Title
Sensitivity Study of Neuronal Excitation and Cathodal Blocking Thresholds of Myelinated Axons for Percutaneous Auricular Vagus Nerve Stimulation
Abstract
Objective: Excitation of myelinated nerve fibers is investigated by means of numerical simulations, for the application of percutaneous auricular vagus nerve stimulation (pVNS). High sensitivity to axon diameter is of interest regarding the goal of targeting thicker fibers. Methods: Excitation and blocking thresholds for different pulse types, phase durations, axon depths, axon-electrode distances, temperatures and axon diameters are investigated. The used model consists of a 50 mm long axon and a centrally located needle electrode in a layered medium representing the auricle. Neuronal excitation is simulated using the Frankenhaeuser-Huxley equations for all combinations of parameter values. Results and conclusion: Multiple modes and locations of excitation along the axon were observed, depending on the pulse type and amplitude. When increasing the axon-electrode distance from 1 mm to 2 mm, sensitivity of thresholds to axon depth decreased with ca. 50%, while sensitivity to axon-electrode distance, axon diameter and phase duration each increased with ca. 15% to 20%, except from monophasic anodal pulses, showing a 45% decrease for axon-electrode distance. These trends for axon diameter and axon-electrode distance allow for more selective stimulation of thicker target fibers using monophasic anodal pulses at higher axon-electrode distances. Cathodal monophasic pulses did not perform well due to blocking of the thicker fibers, which was only rarely seen for other pulse types. Significance: Sensitivities of stimulation thresholds to these parameters by numerical simulation reveal how the stimulation parameters can be changed in order to increase therapeutic effect and comfort during pVNS by enabling more selective stimulation.
Year
DOI
Venue
2020
10.1109/TBME.2020.2982271
IEEE Transactions on Biomedical Engineering
Keywords
DocType
Volume
Axons,Electric Stimulation,Electrodes,Models, Neurological,Nerve Fibers, Myelinated,Vagus Nerve,Vagus Nerve Stimulation
Journal
67
Issue
ISSN
Citations 
12
0018-9294
0
PageRank 
References 
Authors
0.34
0
8
Name
Order
Citations
PageRank
Tom Van de Steene100.34
Emmeric Tanghe229333.77
Thomas Tarnaud300.34
stefan kampusch433.33
Eugenijus Kaniusas5188.59
Luc Martens6938104.51
Roel Van Holen7112.21
Wout Joseph8818111.61