Temporal pattern of electrical stimulation is a new dimension of therapeutic innovation

• Published in: Current opinion in biomedical engineering Vol. 8; pp. 1 - 6
• Main Author: Grill, Warren M.
• Format: Journal Article
• Language: English
• Published: England Elsevier Inc 01.12.2018
• Subjects: Deep brain stimulation; Neural prosthesis; Neural stimulation; Spinal cord stimulation; Stimulation parameters; Stimulation parameters; Neural stimulation; Deep brain stimulation; Spinal cord stimulation; Neural prosthesis
• ISSN: 2468-4511; 2468-4511
• DOI: 10.1016/j.cobme.2018.08.007

Artificial activation of the nervous system requires selection of appropriate stimulation parameters including stimulation amplitude, stimulation pulse duration, and stimulation pulse repetition rate. The temporal pattern of stimulation, i.e., the timing between stimulation pulses, is a novel dimension of stimulation parameter tuning. The effects evoked by artificial activation of the nervous system are dependent on the pattern of stimulation, and different patterns of stimulation, even when delivered at the same average rate, evoke different functional effects, different changes in synaptic plasticity, and even different patterns of gene expression. Non-regular temporal patterns of stimulation offer the opportunity to improve the efficacy and efficiency of therapeutic stimulation as well as to manipulate other processes in the nervous system. The potential design space for sequences of varying interpulse intervals is exceedingly large and sound approaches to design stimulation patterns are required as an empirical approach is not practical. •The effects evoked by artificial activation of the nervous system are dependent on the temporal pattern of stimulation.•The temporal pattern of stimulation can be manipulated to increase the efficacy and efficiency of therapeutic stimulation.•Design space for patterns is vast, and model-based design is a successful approach to determine optimal patterns.•Other processes, including neural plasticity and gene expression, are also dependent on the temporal pattern of activity.