of an individual person then be? Will privacy still exist in the collective? These are issues that we must monitor carefully.

We need to watch out for horror-film scenarios, without becoming technophobes. Yes, it is possible to influence all sensory, motor and empathic processes electrically. It is already possible to achieve it chemically and people seem to have few issues with that. Fifty years ago, people were still afraid of a television that could rewind. Yet we are now embracing interactive TV. We are going fast forward into the future. By 2050, I hope that we all live much more pleasant lives and grow old with integrated electronics. Then, looking back, you will no longer wish to return to 2017. 

Text: Marieke Roggeveen
Photo: Marieke Roggeveen

Komt de Terminator tot leven?

De mens in 2050

Elon Musk lanceerde onlangs zijn bedrijf Neuralink. En wat Musk wil is een goede indicatie van de technologie van de toekomst. Hij wil direct contact maken met onze hersenen en daarmee mensen met elkaar verbinden. Informatie-uitwisseling zonder spraak of typen. Die technologie, waarbij elektronica in onze hersenen wordt geïmplementeerd, is nu in de maak. 

Is de mens een cyborg in, zeg, 2050? En is dat erg? Wouter Serdijn, Professor in Bio-Elektronica aan de TU Delft, vraagt het zich hardop af.

Wouter Serdijn

Wat er gaat gebeuren is eigenlijk evolutionair best logisch. Er gaat een verdere integratie van mens en technologie plaatsvinden. De mens is een grote elektrochemische machine. De langzame informatie-uitwisseling in ons lichaam vindt plaats door middel van hormonen; de snelle informatie-uitwisseling door middel van elektriciteit en neurotransmitters. Je kunt de interactie tussen die laatste twee beïnvloeden met elektronica.
Zo is het nu al standaard dat mensen die doof geboren worden een cochleair  implantaat krijgen. In 2050 krijgen mensen die blind zijn standaard een retinaal implantaat op hun netvlies. Dat zal er veel beter uit zien dan vandaag. Het is nu nog een soort van camera, je ziet duidelijk dat iemand gehandicapt is, maar tegen die tijd zit het volledig in de oogbol.
We zullen in 2050 nog beter begrijpen hoe onze hersenen werken. En daardoor dus beter de interactie aan kunnen gaan met onze hersenen om betere behandelingen te kunnen bieden. Eigenlijk worden medische defecten nu op een zeer brute manier onderdrukt. Ik hoop daarom op een volwaardiger alternatief voor chemische geneesmiddelen, die hebben echt een batterij aan bijwerkingen. We werken daarom bijvoorbeeld aan injecteerbare elektronische medicijnen. Die kant moet het opgaan.

Ik richt me vooral op het verbeteren van de kwaliteit van leven bij mensen die medisch wat minder fortuinlijk zijn. Het zal zeker ook aantrekkelijk worden om onszelf via technologie te verbeteren. Of vergroten. Ook wanneer er geen medische noodzaak voor is, zoals Elon Musk en anderen dat willen Waarschijnlijk worden we dan geïntegreerd met het Internet. Wat is dan nog de waarde van de individuele mens? Bestaat er dan nog privacy in het collectief? Dat moeten we goed in de gaten gaan houden.

We moeten waakzaam zijn voor filmscenario’s, maar vooral geen technofoben worden.  Ja, je kunt alle sensorische, motorische en empatische processen elektrisch beïnvloeden. Dat kan nu ook al, chemisch, en daar lijken mensen minder problemen mee te hebben. In de jaren 50 nog was men bang voor een televisie die kon terugkijken. Nu omarmen we onze interactieve tv. We gaan fast forward naar de toekomst. In 2050 hoop ik dat we allemaal op een veel prettigere manier leven en oud worden met geïntegreerde elektronica. Dan wil je echt niet meer terug naar 2017.

Tekst: Marieke Roggeveen
Foto: Marieke Roggeveen

TU Delft en Inholland ontwikkelen chip voor beter gehoor

13 juli 2017

http://nieuws.inholland.nl/tu-delft-en-inholland-ontwikkelen-chip-voor-beter-gehoor/

Een chip die ervoor zorgt dat doven en slechthorenden beter horen met hun gehoorimplantaat, waardoor hun kwaliteit van leven toeneemt. Dat is het ambitieuze streven van project ReaSONS II Demo van de TU Delft en Inholland. Onlangs kreeg het project subsidie van de Nederlandse Organisatie voor Wetenschappelijk Onderzoek (NWO). Docent-onderzoekers en studenten van verschillende onderwijsdomeinen zullen gezamenlijk aan dit project werken.

Onderzoekers van de TU Delft ontwikkelden een chip die de zenuwactiviteit in het oor nauwkeurig kan meten. In combinatie met een cochleair implantaat kan hij slechthorende en dove mensen veel beter laten horen. De chip is echter nog incompleet. Daarom heeft de TU Delft in samenwerking met Inholland financiering aangevraagd om de ontwikkeling ervan voort te zetten onder de naam ReaSONS II Demo. Het uiteindelijke doel is om bedrijven een prototype aan te bieden dat ze kunnen toepassen in hoorproducten. De NWO kende de Demonstrator-subsidie vorige maand toe.

De ReaSONS chip

Dit project heeft impact op de kwaliteit van leven van mensen die een gehoorimplantaat gebruiken. We werken op het snijvlak van techniek en gezondheidszorg.

Cees Jeroen Bes, onderzoeker bij de TU Delft, ontwikkelaar van de ReaSONS-chip

Samenwerking tussen domeinen
Inholland voert dit project uit met behulp van docent-onderzoekers en studenten van de onderwijsdomeinen Techniek, Ontwerpen en Informatica (TOI) en Gezondheid, Sport en Welzijn (GSW). Het onderzoek wordt uitgevoerd door het kernteam Biomedical van het Domein TOI in samenwerking met het Inholland Health and Technology Centre (IHTC). De opgedane kennis wordt ingezet binnen de curricula van de betrokken opleidingen als voorbeelden tijdens de instructiecolleges, als projectopdracht en afstudeeropdracht. Met dit project denkt Inholland op wereldniveau mee over innovatieve oplossingen op het gebied van gezondheid.

Technisch hoogstandje
Cees Jeroen Bes, docent-onderzoeker en projectleider van het kernteam Biomedical, kent als geen ander de gebruikte technologie. Hij bedacht en implementeerde het concept achter de chip en promoveert er binnenkort op aan de TU Delft. “Nu is het tijd om de chip door te ontwikkelen van een proof-of-concept naar prototype en er een showcase van te maken”, zegt Bes. “Het project is niet alleen een technisch hoogstandje, het heeft ook nog eens impact op de kwaliteit van leven van mensen die een gehoorimplantaat gebruiken. We werken daarbij op het snijvlak van techniek en gezondheidszorg.”

Het project ReaSONS II Demo kent een gebruikerscommissie waarin de bedrijven Healthtech, Advanced Bionics, Twente Medical Systems, Applied Biomedical Systems en mede-patenthouder Leids Universitair Medisch Centrum plaatsnemen. Demonstrator is een financieringsinstrument van het NWO-domein Toegepaste en Technisch Wetenschappen dat daarmee kansrijk technisch onderzoek stimuleert en faciliteert om tot een zogeheten minimaal werkbaar product te komen.

Neem bij vragen over de ReaSONS II Demo contact op met onderzoeker Cees Jeroen Bes via ceesjeroen.bes@inholland.nl.

De Gezonde Samenleving

Met dit project dragen docent-onderzoekers en studenten bij aan De Gezonde Samenleving, een profilerend thema van Hogeschool Inholland. Dit is een samenleving waarin burgers, bij fysieke, psychische en sociale problemen, een zo gezond en sociaal mogelijk leven leiden en kunnen participeren. Een samenleving waarin mensen in hun sociale omgeving centraal staan. Waarin professionals mensen – preventief en bij problemen – activeren en ondersteunen bij het ontwikkelen van zelfmanagement en empowerment. Deze professionals werken interprofessioneel en maken gebruik van de laatste (technologische) innovaties.

Analog Processing of Electrophysiological Signals (lecture)

Today, I gave a lecture for the lecture series Themes in Biomedical Electronics (ET4127) on analog processing of electrophysiological signals. The lecture has been recorded by Collegerama and can be viewed here: https://collegerama.tudelft.nl/Mediasite/Play/ac76aa3b68a6404dbd92a5e862020eaf1d?catalog=528e5b24-a2fc-4def-870e-65bd84b28a8c&playFrom=12188&autoStart=true.

Enjoy!

Wouter

Acting on the potential of action potentials: will bioelectronic medicines be the next biologics?

Article in The Pharmaceutical Journal9 DEC 2016, By Emma Dorey

Bioelectronic medicine is a new approach to treating major chronic diseases that could give doctors and patients alternatives to costly mainstream medicine and may become as commonly prescribed as chemical or biological drugs. Some researchers and pharmaceutical companies are already taking this potential new class of treatments seriously and, as promising results emerge, others are expected to follow.

Imagine a prescription from your doctor, not for tablets but for a tiny electrical device implanted on a nerve in your neck. The device will monitor and treat your condition — whether it is diabetes, asthma, hypertension or even cancer — by modulating electrical impulses.

Pharmaceutical drugs can be highly effective, but don’t work for everyone. They tend to work systemically, often causing a variety of adverse effects, and rely on patient adherence. As a result, there are still countless chronic diseases that remain untreated or poorly treated by mainstream medicine. Enter bioelectronic medicines, a new group of therapies that work by transmitting electrical impulses along nerve fibres, rather than through molecular mechanisms. Tapping into the electrical wiring of the body, bioelectronic medicines — also called electroceuticals — could transform pharmaceutical treatment of many chronic diseases, providing an alternative or adjunct to traditional chemical or biological drugs. With technical advances and burgeoning research activity, this revolutionary approach to treating disease is starting to become a reality.

“Drugs are based on exercising the chemical component of our nervous systems and tend to act very globally. Electroceuticals act locally,” explains Wouter Serdijn, a bioelectronics researcher at Delft University of Technology in the Netherlands and University College London. “Moreover, contrary to drugs, electroceuticals have an instantaneous effect and their effect is reversible. It takes quite some time for drugs to [exert] their beneficial effect and, as a consequence, it takes quite some time to be able to administer the right dose.”

Wouter Serdijn, a bioelectronics researcher at Delft University of Technology in the Netherlands and University College London

Source: Courtesy of Wouter Serdijn

It’s a tall order. “The problem with nerves is that they usually are grouped in bundles and they carry information to and from the brain, from and to the organ; often to more than one organ or to more than one part of an organ,” explains Serdijn. “So stimulation and recording nerves becomes a delicate and highly selective task.”

Serdijn agrees: “I think pharma perceives electroceuticals as a game changer.”

Energy-Efficient Low-Power Circuits for Wireless Energy and Data Transfer in IoT Sensor Nodes

[1704.08910] Energy-Efficient Low-Power Circuits for Wireless Energy and Data Transfer in IoT Sensor Nodes, paper by G. C. Martins, A. Urso, A. Mansano, Y. Liu, W. A. Serdijn

Abstract: In this paper, we present techniques and examples to reduce power consumption and increase energy efficiency of autonomous wireless sensor nodes for the Internet of Things. We focus on RF energy harvesting and data transfer, all of which have a large impact on the device cost, lifetime and functionality. We explore the co-design of antenna and electronics to increase RF-DC conversion and efficiency and to improve the performance of the LNA. A high-efficiency orthogonally switching charge pump rectifier is presented. Its measurement results are presented, along with a discussion on how to define its power conversion efficiency. To boost the rectifier output voltage, while presenting the best output load to it, a DC-DC converter with maximum power point tracking is presented. To transmit slowly-varying signals in a low-power manner, an asynchronous data converter is discussed and two modalities of data transmission are presented. The first one is a passive transmitter implementation and the second a novel low-power sub-GHz UWB transmitter.

Comments: 15 pages, 32 figures, 4 tables
Subjects: Emerging Technologies (cs.ET)
Cite as: arXiv:1704.08910 [cs.ET]
(or arXiv:1704.08910v1 [cs.ET] for this version)

Feit of fictie: kunnen we microchips in onze hersenen implanteren om onze gedachten te downloaden en te uploaden, zoals Elon Musk wil met zijn nieuwe bedrijf “Neurolink”?

Is het mogelijk om microchips te implanteren en daarmee beter onze bedoelingen en wensen over te brengen op een digitale “artificial intelligence layer”, geimplanteerd op onze hersenschors? Fact-check nieuws-item op NPO Radio 1 in de rubriek “Feit of Fictie?”, d. 30 maart 2017. Met bijdragen van Elon Musk, Bas Bloem en Wouter Serdijn.

Het item begint na 54 minuten.

Hoe kun je een dove laten horen en een blinde laten zien?

De Universiteit van Nederland

met
prof. dr. ir. Wouter Serdijn

Doven weer laten horen en blinden weer laten zien: het lijkt misschien een godswonder, maar in principe heb je genoeg aan een superslimme chip. Hoe dat precies werkt weet elektronicus Wouter Serdijn (TU Delft) als geen ander. Laat je rondleiden in een wereld die zich op de vierkante millimeter afspeelt en ervaar zelf hoe het klinkt om met een chip te horen.

prof. dr. ir. Wouter Serdijn

Je lijf aansturen met behulp van bio-elektronica, dat is de tak van sport van prof. dr. Wouter Serdijn (TU Delft). Met behulp van implanteerbare chips in je lijf kun je je brein een handje helpen om losse elektronische eindjes weer goed aan elkaar te knopen. Het gevolg? Patiënten beter laten zien, horen of minder laten trillen (bij bijvoorbeeld Parkinsonpatienten).

Technische Universiteit Delft

De TU Delft inspireert je. Daagt je uit om kritisch te denken. Om creatief te zijn. Of je fascinatie voor techniek om te zetten in frisse ideeën. In elk vak, in elk project. Studeren aan de TU Delft betekent samen met anderen actief werken aan de nieuwste technologische oplossingen.

U.S. Government Awards $20 Million for Electroceuticals Research

nerves

Image: Pradeep Rajendran and Rosemary Challis/Shivkumar Lab/UCLA

The U.S. National Institutes of Health (NIH) wants better ways to treat disease with electrical stimulation, and last week announced the recipients of more than US $20 million in funding for the field. The awards aim to improve maps of the peripheral nervous system—the body’s electrical wiring—and generate sophisticated systems that can hack into its codes.

The funding is part of a $248 million, seven-year program that the NIH Common Fund announced in 2014. Last week’s awards mark the start of the core of that program. Up to $39 million in additional awards will be announced next year. The agency will begin accepting applications for those awards by early 2017, says NIH’s Gene Civillico, who heads up the funding program, called SPARC, or Stimulating Peripheral Activity to Relieve Conditions.

Researchers have for decades been electrically stimulating the brain, the spinal cord and peripheral nerves in an attempt to alleviate ailments such as Parkinson’s disease, epilepsy, pain, and paralysis. The technique can work as well or better than drugs, leading some to dub the field “electroceuticals.” Several companies sell such devices with approval from the U.S. Food and Drug Administration (FDA).

Those tools have seen some success. In clinical studies they have been shown to reduce seizures and symptoms of rheumatoid arthritis, and help people regain bladder control and muscle mobility.

The tools on the market are surprisingly simplistic. In most systems, a pulse generator blindly sends electrical impulses along a lead to electrodes that are placed on a nerve. With enough intensity, the stimulation causes neurons to fire. Those induced impulses, called action potentials, are just like the ones produced naturally by the body. The signals travel along neural networks in different temporal patterns, communicating with the body and influencing chemical and biological processes.

The problem with current devices is that they shoot electrical impulses broadly at nerves in patterns that don’t begin to mimic the body’s natural code. It’s miraculous that the body responds at all to these crude signal patterns. And often the devices activate entire nerves, rather a subset of particular fiber groups, wasting battery power and creating side effects.

That leaves a lot of room for improvement—an exciting prospect for engineers. Many more diseases could be treated with electrical stimulation if the devices were designed more elegantly, say leaders in the field. New designs for electrodes and other tools must better interface with the body and activate nerves that are currently out of reach. And such tools must selectively activate key fibers within the nerve that perform specific functions, these leaders say.

To do that, we need a better understanding of the anatomy of neural circuits—where they are and what they do. We also need to know the precise signal patterns neural circuits use to communicate with organs. In other words, if we want to hack the system, we need maps and codes.

Those are the kinds of breakthroughs NIH Common Fund intends to stimulate with the awards. “We’re seeing a fair bit of clinical success, but with fairly primitive understanding of what the stimulation is actually doing,” says Civillico.

The awards focus on treating conditions such as heart disease, asthma and gastrointestinal disorders. The program’s leaders want researchers to focus on peripheral nerves—those that connect the brain and spinal cord with the rest of the body—because of their potential direct effects on organ systems and their accessibility. (The brain is far more complex, and harder to map.)