A soft, scalable and adaptable multi-contact cuff electrode for targeted peripheral nerve modulation.

BACKGROUND: Cuff electrodes target various nerves throughout the body, providing neuromodulation therapies for motor, sensory, or autonomic disorders. However, when using standard, thick silicone cuffs, fabricated in discrete circular sizes, complications may arise, namely cuff displacement or nerve compression, due to a poor adaptability to variable nerve shapes and sizes encountered in vivo. Improvements in cuff design, materials, closing mechanism and surgical approach are necessary to overcome these issues. METHODS: In this work, we propose a microfabricated multi-channel silicone-based soft cuff electrode with a novel easy-to-implant and size-adaptable design and evaluate a number of essential features such as nerve-cuff contact, nerve compression, cuff locking stability, long-term integration and stimulation selectivity. We also compared performance to that of standard fixed-size cuffs. RESULTS: The belt-like cuff made of 150 µm thick silicone membranes provides a stable and pressure-free conformal contact, independently of nerve size variability, combined with a straightforward implantation procedure. The adaptable design and use of soft materials lead to limited scarring and demyelination after 6-week implantation. In addition, multi-contact designs, ranging from 6 to 16 electrodes, allow for selective stimulation in models of rat and pig sciatic nerve, achieving targeted activation of up to 5 hindlimb muscles. CONCLUSION: These results suggest a promising alternative to classic fixed-diameter cuffs and may facilitate the adoption of soft, adaptable cuffs in clinical settings.

Revealing the complexity of ultra-soft hydrogel re-swelling inside the brain.

The brain is an ultra-soft viscoelastic matrix. Sub-kPa hydrogels match the brain's mechanical properties but are challenging to manipulate in an implantable format. We propose a simple fabrication and processing sequence, consisting of de-hydration, patterning, implantation, and re-hydration steps, to deliver brain-like hydrogel implants into the nervous tissue. We monitored in real-time the ultra-soft hydrogel re-swelling kinetics in vivo using microcomputed tomography, achieved by embedding gold nanoparticles inside the hydrogel for contrast enhancement. We found that re-swelling in vivo strongly depends on the implant geometry and water availability at the hydrogel-tissue interface. Buckling of the implant inside the brain occurs when the soft implant is tethered to the cranium. Finite-element and analytical models reveal how the shank geometry, modulus and anchoring govern in vivo buckling. Taken together, these considerations on re-swelling kinetics of hydrogel constructs, implant geometry and soft implant-tissue mechanical interplay can guide the engineering of biomimetic brain implants.