The effect of nerve cuff geometry on interference reduction: a study by computer modeling

The effect of nonlinearity in the extrafascicular field in tripolar electrode cuffs on interference pick-up was investigated. It was concluded that the interference is sensitive to electrode separation, especially in short cuffs. This suggests that significant improvements can be obtained by placing the end electrodes a few mm from the cuff ends.     

A nerve cuff technique for selective excitation of peripheral nervetrunk regions

Numerical modeling and experimental testing of a nerve cuff technique for selective stimulation of superficial peripheral nerve trunk regions is presented. Two basic electrode configurations ("snug" cuff monopolar and tripolar longitudinally aligned dots) have been considered. In addition, the feasibility of "steering" excitation into superficial nerve trunk regions using subthreshold levels of current flow from an electrode dot located on the opposite side of the nerve has been tested. Modeling objectives were to solve for the electric field that would be generated within a representative nerve trunk by each electrode configuration; and to use a simple nerve cable model to predict the effectiveness of each configuration in producing localized excitation. In three acute experiments on cat sciatic nerve the objective was to characterize the effectiveness of each electrode configuration in selectively activating only the medial gastrocnemius muscle. Modeling and experimentation both suggest that longitudinally aligned tripolar dot electrodes on the surface of a nerve trunk, and bounded by a layer of insulation (such as a nerve cuff), will restrict excitation to superficial nerve trunk regions more successfully than will monopolar dot electrodes. Excitation "steering" will improve the spatial selectivity of both monopolar and tripolar electrode configurations.     

Design of an adaptive interference reduction system for nerve-cuff electrode recording

This paper describes the design of an adaptive control system for recording neural signals from tripolar cuff electrodes. The control system is based on an adaptive version of the true-tripole amplifier configuration and was developed to compensate for possible errors in the cuff electrode balance by continuously adjusting the gains of the two differential amplifiers. Thus, in the presence of cuff imbalance, the output signal-to-interference ratio is expected to be significantly increased, in turn reducing the requirement for post-filtering to reasonable levels and resulting in a system which is fully implantable. A realization in 0.8-/spl mu/m CMOS technology is described and simulated and preliminary measured results are presented. Gain control is achieved by means of current-mode feedback and many of the system blocks operate in the current-mode domain. The chip has a core area of 0.4 mm/sup 2/ and dissipates 3 mW from /spl plusmn/ 2.5V power supplies. Measurements indicate that the adaptive control system is expected to be capable of compensating for up to /spl plusmn/5% errors in the tripolar cuff electrode balance.     

On cuff imbalance and tripolar ENG amplifier configurations

Electroneurogram (ENG) recording techniques benefit from the use of tripolar cuffs because they assist in reducing interference from sources outside the cuff. However, in practice the performance of ENG amplifier configurations, such as the quasi-tripole and the true-tripole, has been widely reported to be degraded due to the departure of the tripolar cuff from ideal behavior. This paper establishes the presence of cuff imbalance and investigates its relationship to cuff asymmetry, cuff end-effects and interference source proximity. The paper also presents a comparison of the aforementioned amplifier configurations with a new alternative, termed the adaptive-tripole, developed to automatically compensate for cuff imbalance. The output signal-to-interference ratio of the three amplifier configurations were compared in vivo for two interference signals (stimulus artifact and M-wave) superimposed on compound action potentials. The experiments showed (for the first time) that the two interference signals result in different cuff imbalance values. Nevertheless, even with two distinct cuff imbalances present, the adaptive-tripole performed better than the other two systems in 61.9% of the trials.     

An adaptive ENG amplifier for tripolar cuff electrodes

Electroneurogram (ENG) recording from tripolar cuff electrodes is affected by interference signals, mostly generated by muscles nearby. Interference reduction may be achieved by suitably designed amplifiers such as the true-tripole and quasi-tripole systems. However, in practice their performance is severely degraded by cuff imbalance, resulting in very low output signal-to-interference ratios. Although some improvement may be offered by post filtering, this considerably increases complexity, size and power dissipation, rendering the approach unsuitable for the development of a high-performance ENG recording system which is fully implantable. This paper describes an integrated, fully implantable, adaptive ENG amplifier developed to automatically compensate for cuff imbalance, and thus significantly improve the quality of the recorded ENG. Measured results show that the adaptive ENG amplifier has a yield of 100%, a cuff imbalance correction range of more than /spl plusmn/40%, and an output signal-to-interference ratio of about 2/1 (6 dB) even for /spl plusmn/40% imbalance. The latter should be compared with an input signal-to-interference ratio of 1/500 (-54 dB). The circuit was fabricated in 0.8-/spl mu/m BiCMOS technology, has a core area of 0.68 mm/sup 2/, and dissipates 7.2 mW from /spl plusmn/2.5 V power supplies. The adaptive ENG amplifier advances the state-of-the-art in implantable tripolar nerve cuff electrode recording techniques.     

Recruitment data for nerve cuff electrodes: implications for designof implantable stimulators

Recruitment characteristics of nerve cuff electrodes implanted in four cats for five months were measured. Monopolar, bipolar, and tripolar configurations were considered. Approximately twice the current was required to achieve a given response using the tripolar configuration as compared with monopolar stimulation. Bipolar stimulation also required more current than monopolar stimulation. Using the recruitment data, a number of strategies for modulating muscle tension were considered. It was shown that both pulse amplitude and pulse duration should be software-selectable to achieve adequate control of muscle tension when using either pulse amplitude modulation or pulse duration modulation. When using pulse amplitude modulation, it was found to be desirable to operate at a low pulse duration in the high end of the allowable range for pulse amplitude. For pulse duration modulation, one should operate at a low pulse amplitude in the high end of the allowable range for pulse duration. The effect of pulse amplitude and pulse duration step size on the maximum step change in muscle tension and the linearity of the recruitment curves were examined. The use of logarithmic steps in the modulation parameter was examined and was shown to result in improved controllability and linearity.     

Simulation of multipolar fiber selective neural stimulation usingintrafascicular electrodes

A realistic, quantitative model is presented for the excitation of myelinated nerve fibers by intrafascicular electrodes. It predicts the stimulatory regions of any configuration of any number of electrodes, positioned anywhere inside the fascicle. The model has two parts. First, the nerve fiber is represented by a lumped electrical network and its response to an arbitrary extracellular potential field is calculated. Second, assuming a cylindrical geometry of the nerve bundle and its surroundings, an analytical expression for this field is derived. With realistic parameters, the model is applied to two cases: monopolar stimulation by a single cathode and stimulation by a specific tripolar configuration. It is shown that tripolar stimulation has the better spatial selectivity. Also tripolar stimulation is less sensitive to the conductivity of the medium surrounding the nerve and yields a more natural recruitment order.     

Selective control of muscle activation with a multipolar nerve cuffelectrode

Acute experiments were performed on adult cats to study selective activation of medial gastrocnemius, soleus, tibialis anterior, and extensor digitorium longus with a cuff electrode. A spiral nerve cuff containing twelve dot electrodes was implanted around the sciatic nerve, and evoked muscle twitch forces were recorded in six experiments. Spatially isolated dot electrodes in four geometries (monopolar, longitudinal tripolar, tripolar with four common anodes, and two parallel tripoles) were combined with transverse field steering current(s) from an anode(s) located 180° around from the cathode(s) to activate different regions of the nerve trunk. A selectivity index was used to construct recruitment curves for a muscle with the optimal degree of selectivity. Physiological responses were correlated with the anatomical structure of the sciatic nerve by identifying the nerve fascicles innervating the four muscles, and by determining the relative positions of the electrodes and the nerve fascicles. The results indicated that the use of transverse field steering current improved selectivity. The relative performance of the various electrode arrangements is discussed     

An Asymmetric Two Electrode Cuf for Generation of Unidirectionally Propagated Action Potentials

An asymmetric two electrode cuff (ATEC) for generation of unidirectionally propagated action potentials (UPAP's) has been tested in animals. Results indicate that the design is well suited for applications of "collision block" of peripheral nerve transmission. This electrode cuff differs from a standard bipolar electrode cuff in that the anode is enclosed by an insulating sheath of larger diameter than the cuff's cathode and the electrodes are asymmetrically placed within the cuff. In all 13 animals studied, ATEC's with anodes of 1.6 or 3.4 mm diameter and with cathodes of 1.2 mm diameter generated UPAP's when used on a nerve trunk of approximately 1 mm diameter. The cuff length used was 16 mm and the cuff length asymmetry (i. e., distance from cathode to proximal end over distance from cathode to distal end) was 1.7:1. Stimuli were regulated-current rectangular pulses with exponential trailing phases. For pulse widths of 100-500 ?s, exponential (90-10 percent) fall-times of 100-500 f4s minimized total charge injection. The virtual cathode excitation typically seen in standard bipolar electrode cuffs was always adequately suppressed with the ATEC configuration. ATEC's generated UPAP's over a larger window of current amplitudes than monopolar electrodes of similar dimensions.     

Transverse versus longitudinal tripolar configuration for selective stimulation with multipolar cuff electrodes

The ability to stimulate subareas of a nerve selectively is highly desirable, since it has the potential of simplifying surgery to implanting one cuff on a large nerve instead of many cuffs on smaller nerves or muscles, or alternatively can improve function where surgical access to the smaller nerves is limited. In this paper, stimulation was performed with a four-channel multipolar cuff electrode implanted on the sciatic nerve of nine rabbits to compare the extensively researched longitudinal tripolar configuration with the transverse tripolar configuration, which has received less interest. The performance of these configurations was evaluated in terms of selectivity in recruitment of the three branches of the sciatic nerve. The results showed that the transverse configuration was able to selectively activate the sciatic nerve branches to a functionally relevant level in more cases than the longitudinal configuration (20/27 versus 11/27 branches) and overall achieved a higher mean selectivity [0.79 ± 0.13 versus 0.61 ± 0.09 (mean ± standard deviation)]. The transverse configuration was most successful at recruiting the small cutaneous and medium-sized peroneal branches, and less successful at recruiting the large tibial nerve.     

Selective stimulation of sacral nerve roots for bladder control: astudy by computer modeling

The aim of this study was to investigate theoretically the conditions for the activation of the detrusor muscle without activation of the urethral sphincter and afferent fibers, when stimulating the related sacral roots, Therefore, the sensitivity of excitation and blocking thresholds of nerve fibers within a sacral root to geometric and electrical parameters in tripolar stimulation using a cuff electrode, have been simulated by a computer model. A 3D rotationally symmetrical model, representing the geometry and electrical conductivity of a nerve root surrounded by cerebrospinal fluid and a cuff was used, in combination with a model representing the electrical properties of a myelinated nerve fiber. The electric behavior of nerve fibers having different diameters and positions in a sacral root was analyzed and the optimal geometric and electrical parameters to be used for sacral root stimulation were determined. The model predicts that an asymmetrical tripolar cuff can generate unidirectional action potentials in small nerve fibers. While blocking the large fibers bidirectionally. This result shows that selective activation of the detrusor may be possible without activation of the urethral sphincter and the afferent fibers     

The effect of interference source proximity on cuff imbalance

The presence of cuff imbalance degrades the signal-to-interference (ENG/EMG) ratio in tripolar nerve cuff electrode recordings. Known causes of cuff imbalance include inhomogeneous tissue growth after cuff implantation and cuff manufacturing tolerances. In this paper, we report on an additional contribution to cuff imbalance that stems from variations in orientation and distance of the tripolar cuff relative to the external interference source. The latter is represented here by a dipole. Interference amplitude is also shown to depend on orientation and distance variations, here both factors included in the term "proximity." The study was conducted using field simulations and saline-bath experiments.     

On statistical properties of whole nerve cuff recordings

Whole nerve cuff electrodes can record an electric signal generated by the superposition of single fiber action potentials (AP's). Using a simple stochastic model for the superposition of AP's, the statistical properties of nerve cuff signals are mathematically derived in this study. Consequences of common signal processing methods like rectification and time-averaging are also explained. The nerve cuff signals are found to be approximately identically, independently distributed Gaussian signals with zero mean and varying variance. The spectral properties of the cuff signals generated by single AP shape or different AP shapes are also addressed and investigated by examining the properties of the autocorrelation functions of the nerve cuff signals. The theoretical results were found to be in accordance with computer simulations and processing of actual recorded data.     

Improved nerve cuff electrode recordings with subthreshold anodiccurrents

A method has been developed for improving the signal amplitudes of the recordings obtained with nerve cuff electrodes. The amplitude of the electroneurogram (ENG) has been shown to increase with increasing distance between the contacts when cuff electrodes are used to record peripheral nerve activity. The effect is directly related to the propagation speed of the action potentials. Computer simulations have shown that the propagation velocity of action potentials in a length of a nerve axon can be decreased by subthreshold extracellular anodic currents. Slowing the action potentials is analogous to increasing the cuff length in that both result in longer intercontact delays, thus, larger signal outputs. This phenomenon is used to increase the amplitudes of whole nerve recordings obtained with a short cuff electrode. Computer simulations predicting the slowing effect of anodic currents as well as the experimental verification of this effect are presented. The increase in the amplitude of compound action potentials (CAPs) is demonstrated experimentally in an in vitro preparation. This method can be used to improve the signal-to-noise ratios when recording from short nerve segments where the cuff length is limited     

Gait phase information provided by sensory nerve activity duringwalking: applicability as state controller feedback for FES

In this study, we extracted gait-phase information from natural sensory nerve signals of primarily cutaneous origin recorded in the forelimbs of cats during walking on a motorized treadmill. Nerve signals were recorded in seven cats using nerve cuff or patch electrodes chronically implanted on the median, ulnar, and/or radial nerves. Features in the electroneurograms that were related to paw contact and lift-off were extracted by threshold detection. For four cats, a state controller model used information from two nerves (either median and radial, or ulnar and radial) to predict the timing of palmaris longus activity during walking. When fixed thresholds were used across a variety of walking conditions, the model predicted the timing of EMG activity with a high degree of accuracy (average error = 7.8%, standard deviation = 3.0%, n = 14). When thresholds were optimized for each condition, predictions were further improved (average error = 5.5%, standard deviation = 2.3%, n = 14). The overall accuracy with which EMG timing information could be predicted using signals from two cutaneous nerves for two constant walking speeds and three treadmill inclinations for four cats suggests that natural sensory signals may be implemented as a reliable source of feedback for closed-loop control of functional electrical stimulation (FES).     

Neuro-fuzzy extraction of angular information from muscle afferentsfor ankle control during standing in paraplegic subjects: an animalmodel

This paper is part of a project whose aim is the implementation of closed-loop control of ankle angular position during functional electrical stimulation (FES) assisted standing in paraplegic subjects using natural sensory information. In this paper, a neural fuzzy (NF) model is implemented to extract angular position information from the electroneurographic signals recorded from muscle afferents using cuff electrodes in an animal model. The NF model, named dynamic nonsingleton fuzzy logic system is a Mamdani-like fuzzy system, implemented in the framework of recurrent neural networks. The fuzzification procedure implemented was the nonsingleton technique which has been shown in previous works to be able to take into account the uncertainty in the data. The proposed algorithm was tested in different situations and was able to predict reasonably well the ankle angular trajectories especially for small excursions (as during standing) and when the stimulation sites are far from the registration sites. This suggests it may be possible to use activity from muscle afferents recorded with cuff electrodes for FES closed-loop control of ankle position during quite standing.     

Selective activation of small motor axons by quasitrapezoidalcurrent pulses

We have found a method to activate electrically smaller nerve fibers without activating larger fibers in the same nerve trunk. The method takes advantage of the fact that action potentials are blocked with less membrane hyperpolarization in larger fibers than in smaller fibers. In our nerve stimulation system, quasitrapezoidal-shaped current pulses were delivered through a tripolar cuff electrode to effect differential block by membrane hyperpolarization. The quasitrapezoidal-shaped pulses with a square leading edge, a 350 microsecond(s) plateau, and an exponential trailing phase ensured the block of propagating action potentials and prevented the occurrence of anodal break excitation. The tripolar cuff electrode design restricted current flow inside the cuff and thus eliminated the undesired nerve stimulation due to a "virtual cathode." Experiments were performed on 13 cats. The cuff electrode was placed on the medial gastrocnemius nerve. Both compound and single fiber action potentials were recorded from L7 ventral root filaments. The results demonstrated that larger alpha motor axons could be blocked at lower current levels than smaller alpha motor axons, and that all alpha fibers could be blocked at lower current levels than gamma fibers. A statistical analysis indicated that the blocking threshold was correlated with the axonal conduction velocity or fiber diameter. This method could be used in physiological experiments and neural prostheses to achieve a small-to-large recruitment order in motor or sensory systems.     

A pseudodifferential amplifier for bioelectric events with DC-offset compensation using two-wired amplifying electrodes

Most wired active electrodes reported so far have a gain of one and require at least three wires. This leads to stiff cables, large connectors and additional noise for the amplifier. The theoretical advantages of amplifying the signal on the electrodes right from the source has often been described, however, rarely implemented. This is because a difference in the gain of the electrodes due to component tolerances strongly limits the achievable common mode rejection ratio (CMRR). In this paper, we introduce an amplifier for bioelectric events where the major part of the amplification (40 dB) is achieved on the electrodes to minimize pick-up noise. The electrodes require only two wires of which one can be used for shielding, thus enabling smaller connecters and smoother cables. Saturation of the electrodes is prevented by a dc-offset cancelation scheme with an active range of +/- 250 mV. This error feedback simultaneously allows to measure the low frequency components down to dc. This enables the measurement of slow varying signals, e.g., the change of alertness or the depolarization before an epileptic seizure normally not visible in a standard electroencephalogram (EEG). The amplifier stage provides the necessary supply current for the electrodes and generates the error signal for the feedback loop. The amplifier generates a pseudodifferential signal where the amplified bioelectric event is present on one lead, but the common mode signal is present on both leads. Based on the pseudodifferential signal we were able to develop a new method to compensate for a difference in the gain of the active electrodes which is purely software based. The amplifier system is then characterized and the input referred noise as well as the CMRR are measured. For the prototype circuit the CMRR evaluated to 78 dB (without the driven-right-leg circuit). The applicability of the system is further demonstrated by the recording of an ECG.     

The single nerve fiber action potential and the filter bank--a modeling approach

Single fiber action potentials (SFAPs) from peripheral nerves, such as recorded with cuff electrodes, can be modelled as the convolution of a source current and a weight function that describes the recording electrodes and the surrounding medium. It is shown that for cuff electrodes, the weight function is linearly scaled with the action potential (AP) velocity and that it is, therefore, possible to implement a model of the recorded SFAPs based on a wavelet multiresolution technique (filterbank), where the wavelet scale is proportional to the AP velocity. The model resulted in single fiber action potentials matching the results from other models with a goodness of fit exceeding 0.99. This formulation of the SFAP may serve as a basis for model-based wavelet analysis and for advanced cuff design.     

Tri-polar concentric ring electrode development for laplacian electroencephalography

Brain activity generates electrical potentials that are spatio-temporal in nature. Electroencephalography (EEG) is the least costly and most widely used noninvasive technique for diagnosing many brain problems. It has high temporal resolution, but lacks high spatial resolution. In an attempt to increase the spatial selectivity, researchers introduced a bipolar electrode configuration utilizing a five-point finite difference method (FPM) and others applied a quasi-bipolar (tri-polar with two elements shorted) concentric electrode configuration. To further increase the spatial resolution, the authors report on a tri-polar concentric electrode configuration for approximating the analytical Laplacian based on a nine-point finite difference method (NPM). For direct comparison, the FPM, quasi-bipolar method (a hybrid NPM), and NPM were calculated over a 400 x 400 mesh with 1/400 spacing using a computer model. A closed-form analytical computer model was also developed to evaluate and compare the properties of concentric bipolar, quasi-bipolar, and tri-polar electrode configurations, and the results were verified with tank experiments. The tri-polar configuration and the NPM were found to have significantly improved accuracy in Laplacian estimation and localization. Movement-related potential (MRP) signals were recorded from the left prefrontal lobes on the scalp of human subjects while they performed fast repetitive movements. Disc, bipolar, quasi-bipolar, and tri-polar electrodes were used. MRP signals were plotted for all four electrode configurations. The signal-to-noise ratio and spatial selectivity of the MRP signals acquired with the tri-polar electrode configuration were significantly better than the other configurations.