Model-based Investigations of Peripheral Nerve Stimulation Using Longitudinal Intrafascicular Electrodes

Electrical stimulation of the human peripheral nervous system can be a powerful tool to treat various medical conditions and provide insight into nervous system processes. A critical challenge for many applications is to selectively activate neurons that have the desired effect while avoiding the activation of neurons that produce side effects. To stimulate peripheral fibers, the longitudinal intrafascicular electrode (LIFE) targets small groups of fibers inside the fascicle using low-amplitude pulses and is well-suited for chronic use. This work aims to understand better the ability to use intrafascicular stimulation with LIFEs to activate small groups of neurons within a fascicle selectively.A hybrid workflow was developed to simulate: 1) the production/propagation of the electric field induced by the stimulation pulse and 2) the effect of the electric field on fiber activation (recruitment). To create efficient and robust strategies for the selective recruitment of axons, recognizing the effect of each parameter on their recruitment and activation pattern is essential. Thus, using this hybrid workflow, the effects of various factors such as fascicular anatomy, electrode parameters, and stimulation pulse parameters on recruitment have been characterized, and the sensitivity of the recruitment patterns to these parameters has been explored. Results demonstrated the potential advantages of specific stimulation strategies and the sensitivity of recruitment patterns to electrode placement and tissue properties. For example, it is demonstrated: the significant effect of endoneurium conductivities on threshold levels; that a configuration with a LIFE as a local ground can be used to deselect its surrounding axons; the advantages of changing the delay between pulses in dual monopolar stimulation in targeting different axons clusters and increasing the activation frequency of some axons; how monopolar and bipolar configurations can be used to enhance spatial selectivity; the effect of longitudinal displacement of axons, electrode length and electrode movement on the recruitment and the activation pattern. In summary, this work forms the foundation for developing stimulation strategies to enhance the selectivity that can be achieved with intrafascicular stimulation.