EFFECTS OF ELECTRODE GEOMETRY AND COMBINATION ON NERVE-FIBER SELECTIVITY IN SPINAL-CORD STIMULATION
EFFECTS OF ELECTRODE GEOMETRY AND COMBINATION ON NERVE-FIBER SELECTIVITY IN SPINAL-CORD STIMULATION
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DOI：
10.1007/bf02510785
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发表时间：
1995-09-01
影响因子：
3.2
通讯作者：
TAS, NR
中科院分区：
文献类型：
--
作者：
HOLSHEIMER, J;STRUIJK, JJ;TAS, NR
本文从理论上分析了在脊髓刺激过程中，肩尾电极触点的几何形状对背柱纤维和背根纤维激活的不同影响。刺激感生场电位的计算采用颈中段和胸中段的三维模型，而有髓神经纤维的缆索模型用于计算大的背柱和背根纤维的兴奋阈值。当施加单极、双极和三极刺激时，二维矩形电极触点的大小和间距是不同的。该模型预测，大阴极单极刺激对背根纤维的选择性最高，而小接触、小接触间隔的三极刺激对背根纤维的选择性最高。纤维类型偏好对吻尾接触大小的变化最敏感，对侧向接触大小的变化最不敏感。随着接触点到脊髓距离的增加，背根纤维偏好性增加，对导线几何形状的敏感性降低。
The differential effects of the geometry of a rostrocaudal array of electrode contacts on dorsal column fibre and dorsal root fibre activation in spinal cord stimulation are analysed theoretically. 3-D models of the mid-cervical and mid-thoracic vertebral areas are used for the computation of stimulation induced field potentials, whereas a cable model of myelinated nerve fibre is used for the calculation of the excitation thresholds of large dorsal column and dorsal root fibres. The size and spacing of 2-D rectangular electrode contacts are varied while mono-, bi- and tripolar stimulation are applied. The model predicts that the highest preferential stimulation of dorsal root fibres is obtained in monopolar stimulation with a large cathode, whereas dorsal column fibre preference is highest in tripolar stimulation with small contacts and small contact spacings. Fibre type preference is most sensitive to variations of rostrocaudal contact size and least sensitive to variations of lateral contact size. Dorsal root fibre preference is increased and sensitivity to lead geometry is reduced as the distance from contacts to spinal cord is increased.