Electrical Stimulation publications

Objective. Deep brain stimulation (DBS) of the subthalamic nucleus (STN) is an established therapy for Parkinson’s disease (PD). Yet, optimizing lead placement and stimulation programming remains challenging. Current techniques rely on imaging and intraoperative microelectrode recordings (MER), while programming relies on trial-and-error clinical testing, which can be time-consuming. DBS-induced local evoked potentials (DLEP), also known as evoked resonant neural activity, have emerged as a potential alternative electrophysiological marker for mapping. However, direct comparisons with traditional spectral features, such as beta-band, high-frequency oscillations (HFOs), and aperiodic component are lacking. Approach. We evaluated DLEP across 39 STN DBS leads in 31 subjects with PD undergoing DBS surgery, using both a single-pulse and high-frequency (HF) burst stimulation paradigms. We developed a novel artifact-removal method to enable monopolar DLEP recovery, including estimating the DLEP amplitudes at stimulated contacts, further enhancing spatial sampling of DLEP. We evaluated spectral features and DLEP in respect to imaging-based and MER-based localization, and its predictive power for post-operative programming. Main results. DLEP showed great spatial consistency, maximizing within STN with 100% accuracy for single-pulse and 84.62% for burst stimulation, surpassing spectral measures including beta (89.74%) and HFO (82.05%). DLEP better correlated with clinical outcomes (single-pulses ρ = −0.33, HF bursts ρ = −0.26), than spectral measures (beta ρ = −0.25, HFO ρ = 0.05). Furthermore, single-pulses at low-frequencies are sufficient for DLEP-based mapping. Significance. We show how DLEP provide higher STN-spatial specificity and correlation with postoperative programming compared to spectral features. To support clinical translation of DLEP, we developed two methods aimed to recover artifact-free DLEP and estimating DLEP amplitudes at stimulating contacts. DLEP appear distinct from beta and HFO activity, yet strongly tied to aperiodic spectral components, suggesting that DLEP amplitude reflects underlying STN excitability. This study highlights that DLEP are a robust and clinically valuable marker for DBS targeting and programming.

Introduction Deep brain stimulation (DBS) is a neuromodulation method for treatment of various neurological disorders. Research on DBS has often focused on local inhibition or excitation effects, at the site of stimulation. However, it is well-known that DBS can lead to robust evoked potentials (EP) not only at the stimulation site, representing the local effect, but also in distant brain regions, representing the effects on distant targets. While the significance of these EPs for therapeutic outcomes is not known, it appears that the electrical effects of DBS have a partial modulatory impact on downstream targets. Nonetheless, it partly remains unclear through what mechanism DBS pulses travel to the distant targets or what portion of the pulses travel along the normal pathways from the stimulation site. The possible scenarios include orthodromic or antidromic pathways, accessory pathways, normally inhibited pathways, and direct electromagnetic activation of distant sites. We hypothesize that the pathways that transmit DBS pulses include the pathways that transmit intrinsic neural signals. Methods To test this, we performed a transfer function analysis on deep brain recordings from children with dystonia, during DBS-off condition and compared its impulse response with the transmission of signals from electrical stimulation during DBS-on condition. We compared impulse responses derived from intrinsic neural signals during voluntary movement (DBS-off) to evoked potentials (EPs) recorded during electrical stimulation (DBS-on), focusing on directional transmission (orthodromic vs. antidromic). Results DBS EPs were more accurately predicted by impulse responses corresponding to direct axonal activation rather than somatic relay. Significant correlations between intrinsic signal transfer functions and EPs, particularly in orthodromic directions ( p -value < 0.01) from pallidum to thalamus and subthalamic nucleus, support our hypothesis that DBS travels along physiological pathways. Discussion These results suggest that DBS engages existing motor pathways to reach distant targets, offering mechanistic insight into its network effects. This supports future approaches that could tailor treatment plans based on individual connectivity maps to improve clinical efficacy of DBS.

Fluent speech production is mediated by serially ordering and preparing motor plans corresponding to target speech sounds, a process known as speech-motor sequencing. Here we used high-density direct cortical recordings while 14 participants spoke utterances with varying phonemic and syllabic sequence complexity after reading a target sequence and a delay period. Phasic activations corresponding to speech production and auditory feedback were observed, but also sustained neural activity that persisted throughout all task phases including the target presentation, the delay period and production of the sequence. Furthermore, sustained activity in a specific area, the middle precentral gyrus (mPrCG), was both modulated by sequence complexity and predicted reaction time, suggesting a role in speech-motor sequencing. Electrocortical stimulation of the mPrCG caused speech disfluencies resembling those seen in apraxia of speech. These results suggest that speech-motor sequencing is mediated by a distributed cortical network in which the mPrCG plays a central role.

The hippocampus is critical for encoding episodic memories, but how it interacts with cortical regions during this process remains unclear. In this study, 16 participants with implanted electrodes in the insula (217 sites) and hippocampus (131 sites) viewed emotionally valenced words and attempted to recall them. During encoding, one subset of insular neuronal populations showed changes in aperiodic activity that predicted successful recall. These insular changes followed hippocampal theta but preceded hippocampal ripples. Another subset of insular sites responded to word valence, unrelated to memory performance. Direct electrical stimulation of memory-related insular sites evoked early responses in the ipsilateral hippocampus, whereas stimulation of valence-related sites did not. Conversely, stimulating hippocampal sites produced slow, variable signals across all insular sites, suggesting asymmetric communication between the hippocampus and the insula. These findings provide a glimpse of mesoscale hippocampal interactions with functionally selective neuronal populations within a given cortical structure.

Introduction Prenatal exposure to valproic acid (VPA) is a common environmental cause of autism spectrum disorder (ASD) and often leads to expressive and receptive language impairments. Similar communication difficulties among individuals with ASD are often linked to abnormal subcortical and cortical sound processing. Rodents prenatally exposed to VPA exhibit degraded cortical responses to speech and an impaired ability to behaviorally discriminate speech sounds. Methods We sought to determine whether sound processing could be restored with paired vagus nerve stimulation (VNS). In a first experiment, we evaluated whether sound-paired VNS would alter in vivo extracellular multi-unit responses to tones, noise burst trains, and speech sounds from the anterior auditory field. We next sought to evaluate whether improvements to neural sound processing led to improvements in sound discrimination ability. In a second experiment, rats underwent go/no-go sound discrimination testing where VNS was paired with successful trials. Results We found that VPA-exposed rats had degraded spectral, temporal, and speech sound processing compared to saline-exposed control rats. VPA-exposed rats which received sound-paired VNS exhibited a partial or full restoration of processing across sound types. However, across several sound discrimination tasks, we did not observe changes in behavioral performance in response to prenatal exposure to VPA or VNS. Discussion Our study is the first to show that speech-paired VNS leads to a generalized improvement in cortical sound processing across sound types, rescuing neural processing among VPA-exposed rats. These results provide a framework for future studies to develop VNS-based interventions for communication disorders.

Objective. The development of electrodes for chronic peripheral nerve stimulation faces several challenges, including complex compositions, intricate manufacturing processes, and high costs associated with the availability and fabrication of suitable materials. These limitations hinder the accessibility and feasibility of producing effective devices for chronic preclinical studies. This study evaluated the feasibility of a simple-to-manufacture gold helical microwire structure electrode (Au-HMSE) for peripheral nerve stimulation, electromyography (EMG) recording, and preliminary tissue response on the rat sciatic nerve. Approach. Manufactured electrodes were used for up to 8 weeks in rats for nerve stimulation and EMG recordings, with electrode-tissue impedances and motor thresholds measured to assess in vivo stability and feasibility. Evoked motor responses were measured via gastrocnemius muscle activity and ankle torque. Terminal histology was performed at 12 weeks to assess chronic tissue response to the implanted electrodes. Main results. Implanted electrodes with impedances <10 kΩ effectively evoked motor responses in monopolar and bipolar configurations and successfully recorded EMG activity. Gastrocnemius activation overlapped with off-target motor responses, likely due to the electrode’s size relative to rat nerve anatomy and the absence of anchoring, which may have allowed migration. High impedance failure appeared related to interconnects between electrodes and tunneled leads and at solder joints in the stimulating and recording setup. Histology showed typical fibrotic encapsulation, with the helical design promoting tissue in-growth around the microwires, creating a high surface area electrode-tissue interface. Significance. This study evaluated the early feasibility of Au-HMSE for chronically implanted rodent nerve stimulation and EMG recordings. While gold electrodes are non-standard for chronic stimulation, the construction of these devices may be appropriate for the evaluation of chronic peripheral nerve stimulation in the preclinical setting due to their simple composition, manufacturing, and availability of gold microwire as a raw material. The findings provide valuable insights for developing future implantable leads used for peripheral nerve stimulation.

Intracortical microstimulation (ICMS) of sensory brain regions can create artificial sensations, yet these percepts fade with continued stimulation, suggesting dynamic changes in underlying neural activity. Using two-photon imaging in transgenic mice, this study examines how prolonged ICMS (30 s) shapes activity in excitatory and inhibitory neurons within the visual cortex. Inhibitory neuron activity was more likely to increase throughout the stimulation period, while excitatory neuron activity was more likely to decrease and be suppressed post-stimulation. Stimulation patterns differentially shaped neuronal engagement: theta-burst stimulation most effectively activated inhibitory neurons, whereas 10-Hz burst most effectively activated excitatory neurons. ICMS evoked more diverse responses in neurons farther from the electrode, reflecting complex synaptic interactions involving inhibition and disinhibition. These results show that ICMS affects excitatory and inhibitory neurons differently over extended durations. Modulation of stimulation patterns may allow for preferential engagement of specific neuron types and shaping of cortical activity.

Purpose Present-day cochlear-implant (CI) users can achieve high levels of speech reception in quiet surroundings. Nevertheless, sensitivity to the temporal pitch of sounds is limited, which contributes to deficits in speech reception amid multiple talkers and in appreciation of musical melodies. Short-term, invasive neurophysiological studies in animals have demonstrated limitations in neural phase locking in the tonotopic range of the auditory pathway that is activated by CIs. It remains an open question, however, whether those neural limitations can account for perceptual deficits in those animal species, let alone in human CI users. For that reason, we have evaluated non-invasive recordings of phase locking from cats chronically implanted with a CI. Methods Ten deafened cats (eight female) were implanted with an animal version of a clinical CI array. The electrically evoked frequency following response (eFFRs) was recorded from the scalps of sedated animals at ≥ 10 weeks post-implantation. Stimuli consisted of constant-amplitude electrical pulse trains at rates from ~ 40 to 640 pulses per second. Results Recordings of the eFFR demonstrated robust responses synchronized to electrical pulse trains across all stimulus rates. Analyses of eFFR amplitude and phase transfer functions confirmed that the eFFR, as with its normal-hearing counterpart, originates from multiple subcortical and cortical generators. The slopes of segments of eFFR phase transfer functions revealed stimulus-to-response latencies of generators that dominated the eFFR across restricted ranges of pulse rates. Those rate ranges must coincide with the limits of phase locking by putative generators at successive levels of the auditory neuroaxis and could inform our understanding of the limits to perceptual temporal acuity. Conclusion The eFFR demonstrated here in an animal model provides a valuable non-invasive measure of temporal processing in electric cochlear stimulation that can be related to ongoing perceptual measures in the same animals and is well-suited to evaluate novel modes of auditory prosthesis for enhancing temporal acuity.

For patients with severe and profound hearing loss, cochlear implant (CI), a common and effective modality for restoring hearing, directly stimulates spiral ganglion neurons (SGNs) to generate electrical activity and form auditory perception. However, the postoperative outcome of CI is significantly influenced by the number of surviving SGNs, ​​which is a key focus of preoperative evaluation​​. Existing audiologic function and radiographic tests cannot directly demonstrate the integrity of inner ear primary neurons. In this study, ​​we developed and validated​​ a radionuclide‐labeled anti‐vesicular glutamate transporter 1 (anti‐VGLUT1) antibody‐drug and achieved animal‐level in vivo imaging of cochlear SGNs using nuclear imaging. By screening the public single‐cell sequencing database, it is found that VGLUT1 can serve as a representative cell membrane marker for SGN in the cochlea. The potential of anti‐VGLUT1 conjugated to the long half‐life 177 Lu as a molecular probe to detect the relative number of SGNs in SGN‐injured mouse and pig models is explored. The study provides a novel method for assessing cochlear nerve integrity in vivo by visualizing target antigen expression levels through nuclear imaging. This approach is promising to help CI candidates with preoperative inner ear SGN integrity assessment, contributing to clinical decision‐making.

Severe to profound sensorineural hearing loss seriously affects the communication and cognitive ability of the patients. Cochlear implantation (CI) is currently the most effective treatment, while it may damage the remaining inner ear function due to its poor biocompatibility and the resultant fibrosis. Herein, a porous methacrylated poly(dimethylsiloxane) (MA‐PDMS)‐coated cochlear electrode is presented for CI and hearing protection. The porous MA‐PDMS is filled with a hybrid hydrogel system made of dexamethasone sodium phosphate (Dex), Ti 3 C 2 T x MXene (MXene), and methacrylate gelatin (GelMA). The coating shows good biocompatibility and drug loading and release capacity in vitro, protective effects on hair cells (HCs) and spiral ganglion neurons (SGNs) of the inner ear, as well as the residual hearing protection and the effective fibrosis reduction in vivo. It is anticipated that this porous electrode drug‐loading coating may provide a valuable reference strategy for the future cochlear electrode transplantation system.

Epidural electrical stimulation of the spinal cord (ES) is used to restore/improve locomotor movements in patients. However, the neuronal mechanisms underlying activation of locomotor networks by ES are unknown. Here, we analyzed the effects of ES on the activity of individual spinal neurons of different functional locomotor groups. Neuronal activity was recorded in decerebrate cats before and during ES that evoked locomotion. During ES initial period (NW-period, before the locomotion onset), the activity was increased in most neurons as compared to that before ES. We found that ES-caused activation of neurons of locomotor network to the average level similar to that observed during locomotion is not sufficient for initiation of locomotion. We demonstrated that the onset of ES-evoked locomotion was associated with specific changes in the activity of individual neurons within functional locomotor groups and in their responses to epidural stimuli. With the locomotion onset, there was a trend for individual neurons with extremely high activity during NW-period to decrease their activity, while for neurons with extremely low activity to become more active. Also, in neurons contributing to generation of a specific mode of locomotion, peaks and troughs in responses to individual epidural stimuli were significantly less pronounced as compared with those observed during NW-period. We suggest that these changes allow ES to maintain the high level of excitability of the locomotor network necessary for its operation without distortion of the locomotor rhythm. The obtained results advance our understanding of the neuronal mechanisms underlying activation of locomotor network by ES.

Although control of movement involves many cortical association areas, bidirectional brain-machine interfaces (BMIs) typically decode movement intent from the motor cortex and deliver feedback information to the primary somatosensory cortex (S1). Compared to the S1, the parietal and premotor areas encode more complex information about object properties, hand pre-shaping, and reach trajectories. BMIs therefore might deliver richer information to those cortical association areas than to primary areas. Here, we investigated whether instructions for a center-out task could be delivered via intracortical microstimulation (ICMS) in the anterior intraparietal area (AIP), dorsal posterior parietal cortex (dPPC), or dorsal premotor cortex (PMd) as well as the ventral premotor cortex (PMv) and S1. Two monkeys successfully learned to use AIP, PMv, or S1-ICMS instructions, but neither learned to use dPPC- or PMd-ICMS instructions. The AIP, PMv, and S1 may thus be effective cortical territory for delivering information to the brain, whereas the dPPC or PMd may be comparatively ineffective.

Presbycusis or age-related hearing loss (ARHL) affects millions of people worldwide, increasing their risk of cognitive decline and poor quality of life. However, ARHL remains an irreversible condition due to our inability to induce inner-ear hair cell regeneration. Nevertheless, multisession epidural stimulation of the auditory cortex (AC) at the onset of ARHL prevents hearing threshold elevation in naturally aging Wistar rats. Accordingly, we hypothesized that anodal direct current (DC) stimulation of the AC may also compensate for age-related maladaptive, activity-dependent changes. Here, we examined immunocytochemical markers in the AC, including early genes (c-fos and Arc), AMPA receptors (GluR2/3), parvalbumin (PV), and GAD67, along with auditory-evoked potentials (CAEPs) recorded in both auditory and visual (VC) cortices. When comparing 6 and 18.13-month-old rats without AC simulation, we observed loss of c-fos and Arc-positive neurons and decreased GluR2/3 expression, confirming altered AC neuronal network plasticity and activation. In addition, we noted changes in PV and decreased GAD67 immunoreactivity suggesting disrupted inhibition and significantly increased wave amplitudes in CAEPs, altered AC latencies, and decreased VC responses. By contrast, electrically stimulated rats showed no significant variations in early gene markers, GluR2/3, PV, or GAD67 with age, and the amplitudes and latencies of CAEPs recorded in their AC and VC resembled those of young rat. These findings indicate that anodal DC stimulation at the onset of ARHL delays AC aging by minimizing the loss of inhibition and preventing increases in cortical excitability in Wistar rats.

Neurostimulation for cardiovascular control faces challenges due to the lack of predictive modeling for stimulus-driven dynamic responses, which is crucial for precise neuromodulation via quality feedback. We address this by employing a digital twin approach that leverages computational mechanisms underlying neuro-hemodynamic responses during neurostimulation. Our results emphasize the computational role of the nucleus tractus solitarius (NTS) in the brainstem in determining these responses. The intrinsic neural circuit within the NTS harbors collective dynamics residing in a low-dimensional latent space, which effectively captures stimulus-driven hemodynamic perturbations. Building on this, we developed a digital twin framework for individually optimized predictive modeling of neuromodulatory outcomes. This framework potentially enables the design of closed-loop neurostimulation systems for precise hemodynamic control. Consequently, our digital twin based on neural computation mechanisms marks an advancement in the artificial regulation of internal organs, paving the way for precise translational medicine to treat chronic diseases.

Perception of rhythm significantly impacts various aspects of daily life, including engaging with music, discerning speech prosody nuances, and coordinating physical activities like walking and sports. Numerous studies in cognitive sciences have highlighted that human rhythmic synchronization is more precise when responding to auditory rhythmic stimuli than to visual ones when the timing cues are identical. However, deaf individuals were shown to display a heightened proficiency in synchronizing their movements with visual timing cues, outperforming hearing controls (HC). Furthermore, it was demonstrated that cochlear implant (CI) users can synchronize their movements with the rhythm of unpitched drum tones. These findings raise an important question: do CI users possess a visual synchronization advantage from their pre-implant deafness, while maintaining auditory synchronization skills comparable to those of HC? Alternatively, does the neural reorganization post-implantation negate the visual synchronization advantage acquired before the implant? This study aims to answer these questions by using a sensorimotor synchronization task to probe multisensory processing abilities in CI users. Specifically, we assessed unimodal and multimodal auditory and visual abilities in CI users compared to HC using a finger tapping synchrony task with four isochronous stimulus conditions: an auditory metronome, a visual metronome, a synchronous presentation of both the auditory and visual metronomes at the same tempo, and an asynchronous presentation of the auditory and visual stimuli at differing tempos. Synchronization to auditory stimuli surpassed synchronization to visual stimuli in both groups. CI users and HC demonstrated similar unisensory synchronization consistency within the visual and auditory conditions. While HC enhanced their consistency in the audio-visual synchronous condition compared to the unisensory visual condition, CI users did not display the same improvement. Furthermore, the interference from incongruent auditory information in the asynchronous condition was comparable in HC and CI users. This study highlights that, although pitch processing is known to be impaired in CI users, our findings suggest that rhythm processing remains relatively spared. As anticipated, CI users demonstrate similar auditory rhythmic synchronization skills to those of HC, in line with existing research. Moreover, we find that, unlike deaf individuals, CI users do not exhibit an advantage in visual rhythmic synchronization, which may be due to the relatively few CI users in the study who had early prolonged pre-implantation deafness. The observed shift in audio-visual integration among CI users suggests that post-deafness or post-implantation reorganization of their auditory cortex may impede the effective integration of temporal auditory stimulation from the implant and visual information.

Restoring upper limb function is critical in individuals with central paralysis, and hand control is a priority in patients with neurological impairments. Functional electrical stimulation with implantable electrodes targeting the peripheral nervous system has the potential to selectively recruit hand muscles and generate multiple functional hand movements. However, the implantation of electrodes in the forearm or elbow areas requires multiple incisions for surgery, and elbow joint movements cannot be performed. In this study, we designed and implanted two epineural cuffs on the median and radial nerves in the distal brachial plexus of a single Japanese macaque ( Macaca fuscata ) monkey. The cuffs were successfully placed via an axillary approach using a single incision. Electrical stimuli were applied to innervate the contraction patterns of the hand, forearm, and triceps muscles relevant to the median and radial nerves. The evoked potentials of the target muscles electrically stimulated the distal brachial plexus to reliably and selectively innervate the upper limb muscles at the functional group level. Our results demonstrated that the distal brachial plexus can be a useful stimulation site for upper limb muscle contraction and that the axillary approach enables electrode placement to peripheral nerves required for upper limb control.

Voluntary, flexible stopping of speech output is an essential aspect of speech motor control, especially during natural conversations. The cognitive and neural mechanisms of speech inhibition are not well understood. Here we have recorded direct high-density cortical activity while participants engaged in continuous speech production and were visually cued to stop speaking. Neural recordings revealed distinct activity in the premotor frontal cortex correlated with stopping speech. This activity was found in largely separate cortical sites from regions encoding vocal tract articulatory movements. Moreover, this activity primarily occurred with abrupt stopping in the middle of an utterance, rather than naturally completing a phrase. Electrocortical stimulation at many premotor sites with inhibitory stop activity caused involuntary speech arrest, which contradicts previous clinical interpretations of this effect as evidence for critical centres of speech production. Together, these results suggest a previously unknown premotor cortical network that supports the inhibitory control of speech, providing implications for understanding both natural and altered speech production.

Closed-loop neural control is a powerful tool for both the scientific exploration of neural function and for mitigating deficiencies found in open-loop deep brain stimulation (DBS). Here, we present a protocol for artificial intelligence-guided neural control in rats using deep reinforcement learning (RL) and infrared neural stimulation (INS). We describe steps for integrating RL closed-loop control into neuroscience and neuromodulation studies. We then detail procedures for using and deploying infrared INS in chronic DBS applications. For complete details on the use and execution of this protocol, please refer to Coventry et al.1 and Coventry and Bartlett.2.

Cochlear implants are well established devices for treating severe hearing loss. However, due to the trauma caused by the insertion of the electrode and the subsequent formation of connective tissue, their clinical effectiveness varies. The aim of the current study was to achieve a long-term reduction in connective tissue growth and impedance by combining surface patterns on the electrode array with a poly-L-lactide coating containing 20% diclofenac. Three groups of six guinea pigs each (control, structure, structure with diclofenac in the coating) were implanted for four weeks. The hearing thresholds were measured before implantation and after 28 days, and impedances were monitored over time. After histological preparation, connective tissue growth and spiral ganglion neuron (SGN) survival were quantified. The hearing thresholds and impedances increased over time in all groups, showing no significant differences. The treatment groups showed increased damage in the cochlea, which appeared to be caused by the elevated parts of the microstructures. This seems to be amplified by the trauma model used in the current study. The impedances correlated with connective tissue growth near the electrode contacts. In addition, SGN survival was negatively correlated with the presence of connective tissue, both of which highlight the importance of successfully reducing connective tissue formation after cochlear implantation.