NDLI: Computational modeling analysis of a spinal cord stimulation paddle lead reveals broad, gapless dermatomal coverage

Content Provider	IEEE Xplore Digital Library
Author	Kent, A.R. Xiaoyi Min Rosenberg, S.P. Fayram, T.A.
Copyright Year	2014
Description	Author affiliation: St. Jude Med., Sunnyvale, CA, USA (Kent, A.R.; Fayram, T.A.) \|\| St. Jude Med., Sylmar, CA, USA (Xiaoyi Min; Rosenberg, S.P.)
Abstract	Spinal cord stimulation (SCS) is an effective therapy for treating chronic pain. The St. Jude Medical $PENTA^{TM}$ paddle lead features a 4×5 contact array for achieving broad, selective coverage of dorsal column (DC) fibers. The objective of this work was to evaluate DC activation regions that correspond to dermatomal coverage with use of the PENTA lead in conjunction with a lateral sweep programming algorithm. We used a two-stage computational model, including a finite element method model of field potentials in the spinal cord during stimulation, coupled to a biophysical cable model of mammalian, myelinated nerve fibers to determine fiber activation within the DC. We found that across contact configurations used clinically in the sweep algorithm, the activation region shifted smoothly between left and right DC, and could achieve gapless medio-lateral coverage in dermatomal fiber tract zones. Increasing stimulation amplitude between the DC threshold and discomfort threshold led to a greater area of activation and number of dermatomal zones covered on the left and/or right DC, including L1-2 zones corresponding to dermatomes of the lower back. This work demonstrates that the flexibility in contact selection offered by the PENTA lead may enable patient-specific tailoring of SCS.
Sponsorship	IEEE Eng. Med. Biol. Soc.
Starting Page	6254
Ending Page	6257
File Size	875100
Page Count	4
File Format	PDF
ISBN	9781424479290
ISSN	1557170X
DOI	10.1109/EMBC.2014.6945058
Language	English
Publisher	Institute of Electrical and Electronics Engineers, Inc. (IEEE)
Publisher Date	2014-08-26
Publisher Place	USA
Access Restriction	Subscribed
Rights Holder	Institute of Electrical and Electronics Engineers, Inc. (IEEE)
Subject Keyword	Computational modeling Biological system modeling Optical fiber cables Spinal cord Electrical stimulation Finite element analysis Nerve fibers
Content Type	Text
Resource Type	Article
Subject	Signal Processing Biomedical Engineering Health Informatics Computer Vision and Pattern Recognition

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