MEDICA / COMPAMED 2021

•••6••• Innovationen Miniaturized and networked active implants Safe, patient-friendly implants for personalized therapy The latest developments will be presented at COMPAMED/MEDI- CA in Düsseldorf from November 15 to 18 (Hall 13, Stand D60). While dental implants “just” re- place the tooth and help to chew food in the same way as the origi- nal, other implants actively sup- port the body and are therefore called “active implants”. One well known example is the pacemaker, which is implanted in the chest area under the patient’s skin and emits pulses to stimulate the heart rhythmwhen it becomes too slow. The energy it needs is supplied by a battery. However, there are some innovative therapies in de- velopment that could use small im- plants to replace some drug-based therapies – these will require tiny implants that use very little en- ergy. The major goal is to provide maximum care and personalized therapy for the patient. Scientists at the Fraunhofer IBMT are supporting manufacturers with their huge expertise gained over 20 years of work on active implants. The latest developments from the Fraunhofer IBMT can be seen at the COMPAMED/MEDICA trade show being held from No- vember 15 to 18 in Düsseldorf (Hall 13, Stand D60). “We’re not just a technology partner but a system provider for the design and de- velopment of active implants,” says Andreas Schneider-Ickert, Project Manager and Innovation Manager at the Fraunhofer IBMT. “Ultimately, we work on the min- iaturization of implants as well as on biocompatibility and long-term stability, power supply, near-sen- sor signal processing, alternative stimulation methods and implant networks,” adds Group Manager Roman Ruff. Controlling neuroprostheses di- rectly through muscle or nerve signals One example is prosthetic hands, which can be used by people who have lost a hand or an arm to al- low them to grasp objects – by opening and closing their “hand” – and to rotate their hand. The future will see the addition of sig- nificantly greater levels of free- dom and the electrodes that are currently needed on the skin for these prosthetic hands to work will become passé. “We have de- veloped flexible, implantable mi- croelectrodes, for example in the ‘Theranostic Implants’ project,” says Roman Ruff. “We can place these electrodes inside the body and record useful signals directly from muscles or nerves.” These signals are then converted into movement of the prosthesis. “In the long term, patients with these prostheses will be able to feel a lot more like they have a naturally working hand, because they will be able to carry out much more complex movements. What ’s more, feedback can be trans- ferred through the implanted electrodes back into the peripher- al nervous system. These trigger perceptions that can represent changes in gripping strength, for example. It will be significantly more intuitive for the wearer to control a prosthesis,” explains Ruff. Energy transfer from outside: depth of penetration increased by a factor of two to three Active implants require energy. With induction, this energy can be supplied from outside the body, but the depth of penetration in- to the body is limited. At greater implant depths, effectiveness is significantly reduced. “We have been able to increase the depth of penetration by a factor of two to three by transferring the ener- gy into the body via ultrasound,” says Schneider-Ickert. This meth- od can be used to supply implants encased in titanium, for example, that cannot be supplied using in- duction. Another advantage of energy supply and communication via ultrasound is security. While in- ductive or radio-based interfaces can be hacked, this is more diffi- cult to do with ultrasound. The scientists at the Fraunhofer IBMT are also working on the re- cently launched ”SOMA” Euro- pean project with seven partners from five European countries to stimulate nerves via ultrasound as well. “If we could stimulate the peripheral nervous system via ul- trasound from a greater distance to the nerve, using the implants would be even more patient- friendly,” explains Schneider-Ick- ert. Networked implants Another trend for the future of active implants is the use of net- worked systems comprising mul- tiple highly miniaturized implants that coordinate with each other, rather than one central implant. The team of scientists at the Fraunhofer IBMT is working on this together with 16 partners in the innovation cluster “INTAKT” (from the German for “interactive microimplants”) funded by the German Federal Ministry of Educa- tion and Research BMBF. The main advantage of these networked systems is greater biostability. “The sensors and actuators can be directly integrated into the casing, which removes the need for sensi- tive cable connections,” explains Ruff. If an implant fails, these im- plants are also much easier to re- place. In the development of plat- form technologies for networked active implants, the Fraunhofer researchers are pursuing three use cases. The first is a pacemaker for the gastrointestinal tract that uses distributed implants to facili- tate or inhibit the intestine’s mo- tility, i.e., ability to move actively. The second is a tinnitus suppres- sor that uses electrical stimulation to mask the ringing sound and make it less intrusive. The third is a gripping neuroprosthesis that can be used by paraplegics who have residual muscle activity to support them in performing arm move- ments, for example lifting a glass. Highly integrated implant electronics with radiotelemetry and an application-specific inte- grated circuit (ASIC) to record biosignals and for stimulation. Foto: Fraunhofer IBMT Continued from Page 1 13. Healthcare Innovation World Cup Beim “13. Healthcare Innovation Wor ld Cup“ geht es schwer- punktmäßig um innovative Gerä- te und smarte Applikationen zur digitalen Vernetzung und Pro- zessintegration im Sinne des „In- ternet of Medical Things“. Mehr als dreihundert Start-ups haben sich für diesen Wettbewerb be- worben. Zu den zwölf ausgewähl- ten Finalisten gehört die indische Ai Health Highway India Private Limited mit „AiSteth“, einem smarten Stethoskop zur Untersu- chung, Erkennung und Vor- hersage von Herz- und Lungener- krankungen mittels Künstlicher I n te l l i genz . Cyn te r ac t aus Deutschland ist ebenfalls im Fina- le mit dabei. Ihr intell igenter Handschuh mit Sensoren soll Pa- tienten zuhause unterstützen. Denn in Kombination mit abge- stimmter Sof tware kann der Handschuh für die Rehabilitation von Finger-, Hand- und Armver- letzungen nicht nur in Rehabilita- tionszentren, sondern auch in den eigenen vier Wänden einge- setzt werden. Eine softwarege- stützte Zusammenfassung der Trainingsdaten liefert dabei An- haltspunkte für die weitere The- rapiefindung. Die Finalpräsentationen und Preis- verleihung des „13. Healthcare Innovation World Cup“ finden am Montag, 15.11., von 13 bis 15 Uhr statt – ebenfalls auf der Pro- grammbühne des MEDICA CON- NECTED HEALTHCARE FORUM und mit entsprechendem Ticket online abrufbar als Livestream. Informationen zumMEDICA CON- NECTED HEALTHCARE FORUM und den Start-up-Wettbewerben mit Abstracts zu allen Finalisten sind abrufbar unter: https://www. medica.de/mchf1.