Model-Based Vestibular Afferent Stimulation: Evaluating Selective Electrode Locations and Stimulation Waveform Shapes

Abstract

A dysfunctional vestibular system can be a severe detriment to the quality of life of a patient. Recent studies have shown the feasibility for a vestibular implant to restore rotational sensation via electrical stimulation of vestibular ampullary nerves. However, the optimal stimulation site for selective elicitation of the desired nerve is still unknown. We realized a finite element model on the basis of μCT scans of a human inner ear and incorporated naturally distributed, artificial neural trajectories. A well-validated neuron model of myelinated fibers was incorporated to predict nerve responses to electrical stimulation. Several virtual electrodes were placed in locations of interest inside the bony labyrinth (intra-labyrinthine) and inside the temporal bone, near the target nerves (extra-labyrinthine), to determine preferred stimulation sites and electrode insertion depths. We investigated various monopolar and bipolar electrode configurations as well as different pulse waveform shapes for their ability to selectively stimulate the target nerve and for their energy consumption. The selectivity was evaluated with an objective measure of the fiber recruitment. Considerable differences of required energy and achievable selectivity between the configurations were observed. Bipolar, intra-labyrinthine electrodes provided the best selectivities but also consumed the highest amount of energy. Bipolar, extra-labyrinthine configurations did not offer any advantages compared to the monopolar approach. No selective stimulation could be performed with the monopolar, intra-labyrinthine approach. The monopolar, extra-labyrinthine electrodes required the least energy for satisfactory selectivities, making it the most promising approach for functional vestibular implants. Different pulse waveform shapes did not affect the achieved selectivity considerably but shorter pulse durations showed consistently a more selective activation of the target nerves. A cathodic, centered triangular waveform shape was identified as the most energy-efficient of the tested shapes. Based on these simulations we are able to recommend the monopolar, extra-labyrinthine stimulation approach with cathodic, centered triangular pulses as good trade-off between selectivity and energy consumption. Future implant designs could benefit from the findings presented here.

Impact of galvanic vestibular stimulation electrode current density on brain current flow patterns: Does electrode size matter?

“…With respect to GVS, there are none prior efforts looking specifically at electrode size. However, computational forward modeling has been employed to investigate electrode configurations via a model of the human inner ear [21]. In addition, there exists a whole human head model-based current flow analysis which is a prior effort by our group [22].…”

“…The isotropic and homogeneous electrical conductivity value in S/m assigned to each mask were: skin (0.465), skull (0.01), cerebrospinal fluid (CSF) (1.65), gray matter (0.276), white matter (0.126), air (1e-7), cranial nerves (0.017126), ear auricular cartilage (0.16113), ear semicircular canals (2), blood (0.7), gel (1.4), and electrodes (5.8e7) [21,24,26].…”

A Multiscale Approach to Axon and Nerve Stimulation Modeling: A Review

“…The Finite Element model can be built starting from histological images of nerves [9], [83], from micro-computed tomography (μCT) anatomical studies [84] or magnetic resonance imaging (MRI) data of the subject so as to obtain more accurate results [8]. Following this approach, it is possible to have a more realistic model able to describe nerve-electrode interaction and to study properties of different types of electrodes [11], [85].…”

Design and Implementation of an Intelligent Analgesic Bracelet Based on Wrist-ankle Acupuncture

“…Then the electrical stimulation pulses stimulate the corresponding area of the wrist or the ankle through a pair of gold electrodes embedded in the flexible bracelet. The electrical stimulation pulses use symmetrical bipolar pulse waveforms, which can reduce the polarization response during pain treatment and prevent skin damage [36]. The proposed architecture is fully integrated and highly scalable, and it can be scaled without compromising analgesic performance.…”