Temporal Current Steering

A novel stimulation technique for increased spatial selectivity in vagus nerve stimulation

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Abstract

Cervical Vagus Nerve Stimulation (CVNS) has shown efficacy in treating depression, therapy-resistant epilepsy, and is being explored for conditions such as obesity and migraine. The side effects of whole nerve stimulation, which is currently the only approved method, can be minimized using spatially selective stimulation. This thesis introduces Temporal Current Steering (TCS), a novel stimulation technique aimed at enhancing spatial selectivity for CVNS. TCS introduces a temporal variation to standard current steering, creating an electric field that varies both temporally and spatially. With this study, enhanced spatial selectivity was confirmed through simulations of extracellular stimulation of neurons with time-dependent waveforms on two electrodes located on a single plane. Particle swarm optimization was employed over 2000 iterations and 98 runs to identify a waveform with the highest spatial selectivity. The optimal solution achieved a 30% improvement over a single electrode placed directly in line with the target and a 31% improvement over the standard direct current steering technique, simulated in the same model. The findings of this thesis suggest that TCS can increase spatial selectivity in invasive stimulation, although further simulations are needed for non-invasive applications with greater electrode-to-neuron distances.