Wireless Implantable Pressure Monitor for Conditional Bladder Neuromodulation.
Wireless Implantable Pressure Monitor for Conditional Bladder Neuromodulation.
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用于有条件膀胱神经调节的无线植入式压力监测器。
DOI：
10.1109/biocas.2015.7348337
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发表时间：
2015
期刊：
影响因子：
--
通讯作者：
Damaser,MargotS
中科院分区：
文献类型：
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作者：
Majerus,Steve;Makovey,Iryna;Zhui,Hui;Ko,Wen;Damaser,MargotS
根据反馈应用或修改神经刺激的条件神经调节是增强膀胱功能刺激的可行方法。目前测量膀胱压力的方法完全依赖于放置在膀胱腔中的外部导管。这种方法在慢性神经调节治疗所需的门诊使用中的效用有限。我们开发了一种无线膀胱压力监测仪，可提供实时、无导管的膀胱压力测量，以支持条件神经调节。该装置的尺寸适合粘膜下膀胱镜植入膀胱。该植入式微系统由超低功耗专用集成电路 (ASIC)、微机电 (MEMS) 压力传感器、射频天线和微型可充电电池组成。电源管理的战略方法通过减少电池容量需求来实现植入物的小型化。在这里，我们描述了两种降低微系统平均电流消耗的方法：开关偏置功率控制和自适应速率传输。对人体膀胱测压追踪的测量表明，与全速率传输相比，自适应传输速率可以平均节省 96% 的功率，同时增加 1.6% RMS 误差。我们已在大型动物体内长期植入无线压力监测器长达 4 周。据我们所知，这些发现代表了通过长期植入膀胱逼尿肌内的压力监测器进行无导管、实时膀胱压力传感的第一个例子。
Conditional neuromodulation in which neurostimulation is applied or modified based on feedback is a viable approach for enhanced bladder functional stimulation. Current methods for measuring bladder pressure rely exclusively on external catheters placed in the bladder lumen. This approach has limited utility in ambulatory use as required for chronic neuromodulation therapy. We have developed a wireless bladder pressure monitor to provide real-time, catheter-free measurements of bladder pressure to support conditional neuromodulation. The device is sized for submucosal cystoscopic implantation into the bladder. The implantable microsystem consists of an ultra-low-power application specific integrated circuit (ASIC), micro-electro-mechanical (MEMS) pressure sensor, RF antennas, and a miniature rechargeable battery. A strategic approach to power management miniaturizes the implant by reducing the battery capacity requirement. Here we describe two approaches to reduce the average microsystem current draw: switched-bias power control and adaptive rate transmission. Measurements on human cystometric tracings show that adaptive transmission rate can save an average of 96% power compared to full-rate transmission, while adding 1.6% RMS error. We have chronically implanted the wireless pressure monitor for up to 4 weeks in large animals. To the best of our knowledge these findings represent the first examples of catheter-free, realtime bladder pressure sensing from a pressure monitor chronically implanted within the bladder detrusor.