Mathematical Model of Nerve Fiber Activation During Low Back Peripheral Nerve Field Stimulation: Analysis of Electrode Implant Depth

Mørch, Carsten Dahl; Nguyen, G.P.; Wacnik, Paul W.; Andersen, Ole Kæseler

doi:10.1111/ner.12163

Cited by 25 publications

(29 citation statements)

References 45 publications

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“…Throughout this study, the Aβ fibers had lower thresholds than Aδ fibers, which fits well with previous data . Furthermore, the area of activated nerve fibers was larger for Aβ fibers than for Aδ fibers, showing that PNFS will predominantly activate Aβ fibers.…”

Section: Discussionsupporting

confidence: 91%

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Nerve Fiber Activation During Peripheral Nerve Field Stimulation: Importance of Electrode Orientation and Estimation of Area of Paresthesia

Frahm

Hennings²,

Vera–Portocarrero

et al. 2016

Neuromodulation: Technology at the Neural Interface

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Section: Discussionsupporting

confidence: 91%

“…Within the FE model, a PNFS electrode was modeled along the x axis in a depth of 10 mm (i.e. in the superficial part of the adipose layer, similar clinically observed implantation depth) .…”

Section: Methodsmentioning

confidence: 99%

Nerve Fiber Activation During Peripheral Nerve Field Stimulation: Importance of Electrode Orientation and Estimation of Area of Paresthesia

Frahm

Hennings²,

Vera–Portocarrero

et al. 2016

Neuromodulation: Technology at the Neural Interface

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“…78 Recently, stimulation of the brachial 79 or lumbar 80 plexuses has been shown to restore tactile sensation, treat amputee 81 and back 82 pain, and neuropathies 83 throughout the body, with the only major drawbacks involving electrode migration or failure. 84,85 Electrical stimulation in both the cranial and peripheral setting must account for device or battery failure, as well as program or pulse generator malfunction and migration. Biological consequences of improper device implantation or overstimulation include biofilm formation, subcutaneous hematomas, skin erosion, pain/numbness, foreign body reactions, paresthesias, and muscle cramps.…”

Section: )mentioning

confidence: 99%

“…Classically, peripheral nerves, such as the tibial and sacral nerves, have been directly stimulated to treat reflex sympathetic dystrophy, urinary and fecal incontinence, and pain . Recently, stimulation of the brachial or lumbar plexuses has been shown to restore tactile sensation, treat amputee and back pain, and neuropathies throughout the body, with the only major drawbacks involving electrode migration or failure …”

Section: Introductionmentioning

confidence: 99%

Functional and Histological Effects of Chronic Neural Electrode Implantation

Sahyouni

Chang

Moshtaghi

et al. 2017

Laryngoscope Investig Oto

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ObjectivesPermanent injury to the cranial nerves can often result in a substantial reduction in quality of life. Novel and innovative interventions can help restore form and function in nerve paralysis, with bioelectric interfaces among the more promising of these approaches. The foreign body response is an important consideration for any bioelectric device as it influences the function and effectiveness of the implant. The purpose of this review is to describe tissue and functional effects of chronic neural implantation among the different categories of neural implants and highlight advances in peripheral and cranial nerve stimulation. Data Sources: PubMed, IEEE, and Web of Science literature search. Review Methods: A review of the current literature was conducted to examine functional and histologic effects of bioelectric interfaces for neural implants.ResultsBioelectric devices can be characterized as intraneural, epineural, perineural, intranuclear, or cortical depending on their placement relative to nerves and neuronal cell bodies. Such devices include nerve‐specific stimulators, neuroprosthetics, brainstem implants, and deep brain stimulators. Regardless of electrode location and interface type, acute and chronic histological, macroscopic and functional changes can occur as a result of both passive and active tissue responses to the bioelectric implant.ConclusionA variety of chronically implantable electrodes have been developed to treat disorders of the peripheral and cranial nerves, to varying degrees of efficacy. Consideration and mitigation of detrimental effects at the neural interface with further optimization of functional nerve stimulation will facilitate the development of these technologies and translation to the clinic.Level of Evidence3.

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“…A specific nerve is not targeted during this procedure but the smaller branches of the cutaneous nerve fibers appears to be the neural target, thus the name peripheral nerve field stimulation. While the mechanisms of peripheral nerve field stimulation remain unclear, mathematical modeling has described the nerve fibers being activated and proposed the optimal depth of implantation [10].…”

Section: Peripheral Nerve Field Stimulationmentioning

confidence: 99%

Mathematical Modeling in Neuromodulation for Pain Relief

Mørch

2014

Biosystems &Amp; Biorobotics

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Abstract. Neuromodulation has been used for activation of the nervous system to cause pain relief for more than a half century. Mathematical modelling is being used gain better understanding of the neuromodulatory methods and to facilitate electrode design. Here the well-known method of spinal cord stimulation and the more resent method of peripheral nerve field stimulation will be discussed in relation to relief of low-back pain. IntroductionSeveral neural targets have been approached for electrical activation of the central nervous system aiming causing pain relief. This form of neuromodulation for pain relief dates back to the formulation of the gate control theory proposed by Melzack and Wall in 1965 [1]. Despite the fact that neuromodulation methods have proven clinically effective for pain relief only little is known about the mechanisms of action. Therefore, mathematical modelling has been used to investigate the possible neural target of the electrical stimulation, how the nerve fibers are activated by the stimulation, and to some extent, the impact on the CNS. Principles of Modeling NeuromodulationMathematical models of electrical stimulation of the nervous system are most often done by two step approach. Initially, the current flow and thus the electrical field are estimated in the tissue in which the nerve fibers are embedded. These volume conductor estimations are often performed by finite element models. From these models the extracellular potentials at the nodes of Ranvier along the nerve fiber can readily be extracted. As the second step a model for nerve fiber activation is established and neural responses such as the activation threshold of particular fiber types are estimated. Several types of nerve fiber models have been used, ranging from passive cable models [2] to models explicitly describing the ion currents both in the nodes of Ranvier and the internodes [3].

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Mathematical Model of Nerve Fiber Activation During Low Back Peripheral Nerve Field Stimulation: Analysis of Electrode Implant Depth

Cited by 25 publications

References 45 publications

Nerve Fiber Activation During Peripheral Nerve Field Stimulation: Importance of Electrode Orientation and Estimation of Area of Paresthesia

Nerve Fiber Activation During Peripheral Nerve Field Stimulation: Importance of Electrode Orientation and Estimation of Area of Paresthesia

Functional and Histological Effects of Chronic Neural Electrode Implantation

Mathematical Modeling in Neuromodulation for Pain Relief

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