A systematic review of computational models for the design of spinal cord stimulation therapies: from neural circuits to patient-specific simulations.
A systematic review of computational models for the design of spinal cord stimulation therapies: from neural circuits to patient-specific simulations.
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对脊髓刺激疗法设计的计算模型的系统回顾：从神经回路到患者特异性模拟。
DOI：
10.1113/jp282884
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发表时间：
2023
期刊：
影响因子：
--
通讯作者：
Pirondini,Elvira
中科院分区：
文献类型：
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作者：
Liang,Lucy;Damiani,Arianna;DelBrocco,Matteo;Rogers,EvanR;Jantz,MariaK;Fisher,LeeE;Gaunt,RobertA;Capogrosso,Marco;Lempka,ScottF;Pirondini,Elvira
70年前，霍奇金和赫胥黎发表了第一个描述动作电位产生的数学模型，为现代计算神经科学奠定了基础。从那时起，这一领域发生了巨大的变化，研究范围从基础神经科学到神经调节的临床应用。神经调节的计算机模型已经在复杂性和个性化方面发展，推动了临床实践和新的神经刺激疗法，如脊髓刺激。脊髓刺激是一种广泛用于治疗慢性疼痛的疗法，适应症迅速扩大，如恢复运动功能。总体而言，模拟极大地改进了导联设计、刺激配置、波形参数和编程程序，并提供了对电刺激潜在作用机制的洞察。尽管神经模型的实施在数量和复杂性上不断增加，但我们有理由问，这种观察到的复杂性增加是否对于提高准确性和最终临床疗效是必要的。为了达到这个目的，我们对计算模型的演变进行了系统的文献综述和定性的综合，重点放在复杂性、个性化和使用医学成像来捕捉真实的解剖结构上。我们的综述表明，模型复杂性和个性化的增加改善了机械性和翻译性研究。更具体地说，医学成像的使用使针对患者的模型的开发能够帮助改变脊髓刺激的临床实践。最后，我们结合我们的结果，为脊髓刺激计算模型的标准化和扩展提供了明确的指导方针。
Seventy years ago, Hodgkin and Huxley published the first mathematical model to describe action potential generation, laying the foundation for modern computational neuroscience. Since then, the field has evolved enormously, with studies spanning from basic neuroscience to clinical applications for neuromodulation. Computer models of neuromodulation have evolved in complexity and personalization, advancing clinical practice and novel neurostimulation therapies, such as spinal cord stimulation. Spinal cord stimulation is a therapy widely used to treat chronic pain, with rapidly expanding indications, such as restoring motor function. In general, simulations contributed dramatically to improve lead designs, stimulation configurations, waveform parameters and programming procedures and provided insight into potential mechanisms of action of electrical stimulation. Although the implementation of neural models are relentlessly increasing in number and complexity, it is reasonable to ask whether this observed increase in complexity is necessary for improved accuracy and, ultimately, for clinical efficacy. With this aim, we performed a systematic literature review and a qualitative meta‐synthesis of the evolution of computational models, with a focus on complexity, personalization and the use of medical imaging to capture realistic anatomy. Our review showed that increased model complexity and personalization improved both mechanistic and translational studies. More specifically, the use of medical imaging enabled the development of patient‐specific models that can help to transform clinical practice in spinal cord stimulation. Finally, we combined our results to provide clear guidelines for standardization and expansion of computational models for spinal cord stimulation.