WAS WIRD IM ZNS STIMULIERT?

Role of electrode design on the volume

of issue activated during deep brain
stimulation
Neuron 63, 508–522, 2009
vs
Direct activation of sparse, distributed
populations of cortical neurons by
electrical microstimulation
J. Neural Eng. 3, 1–8, 2006
Neuroprothetik
 Mechanisms
of
Electrical Stimulation Deep brain
stimulation
with
Neural Prostheses Retina
stimulation
Cochlear
nerve
stimulation
Frank Rattay,
Susanne Resatz, Ilse Persy
Vienna University of Technology
Electrical
Winfried Mayr & coworker spinal cord
Medical University Vienna stimulation

Karen Minassian, Christian Hofer, Helmut Kern

Physical Medicine Wilhelminenspital
Milan Dimitrijevic
Baylor College of Medicine,Houston, Texas
1790: Galvani and Volta examined electrical excitation

Which
elements are
stimulated ?
Cochlear
Implant
Motion Analysis in the Hemicochlea
Comparison of
calculated optical
flow field
(blue arrows) with
computer-generated
artificial
displacements
(red arrows).
scale bars are for the
image and the
displacement arrows.

Cai H, Richter CP, Chadwick RS, Biophys J. 2003, 85: 1929-37

Elektrische Brille
sub- und epiretinale Implantate
Retina
 4,0

2,0

0,0
-200,0 0,0 200,0 400,0 600,0 800,0

-2,0

-4,0

-6,0

Ganglionzelle
-8,0

y
 Epidural stimulation of posterior
structures of the upper lumbar cord
Poly-surface EMG recording of muscle responses

Quadriceps(Q)
Hamstrings (H)
T
1
1
L
1
Adductor(A)
Tibialis anterior(TA)
Triceps surae(TS)
Electrode
L2
Th11
1 – 10 V
Th12 2.2 – 60 Hz
L1
 Which
elements are Computersimulation
stimulated ?

1. Finite element calculation of the applied electrical

field
2. Response of single target neurons
3. Response of the neural network in the spinal cord
to different stimulation frequencies
A UNMYELINATED AXON

ELECTRODE

Hodgkin-Huxley B SPHERICAL CELL

membrane dynamics ELECTRODE

C
50mV
Ve Vi

5ms

Constant membrane conductance

Istimulus=100pA
 Human
Cochlea,
simplified
Finite Element calculation of the
electrical field
Cochlea Neuron: Simulation of excitation
Deep Brain Stimulation: Placement of the electrode in the
brain and the pulse generator in the chest
right: Three-dimensional reconstruction of the targeted nuclei
view from the base of the brain looking upwards
 Which
elements are Answer from the compartment model:
stimulated ?

1. Axons are easier to stimulate than cell bodies or

dendrites
2. Cathodic stimulation is often easier than anodic
3. Thicker fibers are easier to stimulate
4. The points of strong axonal curvature as well as
irregularities in the conducting medium are
candidates for spike initiation
 5V
Computersimulation – step 1:
Finite element calculation of the
0V applied electrical field

-5 V

z
y
x
Spinal cord 1 cm
Cerebrospinal fluid Potential distribution within
the dural sac generated by a
Dura mater
y
bipolar electrode with 10 V
5V
x
potential difference between
the two contacts
1 cm
 Computersimulation – step 2:
Extracellular potential along the neuron causes the
activating input for the compartment model
A B C D
Extracellular Activating To Membrane voltage
voltage [mV] function [mV/ms] spinal cord
50mV

-200 -100 0 100 -2000 0 2000 4000 0.5ms

0
Distance along root

4 Anti-
dromic
6 AP

8 cm

Stimulus: 5.0V / 210 ms

Directly stimulated neuronal structures:
Computer simulation, Posterior roots
A B Stimulus- C
Back view amplitude: 3 V 4V 6V
1.5 V 2.0 V 3.0 V

0V 0V 0V

-1.5 V -2.0 V -3.0 V

L2
low threshold
-0.05 V
sites
-0.05 V

-0.05 V

CSF
Spinal cord low threshold
Dura mater sites

Stimulation of posterior root fibers can explain the

L2-posterior root
segmental-selective muscle recruitment
Threshold (Q)
group 2
Q
TS
Top view Stimulation- 0 1 2 3 4 5 6 7 8 9 10
strength (V) Threshold (TS)
McIntyre et al.
2004
J Neurophysiol
91: 1457–1469.
 McIntyre et al. 2004
J Neurophysiol 91: 1457–1469.

B: human thalamic neuron intra-

operative recording before and after
stimulation (5µA, 0.15ms, 100Hz)
(Dostrovsky and Lozano 2002,
Mov Disord 17, Suppl 3: 63–68)
 Epidural stimulation of posterior
structures of the upper lumbar cord
Poly-surface EMG recording of muscle responses

Quadriceps(Q)
Hamstrings (H)
T
1
1
L
1
Adductor(A)
Tibialis anterior(TA)
Triceps surae(TS)
Electrode
L2
Th11
1 – 10 V
Th12 2.2 – 60 Hz
L1
 Complex patterns of motor output in response to
non-patterned stimulation depends on the applied
frequency

L4/5, 0–3+, 10 V, 210 µs pulse width.

Vertical markers: 500 µV, 45 °. Horizontal marker: 1 s.
Raster representation of CMUP responses

Low frequency
stimulation: constant
output

Higher frequency
stimulation: patterned
output
3s
150
[µV]

Q 0
-150
300 100
[µV]

H 0
-300 [µV] 0

-100
0 time [ms] 30
 2.2 Hz
A

1 mV
1.5 mV

2.2 Hz 11 Hz Transitions from

mono- to
1.5 mV
11 Hz

16 Hz 16 Hz
22 Hz 1.5 mV
polysynaptic
pathways
Stimulus

22 Hz
1.5 mV

0 50 ms 0 50 ms
Time after stimulus Time after stimulus

B 7 V, 28 Hz
30
Latency (ms)

25
20
15

EMG-amplitude
10
5

1.5 mV
0

0 3 6 9
Time (s)
#1 #2 #3

EMG-amplitude
#1 #2 #3
0.1 mV

0.1 mV

2 mV

0 50 ms 0 50 ms 0 50 ms
Time after stimulus Time after stimulus Time after stimulus
 Complex patterns of motor output in response to
different non-patterned input to the spinal cord

Spinal cord injury Spinal cord injury

25–50 Hz 5–15 Hz
Spinal cord Spinal cord
stimulation stimulation
“Lumbar locomotor pattern generator” “Lumbar extension pattern generator”
(LLPG) configuration (LEPG) configuration

Rhythmical, stepping-like Lower limb

lower limb movement extension
CONCLUSION
Epidural stimulation of the lower spinal cord,
trains of cathodic 210µs main-pulses <10Volt:

„ Spikes are primarily initiated at the root entries, not

within the dorsal columns or spinal inter-neurons
„ Low frequency stimulation results in monosynaptic
activities with constant latencies which switches to
„ poly-synaptic answers that causes extension of the
lower limbs (5-15 Hz) and stepping like movements
(25-50 Hz)