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Biology subjects

Shah Idil, A.

Publications and source records attributed to Shah Idil, A..

3 recordsLinked to original sources

An Implantable Wireless Battery-Free Selective Vagus Nerve Stimulator

Objective. Vagus nerve stimulation (VNS) is an established clinical therapy for drug-resistant epilepsy and other inflammatory conditions. However, off-target stimulation can produce unwanted side effects that limit therapeutic stimulation and hinder the development of new neuromodulation therapies. Selective VNS (sVNS) offers a strategy to reduce off-target organ activation; however, this approach is not available in humans, and no implantable or portable devices exist to trial sVNS in the clinical setup. This work aimed to design, manufacture, and validate an implantable wireless, battery-free stimulator with a selectively addressable output stage for targeted current delivery to specific regions of the human vagus nerve (VN). Approach. We developed a near-field communication-controlled, wirelessly powered, battery-free, temporary implantable multichannel stimulation device, compatible with a 15-channel sVNS cuff electrode (14 selective electrode pairs and one circumferential whole-nerve channel). The device was encapsulated for short-term implantation and evaluated through benchtop characterisation, accelerated ageing, and validation in an acute porcine and a pilot human study. Main result. The sVNS device was evaluated in a porcine (n = 4) trial and a first-in-human pilot study (n = 1). Selective bradycardia of 23.28 {+/-} 12.91% was observed in pigs and 7.5% in the human participant. In the human, a clear separation of bradycardic and tachycardic effects was observed, with additional selectivity in laryngeal activity. Cardiac and laryngeal responses were separated by 231{degrees} around the circumference of the nerve. Significance. This work demonstrates the feasibility of wireless battery-free sVNS for cardiac applications using a temporary implantable device. Geometrically selective stimulation has the potential to improve therapeutic efficacy while reducing stimulation-related side effects, and may facilitate future therapies for heart failure and other autonomic disorders.

bioengineering↗

On the Stability of Silicone-Encapsulated CMOS ICs for Active Implantable Devices: 4.3 Years of Accelerated Life Testing

The reliability of polymer-encapsulated CMOS integrated circuits (ICs) is critical for the development of miniaturised active implantable medical devices (AIMDs). Traditional hermetic packaging methods become impractical as implant sizes decrease, necessitating alternative methods of protection from body fluids. This study evaluates the long-term stability of silicone-encapsulated CMOS ICs through accelerated life testing using electrical impedance spectroscopy (EIS) and visual inspection. CMOS interdigitated combs (IDCs) were encapsulated in medical grade silicone rubber, subjected to immersion in phosphate-buffered saline (PBS), and tested at elevated temperatures (47{degrees}C, 67{degrees}C, and 87{degrees}C) under both 5V DC and biphasic voltage biases for up to 4.3 years. Remarkably, no insulation failures were observed in the IDCs, with no significant water ingress detected through impedance changes. Failures at the ICs were limited to wire bond open-circuits, though there was some pad discolouration/corrosion. Other failures were elsewhere, not at the ICs. This highlights the stability of modern silicon oxide/silicon nitride bilayer passivation when encapsulated in adhesive silicone rubber. Visual analysis revealed occasional solder and aluminium pad corrosion, particularly at higher temperatures, but these changes did not correlate with EIS failures. The findings suggest that silicone encapsulation, combined with passivation and shielding strategies, enables long-term IC reliability in biofluid environments. To our knowledge, this paper presents the longest reported accelerated ageing study of test structures for implantable devices, laying the groundwork for the integration of silicone-encapsulated ICs into next-generation chip-scale bioelectronic implants.

biochemistry↗

Anatomical and functional organization of cardiac fibers in the porcine cervical vagus nerve allows spatially selective efferent neuromodulation

Cardiac disease progression reflects the dynamic interaction between adversely remodeled neurohumoral control systems and an abnormal cardiac substrate. Vagal nerve stimulation (VNS) is an attractive neuromodulatory option to dampen this dynamic interaction; however, it is limited by off-target effects. Spatially-selective VNS (sVNS) offers a promising solution to induce cardioprotection while mitigating off-target effects by specifically targeting pre-ganglionic parasympathetic efferent cardiac fibers. This approach also has the potential to enhance therapeutic outcomes by eliminating time-consuming titration required for optimal VNS. Recent studies have demonstrated the independent modulation of breathing rate, heart rate, and laryngeal contraction through sVNS. However, the spatial organization of afferent and efferent cardiac-related fibers within the vagus nerve remains unexplored. By using trial-and-error sVNS in vivo in combination with ex vivo micro-computed tomography fascicle tracing, we show the significant spatial separation of cardiac afferent and efferent fibers (179{+/-}55{degrees} SD microCT, p<0.05 and 200{+/-}137{degrees} SD, p<0.05 sVNS - degrees of separation across a cross-section of nerve) at the mid-cervical level. We also show that cardiac afferent fibers are located in proximity to pulmonary fibers consistent with recent findings of cardiopulmonary convergent neurons and circuits. We demonstrate the ability of sVNS to selectively elicit desired scalable heart rate decrease without stimulating afferent-related reflexes. By elucidating the spatial organization of cardiac-related fibers within the vagus nerve, our findings pave the way for more targeted neuromodulation, thereby reducing off-target effects and eliminating the need for titration. This, in turn, will enhance the precision and efficacy of VNS therapy in treating cardiac pathology, allowing for improved therapeutic efficacy. Condensed AbstractSpatially-selective vagus nerve stimulation (sVNS) presents a promising approach for addressing chronic heart disease with enhanced precision. Our study reveals significant spatial separation between cardiac afferent and efferent fibers in the vagus nerve, particularly at the mid-cervical level. Utilizing trial-and-error sVNS in vivo and micro-computed tomography fascicle tracing, we demonstrate the potential for targeted neuromodulation, achieving therapeutic effects like scalable heart rate decrease without stimulating afferent-related reflexes. This spatial understanding opens avenues for more effective VNS therapy, minimizing off-target effects and eliminating the need for titration, thereby expediting therapeutic outcomes in myocardial infarction and related conditions. TweetWith functional and structural imaging, we found organization of vagal efferent & afferent cardiac regions. We can selectively activate only cardiac efferents to achieve bradycardia; desired to reduce the effects of sympathetic overactivation associated with heart disease #VNS #Cardiac #VagusNerve Key PointsO_LISpatially-selective vagus nerve stimulation (sVNS) presents a promising approach for addressing chronic heart disease with enhanced precision. C_LIO_LIOur study reveals significant spatial separation between cardiac afferent and efferent fibers in the vagus nerve, particularly at the mid-cervical level. C_LIO_LIUtilizing trial-and-error sVNS in vivo and micro-computed tomography fascicle tracing, we demonstrate the potential for targeted neuromodulation, achieving therapeutic effects like scalable heart rate decrease without stimulating afferent-related reflexes. C_LIO_LIThis spatial understanding opens avenues for more effective VNS therapy, minimizing off-target effects and eliminating the need for titration, thereby expediting therapeutic outcomes in myocardial infarction and related conditions. C_LI

neuroscience↗