A Theoretical Study of Epidural Electrical Stimulation of the Spinal Cord - Part II: Effects on Long Myelinated Fibers

This second paper, of two, draws upon earlier finite element solutions for electrical fields generated within the spinal cord by epidural electrodes. Given those fields, a lumped network model of the myelinated nerve axon is used to predict stimulation thresholds for afferent fiber pathways in the dorsal columns and dorsal roots. Threshold predictions for dorsal column fibers of 5 and 10 , im diameters correspond closely with sensory thresholds reported experimentally. Descending fibers in the lateral corticospinal tracts are also considered. Comparisons are made to other possible targets of stimulation, and the theoretical indications are discussed in the context of clinical findings.

[1]  A. Huxley,et al.  The action potential in the myelinated nerve fibre of Xenopus laevis as computed on the basis of voltage clamp data , 1964, The Journal of physiology.

[2]  J. Mortimer,et al.  Electrical Inhibition of Pain by Stimulation of the Dorsal Columns: Preliminary Clinical Report , 1967, Anesthesia and analgesia.

[3]  S L BeMent,et al.  A model for electrical stimulation of central myelinated fibers with monopolar electrodes. , 1969, Experimental neurology.

[4]  J. B. Ranck,et al.  Which elements are excited in electrical stimulation of mammalian central nervous system: A review , 1975, Brain Research.

[5]  J. Bloedel,et al.  Distribution of activity in spinal pathways evoked by experimental dorsal column stimulation. , 1975, Journal of neurosurgery.

[6]  W H Sweet,et al.  Temporary Abolition of Pain in Man , 1967, Science.

[7]  Barry Coburn,et al.  A Theoretical Study of Epidural Electrical Stimulation of the Spinal Cord Part I: Finite Element Analysis of Stimulus Fields , 1985, IEEE Transactions on Biomedical Engineering.

[8]  V. J. Wilson,et al.  Cervical branching of lumbar vestibulospinal axons , 1974, The Journal of physiology.

[9]  J. Mortimer,et al.  The Effect of Stimulus Parameters on the Recruitment Characteristics of Direct Nerve Stimulation , 1983, IEEE Transactions on Biomedical Engineering.

[10]  Shealy Cn,et al.  Electrical inhibition of pain by stimulation of the dorsal columns: preliminary clinical report. , 1967 .

[11]  B. Nashold,et al.  Dorsal column stimulation for control of pain. Preliminary report on 30 patients. , 1972, Journal of neurosurgery.

[12]  Y. Hosobuchi,et al.  Phantom limb pain. Treatment with dorsal column stimulation. , 1975, Journal of neurosurgery.

[13]  D. Mcneal Analysis of a Model for Excitation of Myelinated Nerve , 1976, IEEE Transactions on Biomedical Engineering.