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Implantable Direct Current Neural Modulation

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Handbook of Neuroengineering

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Abstract

Neuroprostheses are implants that interface with the central or peripheral nervous system to restore or control neural function. Neuroprostheses are limited to the use of charge balanced alternating current (AC) pulses to avoid toxicity from electrochemical reactions occurring at the metal-tissue interface. The use of direct or long-duration current (DC) to modulate neuronal activity is an alternative methodology that bypasses many of the constraints of traditional neuroprostheses. DC directly modulates extracellular membrane potential, exciting or inhibiting neurons in a graded fashion while maintaining their stochastic firing patterns. DC can also modulate neural sensitivity and synaptic connectivity across broad neural populations. Recently, new innovations in device design have led to a resurgence of interest in the interaction and potential therapeutic application of DC in the central and the peripheral nervous system. In this chapter, implanted DC neural modulation and the feasibility of in vivo DC in neuroprosthetic therapy are reviewed. This chapter provides a brief summary of DC/neural interaction and outlines the implications for neural modulation. It assesses the scope of application for direct current modulation as a form of neuroprosthetic treatment in disease and examines the safety implications of long-duration DC delivery.

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Abbreviations

AF:

Activation function

AP:

Action potential

AC:

Alternating current

CIS:

Continuous interleaved stimulation

CI:

Cochlear implant

CNS:

Central nervous system

CSI:

Spinal cord injury

CV:

Coefficient of variation

EPSP:

Excitatory postsynaptic potential

FEM:

Finite element model

DC:

Direct current

iDC:

ionic Direct current

tDCS:

transcranial Direct current stimulation (or sampling)

IPG:

Implantable pulse generator

ISI:

Inter-spike interval

LIF:

Leaky integrate and fire

ME:

Mirror estimate

OEIP:

Organic electronic ion pump

SDCS:

Safe direct current stimulator

SINE:

Separated interface nerve electrode

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Acknowledgments

We would like to thank the following grant sources: JHU Neurosurgery Pain Research Institute, NIH R01 DC009255, NIH R21 NS081425-01A1, NIH R01 NS092726, MedEl Corporation. Significant material in this chapter was adapted or reproduced with permission from Aplin and Fridman, 2019 [197].

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Authors and Affiliations

  1. Department of Otolaryngology Head and Neck Surgery, Johns Hopkins University, Baltimore, MD, USA

    Felix P. Aplin & Gene Y. Fridman

  2. Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD, USA

    Gene Y. Fridman

  3. Department of Electrical and Computer Engineering, Johns Hopkins University, Baltimore, MD, USA

    Gene Y. Fridman

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  1. Felix P. Aplin
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Correspondence to Gene Y. Fridman .

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  1. Neuroengineering and Biomedical Instrumentation Laboratory Department of Biomedical Engineering and Department of Electrical and Computer Engineering, Neurology, Johns Hopkins University, Baltimore, MD, USA

    Nitish V. Thakor

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Aplin, F.P., Fridman, G.Y. (2023). Implantable Direct Current Neural Modulation. In: Thakor, N.V. (eds) Handbook of Neuroengineering. Springer, Singapore. https://doi.org/10.1007/978-981-16-5540-1_14

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