New Flexible Auditory Brainstem Implant Offers Hope for Patients with Severe Hearing Loss
Release time:
2025-04-25
A research team from the Swiss Federal Institute of Technology Lausanne (EPFL) recently published a groundbreaking achievement in Nature Biomedical Engineering: the world’s first flexible auditory brainstem implant (ABI). This innovative technology aims to address the side effects caused by the rigid structure of traditional ABIs, offering a more precise and safe hearing restoration solution for patients with severe cochlear nerve damage who cannot benefit from cochlear implants.
Challenges of Traditional ABI Technology: Side Effects and Limited Efficacy
Since their inception, ABIs have been considered a "last resort" for patients ineligible for cochlear implants. However, conventional rigid electrode arrays struggle to conform to the brainstem’s complex curvature, leading to current spread and unintended nerve activation. Clinically, doctors often deactivate most electrodes to avoid side effects such as dizziness and facial twitching, leaving patients with only vague sound perception and an inability to discern speech.
"These limitations severely hinder the practical utility of ABIs, offering minimal improvement to patients’ quality of life," noted Professor Stéphanie P. Lacour, head of EPFL’s Soft Bioelectronic Interfaces Laboratory. "We need a solution that naturally conforms to brain tissue and delivers precise stimulation."
Flexible Breakthrough: Millimeter-Thick Film Adapts to Brainstem Curvature
The team leveraged advancements in materials science and microfabrication to develop a flexible ABI just millimeters thick. The device embeds micron-sized platinum electrodes into a silicone film, creating a bendable array that conforms seamlessly to the cochlear nucleus surface (with a radius as small as 3 mm). Compared to rigid implants, this flexible design reduces current leakage risks and enables more electrodes to operate simultaneously, enhancing sound resolution.
"Seamless contact between flexible electrodes and tissue is key," explained co-first author Alix Trouillet. "This not only lowers stimulation thresholds but also allows more electrodes to activate, laying the groundwork for high-resolution hearing restoration." The team also utilized microlithography to customize electrode layouts, with future plans to adjust electrode numbers (currently 11) and configurations for patient-specific frequency tuning.
Successful Animal Trials: Macaques "Understand" Electrical Pulse Signals
To validate the flexible ABI’s efficacy, the team conducted months of behavioral experiments on hearing-capable macaques. The monkeys were trained to distinguish between continuous tones using a joystick. Gradually, natural sounds were replaced with ABI-generated electrical stimuli, and eventually, fully artificial signals. Results showed the macaques could accurately differentiate subtle variations between electrode pairs, processing electrical pulses similarly to real sounds.
"The animals’ voluntary triggering of stimuli indicates no discomfort from artificial hearing," emphasized co-first author Emilie Revol. Notably, no facial twitching or side effects occurred, and the implant demonstrated long-term stability without displacement—a common issue causing performance degradation in traditional ABIs.
Clinical Prospects: Potential for Intraoperative Testing
Despite promising results, the team acknowledges challenges such as medical material certification and long-term reliability testing before clinical use. Prof. Lacour revealed plans to collaborate with clinical partners in Boston for short-term intraoperative testing of flexible electrodes during human ABI surgeries, comparing their ability to reduce unintended nerve activation versus traditional devices.
"If intraoperative trials succeed, flexible ABIs could usher in a new era of hearing rehabilitation," Lacour stated. Future efforts will focus on increasing electrode density for improved sound resolution and exploring broader applications in neuroregulation.
Broader Implications
EPFL’s research not only brings hope to patients with severe hearing loss but also sets a benchmark for flexible bioelectronic devices. As the technology evolves and advances toward clinical adoption, flexible ABIs may become the next milestone in neural repair, redefining the boundaries of human-machine interaction.
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