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Med Biol Eng Comput
DOI 10.1007/s11517-015-1442-0
REVIEW ARTICLE
Implantable neurotechnologies: electrical stimulation
and applications
Sudip Nag
1
· Nitish V. Thakor
1
Received: 13 August 2015 / Accepted: 14 December 2015
© International Federation for Medical and Biological Engineering 2016
electric shock-induced pain relief in the 18th century [111],
and soon after Luigi Galvani induced muscle contractions
via electrical stimulation in the leg muscles of killed frogs
[32]. Although the technique of electrical stimulation-
mediated therapy originated centuries ago, routine test-
ing only began in animals and humans in the 19th and
20th centuries, respectively [30, 85]. Functionally useful
stimulation-induced movement of muscles with damaged
nerves was reported by the middle of the 20th century [59].
Later, Brindley and Lewin [8] showed that stimulation of
the visual cortex can produce the sensation of light flashes.
Table 1 outlines the major breakthrough discoveries and
therapeutic studies using electrical stimulation.
The field of neural stimulation harbors promise for basic
science discovery, clinical therapies and translation for the
benefit of the society. Neural stimulation has been carried
out to probe neurons, nerves and all regions of the nervous
system. Major improvements and optimizations were the
result of the fundamental discoveries and novel technolo-
gies developed during the mid-20th century [85]. Hodgkin
and Huxley [40] laid the foundation of the scientific under-
standing of excitable biological tissues, notably in their dis-
covery of the excitability of the nerve and axon by using
a long duration voltage or current pulse. Later, a series of
experimental methods and devices for cell and organ-level
stimulation were developed for both bench-top investiga-
tions and clinical translation [63, 72]. Experimental inves-
tigations on nerves, both peripheral [97] and visceral [47],
and on spinal cord [34] and brain [69, 101] have demon-
strated potential clinical therapies to restore function or
treat neurological disorders.
An electrical stimulator injects Coulombic charge
into biological tissue in a controlled manner to activate
or inhibit excitable cells [38, 108]. Such stimulation is
intended to induce a functional response in otherwise
Abstract Neural stimulation using injected electrical
charge is widely used both in functional therapies and as
an experimental tool for neuroscience applications. Elec-
trical pulses can induce excitation of targeted neural path-
ways that aid in the treatment of neural disorders or dys-
function of the central and peripheral nervous system. In
this review, we summarize the recent trends in the field of
electrical stimulation for therapeutic interventions of nerv-
ous system disorders, such as for the restoration of brain,
eye, ear, spinal cord, nerve and muscle function. Neural
prosthetic applications are discussed, and functional elec-
trical stimulation parameters for treating such disorders are
reviewed. Important considerations for implantable pack-
aging and enhancing device reliability are also discussed.
Neural stimulators are expected to play a profound role
in implantable neural devices that treat disorders and help
restore functions in injured or disabled nervous system.
Keywords Functional electrical stimulation · Charge
injection · Neural prostheses · Biphasic constant current ·
Charge-balanced stimulator · Energy efficiency · Voltage
compliance
1 Introduction
Electrical stimulation is becoming increasingly popular in
medical therapies and research studies to restore biological
functions, such as vision, hearing, movement, tactile per-
ception and proprioception. John Wesley first demonstrated
* Sudip Nag
sudipnag1@nus.edu.sg
1
National University of Singapore, Singapore, Singapore