Dataset Information

A Huygens' surface approach to rapid characterization of peripheral nerve stimulation.

ABSTRACT:

Purpose

Peripheral nerve stimulation (PNS) modeling has a potential role in designing and operating MRI gradient coils but requires computationally demanding simulations of electromagnetic fields and neural responses. We demonstrate compression of an electromagnetic and neurodynamic model into a single versatile PNS matrix (P-matrix) defined on an intermediary Huygens' surface to allow fast PNS characterization of arbitrary coil geometries and body positions.

Methods

The Huygens' surface approach divides PNS prediction into an extensive pre-computation phase of the electromagnetic and neurodynamic responses, which is independent of coil geometry and patient position, and a fast coil-specific linear projection step connecting this information to a specific coil geometry. We validate the Huygens' approach by performing PNS characterizations for 21 body and head gradients and comparing them with full electromagnetic-neurodynamic modeling. We demonstrate the value of Huygens' surface-based PNS modeling by characterizing PNS-optimized coil windings for a wide range of patient positions and poses in two body models.

Results

The PNS prediction using the Huygens' P-matrix takes less than a minute (instead of hours to days) without compromising numerical accuracy (error ≤ 0.1%) compared to the full simulation. Using this tool, we demonstrate that coils optimized for PNS at the brain landmark using a male model can also improve PNS for other imaging applications (cardiac, abdominal, pelvic, and knee imaging) in both male and female models.

Conclusion

Representing PNS information on a Huygens' surface extended the approach's ability to assess PNS across body positions and models and test the robustness of PNS optimization in gradient design.

SUBMITTER: Davids M

PROVIDER: S-EPMC8689355 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:BackgroundPeripheral nerve stimulation (PNS) has been increasingly used to manage acute and chronic pain. However, the level of clinical evidence to support its use is not clear.ObjectivesTo assess the clinical evidence of PNS in the treatment of acute or chronic pain.Study designA systematic review of the efficacy and safety of PNS in managing acute or chronic pain.MethodsData sources were PubMed, Cochrane Library, Scopus, CINAHL Plus, Google Scholar, and reference lists. The literature search was performed up to December 2019. Study selection included randomized trials, observational studies, and case reports of PNS in acute or chronic pain. Data extraction and methodological quality assessment were performed utilizing Cochrane review methodologic quality assessment and Interventional Pain Management Techniques-Quality Appraisal of Reliability and Risk of Bias Assessment (IPM-QRB) and Interventional Pain Management Techniques-Quality Appraisal of Reliability and Risk of Bias Assessment for Nonrandomized Studies (IPM-QRBNR). The evidence was summarized utilizing principles of best evidence synthesis on a scale of 1 to 5. Data syntheses: 227 studies met inclusion criteria and were included in qualitative synthesis.ResultsEvidence synthesis based on randomized controlled trials (RCTs) and observational studies showed Level I and II evidence of PNS in chronic migraine headache; Level II evidence in cluster headache, postamputation pain, chronic pelvic pain, chronic low back and lower extremity pain; and Level IV evidence in peripheral neuropathic pain, and postsurgical pain. Peripheral field stimulation has Level II evidence in chronic low back pain, and Level IV evidence in cranial pain.LimitationsLack of high-quality RCTs. Meta-analysis was not possible due to wide variations in experimental design, research protocol, and heterogeneity of study population.ConclusionsThe findings of this systematic review suggest that PNS may be effective in managing chronic headaches, postamputation pain, chronic pelvic pain, and chronic low back and lower extremity pain, with variable levels of evidence in favor of this technique.