Electrode array for reversing the recruitment order of peripheral nerve stimulation: Experimental studies

One of the most challenging problems in peripheral nerve stimulation is the ability to activate selectively small axons without large ones. Electrical stimulation of peripheral nerve activates large diameter fibers before small ones. Currently available techniques for selective activation of small axons without large ones require long-duration stimulation pulses (>500 >μs) and large stimulation amplitude, which shorten battery life of the implanted stimulator and could lead to electrode corrosion. In the current study, the hypothesis that small axons can be recruited before large ones with narrow pulsewidth (50 μs) using an electrode array was tested in both simulations simulation and experiments in the cat lateral gastrocnemius (LG) model. The LG nerve innervates both LG and soleus muscle groups with axons within 10-13 and 8-12 μm diameter ranges, respectively. A finite element model of LG nerve was constructed and simulations showed that, when activating 40% of LG, a conventional tripolar electrode activated only 9% of soleus whereas the electrode arrays of 5, 7, and 11 contacts activated 39, 46, and 60% of soleus respectively, suggesting that the arrays could activate small axons before fully recruiting large axons. In animal experiments, peak twitch force of LG and soleus were plotted as a function of stimulation amplitude to indicate the recruitment curve. At 40% activation of LG, a conventional tripolar electrode activated only 7% of soleus whereas the electrode arrays of 5, 7, and 11 contacts activated 43, 48, and 72% of soleus respectively. The electrode arrays also decreased significantly the recruitment curve slopes to only 10-20% of the value obtained for the tripolar electrode in both computer simulations and experiments. In conclusion, the 5-, 7-, and 11-contact arrays can be used to reverse the recruitment order of peripheral nerve stimulation with a narrow pulse.