Modeling Trans-Spinal Direct Current Stimulation in the Presence of Spinal Implants

A. Kuck, D.F. Stegeman, E.H.F. Van Asseldonk

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Trans-spinal direct current stimulation (tsDCS) is a technique considered for the treatment of corticospinal damage or dysfunction. TsDCS aims to induce functional modulation in the corticospinal circuitry via a direct current (DC) generated an electric field (EF). To ensure subject safety, subjects with metallic implants are generally excluded from receiving neural dc stimulation. However, spinal injuries often require spinal implants for stabilization. Our goal was to investigate implant imposed changes to EF and current density (CD) magnitude during tsDCS. We simulated the EF and CD, generated by tsDCS in the presence of spinal rods for two electrode configurations and four implant locations along the spinal cord. For each scenario, a no-implant condition was computed for comparison. We assessed changes in EF and CD at the implant location and the EF inside the spinal cord. Our results show that implant presence was able to influence peak CD, compared to the no-implant condition. Nonetheless, the highest calculated CD levels were a factor six lower than those thought to lead to hazardous tissue-damaging effects. Additionally, implant presence did not considerably affect the average EF inside the spinal cord. Our findings do therefore not indicate potentially unsafe CD levels, or significant alterations to stimulation intensity inside the spinal cord, caused by a spinal implant during tsDCS. Our results are relevant to the safety of transcutaneous spinal stimulation applied in the presence of metallic spinal implants.

Original languageEnglish
Article number8649686
Pages (from-to)790-797
Number of pages8
JournalIEEE transactions on neural systems and rehabilitation engineering
Volume27
Issue number5
DOIs
Publication statusPublished - 1 May 2019

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Spinal Cord
Current density
Electric fields
Electric currents
Safety
Spinal Injuries
Electrodes
Stabilization
Modulation
Tissue

Keywords

  • Neuromodulation
  • Spinal cord injury
  • Trans-spinal direct current stimulation

Cite this

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abstract = "Trans-spinal direct current stimulation (tsDCS) is a technique considered for the treatment of corticospinal damage or dysfunction. TsDCS aims to induce functional modulation in the corticospinal circuitry via a direct current (DC) generated an electric field (EF). To ensure subject safety, subjects with metallic implants are generally excluded from receiving neural dc stimulation. However, spinal injuries often require spinal implants for stabilization. Our goal was to investigate implant imposed changes to EF and current density (CD) magnitude during tsDCS. We simulated the EF and CD, generated by tsDCS in the presence of spinal rods for two electrode configurations and four implant locations along the spinal cord. For each scenario, a no-implant condition was computed for comparison. We assessed changes in EF and CD at the implant location and the EF inside the spinal cord. Our results show that implant presence was able to influence peak CD, compared to the no-implant condition. Nonetheless, the highest calculated CD levels were a factor six lower than those thought to lead to hazardous tissue-damaging effects. Additionally, implant presence did not considerably affect the average EF inside the spinal cord. Our findings do therefore not indicate potentially unsafe CD levels, or significant alterations to stimulation intensity inside the spinal cord, caused by a spinal implant during tsDCS. Our results are relevant to the safety of transcutaneous spinal stimulation applied in the presence of metallic spinal implants.",
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Modeling Trans-Spinal Direct Current Stimulation in the Presence of Spinal Implants. / Kuck, A.; Stegeman, D.F.; Van Asseldonk, E.H.F.

In: IEEE transactions on neural systems and rehabilitation engineering, Vol. 27, No. 5, 8649686, 01.05.2019, p. 790-797.

Research output: Contribution to journalArticleAcademicpeer-review

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