Electric Parameters Optimization in Spinal Cord Stimulation. Study in Conventional Nonrechargeable Systems

Abejón, David; Cameron, Tracy; Feler, Claudio A.; Pérez-Cajaraville, J.

doi:10.1111/j.1525-1403.2010.00290.x

Cited by 12 publications

(19 citation statements)

References 27 publications

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“…At the separation distance between edges of electrodes of 6 mm and saline conductivity of 0.5280 S/m, the measured impedance was 561 Ohms. This impedance value was within reported values for spinal cord stimulators with dual lead configuration of 562 ± 389 Ohms [15]. …”

Section: Methodssupporting

confidence: 86%

“…We did further investigation and determined that the threshold factor of 4.34 in SENN model is equivalent to 5.1 mA and 300 μsec output waveform from a spinal cord neurostimulator. Referring back to the study where we obtained best therapy parameters for stimulation [15], the study additionally lists a perception threshold of 4.6 mA in amplitude and 300 μsec in pulse width and a discomfort threshold of 6.0 mA in amplitude and 300 μsec in pulse width. Overall, the output waveform with amplitude of 5.1 mA is higher than the perception threshold and lower than discomfort threshold.…”

Section: Resultsmentioning

confidence: 99%

“…The tank was filled with 5280 μS/cm (0.528 S/m) conductivity saline to the top surface of the neurostimulator pulse generator. The conductivity value was selected to match reported 561 Ohm resistance [15] between electrodes which were 6 mm apart. The holes in the grid filled with the surrounding saline.…”

Section: Methodsmentioning

confidence: 99%

“…The average reported parameters for best therapy were; amplitude of 5.3 mA, pulse width of 300 μsec and pulse repetition of 100 Hz (10 msec) [15]. Since our implantable neurostimulator system was a voltage controlled system, we calculated 5.3 mA (through 561 Ohms impedance) to be 3 V. We programmed the neurostimulator system to output a waveform of 3 V amplitude, 300 μsec pulse width and 100 Hz repetition rate.…”

Section: Methodsmentioning

confidence: 99%

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Analysis of induced electrical currents from magnetic field coupling inside implantable neurostimulator leads

Pantchenko

Seidman

Guag

2011

BioMedical Engineering OnLine

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BackgroundOver the last decade, the number of neurostimulator systems implanted in patients has been rapidly growing. Nearly 50, 000 neurostimulators are implanted worldwide annually. The most common type of implantable neurostimulators is indicated for pain relief. At the same time, commercial use of other electromagnetic technologies is expanding, making electromagnetic interference (EMI) of neurostimulator function an issue of concern. Typically reported sources of neurostimulator EMI include security systems, metal detectors and wireless equipment. When near such sources, patients with implanted neurostimulators have reported adverse events such as shock, pain, and increased stimulation. In recent in vitro studies, radio frequency identification (RFID) technology has been shown to inhibit the stimulation pulse of an implantable neurostimulator system during low frequency exposure at close distances. This could potentially be due to induced electrical currents inside the implantable neurostimulator leads that are caused by magnetic field coupling from the low frequency identification system.MethodsTo systematically address the concerns posed by EMI, we developed a test platform to assess the interference from coupled magnetic fields on implantable neurostimulator systems. To measure interference, we recorded the output of one implantable neurostimulator, programmed for best therapy threshold settings, when in close proximity to an operating low frequency RFID emitter. The output contained electrical potentials from the neurostimulator system and those induced by EMI from the RFID emitter. We also recorded the output of the same neurostimulator system programmed for best therapy threshold settings without RFID interference. Using the Spatially Extended Nonlinear Node (SENN) model, we compared threshold factors of spinal cord fiber excitation for both recorded outputs.ResultsThe electric current induced by low frequency RFID emitter was not significant to have a noticeable effect on electrical stimulation.ConclusionsWe demonstrated a method for analyzing effects of coupled magnetic field interference on implantable neurostimulator system and its electrodes which could be used by device manufacturers during the design and testing phases of the development process.

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Section: Methodssupporting

confidence: 86%

Section: Resultsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Analysis of induced electrical currents from magnetic field coupling inside implantable neurostimulator leads

Pantchenko

Seidman

Guag

2011

BioMedical Engineering OnLine

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“…Based on our previous study on parameter optimization in nonrechargeable systems, Fc was kept constant at 50 Hz and Pw at 300 µsec, while various thresholds ( T p , T d , T t ), the TR, the subjective perception, and the level of satisfaction were assessed .…”

Section: Methodsmentioning

confidence: 99%

Is the Introduction of Another Variable to the Strength–Duration Curve Necessary in Neurostimulation?

Abejón

Rueda

Saz

et al. 2015

Neuromodulation: Technology at the Neural Interface

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Effect of direct voltage induction by low‐frequency security systems on neurostimulator lead

Ardeshirpour,

Cohen,

Seidman

et al. 2023

Bioelectromagnetics

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Low‐frequency (LF) security systems, such as antitheft electronic article surveillance (EAS) gates emit strong magnetic fields that could potentially interfere with neurostimulator operation. Some patients reported pain and shocking sensations near EAS gates, even after they turned off their pulse generator. To investigate the direct voltage induction of EAS systems on neurostimulator leads, we evaluated voltages induced by two EAS systems (14 kHz continuous wave or 58 kHz pulsed) on a 40 cm sacral neurostimulator lead formed in a circular loop attached to a pulse generator that was turned off. The lead and neurostimulator were mounted in a saline‐filled rectangular phantom placed within electromagnetic fields emitted by EAS systems. The measured voltage waveforms were applied to computational models of spinal nerve axons to predict whether these voltages may evoke action potentials. Additional in vitro testing was performed on the semicircular lead geometry, to study the effect of lead geometry on EAS induced voltages. While standard neurostimulator testing per ISO 14708‐3:2017 recommends electromagnetic compatibility testing with LF magnetic fields for induction of malfunctions of the active electronic circuitry while generating intended stimulating pulses, our results show that close to the EAS antenna frames, the induced voltage on the lead could be strong enough to evoke action potentials, even with the pulse generator turned off. This work suggests that patient reports of pain and shocking sensations when near EAS systems could also be correlated with the direct EAS‐induced voltage on neurostimulator lead.

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Electric Parameters Optimization in Spinal Cord Stimulation. Study in Conventional Nonrechargeable Systems

Cited by 12 publications

References 27 publications

Analysis of induced electrical currents from magnetic field coupling inside implantable neurostimulator leads

Analysis of induced electrical currents from magnetic field coupling inside implantable neurostimulator leads

Is the Introduction of Another Variable to the Strength–Duration Curve Necessary in Neurostimulation?

Effect of direct voltage induction by low‐frequency security systems on neurostimulator lead

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