Spinal cord stimulator electrode materials and electrode displacement issues: current status, challenges and future developments
DOI:
https://doi.org/10.61173/cay1hq38Keywords:
Spinal cord stimulator (SCS), electrode materials, electrode displacementAbstract
Spinal cord stimulation (SCS) is a key technology for the treatment of chronic pain and neurological dysfunction, and its effectiveness relies heavily on the selection and design of electrode materials. This paper reviews the electrochemical properties and biocompatibility of several commonly used electrode materials, including platinum-iridium alloys (PtIr), iridium oxides (IrOx), carbon nanotubes (CNTs), conductive polymers (PEDOT/PSS), and boron-doped diamonds (BDDs). The role of liquid crystal polymer (LCP) encapsulation technology in the long-term stability of electrodes is then discussed. Despite significant progress in the application of these materials in SCS devices, complications such as electrode migration and material degradation are still open issues. This paper analyzes the advantages and disadvantages of different electrode materials, discusses the possibility of improving electrode performance through emerging technologies such as nanotechnology and smart electrode systems, and proposes future research directions to reduce surgical complications and enhance treatment outcomes. With intelligent electrode systems and personalised treatment plans, electrical nerve stimulation technology provides greater precision, adaptability and long-term efficacy in the treatment of neurological disorders.References
[1] Simopoulos, T.; Sharma, S.; Aner, M.; Gill, J.S. The Long- Term Durability of Multilumen Concentric Percutaneous Spinal Cord Stimulator Leads. Pain Pract. 2018, 18, 845–849.
[2] Ochani, T.D.; Almirante, J.; Siddiqui, A.; Kaplan, R. Allergic Reaction to Spinal Cord Stimulator. Clin. J. Pain 2000, 16, 178– Dean&Francis Zexi Xu 180.
[3] Durand, D.M.; Ghovanloo, M.; Krames, E. Time to address the problems at the neural interface. J. Neural Eng. 2014, 11, 020201.
[4] Nie, B.; Liu, S.; Qu, Q.; Zhang, Y.; Zhao, M.; Liu, J. Bioinspired flexible electronics for smart E-skin. Acta Biomater. 2022, 139, 280–295.
[5] Someya, T.; Amagai, M. Toward a new generation of smart skins. Nat. Biotechnol. 2019, 37, 382–388.
[6] Han, L.; Lu, X.; Wang, M.; Gan, D.; Deng, W.; Wang, K.; Fang, L.; Liu, K.; Chan, C.W.; Tang, Y.; et al. A Mussel-Inspired Conductive, Self-Adhesive, and Self-Healable Tough Hydrogel as Cell Stimulators and Implantable Bioelectronics. Small 2017, 13, 1601916.
[7] Wang, S.; Xu, J.; Wang, W.; Wang, G.-J.N.; Rastak, R.; Molina-Lopez, F.; Chung, J.W.; Niu, S.; Feig, V.R.; Lopez, J.; et al. Skin electronics from scalable fabrication of an intrinsically stretchable transistor array. Nature 2018, 555, 83–88.
[8] Kaltenbrunner, M.; Sekitani, T.; Reeder, J.; Yokota, T.; Kuribara, K.; Tokuhara, T.; Drack, M.; Schwödiauer, R.; Graz, I.; Bauer-Gogonea, S.; et al. An ultra-lightweight design for imperceptible plastic electronics. Nature 2013, 499, 458–463.
[9] Ganske G, Slavcheva E, Van Ooyen A, et al. Sputtered platinum–iridium layers as electrode material for functional electrostimulation. Thin Solid Films, 2011, 519(11): 3965-3970.
[10] Giagka, V. (2015). Flexible active electrode arrays for epidural spinal cord stimulation (Doctoral dissertation, UCL (University College London)).
[11] Zeng Q, Yu S, Fan Z, et al. Nanocone-array-based platinumiridium oxide neural microelectrodes: structure, electrochemistry, durability and biocompatibility study. Nanomaterials, 2022, 12(19): 3445.
[12] Maheswaran R, Shanmugavel B P. A critical review of the role of carbon nanotubes in the progress of next-generation electronic applications. Journal of Electronic Materials, 2022, 51(6): 2786-2800.
[13] Gooding J J. Nanostructuring electrodes with carbon nanotubes: A review on electrochemistry and applications for sensing. Electrochimica Acta, 2005, 50(15): 3049-3060.
[14] Dijk G, Ruigrok H J, O‘Connor R P. Influence of PEDOT: PSS coating thickness on the performance of stimulation electrodes. Advanced Materials Interfaces, 2020, 7(16): 2000675.
[15] Okhay O, Tkach A. Graphene/reduced graphene oxidecarbon nanotubes composite electrodes: From capacitive to battery-type behaviour. Nanomaterials, 2021, 11(5): 1240.
[16] Alcaide, M.; Taylor, A.; Fjorback, M.; Zachar, V.; Pennisi, C.P. Boron-Doped Nanocrystalline Diamond Electrodes for Neural Interfaces: In vivo Biocompatibility Evaluation. Front. Neurosci. 2016, 10, 87.
[17] Piret, G.; Hébert, C.; Mazellier, J.-P.; Rousseau, L.; Scorsone, E.; Cottance, M.; Lissorgues, G.; Heuschkel, M.O.; Picaud, S.; Bergonzo, P.; et al. 3D-nanostructured borondoped diamond for microelectrode array neural interfacing. Biomaterials 2015, 53, 173–183.
[18] Ariano, P.; Giudice, A.L.; Marcantoni, A.; Vittone, E.; Carbone, E.; Lovisolo, D. A diamond-based biosensor for the recording of neuronal activity. Biosens. Bioelectron. 2009, 24, 2046–2050.
[19] Trevathan, J.K.; Baumgart, I.W.; Nicolai, E.N.; Gosink, B.A.; Asp, A.J.; Settell, M.; Polaconda, S.R.; Malerick, K.D.; Brodnick, S.K.; Zeng, W.; et al. An Injectable Neural Stimulation Electrode Made from an In-Body Curing Polymer/ Metal Composite. Adv. Healthc. Mater. 2019, 8, e1900892.
[20] Yun S, Koh C S, Seo J, et al. A fully implantable miniaturized liquid crystal polymer (lcp)-based spinal cord stimulator for pain control. Sensors, 2022, 22(2): 501.
[21] Rihani R, Tasnim N, Javed M, et al. Liquid crystalline polymers: opportunities to shape neural interfaces. Neuromodulation: Technology at the Neural Interface, 2022, 25(8): 1259-1267.
[22] Dombovy-Johnson M L, D‘Souza R S, Ha C T, et al. Incidence and risk factors for spinal cord stimulator lead migration with or without loss of efficacy: a retrospective review of 91 consecutive thoracic lead implants. Neuromodulation: Technology at the Neural Interface, 2022, 25(5): 731-737.
[23] Gazelka H M, Freeman E D, Hooten W M, et al. Incidence of clinically significant percutaneous spinal cord stimulator lead migration. Neuromodulation: Technology at the Neural Interface, 2015, 18(2): 123-125.
[24] Esomonu C, Hagedorn J M. Teaching points: overview of spinal cord stimulation lead migration. Pain Medicine, 2021, 22(2): 520-522.
[25] Gupta M, Abd-Elsayed A, Hughes M, et al. A retrospective review of lead migration rate in patients permanently implanted with percutaneous leads and a 10 kHz SCS device. Pain Research and Management, 2021, 2021(1): 6639801.
[26] North R B, Recinos V R, Attenello F J, et al. Prevention of percutaneous spinal cord stimulation electrode migration: a 15- year experience. Neuromodulation: Technology at the Neural Interface, 2014, 17(7): 670-677.
[27] Kim D D, Vakharyia R, Kroll H R, et al. Rates of lead migration and stimulation loss in spinal cord stimulation: a retrospective comparison of laminotomy versus percutaneous implantation. Pain Physician, 2011, 14(6): 513.
Downloads
Published
Issue
Section
License
Copyright (c) 2024 by the authors.

This work is licensed under a Creative Commons Attribution 4.0 International License.
