Flexible Polymer Electrodes for Stable Prosthetic Visual Perception in Mice.

Brain interfaces that can stimulate neurons, cause minimal damage, and work for a long time will be central for future neuroprosthetics. Here, the long-term performance of highly flexible, thin polyimide shanks with several small (<15 µm) electrodes during electrical microstimulation of the visual cortex, is reported. The electrodes exhibit a remarkable stability when several billions of electrical pulses are applied in vitro. When the devices are implanted in the primary visual cortex (area V1) of mice and the animals are trained to detect electrical microstimulation, it is found that the perceptual thresholds are 2-20 microamperes (µA), which is far below the maximal currents that the electrodes can withstand. The long-term functionality of the devices in vivo is excellent, with stable performance for up to more than a year and little damage to the brain tissue. These results demonstrate the potential of thin floating electrodes for the long-term restoration of lost sensory functions.

Liquid-metal-based three-dimensional microelectrode arrays integrated with implantable ultrathin retinal prosthesis for vision restoration.

Electronic retinal prostheses for stimulating retinal neurons are promising for vision restoration. However, the rigid electrodes of conventional retinal implants can inflict damage on the soft retina tissue. They also have limited selectivity due to their poor proximity to target cells in the degenerative retina. Here we present a soft artificial retina (thickness, 10 µm) where flexible ultrathin photosensitive transistors are integrated with three-dimensional stimulation electrodes of eutectic gallium-indium alloy. Platinum nanoclusters locally coated only on the tip of these three-dimensional liquid-metal electrodes show advantages in reducing the impedance of the stimulation electrodes. These microelectrodes can enhance the proximity to the target retinal ganglion cells and provide effective charge injections (72.84 mC cm-2) to elicit neural responses in the retina. Their low Young's modulus (234 kPa), owing to their liquid form, can minimize damage to the retina. Furthermore, we used an unsupervised machine learning approach to effectively identify the evoked spikes to grade neural activities within the retinal ganglion cells. Results from in vivo experiments on a retinal degeneration mouse model reveal that the spatiotemporal distribution of neural responses on their retina can be mapped under selective localized illumination areas of light, suggesting the restoration of their vision.

[Vision restoration: science fiction or reality?] / Restauration de la vision: Science-fiction ou réalité ?

Visual prostheses aim at restoring useful vision to patients who have become blind. This useful vision should enable them to regain autonomy in society for navigation, face recognition or reading. Two retinal prostheses have already obtained market authorization for patients affected by retinal dystrophies while a new device is in clinical trials for patients affected by age-related macular degeneration. Various prostheses, in particular cortical prostheses, are currently in clinical trials for optic neuropathies (glaucoma). Optogenetic therapy, an alternative strategy, has now reached the stage of clinical trials at the retinal level while moving forward at the cortical level. Other innovating strategies have obtained proofs of concepts in rodents but require a further validation in large animals prior to their evaluation on patients. Restoring vision should therefore become a reality for many patients even if this vision will not be as extensive and perfect as natural vision.

TITLE: Restauration de la vision: Science-fiction ou réalité ? ABSTRACT: Les prothèses visuelles ont pour objet de redonner une vision utile aux patients devenus aveugles. Cette vision utile doit leur permettre de retrouver une autonomie dans la société pour leurs déplacements, la reconnaissance des visages ou la lecture. Plusieurs prothèses rétiniennes ont déjà obtenu l'autorisation de mise sur le marché pour les dystrophies rétiniennes alors qu'un nouveau dispositif est en essai clinique pour la dégénérescence maculaire liée à l'âge. D'autres prothèses, notamment corticales, sont en essai clinique pour les neuropathies optiques (glaucome). Des stratégies alternatives, comme la thérapie optogénétique, ont également atteint le stade des essais cliniques. D'autres ont été évaluées sur les rongeurs, attendant leur validation sur le gros animal. Revoir devrait donc prochainement devenir une réalité pour de nombreux patients, même si cette vision ne sera ni aussi étendue, ni aussi parfaite que la vision naturelle.

Photochemistry of Organic Retinal Prostheses.

Organic devices are attracting considerable attention as prostheses for the recovery of retinal light sensitivity lost to retinal degenerative disease. The biotic/abiotic interface created when light-sensitive polymers and living tissues are placed in contact allows excitation of a response in blind laboratory rats exposed to visual stimuli. Although polymer retinal prostheses have proved to be efficient, their working mechanism is far from being fully understood. In this review article, we discuss the results of the studies conducted on these kinds of polymer devices and compare them with the data found in the literature for inorganic retinal prostheses, where the working mechanisms are better comprehended. This comparison, which tries to set some reference values and figures of merit, is intended for use as a starting point to determine the direction for further investigation.

Nanowire arrays restore vision in blind mice.

The restoration of light response with complex spatiotemporal features in retinal degenerative diseases towards retinal prosthesis has proven to be a considerable challenge over the past decades. Herein, inspired by the structure and function of photoreceptors in retinas, we develop artificial photoreceptors based on gold nanoparticle-decorated titania nanowire arrays, for restoration of visual responses in the blind mice with degenerated photoreceptors. Green, blue and near UV light responses in the retinal ganglion cells (RGCs) are restored with a spatial resolution better than 100 µm. ON responses in RGCs are blocked by glutamatergic antagonists, suggesting functional preservation of the remaining retinal circuits. Moreover, neurons in the primary visual cortex respond to light after subretinal implant of nanowire arrays. Improvement in pupillary light reflex suggests the behavioral recovery of light sensitivity. Our study will shed light on the development of a new generation of optoelectronic toolkits for subretinal prosthetic devices.

Development of a Magnetic Attachment Method for Bionic Eye Applications.

Successful visual prostheses require stable, long-term attachment. Epiretinal prostheses, in particular, require attachment methods to fix the prosthesis onto the retina. The most common method is fixation with a retinal tack; however, tacks cause retinal trauma, and surgical proficiency is important to ensure optimal placement of the prosthesis near the macula. Accordingly, alternate attachment methods are required. In this study, we detail a novel method of magnetic attachment for an epiretinal prosthesis using two prostheses components positioned on opposing sides of the retina. The magnetic attachment technique was piloted in a feline animal model (chronic, nonrecovery implantation). We also detail a new method to reliably control the magnet coupling force using heat. It was found that the force exerted upon the tissue that separates the two components could be minimized as the measured force is proportionately smaller at the working distance. We thus detail, for the first time, a surgical method using customized magnets to position and affix an epiretinal prosthesis on the retina. The position of the epiretinal prosthesis is reliable, and its location on the retina is accurately controlled by the placement of a secondary magnet in the suprachoroidal location. The electrode position above the retina is less than 50 microns at the center of the device, although there were pressure points seen at the two edges due to curvature misalignment. The degree of retinal compression found in this study was unacceptably high; nevertheless, the normal structure of the retina remained intact under the electrodes.

An all-diamond, hermetic electrical feedthrough array for a retinal prosthesis.

The interface between medical implants and the human nervous system is rapidly becoming more and more complex. This rise in complexity is driving the need for increasing numbers of densely packed electrical feedthrough to carry signals to and from implanted devices. This is particularly crucial in the field of neural prosthesis where high resolution stimulating or recording arrays near peripheral nerves or in the brain could dramatically improve the performance of these devices. Here we describe a flexible strategy for implementing high density, high count arrays of hermetic electrical feedthroughs by forming conducting nitrogen doped nanocrystalline diamond channels within an insulating polycrystalline diamond substrate. A unique feature of these arrays is that the feedthroughs can themselves be used as stimulating electrodes for neural tissue. Our particular application is such a feedthrough, designed as a component of a retinal implant to restore vision to the blind. The hermeticity of the feedthroughs means that the array can also form part of an implantable capsule which can interface directly with internal electronic chips. The hermeticity of the array is demonstrated by helium leak tests and electrical and electrochemical characterisation of the feedthroughs is described. The nitrogen doped nanocrystalline diamond forming the electrical feedthroughs is shown to be non-cyctotoxic. New fabrication strategies, such as the one described here, combined with the exceptional biostability of diamond can be exploited to generate a range of biomedical implants that last for the lifetime of the user without fear of degradation.

Performance of conducting polymer electrodes for stimulating neuroprosthetics.

OBJECTIVE: Recent interest in the use of conducting polymers (CPs) for neural stimulation electrodes has been growing; however, concerns remain regarding the stability of coatings under stimulation conditions. These studies examine the factors of the CP and implant environment that affect coating stability. The CP poly(ethylene dioxythiophene) (PEDOT) is examined in comparison to platinum (Pt), to demonstrate the potential performance of these coatings in neuroprosthetic applications. APPROACH: PEDOT is coated on Pt microelectrode arrays and assessed in vitro for charge injection limit and long-term stability under stimulation in biologically relevant electrolytes. Physical and electrical stability of coatings following ethylene oxide (ETO) sterilization is established and efficacy of PEDOT as a visual prosthesis bioelectrode is assessed in the feline model. MAIN RESULTS: It was demonstrated that PEDOT reduced the potential excursion at a Pt electrode interface by 72% in biologically relevant solutions. The charge injection limit of PEDOT for material stability was found to be on average 30× larger than Pt when tested in physiological saline and 20× larger than Pt when tested in protein supplemented media. Additionally stability of the coating was confirmed electrically and morphologically following ETO processing. It was demonstrated that PEDOT-coated electrodes had lower potential excursions in vivo and electrically evoked potentials (EEPs) could be detected within the visual cortex. SIGNIFICANCE: These studies demonstrate that PEDOT can be produced as a stable electrode coating which can be sterilized and perform effectively and safely in neuroprosthetic applications. Furthermore these findings address the necessity for characterizing in vitro properties of electrodes in biologically relevant milieu which mimic the in vivo environment more closely.

In vitro biocompatibility of various polymer-based microelectrode arrays for retinal prosthesis.

PURPOSE: The purpose of our study is to evaluate the biocompatibility of various polymers used as microelectrode arrays (MEAs) in retinal prostheses through in vitro cytotoxicity testing following a standardized METHODS: Three types of polymer-based MEAs were examined: silicone-based platinum, polyimide-based gold and liquid crystal polymer (LCP)-based gold MEAs. The silicone/platinum MEAs were fabricated by a Nd:YAG laser, polyimide/gold MEAs by a semiconductor manufacturing technique, and LCP/gold MEAs by laser micromachining and thermal-bonding process. All experimental procedures followed the International Organization for Standardization (ISO) 10993-5. To obtain the extracts of specimens, 4 g of each type of MEA were eluted by culture media, MEM, for 24 hours. Then, several diluents of extracts, including the original extracts, were applied to a cultured-cell monolayer, L929 fibroblasts. The morphologic changes of cells were analyzed by microscope after 24 and 48 hours of incubation. The quantitative evaluations of cell viability were performed by MTT assay after 24 hours of incubation. RESULTS: The microscopic evaluations revealed that extracts from polymer-based MEAs did not induce morphologic changes or reduction of cells compared with control irrespective of concentrations of extracts. The MTT assay showed high viability values of approximately 80 to 130% regardless of diluted ratio of extracts from polymer-based MEAs. None of the polymers demonstrated a significant reduction of cell viability when compared with control. CONCLUSIONS: All types of polymer-based MEAs, including silicone/platinum, polyimide/gold, and LCP/gold MEAs, meet the criteria of biocompatibility guided by international standards, ISO 10993-5.

Hermetic glass soldered micro-packages for a vision prosthesis.

Micro-packages based on alumina ceramics hermetically sealed with glass solder were fabricated and tested over a 1.5 years period under accelerated aging at 85 °C. A device for sealing the 1.2 mm high, and ø10mm packages while cooling the critical centre of the package containing the electronics was developed. Heating of the rim up to 550 °C while maintaining the package centre below 300°C was successful, allowing a symmetrical heating of the device during the sealing procedure. The fabricated packages with an inner volume of 0.05 cc were backfilled with helium and tested for hermeticity with a fine leak tester. Samples passing the fine leak (1•10(-12) atm•cc/s) test were attached to a larger chamber containing a humidity sensor. Some devices covered in PDMS and some directly exposed were stored at 85 °C in water to measure the humidity intrusion into the device due to deterioration of glass solder. 1 out of the 8 successfully fabricated devices failed after 5 years extrapolated lifetime. Two of the devices have kept constant humidity levels while others gradually rise. Nevertheless, 7 out of 8 have maintained a level below 17,000 ppm humidity. Furthermore, the deterioration of glass solder was electrically and optically studied over a year's period showing no corrosion of glass if properly coated in PDMS.

Comparison of electrode materials for the use of retinal prosthesis.

Retinal implants may provide vision for people suffering from photoreceptor degeneration caused by different eye diseases. Electrode size in retinal implant should be decreased in order to increase the resolution provided by the implant. We defined electric properties of five different electrode materials (Au, Ir-b, Ti, TiN, Pt-b) widely used in retinal prostheses. The comparison of different electrode materials requires that the electrical properties of different materials are defined using exactly the same measurement conditions and devices. Existing studies about electrode material properties are often made using slightly different measurement parameters or electrode processing conditions making the comparison between different materials difficult. Here, the electrochemical characterization included cyclic voltammetry and electrochemical impedance spectroscopy. Ir-b and Pt-b had greater charge injection capacity than other materials. The fabricated material samples showed that in this experiment the electrode diameter larger than 200 µm should be used to suppress irreversible reaction of stimulus electrodes with the needed stimulus currents. Thus, either we have to find novel electrode materials or surface treatment methods to decrease the electrode area providing increased electrode and pixel number of the prosthesis or we have to show that stimulus currents smaller than 40 µA are enough to induce phosphenes.