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If the Medicine of the future is Bioelectronic, how does the pill of the future look like? – and what does it take to make it?

Authors:

Abstract

In a world where medicine is becoming more personalised the promise of Bioelectronic Medicine is that tiny implants will deliver energy in the form of electrical impulses, replacing pharmaceuticals, their conventional chemical counterparts. But how can we develop such tiny smart and autonomous implants that (need to) seamlessly interact with the tissue and live in the body for decades [1]? How can we protect all the components in such an implant while still maintaining the small form factor and essential flexibility? How can we design electronics such that they remain better protected in such a harsh environment [2]? How can we ensure autonomy under the above restrictions [3]? Eventually, how can we make our medicine more precise, i.e. increase the specificity at which we interact with the tissue [4, 5]? And if we achieve all these, how will the pill of the future look like? References [1] V. Giagka, and W. Serdijn, "Realizing flexible bioelectronic medicines for accessing the peripheral nerves-technology considerations,"
NanoVision 2020 “Sense of materials”: Abstract for the NanoVision program
If the Medicine of the future is Bioelectronic, how does the pill of the future look like? –
and what does it take to make it?
Vasiliki Giagka1,2
1Bioelectronics Section, Department of Microelectronics, Faculty of Electrical Engineering, Mathematics and
Computer Science, Delft University of Technology, Mekelweg 4, 2628 CD, Delft, The Netherlands
2Technologies for Bioelectronics Group, Department of System Integration and Interconnection Technologies,
Fraunhofer Institute for Reliability and Microintegration IZM, Gustav-Meyer-Allee 25, 13355, Berlin, Germany
E-mail: vasiliki.giagka@izm.fraunhofer.de; v.giagka@tudelft.nl
In a world where medicine is becoming more personalised the promise of Bioelectronic
Medicine is that tiny implants will deliver energy in the form of electrical impulses, replacing
pharmaceuticals, their conventional chemical counterparts. But how can we develop such
tiny smart and autonomous implants that (need to) seamlessly interact with the tissue and
live in the body for decades [1]? How can we protect all the components in such an implant
while still maintaining the small form factor and essential flexibility? How can we design
electronics such that they remain better protected in such a harsh environment [2]? How
can we ensure autonomy under the above restrictions [3]? Eventually, how can we make our
medicine more precise, i.e. increase the specificity at which we interact with the tissue [4,
5]? And if we achieve all these, how will the pill of the future look like?
References
[1] V. Giagka, and W. Serdijn, Realizing flexible bioelectronic medicines for accessing the peripheral nerves technology
considerations,” Bioelectronic Medicine journal, vol. 4, no. 8, Jun. 2018, https://doi.org/10.1186/s42234-018-0010-y
[2] K. Nanbakhsh, M. Kluba, B. Pahl, F. Bourgeois, R. Dekker, W. Serdijn, and V. Giagka, “Effect of Signals on the
Encapsulation Performance of Parylene Coated Platinum Tracks for Active Medical Implants,” in Proc. 41st Int. Conf. of the
IEEE Engineering in Medicine and Biology (EMBC) 2019, Berlin, Germany, Jul. 2019.
[3] L. Tacchetti, W. A. Serdijn, and V. Giagka, “An ultrasonically powered and controlled ultra-high-frequency biphasic
electrical neurostimulator,” in Proc. IEEE Biomed. Circ. Syst. Conf. (BioCAS) 2018, Cleveland, Ohio, USA, Oct. 2018, pp. 1 4.
[4] A. I. Velea, S. Vollebregt, G. K. Wardhana, and V. Giagka, Wafer-Scale Graphene-Based Soft Electrode Array with
Optogenetic Compatibility,” 2020 IEEE 33rd International Conference on Micro Electro Mechanical Systems (MEMS),
Vancouver, BC, Canada, 2020, pp. 421-424.
[5] S. Kawasaki, V. Giagka, M. de Haas, M. Louwerse, V. Henneken, C. van Heesch, and R. Dekker, Pressure measurement
of geometrically curved ultrasound transducer array for spatially specific stimulation of the vagus nerve,” in Proc. IEEE
Conf. on Neural Eng. (NER) 2019, San Francisco, CA, USA, Mar. 2019.
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Patients suffering from conditions such as paralysis, diabetes or rheumatoid arthritis could in the future be treated in a personalised manner using bioelectronic medicines (BEms) (Nat Rev Drug Discov 13:399–400, 2013, Proc Natl Acad Sci USA 113:8284–9, 2016, J Intern Med 282:37–45, 2017). To deliver this personalised therapy based on electricity, BEms need to target various sites in the human body and operate in a closed-loop manner. The specific conditions and anatomy of the targeted sites pose unique challenges in the development of BEms. With a focus on BEms based on flexible substrates for accessing small peripheral nerves, this paper discusses several system-level technology considerations related to the development of such devices. The focus is mainly on miniaturisation and long-term operation. We present an overview of common substrate and electrode materials, related processing methods, and discuss assembly, miniaturisation and long-term stability issues.