Department of Biomedical Engineering, Duke University, Durham, NC, USA.
Neuromodulation Research and Advanced Concepts, Boston Scientific Neuromodulation, Valencia, CA, USA.
Brain Stimul. 2022 Sep-Oct;15(5):1051-1062. doi: 10.1016/j.brs.2022.07.046. Epub 2022 Jul 31.
Temporal patterns of stimulation represent a novel dimension for improving the efficacy of spinal cord stimulation to treat chronic neuropathic pain.
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.
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.
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.
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.
刺激的时间模式代表了提高脊髓刺激治疗慢性神经性疼痛疗效的一个新维度。
我们假设，使用计算模型设计的非规则时间刺激模式将优于恒频刺激或完全随机刺激模式。
我们使用背角网络的计算模型和基于生物进化的优化算法，设计了一种与恒频（CF）刺激相比具有相当疗效和更高效率的脊髓刺激优化模式。我们评估了不同时间模式对在麻醉大鼠背角记录的单个神经元的影响。
与随机 50Hz 刺激或故意设计的适应性差的模式相比，优化模式和 50Hz CF 刺激在体内记录的自发性放电神经元的抑制作用更大。脊髓刺激（SCS）导致记录单元的放电模式发生显著变化，产生显著抑制的刺激模式也倾向于降低熵并使单元的放电模式规则化，这表明背角神经元活动的模式可能除了放电率外，对疼痛感知也很重要。
这些结果表明，计算模型可用作优化刺激参数的工具，并表明优化的时间模式可能会提高脊髓刺激的疗效。
