1. Neuromuscular Microstimulators Chris MorinoBME 281

2. Neuroplasticity  The brain ability to actively rewire itself in response to external stimuli  This ability inspired people to create the microstimulator

3. History  1960 Liberson’s drop foot stimulator  1989 AMF began working on the mircostimulator  late 1990s Mayo clinic performs Occipital nerve stimulation for medically refractory headache pain  2008 AMF develops working prototypes of injectable microstimulators without exoskeleton system

4. OldNew Old verse new

5. How does it work?  Send little electrical shocks to muscles to induce movement  Contains the pulse generator and the electrode together in a package the size of a matchstick  Controlled wirelessly with a cell phone like controller that tells each independent implant when to stimulate

6. Inside look

7. Different types

8. How is it implanted?  Bion insertion tool  Makes the small implants into precisely localized sites within the body a simple task for surgeons

9. Reason for Microstimulartors  Over 32 million (70% women) suffer from migraines  11, 000 suffer a spinal cord injury  750,000 people suffer a stroke  5.3 million with after affects of traumatic brain injury

10. What they have to offer  Can be implanted directly into the damage muscle tissue  Helps reteach the brain how to reuse damaged muscles  No side affects for having it implanted for long period of time

11. Experimentation  Alfred Mann Foundation funded research for this device  Dr. Ross Davis responsible for the implantation  Dr. Daniel Merrill consultant on the research  Goal: to examine the effect of home based electrical stimulation using closed- loop control of implanted microstimulators on upper limb function

12. Results  5 out of 6 patients said it changed their lives  Over a 12 week period patients had dramatic change  Improved their function with the impaired upper limbs  Although external components were inconvenient for patients

13. Availability  The internal device is unfortunately restricted to investigational use only  Although similar experiments were performed in the United Kingdom using the internal device  Results came back positive after 12 weeks of stimulating

14. Future  Working on stimulators that can also sense changes in pressure, limb angle, muscle activity and temperature  Application for lower extremities  Get past the investigative stage in the United States to truly tap the potential this device is capable of.

15. References  URI BME 281 BME Seminar II.  Burridge, Jane H., Ruth Turk, Daniel Merrill, Bridget Dibb, Ann-Marie Hughes, Owen Sparrow, Helen Roberts, and Ross Davis. "A Personalized Sensor-Controlled Microstimulator System for Arm Rehabilitation Poststroke. Part 2: Objective Outcomes and Patients' Perspectives." Neuromodulation: Technology at the Neural Interface (2010): No. Print.  "Microstimulators Hold Promise for Some Medically Refractory Headaches."Microstimulators Hold Promise for Some Medically Refractory Headaches. N.p., n.d. Web. 19 Sept. 2013.  http://aemf.org/our-research/current-focus/neuromuscular-disorders/http://aemf.org/our-research/current-focus/neuromuscular-disorders/  "SpringerImages." SpringerImages. N.p., n.d. Web. 19 Sept. 2013.  http://link.springer.com/article/10.1007%2Fs10439-009-9739-5