OBJECTIVES: This study aims to review some of the basic principles of extracellular electrical stimulation used in spinal cord stimulation therapy for intractable pain. MATERIALS AND METHODS: Spinal cord stimulation has been used therapeutically for more than 40 years. We present the basic principles of extracellular stimulation on which the therapy is based, describe electrode operation and current configurations, and explain the implications of these technological advances for the clinical application of spinal cord stimulation. RESULTS: Computational studies of coupled electric field and neuron models have significantly advanced our understanding of the therapeutic effects of neurostimulation. Neurostimulation is intended to obtain maximal selectivity of desired neural elements while avoiding those resulting in side-effects. Preferential stimulation of the dorsal columns is achieved with a narrow spacing between electrodes using bipolar or tripolar electrode configurations. Stimulus parameters such as amplitude and pulse width may be used to selectively control which neuronal elements are excited during stimulation. CONCLUSIONS: A better understanding of the interaction between electric fields and the targeted neural elements may guide the selection of stimulation parameters in contemporary neurostimulators and lead to continuing advances in engineering solutions for therapeutic spinal cord stimulation.
OBJECTIVES: This study aims to review some of the basic principles of extracellular electrical stimulation used in spinal cord stimulation therapy for intractable pain. MATERIALS AND METHODS: Spinal cord stimulation has been used therapeutically for more than 40 years. We present the basic principles of extracellular stimulation on which the therapy is based, describe electrode operation and current configurations, and explain the implications of these technological advances for the clinical application of spinal cord stimulation. RESULTS: Computational studies of coupled electric field and neuron models have significantly advanced our understanding of the therapeutic effects of neurostimulation. Neurostimulation is intended to obtain maximal selectivity of desired neural elements while avoiding those resulting in side-effects. Preferential stimulation of the dorsal columns is achieved with a narrow spacing between electrodes using bipolar or tripolar electrode configurations. Stimulus parameters such as amplitude and pulse width may be used to selectively control which neuronal elements are excited during stimulation. CONCLUSIONS: A better understanding of the interaction between electric fields and the targeted neural elements may guide the selection of stimulation parameters in contemporary neurostimulators and lead to continuing advances in engineering solutions for therapeutic spinal cord stimulation.
Authors: Andreas Rowald; Salif Komi; Robin Demesmaeker; Edeny Baaklini; Sergio Daniel Hernandez-Charpak; Edoardo Paoles; Hazael Montanaro; Antonino Cassara; Fabio Becce; Bryn Lloyd; Taylor Newton; Jimmy Ravier; Nawal Kinany; Marina D'Ercole; Aurélie Paley; Nicolas Hankov; Camille Varescon; Laura McCracken; Molywan Vat; Miroslav Caban; Anne Watrin; Charlotte Jacquet; Léa Bole-Feysot; Cathal Harte; Henri Lorach; Andrea Galvez; Manon Tschopp; Natacha Herrmann; Moïra Wacker; Lionel Geernaert; Isabelle Fodor; Valentin Radevich; Katrien Van Den Keybus; Grégoire Eberle; Etienne Pralong; Maxime Roulet; Jean-Baptiste Ledoux; Eleonora Fornari; Stefano Mandija; Loan Mattera; Roberto Martuzzi; Bruno Nazarian; Stefan Benkler; Simone Callegari; Nathan Greiner; Benjamin Fuhrer; Martijn Froeling; Nik Buse; Tim Denison; Rik Buschman; Christian Wende; Damien Ganty; Jurriaan Bakker; Vincent Delattre; Hendrik Lambert; Karen Minassian; Cornelis A T van den Berg; Anne Kavounoudias; Silvestro Micera; Dimitri Van De Ville; Quentin Barraud; Erkan Kurt; Niels Kuster; Esra Neufeld; Marco Capogrosso; Leonie Asboth; Fabien B Wagner; Jocelyne Bloch; Grégoire Courtine Journal: Nat Med Date: 2022-02-07 Impact factor: 87.241
Authors: Gerrit Eduard Gmel; Rosana Santos Escapa; John L Parker; Dave Mugan; Adnan Al-Kaisy; Stefano Palmisani Journal: Front Neurosci Date: 2021-01-21 Impact factor: 4.677
Authors: Matthew K Hogan; Sean M Barber; Zhoulyu Rao; Bethany R Kondiles; Meng Huang; William J Steele; Cunjiang Yu; Philip J Horner Journal: Sci Rep Date: 2021-07-21 Impact factor: 4.379
Authors: Timothy R Deer; Christopher A Gilmore; Mehul J Desai; Sean C Li; Michael J DePalma; Thomas J Hopkins; Abram H Burgher; David A Spinner; Steven P Cohen; Meredith J McGee; Joseph W Boggs Journal: Pain Med Date: 2021-03-18 Impact factor: 3.750