The accuracy and robustness of stimulating signals are critical important for implantable neural stimulators since they stimulate neurons directly. The characteristics and applications of stimulating signals were depicted in the paper. The principles and features of five common generation and regulation technology of stimulating signals for implantable neural stimulators were introduced. The technical characteristics of them were analyzed. Finally, the development of the implantable neural simulators was prospected.
Humans ; Implantable Neurostimulators ; Neurons

Implantable Neurostimulators ; Micro-Electrical-Mechanical Systems ; Microelectrodes

This paper introduces ISO 14708-3:2017, the new edition of the international standard for implantable neurostimulator, and emphasizes the new requirements in the clause of protection from RF electromagnetic interference. To meet this new requirements, this paper presents a design of torso simulator for the testing of implantable neurostimulator. The design includes volume conductor, electrodes and grids, which can simulate the actual operating environment of implantable neurostimulator in RF electromagnetic interference testing. The torso simulator is verified by performance in the last part of the paper.
Electromagnetic Fields ; Electromagnetic Phenomena ; Implantable Neurostimulators ; standards ; Torso

Among current treatment options for obstructive sleep apnea (OSA) including surgeries and oral appliances, positive airway pressure (PAP) is accepted as a standard modality, particularly for moderate to severe OSA patients. Because long-term compliance for PAP is less than 50%, however, strong demands for a novel therapy have existed. Based on the findings that electromyographic activities of pharyngeal dilator muscles are significantly decreased in OSA patients during sleep, researches on hypoglossal nerve stimulation (HGNS) have been conducted. Therapeutic effects of HGNS on OSA have been proven through a series of clinical trials, and the American Food and Drug Administration recently approved its application on moderate to severe OSA patients who failed or are intolerant to PAP treatment. Given recent advances in HGNS therapy, it would be timely to review the history of HGNS and discuss its clinical implications.
Compliance ; Humans ; Hypoglossal Nerve* ; Implantable Neurostimulators ; Muscles ; Sleep Apnea, Obstructive* ; Tongue ; United States Food and Drug Administration

ISO 14708-3 "Implants for surgery-active implantable medical devices-Part 3:implantable neurostimulators" 2017 version and 2008 version are compared, and changes in the standard are interpreted combined with the characteristics of the neurostimulator. The new version of the standard for the first time in the introduction mentioned a new type of non-electrode or extension's neurostimulator. Key issues that have significant impact on safety concerns such as wireless charging temperature rise, MRI acceptance criteria, etc., are given for the first time in the new version. New requirements to the wireless communication section are added, and the electromagnetic compatibility part is greatly adjusted. With more miniature non-electrode or extension's neurostimulator entering the market, standards such as electromagnetic compatibility and MRI, there will be greater adjustments.
Electromagnetic Phenomena ; Implantable Neurostimulators ; standards ; Magnetic Resonance Imaging ; Prostheses and Implants ; Reference Standards

Neuromodulation was introduced for patients with poor outcomes from the existing traditional treatment approaches. It is well-established as an alternative, novel treatment option for voiding dysfunction. The current system of neuromodulation uses an open-loop system that only delivers continuous stimulation without considering the patient’s state changes. Though the conventional open-loop system has shown positive clinical results, it can cause problems such as decreased efficacy over time due to neural habituation, higher risk of tissue damage, and lower battery life. Therefore, there is a need for a closed-loop system to overcome the disadvantages of existing systems. The closed-loop neuromodulation includes a system to monitor and stimulate micturition reflex pathways from the lower urinary tract, as well as the central nervous system. In this paper, we reviewed the current technological status to measure biomarker for closed-loop neuromodulation systems for voiding dysfunction.
Biomarkers* ; Central Nervous System ; Humans ; Implantable Neurostimulators ; Reflex ; Urinary Bladder Diseases ; Urinary Bladder* ; Urinary Tract ; Urination

BACKGROUND: Sacral nerve stimulation is a therapeutic option with demonstrated efficacy for conditions presenting with perineal pain caused by different etiologies. We aimed to assess whether a sacral electrode (InterStim(R), Medtronic, Minneapolis, MN, USA) inserted through the caudal pathway is able to offer an acceptable level of sacral stimulation and rate of catheter migration. METHODS: We present 12 patients with pelvic pain who received sacral neuromodulation via the sacral hiatus with the InterStim electrode. We evaluated patient satisfaction as well as migration and removal of the electrode, if necessary. RESULTS: Our experience included 12 patients, 10 women and two men, with a mean age of 60 years. In eight of the 12 patients, the initial therapy was effective, and the final system implantation was performed. During subsequent follow-up, patient satisfaction was good. To date, there have been no cases of electrode displacement or migration. CONCLUSIONS: The caudal insertion of the InterStim electrode, with its own fixation system, and initially designed for transsacral insertion, appears in our experience to be a satisfactory option which can minimize electrode displacements, achieving similar results in therapeutic efficacy and causing no difficulties in removal.
Catheters ; Electrodes* ; Female ; Follow-Up Studies ; Humans ; Implantable Neurostimulators ; Male ; Pain Clinics* ; Patient Satisfaction ; Pelvic Pain ; Perineum ; Sacrococcygeal Region ; Sacrum ; Spinal Cord Stimulation

Electrical devices, which have become an integral part of our daily life, may influence the electrical recording of the heart. These disturbances from external sources outside of the heart's own activity produce changes in the electrocardiography (ECG) of the patient, simulating rhythmic disturbances of the heart. Understanding these disturbances is essential in order to better interprete the ECG. Common sources of electrical interferences include external devices, such as alternating current and improper earthing, and surgical procedures like diathermy. We report a case of electrical interference in a patient's ECG due to an inserted bladder stimulator. This case report highlights the importance of precise identification of artefacts in the interpretation of ECG, as well as prompt localisation and elimination of the source of interference.
Artifacts ; Diagnosis, Differential ; Electrocardiography ; Electrodes ; Electronics, Medical ; Equipment Design ; Female ; Humans ; Image Processing, Computer-Assisted ; Implantable Neurostimulators ; adverse effects ; Middle Aged ; Syncope ; diagnosis ; Urinary Bladder ; pathology

A 56-year-old man complained of continuous pain in the right foot that began 6 months after undergoing surgery on the right calcaneus bone. The patient was diagnosed with complex regional pain syndrome (CRPS) type I and was treated with medication, lumbar sympathetic ganglion blocks, epidural nerve blocks, and spinal cord stimulation. However, all treatments were halted because they were ineffective or complications developed. Peripheral nerve stimulation (PNS) was planned after confirming the analgesic effects of a sciatic nerve block, and the patient received PNS via minimally invasive ultrasound-guided electrode placement. PNS reduced the pain intensity and the incidence of paroxysmal pain. Other than discomfort at the battery insertion site (resolved with re-implantation), the patient developed no complications. These results suggest that ultrasound-guided minimally invasive PNS is a safe and effective treatment for patients with CRPS in the lower extremities.
Calcaneus ; Complex Regional Pain Syndromes ; Electrodes ; Foot ; Ganglia, Sympathetic ; Humans ; Implantable Neurostimulators ; Incidence ; Lower Extremity ; Middle Aged ; Nerve Block ; Neuralgia ; Pain Management ; Peripheral Nerves* ; Sciatic Nerve ; Spinal Cord Stimulation ; Ultrasonography

Sensorineural hearing loss is one of the most common chronic clinical disorders that we can easily encounter. The etiology of sensorineural hearing loss is multifactorial: congenital, idiopathic, traumatic, noise-induced, head injury induced, infectious disease, drug induced, degenerative, immune disorder, vestibular schwannoma and Meniere's disease. Many people are living with the discomfort of hearing loss because fundamental treatment is has not yet been found. Also due to the progress of medical science, human life span has been extended. As the result, the number of patients suffering from hearing loss has increased. But the present situation does not measure up to the demand for recovery of hearing loss. Hearing loss has a great influence on the quality of life. To overcome this situation, neural prostheses such as the cochlear implant and auditory brainstem implant are helpful for the rehabilitation of total deaf patients. Recently, due to the advancement of studies related to hair cell regeneration and the field of gene therapy on the inner ear has made big progress during the last few years. The purpose of this study is to describe the latest known causes and rehabilitation of sensorineural hearing loss.
Auditory Brain Stem Implants ; Cochlear Implants ; Communicable Diseases ; Correction of Hearing Impairment ; Craniocerebral Trauma ; Ear, Inner ; Genetic Therapy ; Hair ; Hearing Loss ; Hearing Loss, Sensorineural* ; Hearing* ; Humans ; Immune System Diseases ; Meniere Disease ; Neural Prostheses ; Neuroma, Acoustic ; Quality of Life ; Regeneration ; Rehabilitation*