Technology and Long-term Application of an Epineural Electrode

Thoma, H.; Girsch, Werner; J, Holle; Mayr, Winfried

doi:10.1097/00002480-198907000-00103

Cited by 35 publications

(2 citation statements)

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“…Der Einsatz eines Atemschrittmachers hat schon vor Jahrzehnten in klinischen Studien zu guten Ergebnissen geführt. Es wurden verschiedene Elektroden [37,38,39,40,41] entwickelt und in humanen Studien erfolgreich eingesetzt. Nach heutigem Stand bieten nur zwei Unternehmen ein Implantat mit CE-Zeichen an [39,40].…”

Section: Atemschrittmacherunclassified

Neuroprothetik und Neuromodulation

Stieglitz

2010

Bundesgesundheitsbl.

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Stimulation of the nervous system with the aid of electrical active implants has changed the therapy of neurological diseases and rehabilitation of lost functions and has expanded clinical practice within the last few years. Alleviation of effects of neurodegenerative diseases, therapy of psychiatric diseases, the functional restoration of hearing as well as other applications have been transferred successfully into clinical practice. Other approaches are still under development in preclinical and clinical trials. The restoration of sight by implantable electronic systems that interface with the retina in the eye is an example how technological progress promotes novel medical devices. The idea of using the electrical signal of the brain to control technical devices and (neural) prostheses is driving current research in the field of brain-computer interfaces. The benefit for the patient always has to be balanced with the risks and side effects of those implants in comparison to medicinal and surgical treatments. How these and other developments become established in practice depends finally on their acceptance by the patients and the reimbursement of their costs.

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Section: Atemschrittmacherunclassified

Neuroprothetik und Neuromodulation

Stieglitz

2010

Bundesgesundheitsbl.

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“…The electrode poles are affixed to perineural tissue without the need for surgery. Each of the four circumferential quadrants of the nerve is stimulated in rapid succession to trigger a paced breath [52]- [54].…”

Section: A Functional Electrical Stimulationmentioning

confidence: 99%

Functional Neuromuscular Stimulation of the Respiratory Muscles for Patients With Spinal Cord Injury

Lin

Hsiao

2008

Proc. IEEE

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The ability to breathe or cough has been restored by electrical and magnetic stimulation devices; use of implanted microelectronic stimulators awaits clinical trial proof of reliability, safety and efficacy.ABSTRACT | Respiratory complication is a major cause of morbidity and mortality in patients with spinal cord injury (SCI).These complications arise partly due to the loss of supraspinal control over expiratory and/or inspiratory muscles caused by SCI. Functional neuromuscular stimulation of the respiratory muscles has been used to restore inspiratory and respiratory functions to these patients, helping them to reduce the incidence of respiratory complications and to have more normal lives. This paper covers three types of techniques for respiratory muscle stimulation: functional electric stimulation, functional magnetic stimulation, and semiconductor-based microstimulator stimulation. Functional electrical stimulation has been used to restore breathing to patients with spinal cord injury for several decades. It is a mature and reliable technology, and there are several commercial systems available. Functional magnetic stimulation of the respiratory muscles has been demonstrated to be an effective tool for producing cough in patients with SCI for nearly a decade. This is a safe and noninvasive technology that is well tolerated by most subjects. Semiconductor-based microstimulators have been widely publicized in recent years, and several clinical applications have been demonstrated, including the applications for restoring cough and breathing. This technology may eventually play a major role in respiratory muscle pacing.

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Neural and connective tissue response to long-term implantation of multiple contact nerve cuff electrodes

Grill

Mortimer

2000

J. Biomed. Mater. Res.

107

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The objective of this study was to characterize the tissue response to multiple contact spiral nerve cuff electrodes implanted on the sciatic nerve of seven cats for 28-34 weeks. The cuffs were surrounded by fibrous tissue encapsulation consisting of foreign body cells, collagen, and fibroblasts. Focal areas of abnormal neural morphology including perineurial thickening, endoneurial fibrosis, thinly myelinated axons, and focal reduction in the density of myelinated axons were noted in five of seven nerves. In three implants, the percutaneous lead cable was destroyed by the animal pulling on the external leads. Morphological changes were observed in two of three nerves from implants sustaining no known animal induced trauma (group A), and in three of four nerves from implants damaged by the animal pulling at the leads (group B). All nerves appeared normal 2 cm proximal to the cuff. At the cuff level, small regions of one fascicle in each of two nerves (both group B) exhibited abnormalities, while the proximal and distal sections of both nerves were normal. Distal to the cuff, small regions of seven fascicles distributed among three nerves (two group A, one group B) exhibited abnormalities. These nerves were normal at the cuff level but exhibited abnormalities in individual nerve branches distal to the cuff. The incidence and characteristics of the morphological abnormalities at the cuff level are consistent with those observed in previous studies of nerve cuff electrodes, and support the hypothesis that spiral cuff electrodes can be implanted with an internal diameter less than that of the nerve and expand to accommodate the nerve without compression The pattern of morphological abnormalities indicated that mechanical trauma had occurred at some time in the past, and the distribution suggested animal intervention and the lead cable as possible causes.

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Technology and Long-term Application of an Epineural Electrode

Cited by 35 publications

References 0 publications

Neuroprothetik und Neuromodulation

Neuroprothetik und Neuromodulation

Functional Neuromuscular Stimulation of the Respiratory Muscles for Patients With Spinal Cord Injury

Neural and connective tissue response to long-term implantation of multiple contact nerve cuff electrodes

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