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Αλέξανδρος Γ. Σφακιανάκης

Thursday, February 25, 2021

Implications of vestibular telemetry for the management of Ménière’s Disease—Our experience with three adults

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EUROPEAN DEVELOPMENT OF BIONICS VESTIBULAR IMPLANT FOR BILATERAL VESTIBULAR DYSFUNCTION
Fact SheetReportingResults
Project Information
BionicVEST
Grant agreement ID: 801127
Project website Opens in new window
Status
Ongoing project
Start date
1 September 2018
End date
31 August 2022
Funded under
H2020-EU.1.2.1.
Overall budget
€ 2 899 690
EU contribution
€ 2 899 690
Coordinated by
SERVICIO CANARIO DE LA SALUD
Spain

Objective
Vertigo of vestibular origin has a global prevalence of 38% in the elderly and deserves special attention because
of the high risk of falls and permanent functional disability, and even death. This seriously handicaps their lives,
disabling them of doing routine daily activities, such as driving and even walking. The associated total costs are
around 60.000 million euros in Europe. It is estimated that at least 100 million people worldwide could benefit
from a vestibular implant as an effective solution to this disease. Restoring the function of the vestibular
labyrinths was not possible until now. Current devices, under research, detect change in angular velocity of the
cephalic movements through gyroscopes and use this information to stimulate the semicircular canals. However,
they do not code vertical and horizontal accelerations, used to sense gravitational forces, keep a stand up position
and restore the sense of self-position. Linear accelerations are detected by a different set of structures which are a
more complex and harder to access: the saccule and utricle. This project will develop the first system to
electrically reproduce linear accelerations in the otolith organ by stimulating their neural ends. The project will
have three phases: Device design, fabrication and clinical trial. Therefore, the objectives will be: 1) to study, for
the first time, vestibular pathways through electrical saccule-utricle stimulation; 2) to develop a vestibular
response telemetry system to analyse the evoked action potential of vestibular nerve; 3) to design, manufacture
and test the first vestibular prosthesis that restores the sense of linear accelerations. The main objectives are to
demonstrate the safety of a vestibular implant for human, to determine its efficacy in restoring vestibular function
by measuring the improvement in objective and to objectify the improvement in Quality of Life of patients.


Novel Telemetry System for Closed Loop Vestibular Prosthesis
Cirmirakis, D; (2013) Novel Telemetry System for Closed Loop Vestibular Prosthesis (Cirmirakis, D, Trans.). Doctoral thesis , UCL (University College London).
Full text not available from this repository.
Abstract
Disorders of the vestibular system result in loss of body balance and a steady vision in humans and animals. The most common consequences include vertigo, oscillopsia, postural instability and blurred vision. Currently, conventional medicine cannot cure the damage or restore the function of the vestibular system. Vestibular prosthesis may assist in restoring its function using electrical stimulation, which involves delivering current pulses into the nerves innervating the semi-circular canals in the inner ear. A vestibular prosthesis contains external electronics and an implantable medical device . The system delivers modulated electrical pulses and stimulates vestibular nerves with these pulses to inform the brain about the motion. Power transfer to, and communication with the implanted device, is provided by telemetry. In biomedical implanted devices the telemetry is usually implemented by radio-frequency induction using weakly coupled coils. Using a single set of coils for simulta neous power transfer and communication creates the challenge of contradicting requirements. For high data rates the inductive link must have a wide bandwidth but power transfer requires a low bandwidth. Moreover by modulating a carrier the power transfer is degraded. This thesis describes the design, implementation and experimental evaluation of a novel telemetry system for a three-dimensional vestibular prosthesis with neural recording. The developed telemetry system uses a single pair of inductively-coupled coils to power-up the implant and maintain bi-directional communication to control its operation. It also relays raw electroneurogram (ENG) data out of the body at high speed. For inductive power control two methods are combined: a geometrical approach and a feedback loop to maintain a constant level of delivered power. The communication to the implant (downlink) is obtained by amplitude modulation while the communication from the implant to the external transmitter (uplink) us es passive phase shift modulation. On-chip humidity sensing capabilities are facilitated in the implant microelectronics to monitor hermeticity of the package. The uplink achieves the highest data speed demonstrated in the literature of available methods using a single set of coils with combined power and communication links. The developed technique can be applied to other applications including RFID.

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