- Emily Waltz, “A spark at the periphery,” Nature Biotechnology, vol.34, no. 9, September 2016
- Douglas Fox, “The electric cure,” Nature 545, p 20–22, 4 May 2017
- Anthony Arnold, “The evolution of bioelectronic medicine, Reprogramming the body to fight disease with electricity,” a whitepaper by Setpoint Medical.
Active implantable devices have been used for years to treat chronic conditions with minimal side effects: pacemakers and defibrillators (cardiac rhythm management), cochlear implants (deafness), deep brains stimulation (Parkinson), spinal cord stimulation (chronic pain) etc.
Recently the interest in nerve stimulation has surged because it has been found that mild vagal nerve stimulation can be used as a complementary, or even replacement treatment for (chronic) autoimmune diseases such as, rheumatoid arthritis, Crohn’s disease, colitis, congestive heart failure, psoriasis, multiple sclerosis, asthma, Alzheimer, Parkinson etc.
To make bioelectronic medicines a practical reality, the next generation of smart implantable devices will need to be high miniaturized and autonomous and cost effective so that they can be implanted on the selected nerve with a simple minimally invasive procedure.
With an increasingly aging population, the (cost) effective treatment of chronic diseases is becoming increasingly important to curb the burden of the cost of healthcare. It is widely recognized that many chronic diseases find their roots in inflammatory abnormalities, often involving an over active immune system.
Today, the treatment of chronic autoimmune related diseases with biological cytokine suppressors places a heavy impact on our healthcare systems. Therapies with modern biological compounds such as Etanercept, Adalimumab, and Infliximab cost between $15,000 and $25,000 a year per patient, and even these are effective in only 40% of the cases.
The prospect of a therapy that can be administered with less side effects, lower total costs and with higher efficacy is daunting. Based on the preliminary results obtained so far, it is even justified to consider bioelectronic medicines not only as a last resort, but as a second or first line of therapy.
In Moore4Medical two key technology platforms will be developed that will be essential for the realization of the next generation of active implantable devices: wireless power transfer and selective nerve stimulation:
Wireless power transfer
A technology platform to efficiently transfer energy to implants deep inside the body by means of focused ultrasound will be developed. The objectives are to:
- Efficiently transfer power via ultra sound using tailored small ultrasound transducers and optimized power management electronics including ASIC development to power deep implants;
- Benchmark the above against a best-in-class inductive link for shallow implants;
- Demonstrate the above by an ultrasonically powered bone fraction monitor and an inductively powered conformal peripheral nerve stimulating implant;
- Initiate an innovation track to ultrasonically efficiently energize an UHF neural stimulator.
Selective nerve stimulation
Two technology platforms for neural interfaces will be developed for that match the human anatomy and that can efficiently and selectively trigger nerves:
- Conforming (thin, flexible) subcutaneous leads with electrode layouts that can apply strong gradients of electric current densities near the nerves;
- US Cuff electrodes that are able to focus on specific fascicles within a nerve using ultrasound. The system will be complemented with a ring of electrodes for recording nerve signals so that potential signals traveling along the nerves can be read and modified.