School of Electrical Engineering and Computer Science, Gwangju Institute of Science & Technology, South Korea; Medical Device Development Center, Daegu-Gyeongbuk Medical Innovation Foundation, Daegu, South Korea.
School of Electrical Engineering and Computer Science, Gwangju Institute of Science & Technology, South Korea.
Comput Biol Med. 2021 Aug;135:104290. doi: 10.1016/j.compbiomed.2021.104290. Epub 2021 Mar 26.
Motor cortex stimulation, either non-invasively or with implanted electrodes, has been applied worldwide as a treatment for intractable neuropathic pain syndromes. Although computer simulations of non-invasive brain stimulation have been investigated largely to optimize protocols and improve our understanding of underlying mechanisms using a realistic head model, computational studies of invasive cortical stimulation are rare and limited to very simplified cortical models. In this paper, we present an anatomically realistic head model for epidural cortical stimulation that includes the most sophisticated epidural electrodes with an insulating paddle. The head model predicted the stimulus-induced field strengths according to two different stimulation techniques, bipolar and monopolar stimulations. We found that the stimulus-induced field focused on the precentral and postcentral gyri because of the epidural lead's invasiveness. Different stimulation configurations influenced the shape of the field markedly, and complex patterns of inward and outward directions of the radial field were observed in bipolar stimulation compared to those in monopolar stimulation. The spatial distributions of field strength showed that the optimal stimulation varied according to the target areas. In conclusion, we proposed an anatomically realistic head model and a sophisticated epidural lead to simulate epidural cortical stimulation-induced field strengths and identified the importance of such detailed modeling for epidural cortical stimulation because of the current's shunting through the cerebrospinal fluid.
经颅磁刺激和脑深部电刺激已在全球范围内被应用于治疗难治性神经性疼痛综合征。尽管非侵入性脑刺激的计算机模拟已在很大程度上得到了研究，以优化方案并使用现实的头部模型来提高我们对潜在机制的理解，但侵入性皮质刺激的计算研究很少，并且仅限于非常简化的皮质模型。在本文中，我们提出了一种用于硬膜外皮质刺激的解剖现实的头部模型，该模型包括带有绝缘桨叶的最先进的硬膜外电极。头部模型根据两种不同的刺激技术（双极刺激和单极刺激）预测了刺激诱导的场强。我们发现，由于硬膜外导联的侵入性，刺激诱导的场集中在前中央回和后中央回。不同的刺激配置显著影响场的形状，与单极刺激相比，在双极刺激中观察到径向场的向内和向外方向的复杂模式。场强的空间分布表明，根据目标区域，最佳刺激是不同的。总之，我们提出了一种解剖现实的头部模型和一种复杂的硬膜外导联，以模拟硬膜外皮质刺激诱导的场强，并确定了这种详细建模对于硬膜外皮质刺激的重要性，因为电流会通过脑脊液分流。
