Optimum electrode geometry for spinal cord stimulation: The narrow bipole and tripole

Holsheimer, J.; Wesselink, W.A.

doi:10.1007/bf02525529

Cited by 110 publications

(101 citation statements)

References 20 publications

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“…Therefore, the optimum geometry has been calculated, taking into account both this aspect and the preferential stimulation of DC ®bres. 56 The proposed rostro-caudal`narrow bipole' and`narrow tripole' electrodes have contacts with a rostrocaudal dimension of about 1.5 mm and a centre separation of 3.5 ± 4 mm. The contacts of a plate electrode should be about 4 mm wide.…”

Section: Characteristics Of Clinical Scsmentioning

confidence: 97%

Computer modelling of spinal cord stimulation and its contribution to therapeutic efficacy

1998

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An overview of computer models developed since the late seventies, which enable the simulation of the primary e ects of spinal cord stimulation (SCS) on nerve ®bres, is presented. These models consist of a 3-dimensional volume conductor model, representing anatomical structures and their electrical conductivities, and cable models representing the electrical behaviour of nerve ®bres. The characteristics of these models and their relation to anatomy and physiology, as well as the calculation of stimulation-induced electrical ®elds and their e ect on nerve ®bre models, are reviewed. It is shown that most characteristics of SCS as predicted by computer modelling correspond well with empirical data. Accordingly, a theoretical framework describing the relations between relevant parameters in SCS is presented. Finally, it is shown how theory and computer modeling are applied to improve the e cacy of SCS by the optimization of its technique, primarily by the design of new epidural electrodes.

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Section: Characteristics Of Clinical Scsmentioning

confidence: 97%

Computer modelling of spinal cord stimulation and its contribution to therapeutic efficacy

1998

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“…Their computational model estimated the effect of anatomic parameters on the thresholds of dorsal column fibers (Struijk et al, 1992), predicted the potential location of excitation in dorsal root fibers (Struijk et al, 1993b), and analyzed the effect of CSF thickness (Struijk et al, 1993a) with clinical validations (He et al, 1994;Holsheimer et al, 1995a;Holsheimer et al, 1994). The model contributed significantly to design of stimulation lead design, suggesting optimal parameters for contact size and spacing (Holsheimer and Struijk, 1992;Holsheimer and Wesselink, 1997), to favor preferential stimulation of dorsal column fibers over root fibers (Holsheimer et al, 1995b). …”

Section: Introductionmentioning

confidence: 99%

Dorsal Column Steerability with Dual Parallel Leads using Dedicated Power Sources: A Computational Model

Lee

Gillespie

Bradley

2011

JoVE

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In spinal cord stimulation (SCS), concordance of stimulation-induced paresthesia over painful body regions is a necessary condition for therapeutic efficacy. Since patient pain patterns can be unique, a common stimulation configuration is the placement of two leads in parallel in the dorsal epidural space. This construct provides flexibility in steering stimulation current mediolaterally over the dorsal column to achieve better pain-paresthesia overlap. Using a mathematical model with an accurate fiber diameter distribution, we studied the ability of dual parallel leads to steer stimulation between adjacent contacts on dual parallel leads using (1) a single source system, and (2) a multi-source system, with a dedicated current source for each contact. The volume conductor model of a low-thoracic spinal cord with epidurally-positioned dual parallel (2 mm separation) percutaneous leads was first created, and the electric field was calculated using ANSYS, a finite element modeling tool. The activating function for 10 um fibers was computed as the second difference of the extracellular potential along the nodes of Ranvier on the nerve fibers in the dorsal column. The volume of activation (VOA) and the central point of the VOA were computed using a predetermined threshold of the activating function. The model compared the field steering results with single source versus dedicated power source systems on dual 8-contact stimulation leads. The model predicted that the multi-source system can target more central points of stimulation on the dorsal column than a single source system (100 vs. 3) and the mean steering step for mediolateral steering is 0.02 mm for multi-source systems vs 1 mm for single source systems, a 50-fold improvement. The ability to center stimulation regions in the dorsal column with high resolution may allow for better optimization of paresthesia-pain overlap in patients.

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“…neglecting capacitive effects) to describe the volume conductor, and linear nerve models to describe nerve activation. Up to now non-linear nerve models, which can describe more facets of nerve activation [45], were mainly used for implantable systems [31,49,47], epidural stimulation [18], or motor cortex stimulation [33], where the exciting electrodes are small and close to the nerve (near-field). To address if these nerve models can also be used to model TES (far-field), we have developed a TES model that comprises a volume conductor and different non-linear nerve models.…”

Section: Introductionmentioning

confidence: 99%

A model for transcutaneous current stimulation: simulations and experiments

Kühn

Keller

Lawrence

et al. 2008

Med Biol Eng Comput

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Complex nerve models have been developed for describing the generation of action potentials in humans. Such nerve models have primarily been used to model implantable electrical stimulation systems, where the stimulation electrodes are close to the nerve (nearfield). To address if these nerve models can also be used to model transcutaneous electrical stimulation (TES) (farfield), we have developed a TES model that comprises a volume conductor and different previously published nonlinear nerve models. The volume conductor models the resistive and capacitive properties of electrodes, electrodeskin interface, skin, fat, muscle, and bone. The non-linear nerve models were used to conclude from the potential field within the volume conductor on nerve activation. A comparison of simulated and experimentally measured chronaxie values (a measure for the excitability of nerves) and muscle twitch forces on human volunteers allowed us to conclude that some of the published nerve models can be used in TES models. The presented TES model provides a first step to more extensive model implementations for TES in which e.g., multi-array electrode configurations can be tested. Keywords

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Optimum electrode geometry for spinal cord stimulation: The narrow bipole and tripole

Cited by 110 publications

References 20 publications

Computer modelling of spinal cord stimulation and its contribution to therapeutic efficacy

Computer modelling of spinal cord stimulation and its contribution to therapeutic efficacy

Dorsal Column Steerability with Dual Parallel Leads using Dedicated Power Sources: A Computational Model

A model for transcutaneous current stimulation: simulations and experiments

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