Minimizing Stimulus Current in a Wearable Pudendal Nerve Stimulator Using Computational Models.

After spinal cord injury, functions of the lower urinary tract may be disrupted. A wearable device with surface electrodes which can effectively control the bladder functions would be highly beneficial to the patients. A trans-rectal pudendal nerve stimulator may provide such a solution. However, the major limiting factor in such a stimulator is the high level of current it requires to recruit the nerve fibers. Also, the variability of the trajectory of the nerve in different individuals should be considered. Using computational models and an approximate trajectory of the nerve derived from an MRI study, it is demonstrated in this paper that it may be possible to considerably reduce the required current levels for trans-rectal stimulation of the pudendal nerve compared to the values previously reported in the literature. This was corroborated by considering an ensemble of possible and probable variations of the trajectory. The outcome of this study suggests that trans-rectal stimulation of the pudendal nerve is a plausible long term solution for treating lower urinary tract dysfunctions after spinal cord injury

High Fidelity Bioelectric Modelling of the Implanted Cochlea

Cochlear implants are medical devices that can restore sound perception in individuals with sensorineural hearing loss (SHL). Since their inception, improvements in performance have largely been driven by advances in signal processing, but progress has plateaued for almost a decade. This suggests that there is a bottleneck at the electrode-tissue interface, which is responsible for enacting the biophysical changes that govern neuronal recruitment. Understanding this interface is difficult because the cochlea is small, intricate, and difficult to access. As such, researchers have turned to modelling techniques to provide new insights. The state-of-the-art involves calculating the electric field using a volume conduction model of the implanted cochlea and coupling it with a neural excitation model to predict the response. However, many models are unable to predict patient outcomes consistently. This thesis aims to improve the reliability of these models by creating high fidelity reconstructions of the inner ear and critically assessing the validity of the underlying and hitherto untested assumptions. Regarding boundary conditions, the evidence suggests that the unmodelled monopolar return path should be accounted for, perhaps by applying a voltage offset at a boundary surface. Regarding vasculature, the models show that large modiolar vessels like the vein of the scala tympani have a strong local effect near the stimulating electrode. Finally, it appears that the oft-cited quasi-static assumption is not valid due to the high permittivity of neural tissue. It is hoped that the study improves the trustworthiness of all bioelectric models of the cochlea, either by validating the claims of existing models, or by prompting improvements in future work. Developing our understanding of the underlying physics will pave the way for advancing future electrode array designs as well as patient-specific simulations, ultimately improving the quality of life for those with SHL

Doctor of Philosophy

dissertationHands are so central to the human experience, yet we often take for granted the capacity to maneuver objects, to form a gesture, or to caress a loved-one’s hand. The effects of hand amputation can be severe, including functional disabilities, chronic phantom pain, and a profound sense of loss which can lead to depression and anxiety. In previous studies, peripheral-nerve interfaces, such as the Utah Slanted Electrode Array (USEA), have shown potential for restoring a sense of touch and prosthesis movement control. This dissertation represents a substantial step forward in the use of the USEAs for clinical careâ€"ultimately providing human amputees with widespread hand sensation that is functionally useful and psychologically meaningful. In completion of this ultimate objective, we report on three major advances. First, we performed the first dual-USEA implantations in human amputees; placing one USEA in the residual median nerve and another USEA in the residual ulnar nerve. Chapter 2 of this dissertation shows that USEAs provided full-hand sensory coverage, and that movement of the implant site to the upper arm in the second subject, proximal to nerve branch-points to extrinsic hand muscles, enabled activation of both proprioceptive sensory percepts and cutaneous percepts. Second, in Chapter 3, we report on successful use of USEA-evoked sensory percepts for functional discrimination tasks. We provide a comprehensive report of functional discrimination among USEA-evoked sensory percepts from three human subjects, including discrimination among multiple proprioceptive or cutaneous sensory percepts with different hand locations, sensory qualities, and/or intensities. Finally, in Chapter 4, we report on the psychological value of multiple degree of freedom prosthesis control, multisensor prosthesis sensation, and closed-loop control. This chapter represents the first report of prosthesis embodiment during closed-loop and open-loop prosthesis control by an amputee, as well as the most sophisticated closed-loop prosthesis control reported in literature to-date, including 5-degree-of-freedom motor control and sensory feedback from 4 hand locations. Ultimately, we expect that USEA-evoked hand sensations may be used as part of a take-home prosthesis system which will provide users with both advanced functional capabilities and a meaningful sense of embodiment and limb restoration

Effect of Lead Position and Polarity on Paresthesia Coverage in Spinal Cord Stimulation Therapy: A Computational Study

[EN] Objectives: The effect of lead placement and programming strategies on spinal cord stimulation (SCS) therapy has been widely studied; however, there is a need to optimize these parameters to favor dorsal column (DC) over dorsal root (DR) stimulation in complex pain treatment. This study aimed to determine the optimal lateral distance between two leads and the effect of transverse stimulation using a mathematical model. Materials and Methods: A three-dimensional computational SCS and a nerve fiber model were used to determine the effect of the lateral distance between two leads at the same vertebral level T8 and the effect of the addition of anodes with two parallel leads at T8 and three different lateral distances on the model-based results (perception thresholds, activated DC fiber area and depth, and position of the first stimulated fiber). Results: With two parallel leads programmed with symmetrical polarities, the maximal DC fiber area stimulated was found for a lateral distance of 5 mm. The results also show a higher preference for DR stimulation as the lateral distance increased. The addition of positive contacts at the same level of active contacts in the second lead produces a displacement of the first stimulated fiber laterally. Conclusions: A lateral distance of 5 mm shows a DC stimulated fiber area greater than when leads are placed contiguously. The addition of anodes creates an effect whereby the area of paresthesia is not displaced to the midline, but in the opposite direction. This may be useful when the leads are too close and stimulation of one of the sides is compromised.Dura, JL.; Solanes, C.; De Andres, J.; Saiz Rodríguez, FJ. (2022). Effect of Lead Position and Polarity on Paresthesia Coverage in Spinal Cord Stimulation Therapy: A Computational Study. Neuromodulation: Technology at the Neural Interface. 25(5):680-692. https://doi.org/10.1016/j.neurom.2021.12.01368069225

Adaptive Neural Networks for Control of Movement Trajectories Invariant under Speed and Force Rescaling

This article describes two neural network modules that form part of an emerging theory of how adaptive control of goal-directed sensory-motor skills is achieved by humans and other animals. The Vector-Integration-To-Endpoint (VITE) model suggests how synchronous multi-joint trajectories are generated and performed at variable speeds. The Factorization-of-LEngth-and-TEnsion (FLETE) model suggests how outflow movement commands from a VITE model may be performed at variable force levels without a loss of positional accuracy. The invariance of positional control under speed and force rescaling sheds new light upon a familiar strategy of motor skill development: Skill learning begins with performance at low speed and low limb compliance and proceeds to higher speeds and compliances. The VITE model helps to explain many neural and behavioral data about trajectory formation, including data about neural coding within the posterior parietal cortex, motor cortex, and globus pallidus, and behavioral properties such as Woodworth's Law, Fitts Law, peak acceleration as a function of movement amplitude and duration, isotonic arm movement properties before and after arm-deafferentation, central error correction properties of isometric contractions, motor priming without overt action, velocity amplification during target switching, velocity profile invariance across different movement distances, changes in velocity profile asymmetry across different movement durations, staggered onset times for controlling linear trajectories with synchronous offset times, changes in the ratio of maximum to average velocity during discrete versus serial movements, and shared properties of arm and speech articulator movements. The FLETE model provides new insights into how spina-muscular circuits process variable forces without a loss of positional control. These results explicate the size principle of motor neuron recruitment, descending co-contractive compliance signals, Renshaw cells, Ia interneurons, fast automatic reactive control by ascending feedback from muscle spindles, slow adaptive predictive control via cerebellar learning using muscle spindle error signals to train adaptive movement gains, fractured somatotopy in the opponent organization of cerebellar learning, adaptive compensation for variable moment-arms, and force feedback from Golgi tendon organs. More generally, the models provide a computational rationale for the use of nonspecific control signals in volitional control, or "acts of will", and of efference copies and opponent processing in both reactive and adaptive motor control tasks.National Science Foundation (IRI-87-16960); Air Force Office of Scientific Research (90-0128, 90-0175

Neural models of learning and visual grouping in the presence of finite conduction velocities

The hypothesis of object binding-by-synchronization in the visual cortex has been supported by recent experiments in awake monkeys. They demonstrated coherence among gamma-activities (30–90 Hz) of local neural groups and its perceptual modulation according to the rules of figure-ground segregation. Interactions within and between these neural groups are based on axonal spike conduction with finite velocities. Physiological studies confirmed that the majority of transmission delays is comparable to the temporal scale defined by gamma-activity (11–33 ms). How do these finite velocities influence the development of synaptic connections within and between visual areas? What is the relationship between the range of gamma-coherence and the velocity of signal transmission? Are these large temporal delays compatible with recently discovered phenomenon of gamma-waves traveling across larger parts of the primary visual cortex? The refinement of connections in the immature visual cortex depends on temporal Hebbian learning to adjust synaptic efficacies between spiking neurons. The impact of constant, finite, axonal spike conduction velocities on this process was investigated using a set of topographic network models. Random spike trains with a confined temporal correlation width mimicked cortical activity before visual experience. After learning, the lateral connectivity within one network layer became spatially restricted, the width of the connection profile being directly proportional to the lateral conduction velocity. Furthermore, restricted feedforward divergence developed between neurons of two successive layers. The size of this connection profile matched the lateral connection profile of the lower layer neuron. The mechanism in this network model is suitable to explain the emergence of larger receptive fields at higher visual areas while preserving a retinotopic mapping. The influence of finite conduction velocities on the local generation of gamma-activities and their spatial synchronization was investigated in a model of a mature visual area. Sustained input and local inhibitory feedback was sufficient for the emergence of coherent gamma-activity that extended across few millimeters. Conduction velocities had a direct impact on the frequency of gamma-oscillations, but did neither affect gamma-power nor the spatial extent of gamma-coherence. Adding long-range horizontal connections between excitatory neurons, as found in layer 2/3 of the primary visual cortex, increased the spatial range of gamma-coherence. The range was maximal for zero transmission delays, and for all distances attenuated with finite, decreasing lateral conduction velocities. Below a velocity of 0.5 m/s, gamma-power and gamma-coherence were even smaller than without these connections at all, i.e., slow horizontal connections actively desynchronized neural populations. In conclusion, the enhancement of gamma-coherence by horizontal excitatory connections critically depends on fast conduction velocities. Coherent gamma-activity in the primary visual cortex and the accompanying models was found to only cover small regions of the visual field. This challenges the role of gamma-synchronization to solve the binding problem for larger object representations. Further analysis of the previous model revealed that the patches of coherent gamma-activity (1.8 mm half-height decline) were part of more globally occurring gamma-waves, which coupled over much larger distances (6.3 mm half-height decline). The model gamma-waves observed here are very similar to those found in the primary visual cortex of awake monkeys, indicating that local recurrent inhibition and restricted horizontal connections with finite axonal velocities are sufficient requirements for their emergence. In conclusion, since the model is in accordance with the connectivity and gamma-processes in the primary visual cortex, the results support the hypothesis that gamma-waves provide a generalized concept for object binding in the visual cortex

Neutral coding - A report based on an NRP work session

Neural coding by impulses and trains on single and multiple channels, and representation of information in nonimpulse carrier

Die Rolle des Signal Transducer and Activator of Transcription 3 (STAT3) bei der axonalen Regeneration im zentralen Nervensystem

Jedes Jahr erleiden weltweit circa 22 Menschen pro eine Million Einwohner eine Querschnittslähmung, die bei den Betroffenen zu dauerhaften Behinderungen und erheblichen Einschränkungen im Alltag führt. Die schwerwiegenden Defizite nach einer Querschnittslähmung, darunter Lähmungen und chronischer Schmerz, sind darauf zurückzuführen, dass geschädigte Axone im Rückenmark kaum regenerieren und es auch nur in geringem Ausmaß zur funktionellen Reorganisation der noch erhaltenen Nervenverbindungen kommt. Im Unterschied zum peripheren Nervensystem, wo zerstörte Nervenfasern erfolgreich regenerieren, ist die axonale Regenerationskapazität des zentralen Nervensystems (ZNS) spärlich ausgeprägt. Zwar konnte durch intensive Forschung im Verlauf der letzten Jahrzehnte eine Anzahl von „extrinsischen“ wachstumshemmenden Molekülen von Gliazellen und der extrazellulären Matrix des ZNS identifiziert werden. Es gibt jedoch zunehmend Hinweise darauf, dass zahlreiche dieser „extrinsischen“ Signale letztlich in „intrinsische“ Signalwege der Neuronen selbst einmünden um schließlich die Transkription neuronaler Gene zu verändern. Einer der interessantesten intrinsischen Regulatoren axonaler Regeneration ist der Transkriptionsfaktor ´Signal transducer and activator of transcription 3´ (STAT3). In dieser Arbeit habe ich mithilfe moderner In-vivo-Mikroskopie sowie viraler Gentherapie in Spinalganglien genetisch veränderter Mäuse zum ersten Mal die entscheidende Rolle von STAT3 in der intrinsischen Regulation axonaler Regeneration in vivo identifizieren können. So konnte nachgewiesen werden, dass die nur rudimentär ausgeprägte Regeneration der zentralen Fortsätze der Neuronen in den Spinalganglien mit einer fehlenden Induktion von STAT3 in den entsprechenden Ganglien einhergeht. Durch Überexpression von STAT3 mittels rekombinanter Adeno-assoziierter Viren in zervikalen Spinalganglien konnte zwei Tage nach Läsion das Auswachsen von Axonen sowie das Aussprießen von Kollateralen um mehr als das Vierfache gesteigert werden. Darüber hinaus konnte mittels repetitiver Multiphotonenmikroskopie einzelner fluoreszenzmarkierter Axone gezeigt werden, dass die Überexpression von STAT3 nur in der Frühphase (2-4 Tage) die axonale Wachstumsgeschwindigkeit erhöhen konnte, nicht aber zu einem späteren Zeitpunkt (4-10 Tage) nach Läsion. Um die Hypothese zu überprüfen, dass die fehlende Aufrechterhaltung des axonalen Wachstums durch Kontakt der aussprossenden Axone mit einem zunehmend inhibitorischen ZNS-Milieu bedingt ist, wurde die Überexpression von STAT3 zusätzlich mit der Applikation von Chondroitinase ABC, einem Enzym, das die inhibitorischen Moleküle der glialen Narbe neutralisieren kann, kombiniert. Dabei konnte ich zeigen, dass das durchschnittliche Wachstum von Axonen um mehr als das Zweifache gesteigert werden konnte. Aus den Ergebnissen meiner Versuche konnte ich mehrere Schlussfolgerungen ziehen: Erstens konnte ich STAT3 als effektiven Initiator axonalen Wachstums nach Rückenmarksläsion identifizieren. Zweitens wurde nachgewiesen, dass STAT3 selektiv Wachstum in der frühen Phase reguliert, nicht jedoch zu späteren Zeitpunkten. Daraus folgt, dass das axonale Regenerationsprogramm aus mindestens zwei verschiedenen, molekular distinkten Phasen besteht. Mit STAT3 wurde zum ersten Mal ein phasenspezifischer Regulator der axonalen Regeneration entdeckt. Abschließend konnte gezeigt werden, dass synergistische Therapien - wie hier durch die Kombination von STAT3 und Chondroitinase ABC belegt wurde - axonales Wachstum zusätzlich verbessern. Die gewonnenen Einblicke in die Mechanismen axonaler Regeneration geben Grund zur Hoffnung, dass in der Zukunft effektive Kombinationstherapien für Querschnittsgelähmte entwickelt werden können