Model-based analysis and design of waveforms for efficient neural stimulation

Grill, Warren M.

doi:10.1016/bs.pbr.2015.07.031

Cited by 48 publications

(26 citation statements)

References 65 publications

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“…In all subjects, RMT (Fig 3) decreased with increasing pulse width in agreement with previous reports (D'Ostilio et al 2016). When looking at the correlation with total energy of the pulse as a function of the area of the pulse shape wider pulses require more energy to elicit responses in the cortex (Barker et al 1991;Peterchev et al 2013;Grill 2015). The higher total pulse energy could explain the seemingly greater efficacy of wider pulses when only pulse amplitude is considered (Modugno et al 2001;Fitzgerald et al 2006).…”

Section: Discussionsupporting

confidence: 87%

Increasing pulse energy of 5Hz rTMS improves its efficacy in inducing excitatory aftereffects

Halawa

Reichert

Anil

et al. 2019

Preprint

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Introduction:High frequency repetitive transcranial magnetic stimulation induces excitation when applied to the motor cortex, as measured by increased amplitudes of motor evoked potentials (MEPs) after the intervention. Different pulse widths induce different effects, likely by primarily stimulating distinct segments of neurons due to the different membrane properties of different neuronal segments.Here we focus on the aftereffects generated with high frequencies of controllable pulse TMS (cTMS).Objectives: To investigate the influence of different stimulation intensities, pulse widths and direction of high frequency rTMS on its excitatory plastic aftereffects as reflected by MEP amplitudes. Methods:Using a controllable pulse stimulator TMS (cTMS), we stimulated the hand motor cortex of 20 healthy subjects with 5 Hz rTMS with 1200 bidirectional pulses with the main component widths of 80 and 120 microseconds. 80% resting motor threshold (RMT) intensity was investigated for both directions anterior-posterior (AP) and vice versa (PA), and at 90% RMT in the AP direction for the second experiment.Results: 80% HF rTMS did not produce any significant excitation in both AP and PA directions. 90% RMT AP stimulation exhibited a significant excitation aftereffect with the 120 microseconds wide pulses, whereas the 80 microseconds failed to produce significant excitation. Conclusions:Higher intensity and longer HF pulse rTMS are more efficient in producing excitatory aftereffects, this may be due to the different membrane properties of the various neuronal segments such as dendrites whose activation plays a major role in long term potentiation.Significance: The findings here may contribute to better results in future clinical studies performed with longer cTMS pulses. Figure 1: Diagram of the experiment timeline for each session of the experiment. Methods: ParticipantsFor the first experiment, we recruited fourteen subjects, four males and ten females, mean age was 23.5 ± 2.6 SD years. For the second experiment, a different set of fifteen healthy volunteers was recruited, four males and eleven females, the mean age was 24.1 ± 3.1 SD years. All participants were right-handed and free from any neurological or psychiatric disorders, took no centrally acting medications, and had no contraindications to TMS. Because the power cap of the device and the standard coil for the wider pulse shapes prevented intensities above 50% of maximal stimulator output (MSO), a higher resting motor threshold, i.e. above 70% MSO for a Magstim 200 2 device, was an exclusion criterion.We obtained written informed consent from each subject before participation.The local ethics committee of the University Medical Center Göttingen approved the study protocol, which conformed to the Declaration of Helsinki. RecordingsMotor evoked potentials (MEPs) were recorded from the first dorsal interosseous (FDI) muscle of the right hand with surface Ag-AgCl electrodes in a belly-tendon montage. The electromyography signals were amplified, band-pass filtered (2 Hz-2...

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Section: Discussionsupporting

confidence: 87%

Increasing pulse energy of 5Hz rTMS improves its efficacy in inducing excitatory aftereffects

Halawa

Reichert

Anil

et al. 2019

Preprint

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“…The chronaxie for cell bodies and axons increases as a function of distance from the electrode . Short pulse widths have been found to selectively activate more local fibers, increasing spatial selectivity . Selection of PW should weigh safe charge and charge densities against adequately meeting the activation threshold.…”

Section: Physical Stimulation Considerationsmentioning

confidence: 99%

Considerations in performing and analyzing the responses of cortico‐cortical evoked potentials in stereo‐EEG

2017

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SummaryThis review aims to highlight key considerations when performing cortico-cortical evoked potentials (CCEPs) using stereo-electroencephalography (SEEG) for network mapping and show its clinical applicability to presurgical evaluations. The parameters for performing stimulation and safety aspects have been investigated in electrocorticography (ECoG) and deep brain stimulation (DBS), but not as extensively in SEEG. A review of current literature was performed, with an attempt made to emphasize practical insights from all modalities of intracranial stimulation. This paper reviews physical stimulation parameters, highlights safety limits, and considers the influence of changing common stimulation parameters.These factors are put into the context of CCEPs in SEEG. Given the paucity of direct research in this area, studies utilizing low frequency stimulation, DBS, and ECoG are incorporated along with the fundamental principles of electrical engineering. In addition, postprocessing considerations are reviewed, including electrode localization, application of digital filters, baseline selection, application of connectivity metrics, and higher order network analysis. The aim is to guide CCEP stimulation as well as to provide an understanding of the underlying principles of this technique. At present, there are few articles detailing the design of low-frequency stimulation paradigms, especially in the setting of SEEG. Providing a review of the fundamentals and postprocessing considerations when performing CCEPs in SEEG will increase the accessibility of this technique. K E Y W O R D Sbrain mapping, CCEP, connectivity, electrical stimulation, review, SEEG

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“…The unexpected results here indicate that it is possible to stimulate the production of TNFα and other cytokines using electrical stimulation of the cervical vagus nerve. As bioelectronic therapies continue to evolve for controlling inflammation, increasingly refined stimulation strategies will be needed to activate fibers of interest (Grill, 2015;Tsaava et al, 2019), while also minimizing the potential for the negative outcomes and off-target effects associated with vagus nerve stimulation. The effectiveness of these selective stimulation paradigms will depend on knowing which specific fiber populations mediate the neural regulation of inflammation and the optimal techniques for activating them.…”

Section: Discussionmentioning

confidence: 99%

“…Because different fiber types in the peripheral nervous system have varying functions and innervate different target organs, this fiber recruitment principle is important to achieve the desired physiological changes from activating nerves (Gorman and Mortimer, 1983). Electrical stimulation parameters such as output frequency, current, duration, and amplitude, are important determinants for achieving effective nerve activation that is both selective and efficient (Grill, 2015).…”

Section: Introductionmentioning

confidence: 99%

Serum cytokine levels are modulated by specific frequencies, amplitudes, and pulse widths of vagus nerve stimulation

Tsaava

Datta-Chaudhuri

et al. 2020

Preprint

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Electrical stimulation of peripheral nerves is a widely used technique to treat a variety of conditions including chronic pain, motor impairment, headaches, and epilepsy. Nerve stimulation to achieve efficacious symptomatic relief depends on the proper selection of electrical stimulation parameters to recruit the appropriate fibers within a nerve. Recently, electrical stimulation of the vagus nerve has shown promise for controlling inflammation and clinical trials have demonstrated efficacy for the treatment of inflammatory disorders. This application of vagus nerve stimulation activates the inflammatory reflex, reducing levels of inflammatory cytokines during inflammation.Here, we wanted to test whether altering the parameters of electrical vagus nerve stimulation would change circulating cytokine levels of normal healthy animals in the absence of increased inflammation. To examine this, we systematically tested a set of electrical stimulation parameters and measured serum cytokine levels in healthy mice. Surprisingly, we found that specific combinations of pulse width, pulse amplitude, and frequency produced significant increases of the pro-inflammatory cytokine tumor necrosis factor alpha (TNFα), while other parameters selectively lowered serum TNFα levels, as compared to sham-stimulated mice. In addition, serum levels of the anti-inflammatory cytokine interleukin-10 (IL-10) were significantly increased by select parameters of electrical stimulation but remained unchanged with others. These results indicate that electrical stimulation parameter selection is critically important for the modulation of cytokines via the cervical vagus nerve and that specific cytokines can be increased by electrical stimulation in the absence of inflammation. As the next generation of bioelectronic therapies and devices are developed to capitalize on the neural regulation of inflammation, the selection of nerve stimulation parameters will be a critically important variable for achieving cytokine-specific changes.

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Model-based analysis and design of waveforms for efficient neural stimulation

Cited by 48 publications

References 65 publications

Increasing pulse energy of 5Hz rTMS improves its efficacy in inducing excitatory aftereffects

Increasing pulse energy of 5Hz rTMS improves its efficacy in inducing excitatory aftereffects

Considerations in performing and analyzing the responses of cortico‐cortical evoked potentials in stereo‐EEG

Serum cytokine levels are modulated by specific frequencies, amplitudes, and pulse widths of vagus nerve stimulation

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