The present invention generally relates to code-controlled multi-site wirelessly-powered batteryless stimulators.
Multisite stimulation has proven helpful for different medical applications. For example, in mice, it has been shown that different stimulation patterns in the spinal cord could lead to unique muscle activation. It has also been shown that multisite spinal cord stimulation can enable faster recovery of motor functions. The efficacy of multisite stimulation has been proven for enhanced cardiac resynchronization therapy as well. Both unilateral and bilateral VNS have proven to be useful for cardiac therapy, epilepsy treatment, and weight control. From the point of care perspective, miniaturized and battery-free implants are preferred since natural movements are maintained, and chances of infections or reoperation can be minimized.
There have been multiple approaches to implementing multisite stimulation. As shown in
Systems and methods for code-controlled multi-site wirelessly-powered batteryless stimulators in accordance with embodiments of the invention are described. An embodiment includes a wirelessly powered and controlled implantable stimulator system, including: a transmitter (TX) coil wirelessly powering and controlling several implantable stimulators though electromagnetic waves, where the electromagnetic waves include modulated waveforms that include n-bit passcodes to individually control stimulation of each of the several implantable stimulators; where an implantable stimulator of the several implantable stimulators includes: a receiver (RX) for receiving a modulated waveform from the TX coil, where the implantable stimulator is controlled based on the modulated waveform; a coil that harvests AC power; a voltage regulator; a rectifier that rectifies the harvested power and passes the rectified voltage (Vrect) to the voltage regulator to provide a constant voltage; data recovery and control circuitry coupled to the voltage regulator and configured to output a stimulation control signal based on passcodes detected from the modulated waveform; an output stage and driver circuitry coupled to receive the constant voltage from the voltage regulator and the stimulation control signal from the data recovery and control circuitry, and configured to output a stimulation signal; and one or more electrodes coupled to receive the stimulation signal from the output stage and driver circuitry.
In a further embodiment, an n-bit passcode is hard-wired and set on a printed circuit board (PCB) for each of the several implantable stimulators, where the modulated waveform includes an n-bit passcode to communicate with a particular implantable stimulator of the several implantable stimulators, where the modulated waveform includes several stimulation control settings including a start/stop signal and a voltage level of a stimulation pulse to be delivered by an implantable stimulator.
In a further embodiment, the modulated waveform includes several bits, where a first set of bits of the several bits address a particular implantable stimulator from the several stimulators, at least one bit of the several bits determines a voltage level of a stimulation, and at least one bit of the several bits determines a start/stop signal of a stimulation.
In a further embodiment again, the TX coil wirelessly powers and controls the several implantable stimulators through a near field resonant inductive link.
In a further embodiment again, the modulated waveform is a pulse-width modulated amplitude-shift keying (PWM-ASK) waveform.
In a further embodiment again, the Vrect drops below a threshold voltage and a control block stops stimulation.
In a further embodiment again, at least one implantable stimulator in the several implantable stimulators is battery-less such that the implantable stimulator is wirelessly powered and memory-less such that control of a stimulation of the at least one implantable stimulator is controlled based on the modulated waveform received from the TX coil.
In a further embodiment again, each implantable stimulator in the several implantable stimulators is individually addressable using an n-bit passcode.
In a further embodiment again, the implantable stimulator further includes a system on chip (SOC), wherein the SOC includes: a power management unit (PMU); a clock and data recovery (CDR) unit that recovers clock and data from the modulated waveform; an envelope detection unit; an error detection unit; and an output driving stage.
In a further embodiment again, the voltage regulator is a low dropout voltage regulator (LDO) that includes an amplifier in a negative feedback loop.
In a further embodiment again, the Vrect exceeds a threshold voltage and a limiter is activated and stops the Vrect from accumulating further.
In a further embodiment again, the rectifier is a fully differential cross-coupled 4-stage rectifier.
In a further embodiment again, the RX is used to extract both clock and data, where an incoming signal is self-mixed using the rectifier and low-pass filtered and passed through a Schmitt trigger to extract its envelope that includes baseband data.
In a further embodiment again, clock and data are recovered by passing the envelope though an integrator and a comparator.
In a further embodiment again, the implantable stimulator further includes a finite state machine (FSM) that controls a stimulation pulse width and amplitude of stimulation.
In a further embodiment again, the implantable stimulator is controlled by a 4-bit passcode.
Another embodiment includes a medical system including: a transmitter (TX) coil configured to output transmitter waves having a pulse-width and an amplitude; and several implantable stimulators, each implantable stimulator including: a coil configured to establish a near-field resonant inductive link with the transmitter coil, and to harvest power from the transmitter waves; a voltage regulator that outputs a constant voltage; data recovery and control circuitry coupled to the voltage regulator and configured to output a stimulation control signal based on passcodes detected from the transmitter waves; an output stage and driver circuitry coupled to receive the constant voltage from the voltage regulator and the stimulation control signal from the data recovery and control circuitry, and configured to output a stimulation signal; and one or more electrodes coupled to receive the stimulation signal from the output stage and driver circuitry.
In a further embodiment again, each implantable stimulator further includes: a rectifier that rectifies the harvested power and passes the rectified voltage (Vrect) to the voltage regulator to provide the constant voltage; where output stage and driver circuitry is configured to stop stimulation in response to the Vrect dropping below a threshold voltage.
In a further embodiment again, at least one of the several implantable stimulators is configured for implant in or on a heart, and the stimulation signal is configured to evoke a depolarization of the heart.
In a further embodiment again, a first of the several implantable stimulators is configured for implant in or on a left ventricle of a heart, a second of the several implantable stimulators is configured for implant in or on a right ventricle of a heart, and the output stage and driver circuitry is configured to output respective stimulation signals to the first implantable stimulator and the second implantable stimulator to deliver biventricular pacing.
In a further embodiment again, at least one of the several implantable stimulators is configured for implant in or on a brain, and the stimulation signal is configured to elicit a neural effect.
In a further embodiment again, at least one of the several implantable stimulators is configured for implant in or on a spine, and the stimulation signal is configured to elicit a neural effect.
In a further embodiment again, a first of the several implantable stimulators is configured for implant on a first side of a neck to stimulate a right vagus nerve, a second of the several implantable stimulators is configured for implant on a second side of the neck to stimulate a left vagus nerve, and the output stage and driver circuitry is configured to output respective stimulation signals to the first implantable stimulator and the second implantable stimulator.
In a further embodiment again, the nerve is a vagal nerve.
In a further embodiment again, the transmitter (TX) coil is included in a component configured to be implanted in operation vicinity (within about 80 mm) of each of the several implantable stimulators.
In a further embodiment again, the transmitter (TX) coil is included in an external component configured to be placed in operation vicinity (within about 80 mm) of each of the several implantable stimulators.
In a further embodiment again, at least one of the several implantable stimulators is configured for implant in, on, or adjacent to a peripheral nerve.
The description and claims will be more fully understood with reference to the following figures and data graphs, which are presented as exemplary embodiments of the invention and should not be construed as a complete recitation of the scope of the invention.
The patent or application file contains at least one drawing executed in color. Copies of this patent or patent application publication with color drawing(s) will be provided by the Office upon request and payment of the necessary fee.
Turning now to the drawings, systems and methods for code-controlled multi-site wirelessly-powered batteryless stimulators in accordance with embodiments of the invention are described. Implantable bioelectronics have been clinically used for a wide range of indications. Multisite stimulations have shown to enhance clinical outcomes in different applications such as, multi-chamber cardiac pacing, e.g., biventricular cardiac pacing, and neural stimulation, e.g., spinal cord stimulation, brain stimulation, and bilateral vagus nerve stimulation (VNS) among other applications. Wirelessly powered and controlled implantable devices in accordance with many embodiments can improve miniaturization and safety. In applications such as cardiac pacing or VNS in big animals, the volume of an implant can become unavoidably large when the stimulation sites are far apart from each other and where there is a need for long leads to connect electrodes to the stimulation site. As described, multiple carrier frequencies for implants has been proposed as an alternative solution. However, it has limitations due to the interference between the channels and the scalability of the system due to the higher number of Tx coils. Physical unclonable functions (PUF) have been introduced. However, the PUF may reduce robustness in the presence of thermal noise and supply variations. Furthermore, a PUF can have high complexity and fabrication costs due to native layers. Existing wireless power transfer techniques such as magnetoelectric (ME) or ultrasonic are not currently available for large animals because of the limited distance between Tx and implant (e.g., 40 mm). Moreover, Ultrasonic and ME based devices suffer from narrow channel bandwidths for data communication.
To address the challenges mentioned above, implantable stimulation systems in accordance with many embodiments of the invention provide a hardware platform with a single Tx coil wirelessly powering and controlling multiple implants (e.g., ≤16) through a near-field resonant inductive link. Stimulation systems in accordance with many embodiments can have one or more of the following specifications: (1) robust multi-channel (e.g., 2 channel, 1.8 V or 3.3 V) stimulation for each implant; (2) wirelessly powering and controlling up to a needed long lead distance (e.g., 80 mm in distance); (3) controlling up to N implants (e.g., 16 implants) using an n-bit passcode (e.g., 4-bit passcode); (4) controlling several and/or all implants using a single Tx coil and up to a certain needed distance and misalignment (e.g., 80 mm distance and 70° misalignment between Tx and implants) can be tolerated; (5) miniaturized implants can have a minimal volume and weight as beneficial for use as implants (e.g., volume of 20.1 mm3 and weigh approx., 80 mg).
Stimulation systems in accordance with many embodiments can include an implant that can include a multi-turn coil, storage capacitor, discharge resistor, one or more electrodes (planar, ring, cuff, etc.) and a System on Chip (SoC). In many embodiments, the SoC can include a power management unit (PMU), clock and data recovery (CDR), and output driving stage. The AC power can be harvested from the coil and can be rectified using a fully differential cross-coupled 4-stage rectifier. The rectifier voltage (Vrect) can be then passed to an LDO to provide a constant voltage (e.g., 1.8V (VDD) voltage). The LDO can be a compensated two-stage amplifier in a negative feedback loop.
In many embodiments, if the rectifier voltage drops below a certain voltage (e.g., 2.6V) an error detection circuitry in a control block can stop a stimulation. If the rectifier voltage exceeds a certain voltage (e.g., 3.8V) the limiter can activate and stop the voltage from accumulating further. A finite state machine (FSM) can control the stimulation pulse width and amplitude of stimulation.
Many embodiments of the system can include an implant with a System on Chip (SOC) that can generate several different voltage levels of stimulation (e.g., two voltage level stimulation) of several implants (e.g., 16 implants) using a single Tx coil. Each implant can operate at up to a particular distance (e.g., of about 80 mm) in the air through an inductive resonant link. In many embodiments, an SoC can consume minimal static power (e.g., only approximately 27 μW static power) and enable several channels of stimulation amplitude (e.g., two channels with stimulation amplitudes of 1.8 V and 3.3 V) and a particular timing resolution (e.g., timing resolution of 100 μs). An SoC can be implemented in the standard 180 nm CMOS technology and can have a minimal area (e.g., minimal area of approximately 0.75 mm×1.6 mm). In many embodiments, an SoC can include a RF rectifier, low drop-out regulator (LDO), error detection block, clock data recovery, finite state machine (FSM), and output stage. Each implant can have a PCB-defined passcode, which can enable the individual addressability of the implants for synchronized therapies. For example, an implantable device can weigh only about 80 mg and sizes about 20.1 mm3. Tolerance of up to 70° to angular misalignment was measured at a distance of 50 mm in a phosphate buffered solution (PBS). Many embodiments of the implantable stimulation system can be used for bilateral stimulation including bilateral vagus nerve stimulation (VNS) among others.
In many embodiments, a passcode-enabled implant can be controlled by at least one Tx coil. A passcode-enabled miniaturized implant controlled by a single Tx coil in accordance with an embodiment of the invention is illustrated in
In many embodiments, an n-bit (e.g., 4-bit) passcodes can be defined on a chip's pads. Depending on the printed circuit board (PCB) connections, they can be connected to VDD or VSS. This approach can provide a robust passcode for individual addressability. In many embodiments, the Tx coil can power all the implants simultaneously, and by using Pulse-width modulated amplitude-shift keying (PWM-ASK), implants can be synchronized. Since each implant can be deployed at a different site, there may no longer be a need for long leads and/or electrode arrays. By optimizing link efficiency, a particular longer lead distance (e.g., of 80 mm) can be achieved by using a particular peak power (e.g., 2 W of peak power) for the Tx coil. Many embodiments of the implant can have: (1) reliable two-channel stimulation (e.g., 1.8V or 3.3V); (2) wirelessly powering and controlling up to a particular longer lead distance in air through a frequency link (e.g., 80 mm in air through inductive 40.68 MHz link); (3) an n-bit passcode which can enable N implants to operate at the same time (e.g., 4-bit passcode which enables up to 16 implants to operate at the same time; (4) up to about 70° angular misalignment can be tolerated; (5) implants fabricated using standard FR4 substrate technology can weigh approximately only 80 mg and have a volume of about 20.1 mm3; (6) error detection block can verify if an implant has harvested enough power before stimulation. A conceptual presentation of wirelessly powered and controlled implants for bilateral VNS with two implants in accordance with an embodiment of the invention is illustrated in
Described herein are quantitative and qualitative details of a WPT link co-design and circuit implementation, coil designs, wireless link parameters, chip design, including rectifier, LDO, power-on reset (POR), CDR, and output stage, among other systems components that can be utilized as appropriate to the requirements of specific applications in accordance with embodiments of the invention.
Stimulation systems in accordance with many embodiments can include magnetic resonance power transfer. Capacitive WPT can be sensitive to wireless link parameters. Ultrasound WPT can rely on physical vibrations for power transfer. A limitation of ultrasound can be that it may require direct physical contact by applied gel and can suffer from attenuation in muscle and bone mediums. A drawback of Magnetic resonance WPT can include large physical dimensions of a coil and tuning of a carrier frequency (fc). Furthermore, wireless link variations and rectifier non-linearity can be pivotal factors for frequency tuning.
Coil Design
Implantable stimulator systems in accordance with many embodiments can include a matched series resonant Tx coil and parallel resonant Rx coil which can provide significantly lower power consumption on an implant side. This structure can have superior efficiency in low-power applications. In many embodiments, an approach for a coil design can involve an iterative process. A link efficiency can be calculated from the equation below:
In equation (1), K is the distance-dependent coupling factor, QTx is the Tx coil quality factor (QTx=ωLTx/RTx), QRx is the Rx coil quality factor (QRx=ωLRx/RRx), and QL is the loaded Rx coil quality factor which can be calculated from the following equation:
In many embodiments, a circular coil shape for Rx can be used due to its higher quality facto. A schematic of inductively coupled coils in accordance with an embodiment of the invention is illustrated in
D≤2.288×d (3)
Step1: Apply constraints on the Rx and Tx coil size.
Step2: Initialize N, W, S for Tx coil.
Step3: Optimize Rx coil parameters for best ηlink.
Step4: Optimize Tx coil Parameters for best ηlink.
Step5: Repeat until there is no improvement.
For example, a simulated link efficiency in HFSS before matching can be 2.17% at a distance of 50 mm with an unmatched coil and RL=100 kΩ. Physical dimensions of simulated coils in accordance with an embodiment of the invention are shown in HFSS. Details of coil stand-alone parameters in accordance with an embodiment of the invention are presented in table 1. A Tx coil can be connected to the N5230C network analyzer directly for characterization. The Rx coil, due to its small size and high parasitics of the probes, is not measured directly, and HFSS simulation results are shown in the table 1.
Biological Medium Effects
Wireless link parameters such as power and medium variations can cause a change in an implant's resonant frequency. The intervening biological medium can be approximated as the low-loss complex dielectric material. The real and imaginary part of the dielectric constant corresponds to electrical permittivity and conductivity, respectively. The equation below expresses the frequency-dependent dielectric constant:
In frequencies of a few MHz and above, the dielectric conductivity increase and permittivity decrease can no longer be ignored. A database of dielectric properties of different biological tissues is available in the literature. The dielectric properties can be imported into HFSS to investigate the shift in resonance frequency after adding the material. Electrical permittivity and conductivity of skin, fat, and muscle are plotted in
It can be possible to bring the resonance frequency back to 40.68 MHz by reducing Cp. Power transfer can be done at 40.68 MHz to operate within the industrial, scientific, and medical (ISM) band. In many embodiments, since an implant may need to work inside air and muscle properly, a system's bandwidth can be high enough to cover the frequency shift.
The specific absorption rate (SAR) can be an important figure of merit in determining how safe the wireless power transfer is to biological tissue. SAR can be calculated by the electric field inside the homogeneous tissue and can be calculated from the following equation:
σ is the electrical conductivity, and ρ is the density of the tissue. As described, conductivity increases with frequency, which results in a higher absorption rate. Federal Communication Commission (FCC) recognizes the limit of 1.6 W/kg for the human head. The simulated specific absorption rate is 2 mW/kg in HFSS, which is three orders of magnitude less than the 10 W/kg safety limit according to IEEE Std C95.1-2005 and FCC regulation. The SAR can be simulated over the human model with a port power of 1 W at 40.68 MHz when the Tx coil is placed 3 cm away.
In many embodiments, to ensure batteryless and wireless operation of an implantable device, a power harvesting chip can extract a passcode and control a stimulation. A chip can be interfaced with an Rx coil to harvest the power and extract the clock and data. Tx can send data at a particular rate (e.g., rate of 10 kbps) with PWM-ASK modulation. Based on the pulse width, the clock and data can be extracted. Passcode detection can be realized using a finite state machine (FSM) with received data, and stimuli voltage, amplitude, and duration can be set. An output stage can buffer the control signals and can drive the tissue using standard cuff-electrodes. An on-chip error detection block can ensure that the harvested voltage is not lower than a threshold voltage (e.g., 2.6 V) during stimulations. An architecture of an implantable chip in accordance with an embodiment is illustrated in
In many embodiments, power management unit 705 can be important for an implantable device to operate reliably. A rectifier 706 can harvest power from an Rx coil 707 and can store them on an off-chip capacitor (CStr). An LDO 708 and reference generation 709 can also be important for reliable and efficient operation.
The data recovery block 710 can include an envelope detector 711, error detector 712, CDR 713 and a finite state machine FSM 714, where the FSM can receive a PCB passcode.
The output stage 715 can include output stage and driver circuitry 716 that generate a stimulation on an electrode. Described are further details on different components of implantable stimulator systems in accordance with several embodiments of the invention. Although
Stimulation systems in accordance with many embodiments can include passive rectifiers that can provide an advantage of efficient cold start-up. Many embodiments of the system can use a cross-coupled (CC) full-wave topology due to its excellent power transfer efficiency and dynamic threshold voltage (Vth) compensation. A rectifier in accordance with an embodiment of the invention is illustrated in
A quality factor can be expressed based on (2), and for a properly designed Rx coil, the power going to the rectifier can be much larger than the power wasted in the coil, therefore
And therefore, its bandwidth can be calculated from the following equation:
The inherent efficiency of the rectifier can be another important parameter which is defined as:
The sensitivity of the rectifier can be calculated as QηRect.
Simulated results of rectifier BW and QηRect when the rectifier is loaded by 10 μA of current in accordance with an embodiment are shown in
A resonance frequency of the Rx coil can be calculated using the equation below:
In many embodiments, a rectifier can be a non-linear block, and its input impedance varies with power and loading.
A process of co-designing an Rx coil and rectifier in accordance with an embodiment of the invention is illustrated in
Stimulator systems in accordance with many embodiments can include low drop-out (LDO) regulators that can be important to a chip as they can provide a stable voltage supply (e.g., 1.8 V supply) for other blocks. A schematic of an LDO in accordance with an embodiment of the invention is illustrated in
Line regulation identifies the ratio between regulated voltage and supply voltage variations. Load Regulation can be defined as the amount of the LDO voltage drop concerning a change in the loading current. The output resistance of the LDO can be tightly related to the load regulation but in a small signal domain:
Although
It can be important for a wirelessly powered device to reset the digital blocks every time the chip is powered up. A cross-coupled inverter chain can be used for POR. A fraction of rectifier voltage (α=0.75) can be used for a weak current source to charge the capacitor in cross-coupled inverters. The inverters can be sized for opposite pull-up and pull-down to prevent metastability. As shown in
In many embodiments, clock and data recovery can be used to determine a stimulation's passcode, duration, and/or voltage level. Unlike power-hungry phase detectors, the difference between the pulse width of bit ‘1’ and ‘0’ can be utilized to recover the clock and data. In many embodiments, bits ‘1’ and ‘0’ can have pulse widths of 75% and 25% respectively, and the duration of each bit can be set to be 100 μs. The signal's envelope can be used as the clock for the system.
In
A circuit schematic of a reference generator, comparator and Schmitt trigger in accordance with an embodiment of the invention is illustrated in
In many embodiments, the clock can be integrated by a 40 nA current source on a 1.8 pF capacitor. Bit ‘1’ and ‘0’ reach values of 1.65 V and 0.375 V after integration (Vint). After comparing with the reference voltage of 1.6 V, a pulse of 18 μs is generated if the bit is ‘1’. In order to avoid glitches, a delay of 6 μs can be applied for the detected pulses, then they are passed through a shift register to generate the data (D0) for passcode detection and stimulation. This scheme can enable clock and data recovery without phase locked loops.
Monte Carlo over 204 post-layout simulations can be performed.
In many embodiments, each chip can have a specific n-bit (e.g., 4-bit) passcode based on the PCB connections. After sending n bits (e.g., 8 bits), including flag and voltage level, if the passcode and flag are matched, the stimulation activates.
An output stage of a stimulator in accordance with an embodiment of the invention is illustrated in
The minimum tolerable load resistance for the storage capacitor can be defined as:
Where VStim,Avg is the average stimulation voltage, tStim is the stimulation pulse time, Cstr is the storage capacitance, and ΔVstim is the maximum allowable voltage change during stimulation. For a conventional stimulation of tStim=1 ms, VStim,Avg=3.3 V and ΔVstim=0.3 V, the Rload,min is 271Ω. The maximum load for stable stimulation may need to be verified to be within operating range.
Although
In many embodiments, a SoC can be fabricated in TSMC 180-nm technology. A chip can have an area of 1.2 mm2, as shown in
Although specific implementations for code-controlled multi-side wirelessly powered battery-less implantable stimulators are discussed above with respect to
This application claims benefit of and priority under 35 U.S.C. 119(e) to U.S. Provisional Patent Application No. 63/266,738 entitled “Code-Controlled Multi-Site Wirelessly-Powered Batteryless Stimulator” by Babakhani et al., filed Jan. 13, 2022, the disclosure of which is hereby incorporated by reference in its entirety for all purposes.
This invention was made with government support under Grant Number HL144683, awarded by the National Institutes of Health. The government has certain rights in the invention.
Number | Date | Country | |
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63266738 | Jan 2022 | US |