An optimization framework for targeted spinal cord stimulation.
An optimization framework for targeted spinal cord stimulation.
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DOI：
10.1088/1741-2552/acf522
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发表时间：
2023-09-28
影响因子：
4
通讯作者：
中科院分区：
文献类型：
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客观的。脊髓刺激（SCS）是治疗慢性疼痛的常见神经刺激疗法。技术进步催生了功能扩展的新型神经刺激系统，试图改善与 SCS 相关的临床结果。然而，这些扩展的功能极大地增加了可能的刺激参数的数量，并且使得在标准临床编程程序的背景下有效探索这个大参数空间变得困难。因此，在本研究中，我们开发了一种优化方法来定义 SCS 电极阵列中各个触点的最佳电流幅度或分数。方法。我们开发了一种使用拉格朗日乘子法和平滑近似的分析方法。为了测试我们的优化框架，我们使用了混合计算建模方法，该方法由有限元方法模型和脊髓内轴突和细胞的多室模型组成。此外，我们将我们的方法扩展到多目标优化，以探索激活感兴趣区域（ROI）和回避区域（ROA）之间的权衡。主要结果。对于简单的 ROI，我们的框架建议了类似于简单双极配置的优化配置。然而，当我们考虑多目标优化时，我们的框架建议了可以从 Pareto 前沿中选择的重要刺激配置，以瞄准多个 ROI 或避免 ROA。意义。我们开发了针对目标 SCS 的优化框架。我们的方法是分析方法，可以快速计算最佳解决方案。我们首次为选择性 SCS 提供了多目标方法。通过这种方法，我们能够证明新颖的配置可以提供传统刺激配置（例如双极刺激）无法实现的神经募集特征。最重要的是，一旦与考虑患者间差异来源（例如解剖结构、电极放置）的计算模型集成，我们的优化框架可用于提供适合个体患者需求的刺激设置。
Objective. Spinal cord stimulation (SCS) is a common neurostimulation therapy to manage chronic pain. Technological advances have produced new neurostimulation systems with expanded capabilities in an attempt to improve the clinical outcomes associated with SCS. However, these expanded capabilities have dramatically increased the number of possible stimulation parameters and made it intractable to efficiently explore this large parameter space within the context of standard clinical programming procedures. Therefore, in this study, we developed an optimization approach to define the optimal current amplitudes or fractions across individual contacts in an SCS electrode array(s). Approach. We developed an analytic method using the Lagrange multiplier method along with smoothing approximations. To test our optimization framework, we used a hybrid computational modeling approach that consisted of a finite element method model and multi-compartment models of axons and cells within the spinal cord. Moreover, we extended our approach to multi-objective optimization to explore the trade-off between activating regions of interest (ROIs) and regions of avoidance (ROAs). Main results. For simple ROIs, our framework suggested optimized configurations that resembled simple bipolar configurations. However, when we considered multi-objective optimization, our framework suggested nontrivial stimulation configurations that could be selected from Pareto fronts to target multiple ROIs or avoid ROAs. Significance. We developed an optimization framework for targeted SCS. Our method is analytic, which allows for the fast calculation of optimal solutions. For the first time, we provided a multi-objective approach for selective SCS. Through this approach, we were able to show that novel configurations can provide neural recruitment profiles that are not possible with conventional stimulation configurations (e.g. bipolar stimulation). Most importantly, once integrated with computational models that account for sources of interpatient variability (e.g. anatomy, electrode placement), our optimization framework can be utilized to provide stimulation settings tailored to the needs of individual patients.
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DOI：
10.1109/tnsre.2021.3138297
发表时间：
2021
期刊：
IEEE transactions on neural systems and rehabilitation engineering : a publication of the IEEE Engineering in Medicine and Biology Society
影响因子：
--
作者：
Haji Ghaffari D;Akwaboah AD;Mirzakhalili E;Weiland JD
通讯作者：
Weiland JD
影响因子：
4
作者：
Fauvel, Tristan;Chalk, Matthew
通讯作者：
Chalk, Matthew
影响因子：
2.5
作者：
Billot, Maxime;Naiditch, Nicolas;Rigoard, Philippe
通讯作者：
Rigoard, Philippe
影响因子：
5.3
作者：
Capogrosso, Marco;Wenger, Nikolaus;Micera, Silvestro
通讯作者：
Micera, Silvestro
治疗疼痛的脊髓刺激机制：50年后仍处于黑暗状态。
DOI：
10.1002/ejp.1336
发表时间：
2019-04
期刊：
European journal of pain (London, England)
影响因子：
--
作者：
Jensen MP;Brownstone RM
通讯作者：
Brownstone RM