Evaluating optimized temporal patterns of spinal cord stimulation (SCS)
Background: Temporal patterns of stimulation represent a novel dimension for improving the efficacy of spinal cord stimulation to treat chronic neuropathic pain. Objective: We hypothesized that nonregular temporal patterns of stimulation designed using a computational model would be superior to conv...
| Main Authors: | , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2022-09-01
|
| Series: | Brain Stimulation |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S1935861X22001632 |
| _version_ | 1811241621497315328 |
|---|---|
| author | John E. Gilbert Tianhe Zhang Rosana Esteller Warren M. Grill |
| author_facet | John E. Gilbert Tianhe Zhang Rosana Esteller Warren M. Grill |
| author_sort | John E. Gilbert |
| collection | DOAJ |
| description | Background: Temporal patterns of stimulation represent a novel dimension for improving the efficacy of spinal cord stimulation to treat chronic neuropathic pain. Objective: We hypothesized that nonregular temporal patterns of stimulation designed using a computational model would be superior to conventional stimulation at constant frequencies or completely random patterns of stimulation. Methods: Using a computational model of the dorsal horn network and an optimization algorithm based on biological evolution, we designed an optimized pattern of spinal cord stimulation with comparable efficacy and increased efficiency relative to constant frequency (CF) stimulation. We evaluated the effect of different temporal patterns on individual neurons recorded in the dorsal horn of urethane-anesthetized rats. Results: The optimized pattern and 50 Hz CF stimulation produced greater inhibition of spontaneously firing neurons recorded in vivo than random 50 Hz stimulation or a pattern designed intentionally with poor fitness. Spinal Cord Stimulation (SCS) led to significant changes in the firing patterns of recorded units, and stimulation patterns that generated significant inhibition also tended to reduce entropy and regularize the firing patterns of units, suggesting that patterns of dorsal horn neuron activity may be important for pain perception in addition to the firing rate. Conclusions: These results demonstrate that the computational model can be used as a tool for optimizing stimulation parameters and suggest that optimized temporal patterns may increase the efficacy of spinal cord stimulation. |
| first_indexed | 2024-04-12T13:39:57Z |
| format | Article |
| id | doaj.art-19f3911c44e4487b93279f1751628f05 |
| institution | Directory Open Access Journal |
| issn | 1935-861X |
| language | English |
| last_indexed | 2024-04-12T13:39:57Z |
| publishDate | 2022-09-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Brain Stimulation |
| spelling | doaj.art-19f3911c44e4487b93279f1751628f052022-12-22T03:30:53ZengElsevierBrain Stimulation1935-861X2022-09-0115510511062Evaluating optimized temporal patterns of spinal cord stimulation (SCS)John E. Gilbert0Tianhe Zhang1Rosana Esteller2Warren M. Grill3Department of Biomedical Engineering, Duke University, Durham, NC, USANeuromodulation Research and Advanced Concepts, Boston Scientific Neuromodulation, Valencia, CA, USANeuromodulation Research and Advanced Concepts, Boston Scientific Neuromodulation, Valencia, CA, USADepartment of Biomedical Engineering, Duke University, Durham, NC, USA; Department of Electrical and Computer Engineering, Duke University, Durham, NC, USA; Department of Neurobiology, Duke University School of Medicine, Durham, NC, USA; Department of Neurosurgery, Duke University School of Medicine, Durham, NC, USA; Corresponding author. Duke University, Department of Biomedical Engineering, Fitzpatrick CIEMAS, Room 1427, 101 Science Drive, Box 90281, Durham, NC, 27708-0281, USA.Background: Temporal patterns of stimulation represent a novel dimension for improving the efficacy of spinal cord stimulation to treat chronic neuropathic pain. Objective: We hypothesized that nonregular temporal patterns of stimulation designed using a computational model would be superior to conventional stimulation at constant frequencies or completely random patterns of stimulation. Methods: Using a computational model of the dorsal horn network and an optimization algorithm based on biological evolution, we designed an optimized pattern of spinal cord stimulation with comparable efficacy and increased efficiency relative to constant frequency (CF) stimulation. We evaluated the effect of different temporal patterns on individual neurons recorded in the dorsal horn of urethane-anesthetized rats. Results: The optimized pattern and 50 Hz CF stimulation produced greater inhibition of spontaneously firing neurons recorded in vivo than random 50 Hz stimulation or a pattern designed intentionally with poor fitness. Spinal Cord Stimulation (SCS) led to significant changes in the firing patterns of recorded units, and stimulation patterns that generated significant inhibition also tended to reduce entropy and regularize the firing patterns of units, suggesting that patterns of dorsal horn neuron activity may be important for pain perception in addition to the firing rate. Conclusions: These results demonstrate that the computational model can be used as a tool for optimizing stimulation parameters and suggest that optimized temporal patterns may increase the efficacy of spinal cord stimulation.http://www.sciencedirect.com/science/article/pii/S1935861X22001632Spinal cord stimulationGenetic algorithmNeuropathic painComputational modelSpared nerve injury |
| spellingShingle | John E. Gilbert Tianhe Zhang Rosana Esteller Warren M. Grill Evaluating optimized temporal patterns of spinal cord stimulation (SCS) Brain Stimulation Spinal cord stimulation Genetic algorithm Neuropathic pain Computational model Spared nerve injury |
| title | Evaluating optimized temporal patterns of spinal cord stimulation (SCS) |
| title_full | Evaluating optimized temporal patterns of spinal cord stimulation (SCS) |
| title_fullStr | Evaluating optimized temporal patterns of spinal cord stimulation (SCS) |
| title_full_unstemmed | Evaluating optimized temporal patterns of spinal cord stimulation (SCS) |
| title_short | Evaluating optimized temporal patterns of spinal cord stimulation (SCS) |
| title_sort | evaluating optimized temporal patterns of spinal cord stimulation scs |
| topic | Spinal cord stimulation Genetic algorithm Neuropathic pain Computational model Spared nerve injury |
| url | http://www.sciencedirect.com/science/article/pii/S1935861X22001632 |
| work_keys_str_mv | AT johnegilbert evaluatingoptimizedtemporalpatternsofspinalcordstimulationscs AT tianhezhang evaluatingoptimizedtemporalpatternsofspinalcordstimulationscs AT rosanaesteller evaluatingoptimizedtemporalpatternsofspinalcordstimulationscs AT warrenmgrill evaluatingoptimizedtemporalpatternsofspinalcordstimulationscs |