Designing electrode configuration of electroosmosis based edema treatment as a complement to hyperosmotic therapy

Abstract

Background Hyperosmotic therapy is a mainstay treatment for cerebral edema. Although often effective, its disadvantages include mainly acting on the normal brain region with limited effectiveness in eliminating excess fluid in the edema region. This study investigates how to configure our previously proposed novel electroosmosis based edema treatment as a complement to hyperosmotic therapy. Methods Three electrode configurations are designed to drive the excess fluid out of the edema region, including 2-electrode, 3-electrode, and 5-electrode designs. The focality and directionality of the induced electroosmotic flow (EOF) are then investigated using the same patient-specific head model with localized edema. Results The 5-electrode design shows improved EOF focality with reduced effect on the normal brain region than the other two designs. Importantly, this design also achieves better directionality driving excess edema tissue fluid to a larger region of surrounding normal brain where hyperosmotic therapy functions better. Thus, the 5-electrode design is suggested to treat edema more efficiently via a synergic effect: the excess fluid is first driven out from the edema to surrounding normal brain via EOF, where it can then be treated with hyperosmotic therapy. Meanwhile, the 5-electrode design drives 2.22 mL excess fluid from the edema region in an hour comparable to the other designs, indicating a similar efficiency of EOF. Conclusions The results show that the promise of our previously proposed novel electroosmosis based edema treatment can be designed to achieve better focality and directionality towards a complement to hyperosmotic therapy.

Electrokinetic convection-enhanced delivery for infusion into the brain from a hydrogel reservoir

“…Overall, our experiments show that ECED can potentially be used to augment treatments which use doped hydrogels by increasing the amount of drug delivery to the region of interest. Furthermore, the principles behind ECED are also being used to manipulate fluid flow in the brain and reduce the harmful effects of cerebral edema 51 , 52 . Our current findings can also be compounded with these studies to better control the flow of fluids in the brain and gain, ultimately, control of drug distribution in the brain.…”