Article Google Scholar. Using multiple high-count electrode arrays in human median and ulnar nerves to restore sensorimotor function after previous transradial amputation of the hand. Sci Transl Med. Restoring motor control and sensory feedback in people with upper extremity amputations using arrays of 96 microelectrodes implanted in the median and ulnar nerves. Intraneural stimulation elicits discrimination of textural features by artificial fingertip in intact and amputee humans.
Restoration of motor control and proprioceptive and cutaneous sensation in humans with prior upper-limb amputation via multiple Utah slanted electrode arrays USEAs implanted in residual peripheral arm nerves. J Neuroeng Rehabil. A neural interface provides long-term stable natural touch perception. An osseointegrated human-machine gateway for long-term sensory feedback and motor control of artificial limbs.
The neural basis of perceived intensity in natural and artificial touch. Embedded system for prosthetic control using implanted neuromuscular interfaces accessed via an Osseointegrated implant. Sensory feedback by peripheral nerve stimulation improves task performance in individuals with upper limb loss using a myoelectric prosthesis.
Google Scholar. Rapid conduction and the evolution of Giant axons and myelinated fibers. Curr Biol. Coding and use of tactile signals from the fingertips in object manipulation tasks.
Nat Rev Neurosci. Material considerations for peripheral nerve interfacing. MRS Bull. Long-term stability of stimulating spiral nerve cuff electrodes on human peripheral nerves. Functionally selective peripheral nerve stimulation with a flat Interface nerve electrode. Comparison of mono-, bi-, and Tripolar configurations for stimulation and recording with an Interfascicular Interface. A technique for implantation of a 3-dimensional penetrating electrode array in the modiolar nerve of cats and humans.
Arch Otolaryngol - Head Neck Surg. Acute and chronic implantation of coiled wire intraneural electrodes during cyclical electrical stimulation. Ann Biomed Eng. Long Micro-Channel electrode arrays: a novel type of regenerative peripheral nerve Interface. A flexible, light-weight multichannel sieve electrode with integrated cables for interfacing regenerating peripheral nerves. Sensors Actuators.
Early interfaced neural activity from chronic amputated nerves. Front Neuroeng. Regeneration electrode Units : implants for recording from single peripheral nerve fibers in freely moving animals.
Polyimide micro-channel arrays for peripheral nerve regenerative implants. Sensors Actuators A Phys. A critical review of interfaces with the peripheral nervous system for the control of neuroprostheses and hybrid bionic systems. J Peripher Nerv Syst. On the viability of implantable electrodes for the natural control of artificial limbs: review and discussion.
Biomed Eng Online. Electrochemical considerations for safe electrical stimulation of the nervous system with platinum electrodes. Long-term pain control by direct peripheral-nerve stimulation. Anderson JM. Biological responses to materials. Annu Rev Mater Res. Functional and mechanical evaluation of nerve stretch injury. J Med Syst. Olsson Y. Microenvironment of the peripheral nervous system under normal and pathological conditions. Crit Rev Neurobiol. Light and electron microscopic studies of phrenic nerves after long-term electrical stimulation.
J Neurosurg. Histologic and physiologic evaluation of electrically stimulated peripheral nerve: considerations for the selection of parameters. Damage in peripheral nerve from continuous electrical stimulation: comparison of two stimulus waveforms. Med Biol Eng Comput. A spiral nerve cuff electrode for peripheral nerve stimulation. Perspectives on new electrode Technology for Stimulating Peripheral Nerves with implantable motor prostheses.
Cuff electrodes for chronic stimulation and recording of peripheral nerve activity. J Neurosci Methods Elsevier. Prodanov D, Delbeke J. Mechanical and biological interactions of implants with the brain and their impact on implant design. Front Neurosci.
Durability of implanted electrodes and leads in an upper-limb neuroprosthesis. J Rehabil Res Dev. Stability of the input-output properties of chronically implanted multiple contact nerve cuff stimulating electrodes. Neural and connective tissue response to long-term implantation of multiple contact nerve cuff electrodes.
J Biomed Mater Res. Histological assessment of nerve lesions caused by epineurial electrode application in rat sciatic nerve. Degeneration and regeneration in rabbit peripheral nerve with long-term nerve cuff electrode implant: a stereological study of myelinated and unmyelinated axons.
Acta Neuropathol. The foreign body response to the Utah Slant Electrode Array in the cat sciatic nerve. Acta Biomater. Assessment of biocompatibility of chronically implanted polyimide and platinum Intrafascicular electrodes.
A sensory feedback system for an upper-limb amputation prosthesis. Bull Prosthet Res. Lapicque L. Has the muscular substance a longer chronaxie than the nervous substance? J Physiol. Weiss G. Arch Ital Biol. The electrochemistry of electrical stimulation.
Comparison of neural damage induced by electrical stimulation with faradaic and capacitor electrodes. Exp Neurol. Charge density and charge per phase as cofactors in neural injury induced by electrical stimulation. Shannon RV. A model of save levels for electrical stimulation. Incorporation of the electrode-electrolyte interface into finite-element models of metal microelectrodes. Platinum for neural stimulation: voltammetry considerations.
Estimation of current density distribution under electrodes for external defibrillation. Ksienski DA. A minimum profile uniform current density electrode. Current density profiles of surface mounted and recessed electrodes for neural prostheses. In vitro measurement and characterization of current density profiles produced by nonrecessed, simple recessed, and radially varying recessed stimulating electrodes.
Current density distributions, field distributions and impedance analysis of segmented deep brain stimulation electrodes. Analysis of high-perimeter planar electrodes for efficient neural stimulation. The effect of stimulus parameters on the recruitment characteristics of direct nerve stimulation.
Prospective long-term study of vagus nerve stimulation for the treatment of refractory seizures. Intramuscular electrical stimulation: tissue damage. Lilly JC. Injury and excitation by electric currents. In: Sheer DE, editor. Electr Stimul brain. Austin: University of Texas Press; The choice of pulse duration for chronic electrical stimulation via surface, nerve, and intramuscular electrodes. Tissue damage by pulsed electrical stimulation.
Effect of interphase gap and pulse duration on electrically evoked potentials is correlated with auditory nerve survival. Hear Res. Rattay F. Analysis of models for external stimulation of axons. Vagus nerve stimulation for treatment of partial seizures: 1. A controlled study of effect on seizures. Paradigms for restoration of somatosensory feedback via stimulation of the peripheral nervous system. Brief, noninjurious electric waveform for stimulation of the brain. Adv Sci. CAS Google Scholar. Imbalanced biphasic electrical stimulation: muscle tissue damage.
Comparison of rectangular and exponential current pulses for evoking sensation. Sahin M, Tie Y. Non-rectangular waveforms for neural stimulation with practical electrodes. Efficiency analysis of waveform shape for electrical excitation of nerve fibers.
Burst-modulated waveforms optimize electrical stimuli for charge efficiency and Fiber selectivity. The response of the myelinated nerve fiber to short duration biphasic stimulating currents. Relationship between stimulus amplitude, stimulus frequency and neural damage during electrical stimulation of sciatic nerve of cat. Standing after spinal cord injury with four-contact nerve-cuff electrodes for quadriceps stimulation.
A characterization of the effects on neuronal excitability due to prolonged microstimulation with chronically implanted microelectrodes. Sensations evoked by intraneural microstimulation of single mechanoreceptor units innervating the human hand.
Reduction in excitability of the auditory nerve following electrical stimulation at high stimulus rates. Human ability to discriminate various parameters in afferent electrical nerve stimulation with particular reference to prostheses sensory feedback. A review of vagus nerve stimulation as a therapeutic intervention. J Inflamm Res. Histological evaluation of neural damage from electrical stimulation: considerations for the selection of parameters for clinical application.
Local anaesthetic block protects against electrically-induced damage in peripheral nerve. J Biomed Eng. Interfacing the somatosensory system to restore touch and proprioception: essential considerations.
J Mot Behav. Neuromuscular electrical stimulation for preventing skeletal-muscle weakness and wasting in critically ill patients: a systematic review. BMC Med. Ranck JBJ. Which elements are excited in electrical stimulation of mammalian central nervous system: a review.
Brain Res. The neurophysiology of unmyelinated tactile afferents. Neurosci Biobehav Rev. Macrophage Systems in Peripheral Nerves. Schwann cells, neurotrophic factors, and peripheral nerve regeneration. Electrical stimulation accelerates and enhances expression of regeneration-associated genes in regenerating rat femoral Motoneurons.
Cell Mol Neurobiol. Tam SL, Gordon T. Mechanisms controlling axonal sprouting at the neuromuscular junction. J Neurocytol. Neuromuscular activity impairs axonal sprouting in partially Denervated muscles by inhibiting bridge formation of Perisynaptic Schwann cells.
J Neurobiol. Electrical stimulation promotes sensory neuron regeneration and growth-associated gene expression. Rockland KS. Axon collaterals and brain states. Front Syst Neurosci. Trophic mechanisms in the peripheral nervous system. Annu Rev Neurosci. Evolution and resolution of stimulation-induced axonal injury in peripheral nerve. Muscle Nerve.
Sensory adaptation to electrical stimulation of the somatosensory nerves. Parameters of stimulation and perception in an artificial sensory feedback system. J Bioeng. Afferent electrical nerve stimulation: human tracking performance relevant to prosthesis sensory feedback.
Posterior tibial nerve stimulation in the treatment of urge incontinence. Neurourol Urodyn. Skeletal muscle effects of electrostimulation after COPD exacerbation: a pilot study. Eur Respir J.
Download references. Heymanslaan, 10, , Ghent, Belgium. You can also search for this author in PubMed Google Scholar. Correspondence to Max Ortiz-Catalan. However, in particular when using the in-plane approach, the visibility of the needle shaft is of interest as well because it helps to align the needle properly with the ultrasound beam to visualize the entire length to the target nerve. In principle, stimulating catheters function like insulated needles. The catheter body is made from insulating plastic material and usually contains a metallic wire inside, which conducts the current to its exposed tip electrode.
Usually, such stimulating catheters are placed using a continuous nerve block needle, which is placed by first using nerve stimulation as described. It acts as an introducer needle for the catheter. Once this needle is placed close to the nerve or plexus to be blocked, the stimulating catheter is introduced through it, and the nerve stimulator is connected to the catheter. Stimulation through the catheter should reconfirm that the catheter tip is positioned in close proximity to the target nerve s.
However, it must be noted that the threshold currents with stimulating catheters may be considerably higher. Injection of local anesthetic or saline which is frequently used to widen the space for threading the catheter more easily should be avoided because this may increase the threshold current considerably and can even prevent a motor response.
D5W can be used to avoid losing a motor response. Since the introduction of ultrasound monitoring of the distribution of the local anesthetic after needle or catheter placement, stimulating catheters have become nearly obsolete. This is because the ultimate test of the placement of the catheter tip in the therapeutic position is the distribution of the injectate in the tissue plane that contains the nerve or the plexus.
Because the stimulating catheter can be placed in the proper position without obtaining the motor response, using the stimulation through the catheter will often lead to unnecessary needle and catheter manipulation. Nerve stimulation monitoring of the single-injection or continuous needle placement is useful to avoid needle-nerve contact or intraneural placement and help decrease the risk of nerve inflammation or intraneural injection and consequent injury.
In contrast, catheters are pliable and highly unlikely to cause nerve trauma or be inserted into a fascicle. For a more comprehensive review, continue reading: Monitoring, Documentation, and Consent for Regional Anesthesia Procedures.
Voltage U is the difference in electrical potential between two points carrying different amounts of positive and negative charge.
It is measured in volts V or millivolts mV. Voltage can be compared to the filled level of a water tank, which deter-mines the pressure at the bottom outlet Figure 10A. In modern nerve stimulators using constant-current sources, voltage is adapted automatically and cannot or does not need to be influenced by the user.
Current I is the measure of the flow of a positive or negative charge. It is expressed in amperes A or milliamperes mA. Current can be compared to the flow of water. The minimum current intensity I required to produce an action potential can be expressed by the relationship where t is the pulse duration, c is the time constant of nerve membrane related to chronaxy. In clinical practice, this means that the impedance of the tissue is higher for low frequencies ie, a long pulse duration and lower for higher frequencies ie, a short pulse duration.
Consequently, a constant-current source which delivers longer-duration impulses, eg, 1 ms vs. This means that, at a given voltage, current changes with resistance.
If a constant current must be achieved as needed for nerve stimulation , the voltage has to adapt to the varying resis-tance of the entire electrical circuit.
For nerve localization in particular, the voltage must adapt to the resistance of the needle tip, the electrode-to-skin interface, and the tissue layers. A constant-current source does this automatically. This means that the current or charge that reaches the nerve decreases by a factor of 4 if the distance to the nerve is doubled, or con-versely, it increases by a factor of 4 if the distance is divided in half ideal conditions assumed.
The charge Q is the product of current multiplied by time and is given in ampere-seconds As or coulombs C. According to a worst-case scenario calculation, the temperature increase caused by a stimulus of 5-mA current and 1-ms dura-tion at a maximum output voltage of 95 V would be less than 0. This calculation can be applied for the tip of a nerve stimulation needle. One stimulus creates a temperature difference DT within 1 mm3 of tissue around the tip of a nerve stimulation needle.
That is, the maximum temperature increase in this worst-case scenario calculation is less than 0. In practice, this means that the temperature effect of normal nerve stimulation on the tissue can be neglected. We will demonstrate the performance of the median nerve block for carpal tunnel surgery together with four simple ultrasound machine Cannulation of a peripheral vein is an essential skill in medicine and anesthesiology. A peripheral IV access point is required Understanding the basic ultrasound physics presented in this section will be helpful for anesthesiologists to appropriately select the transducer, set Occurrence of the motor response at 0.
The practitioner should stop advancing the needle, withdraw the needle by 1 mm, and inject 1 mL of local anesthetic assuming the opening pressure is less than 15 psi to determine the needle tip position and adjust the needle and injection process accordingly.
PNS should not be relied on in a patient receiving muscle relaxants. The presence of spinal or epidural anesthesia does not negatively affect the reliability of PNS. Multiple injection techniques may decrease PNS sensitivity due to the partial nerve blockade that occurs between injections.
TABLE 1. Stimulation needle sizes recommended for various nerve blocks. TABLE 2. Common problems encountered during electrolocalization of peripheral nerves and corrective action. Problem Solution Nerve stimulator does not work at all. Nerve stimulator suddenly stops working Check and replace battery. No motor response is achieved despite the appropriate needle placement. Check connectors, skin electrode, cables, and stimulation needle for an interrupted circuit or too high impedance.
Check and make sure that current is flowing—no disconnect indicator on the stimulator. Check the setting of amplitude mA and impulse duration. Check stimulator setting some stimulators have a test mode or pause mode, which prevents current delivery.
Motor response disappears and cannot be regained even after increasing stimulus amplitude and duration. Check for the causes listed previously. Can be caused by injection of local anesthetic. TABLE 3. Comparison of most relevant features of modern nerve stimulators.
For nerve stimulator—guided nerve blocks, adjust the stimulus current amplitude: 1 mA superficial blocks , 2 mA deeper blocks eg, psoas compartment and deep sciatic blocks , 0. Now, with her seizures under control, Janice has a renewed sense of optimism. Mayo Clinic does not endorse companies or products.
Advertising revenue supports our not-for-profit mission. This content does not have an English version. This content does not have an Arabic version. Overview Vagus nerve stimulation involves the use of a device to stimulate the vagus nerve with electrical impulses. Vagus nerve stimulation Open pop-up dialog box Close. Vagus nerve stimulation In vagus nerve stimulation, an implanted pulse generator and lead wire stimulate the vagus nerve, which leads to stabilization of abnormal electrical activity in the brain.
Request an Appointment at Mayo Clinic. Fresh Approach to Epilepsy Treatment Rekindles Zest for Life Janice Breien was anxious to find a better way to manage the seizures that regularly disrupted her daily life. Share on: Facebook Twitter. Show references Edwards CA, et al. Neurostimulation devices for the treatment of neurologic disorders.
Mayo Clinic Proceedings. Wheless JW, et al. Vagus nerve stimulation VNS therapy update. In press. Accessed Oct. Vagus nerve stimulation. American Association of Neurosurgeons. Yuan, H, et al. Vagus nerve and vagus nerve stimulation, a comprehensive review: Part II. Daroff RB, et al. In: Bradley's Neurology in Clinical Practice. Philadelphia, Pa. Bonaz B, et al. Vagus nerve stimulation: A new promising therapeutic tool in inflammatory bowel disease.
Journal of Internal Medicine. Vagus nerve stimulation and headache. Schachter SC. Vagus nerve stimulation therapy for the treatment of epilepsy.
The epilepsies and seizures: Hope through research. National Institute of Neurological Disorders and Stroke. Aaronson ST, et al.
Vagus nerve stimulation changing the paradigm for chronic severe depression? Psychiatry Clinics of North America. FDA releases gammaCore, the first non-invasive vagus nerve stimulation therapy applied at the neck for acute treatment of pain associated with episodic cluster headache in adult patients.
0コメント