Non-invasive electrical stimulation of peripheral nerves for the management of tremor

Pascual-Valdunciel, Alejandro; Rajagopal, Apoorva; Pons, José L.; Delp, Scott L.

doi:10.1016/j.jns.2022.120195

Cited by 18 publications

(17 citation statements)

References 120 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…PES of afferent pathways is becoming a promising alternative to manage pathological tremor [47]. Precise and timely recruitment of the afferent pathways, which might disrupt the tremorgenic input at the central nervous system, is a fundamental feature to optimize neuromodulation mechanisms.…”

Section: Discussionmentioning

confidence: 99%

Prediction of Pathological Tremor Signals Using Long Short-Term Memory Neural Networks

Pascual-Valdunciel

Lopo-Martínez

Sendra-Arranz

et al. 2022

IEEE J. Biomed. Health Inform.

Self Cite

View full text Add to dashboard Cite

Previous implementations of closed-loop peripheral electrical stimulation (PES) strategies have provided evidence about the effect of the stimulation timing on tremor reduction. However, these strategies have used traditional signal processing techniques that only consider phase prediction and might not model the non-stationary behavior of tremor. Here, we tested the use of long shortterm memory (LSTM) neural networks to predict tremor signals using kinematic data recorded from Essential Tremor (ET) patients. A dataset comprising wrist flexionextension data from 12 ET patients was pre-processed to feed the predictors. A total of 180 models resulting from the combination of network (neurons and layers of the LSTM networks, length of the input sequence and prediction horizon) and training parameters (learning rate) were trained, validated and tested. Predicted tremor signals using LSTM-based models presented high correlation values (from 0.709 to 0.998) with the expected values, with a phase delay between the predicted and real signals below 15 ms, which corresponds approximately to 7.5% of a tremor cycle. The prediction horizon was the parameter with a higher impact on the prediction performance. The proposed LSTM-based models were capable of predicting both phase and amplitude of tremor signals outperforming results from previous studies (32-56% decreased phase prediction error compared to the out-of-phase method), which might provide a more robust PES-based closed-loop control applied to PES-based tremor reduction.

show abstract

Section: Discussionmentioning

confidence: 99%

Prediction of Pathological Tremor Signals Using Long Short-Term Memory Neural Networks

Pascual-Valdunciel

Lopo-Martínez

Sendra-Arranz

et al. 2022

IEEE J. Biomed. Health Inform.

Self Cite

View full text Add to dashboard Cite

show abstract

“…In those scenarios where the spinal cord receives aberrant input from supraspinal pathological circuits, which are then amplified through afferent loops, the timing of PES could be used to specifically modulate spinal pathways by shifting the net excitatory output projected to the muscles towards functional states. Moreover, there is evidence of other forms of sensory PES targeting and modulating brain structures with functional implications [18]. Thus, the phase-locked strategies explored here could presumably induce other activity-dependent plastic mechanisms in multiple sites along the CNS.…”

Section: Discussionmentioning

confidence: 99%

“…Despite the recent translation from bench to bedside of several PES-based therapeutic interventions in the upper-limb, including tremor management solutions, none of the prior studies has explored the short-term neural changes elicited after a PES intervention onto the muscles controlling the wrist [18]. The main goal of this study was to assess short-term spinal effects of a novel phase-dependent closed-loop PES strategy named Selective and Adaptive Timely Stimulation (SATS).…”

Section: Introductionmentioning

confidence: 99%

Modulation of spinal circuits following phase-dependent electrical stimulation of afferent pathways

Pascual-Valdunciel

Kurukuti

Pardo

et al. 2022

Preprint

Self Cite

View full text Add to dashboard Cite

Peripheral electrical stimulation (PES) of afferent pathways is a tool commonly used to induce neural adaptations in some neural disorders such as pathological tremor or stroke. However, the neuromodulatory effects of stimulation interventions synchronized with physiological activity (closed-loop strategies) have been scarcely researched in the upper-limb. Here, the short-term spinal effects of a 20-minute stimulation of afferent pathways protocol applied with a closed-loop strategy named Selective and Adaptive Timely Stimulation (SATS) was explored. The SATS strategy was applied to the radial nerve in-phase (INP) or out-of-phase (OOP) with respect to the muscle activity of the extensor carpi radialis (ECR). The neural adaptations at the spinal cord level were assessed for the flexor carpi radialis (FCR) by measuring disynaptic Group I inhibition, Ia presynaptic inhibition, and Ib facilitation from the H-reflex, and estimation of the neural drive before, immediately after, and 30 minutes after the intervention. SATS strategy was proved to deliver synchronous stimulation with the real-time measured muscle activity with an average delay of 17+-8 ms. SATS-INP induced an increase of the disynaptic Group I inhibition (77+-23 % of baseline conditioned FCR H-reflex), while SATS-OOP elicited the opposite effect (125+-46 %). Not all the subjects maintained the changes after 30 minutes. Additionally, no other significant specific neural adaptations were found for the rest of measurements. These results suggest that the short-term modulatory effects of phase-dependent PES occur at the specific targeted spinal pathways for the wrist muscles in healthy individuals. Overall, timely recruitment of afferent pathways with the muscle activity is a fundamental principle which should be considered in tailoring PES protocols for the specific neural circuits to be modulated.

show abstract

“…Studies of the influence of sinusoidal and rectangular signals for filling trapezoidal, bellshaped and sharpend pulses show that the optimal signals, at which the muscles contracted almost painlessly, were sharp pulses filled with a sinusoidal or rectangular signal [5][6][7].…”

Section: Introductionmentioning

confidence: 99%

Method of diagnosing some diseases of the neuro-muscular system and features of data processing in software

Prasol

Dovnar

Yeroshenko

2023

TAPR

View full text Add to dashboard Cite

Electromyostimulation is a method of restorative treatment based on electrical stimulation of nerves and muscles. The electric current, which is used in electrical stimulation to obtain induced muscle contractions, is characterized by a large number of different parameters. However, not every possible option of electrical stimulation is highly effective. To solve the task of diagnosing some diseases of the neuromuscular system, it is important to organize the software by analyzing the parameters of the evoked potentials. Therefore, the object of research is the processes of skeletal muscle contraction under the influence of natural electrical pulses of the nervous system or under the influence of external electrical stimulation. The subject of research is models describing the processes in muscles during contraction and methods of data processing. In the course of the study, such research methods as mathematical modeling methods and methods of processing medical and biological data were used. The paper examines the experimental strength-duration dependence of skeletal muscle and obtained mathematical models for the normal state of the neuromuscular apparatus and different degrees of denervation. On the basis of electrodiagnosis of a patient with impaired motor functions, the dynamics of changes in the patient's condition and the effectiveness of treatment were traced. Based on the results of the study, an analysis of the parameters of the evoked potentials of the stimulation electromyogram during adaptive electrostimulation was carried out in order to control its effectiveness or establish a diagnosis in some diseases of the neuromuscular system. This made it possible to develop a method for correcting errors in the interpretation of one of the quality parameters and increase the reliability of the diagnosis. The obtained results can be used in the improvement of technical devices for electrostimulation therapy, as well as control of the effectiveness of rehabilitation procedures.

show abstract

Non-invasive electrical stimulation of peripheral nerves for the management of tremor

Cited by 18 publications

References 120 publications

Prediction of Pathological Tremor Signals Using Long Short-Term Memory Neural Networks

Prediction of Pathological Tremor Signals Using Long Short-Term Memory Neural Networks

Modulation of spinal circuits following phase-dependent electrical stimulation of afferent pathways

Method of diagnosing some diseases of the neuro-muscular system and features of data processing in software

Contact Info

Product

Resources

About