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Evoked Compound Action Potentials Reveal Spinal Cord Dorsal Column Neuroanatomy
| Content Provider | Scilit |
|---|---|
| Author | Parker, John L. Obradovic, Milan Shariati, Nastaran Hesam Gorman, Robert B. Karantonis, Dean M. Single, Peter S. Laird-Wah, James Bickerstaff, Mark Cousins, Michael J. |
| Copyright Year | 2020 |
| Description | Journal: Neuromodulation: Technology at the Neural Interface Introduction The electrically evoked compound action potential (ECAP) is a measure of the response from a population of fibers to an electrical stimulus. ECAPs can be assessed during spinal cord stimulation (SCS) to elucidate the relationship between stimulation, electrophysiological response, and neuromodulation. This has consequences for the design and programming of SCS devices. Methods Sheep were implanted with linear epidural SCS leads. After a stimulating pulse, electrodes recorded ECAPs sequentially as they propagated orthodromically or antidromically. After filtering, amplification, and signal processing, ECAP amplitude and dispersion (width) was measured, and conduction velocity was calculated. Similar clinical data was also collected. A single-neuron computer model that simulated large-diameter sensory axons was used to explore and explain the observations. Results ECAPs, both animal and human, have a triphasic structure, with P1, N1, and P2 peaks. Conduction velocity in sheep was 109 $ms^{−1}$, which indicates that the underlying neural population includes fibers of up to 20 μm in diameter. For travel in both directions, propagation distance was associated with decrease in amplitude and increase in dispersion. Importantly, characteristics of these changes shifted abruptly at various positions along the cord. Discussion ECAP dispersion increases with propagation distance due to the contribution of slow-conducting small-diameter fibers as the signal propagates away from the source. An analysis of the discontinuities in ECAP dispersion changes with propagation revealed that these are due to the termination of smaller-diameter, slower-conducting fibers at corresponding segmental levels. The implications regarding SCS lead placement, toward the goal of maximizing clinical benefit while minimizing side-effects, are discussed. |
| Related Links | http://www.neuromodulationjournal.org/article/S1094715921020717/pdf |
| Ending Page | 95 |
| Page Count | 14 |
| Starting Page | 82 |
| ISSN | 10947159 |
| e-ISSN | 15251403 |
| DOI | 10.1111/ner.12968 |
| Journal | Neuromodulation: Technology at the Neural Interface |
| Issue Number | 1 |
| Volume Number | 23 |
| Language | English |
| Publisher | Elsevier BV |
| Publisher Date | 2020-01-01 |
| Access Restriction | Open |
| Subject Keyword | Journal: Neuromodulation: Technology at the Neural Interface Closed-loop Feedback Electrically Evoked Compound Action Potential Spinal Cord Stimulation |
| Content Type | Text |
| Resource Type | Article |
| Subject | Neurology Neurology (clinical) Anesthesiology and Pain Medicine |
