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Implants Bring Hope To The Toughest Medical Handicaps

The latest biomedical implants hold the promise of sight for the blind, motor functions for the paralyzed, and an artifical heart for those awaiting transplants.

Date Posted: June 29, 2007 12:00 AM
Author: Roger Allan

Aural artificial implants are available for patients with moderate to severe hearing loss. In fact, the FDA has approved several devices based on pioneering work by the University of Michigan. Devices already on the market include the Nucleus Freedom from Cochlear Corp., the HR90k from Advanced Bionics Corp. (a Boston Scientific company), and the Pulsar CI100 from MED-EL Corp.

Envoy Medical's Envoy implant employs two bio-compatible piezo transducers. One is a microphone that's attached to the ear's incus and malleus bones and receives sound from the natural eardrum. The other, which is attached to the ear's stapes, receives signals from an implanted processor and stimulates the inner ear.

According to the company, it's the only implantable hearing device that leverages the natural anatomical function of the ear.

It's powered by a lithium-iodide battery with a life of three to five years, and it's currently in the final phase of testing at the St. Croix Medical Center.

The Carina hearing implant from Otologics Inc. is also undergoing final-phase testing before FDA approval. Its subdermal microphone feeds signals to an implanted processor, which drives a transducer affixed to the incus and then to the stapes. It operates from a lithium-ion (Li-ion) battery that's recharged by the patient from a belt-worn device, using transdermal inductive coupling for power delivery.

Neural Implants Are Next
Neural implants will be key as researchers learn more about the nervous system. The neurons that make up the nervous system act as pulse-rate-modulated logic elements, forming complex 3D networks that use sensory and physiological functions.

"There is great hope that neural prostheses will help in overcoming diseases and ailments like Parkinson's disease, epilepsy, paralysis, deafness, and blindness," says Kensall Wise, director of the University of Michigan's Engineering Research Center for Wireless Integrated MicroSystems.

Medtronic is working on an implantable "brain radio" system to monitor and control nervous disorders. It's part of a broad category of neural stimulators that send electrical pulses to the brain to control ailments like Parkinson's disease, Alzheimer's disease, epilepsy, and multiple sclerosis. Medtronic's engineers tackled key design issues like noise sensitivity and very low power dissipation by developing a chopper-stabilized amplifier with a noise efficiency factor of 3.6 to 4.5 to handle "popcorn" noise from silicon digital and mixed-signal circuits, as well as a 1.6-V battery that delivers 1.5 µA.

Work on a different kind of neural implant, called "BrainGate," is under way at Brown University. It will enable the mind to control movement—an incredible advantage for the paralyzed. Developed in conjunction with Cyber Kinetics Neurotechnology Systems (founded by professor John Donoghue, head of Brown University's Department of Neuroscience), so far it's allowed one patient to read e-mails, play video games, turn lights on and off, and change and adjust TV controls just by thinking about these actions (Fig. 6).

Epilepsy patients who must rely on vagus nerve stimulators (VNSs) or defibrillators because their seizures don't respond to drugs can look forward to better treatment options. The Massachusetts Institute of Technology (MIT) and the Beth Israel Deaconess Medical Center are creating new software to determine when best to activate the VNS—in this case, a model from Cyberonics Inc. They're developing an implantable detector that measures brain activity to predict when a seizure is about to occur, activating the VNS and halting the seizure before it occurs.

The University of California at Los Angeles (UCLA) David Giffen School of Medicine is creating an implantable trigeminal nerve stimulator (TNS) with Advanced Bionics Corp. According to the researchers, this unique device holds several advantages over VNSs, which only stimulate one side of the brain. A TNS can stimulate both sides.

And unlike the VNS, the TNS can be tested externally to gauge its effectiveness before implantation. Before implanting, the TNS can be worn on a patient's belt with wires attached to the stimulator, passed under clothing, and connected to electrodes attached to the face.

An Exciting Future
Many more implants loom on the horizon. It's come to the point where designers no longer ask if they can be developed, but when. For example, In-Cube Inc. is focusing on tissue engineering. In these hybrid devices, living cells from the patient are integrated with traditionally engineered systems. Researchers there believe this will lead to artificial kidneys, pancreases, lungs, and colons.

In-Cube is pursuing an implantable kidney dialysis system that incorporates implantable polymers and electronics. The patient's own cells perform the dialysis. According to Mir Imran, founder of In-Cube, the implantable kidney is a complex project that's in the bench-testing phase.

The IntelliDrug project for the European Commission's 6th Framework Programme sheds some light on the growing excitement surrounding biomedical implants. The program's aim is to develop electronically controlled intra-oral drug-delivery systems. These remote-controlled systems with replaceable reservoirs would become alternative sources of treatment for addictions and chronic diseases.

Furthermore, nanoparticle implants will monitor the growth and treatment of cancer tumors. Such is the charge of researchers at MIT. They are building implantable nano-particles that can detect specific molecules or analytes like glucose and oxygen, which are associated with tumor growth. The implants are encased in silicone, allowing them to remain in a patient's body for an extended period. They detect tumor growth, show how much of the drug has reached the tumor, and reveal the drug's effectiveness.

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