Model-based geometrical optimisation and in vivo validation of a spatially selective multielectrode cuff array for vagus nerve neuromodulation

TL;DR

This study presents a model-based design and in vivo validation of a multielectrode cuff array for vagus nerve neuromodulation, achieving selective stimulation of specific nerve functions with minimal side effects.

Contribution

The paper introduces a novel model-based optimization method for designing multielectrode cuff arrays and demonstrates their effectiveness in selective nerve stimulation in vivo.

Findings

Achieved 85% reduction in respiratory rate without affecting heart rate.

Localized cardiac and pulmonary nerve sites with 105-degree separation.

Demonstrated selective neuromodulation with minimal adverse effects.

Abstract

Background. Neuromodulation by electrical stimulation of the human cervical vagus nerve may be limited by adverse side effects due to stimulation of off-target organs. It may be possible to overcome this by spatially selective stimulation of peripheral nerves. Preliminary studies have shown this is possible using a cylindrical multielectrode human-sized nerve cuff in vagus nerve selective neuromodulation. New method. The model-based optimisation method for multi-electrode geometric design is presented. The method was applied for vagus nerve cuff array and suggested two rings of 14 electrodes, 3 mm apart, with 0.4 mm electrode width and separation and length 0.5-3 mm, with stimulation through a pair in the same radial position on the two rings. The electrodes were fabricated using PDMS-embedded stainless steel foil and PEDOT: pTS coating. Results. In the cervical vagus nerve in anaesthetised sheep, it was possible to selectively reduce the respiratory breath rate (RBR) by 85 +/- 5% without affecting heart rate, or selectively reduce heart rate (HR) by 20 +/- 7% without affecting respiratory rate. The cardiac- and pulmonary-specific sites on the nerve cross-sectional perimeter were localised with a radial separation of 105 +/- 5 degrees (P < 0.01, N = 24 in 12 sheep). Conclusions. Results suggest organotopic or function-specific organisation of neural fibres in the cervical vagus nerve. The optimised electrode array demonstrated selective electrical neuromodulation without adverse side effects. It may be possible to translate this to improved treatment by electrical autonomic neuromodulation for currently intractable conditions.