Abstract
This computer modelling study on motor cortex stimulation (MCS) introduced a motor cortex model, developed to calculate the imposed electrical potential field characteristics and the initial response of simple fibre models to stimulation of the precentral gyrus by an epidural electrode, as applied in the treatment of chronic, intractable pain. The model consisted of two parts: a three-dimensional volume conductor based on tissue conductivities and human anatomical data, in which the stimulationinnduced potential field was computed, and myelinated nerve fibre models allowing the calculation of their response to this field. A simple afferent fibre branch and three simple efferent fibres leaving the cortex at different positions in the precentral gyrus were implemented. It was shown that the thickness of the cerebrospinal fluid (CSF) layer between the dura mater and the cortex below the stimulating electrode substantially affected the distribution of the electrical potential field in the precentral gyrus and thus the threshold stimulus for motor responses and the therapeutic stimulation amplitude. When the CSF thickness was increased from 0 to 2.5 mm, the load impedance decreased by 28%, and the stimulation amplitude increased by 6.6 V for each millimetre of CSF. Owing to the large anode-cathode distance (10 mm centre-to-centre) in MCS, the cathodal fields in mono- and bipolar stimulation were almost identical. Calculation of activating functions and fibre responses showed that only nerve fibres with a directional component parallel to the electrode surface were excitable by a cathode, whereas fibres perpendicular to the electrode surface were excitable under an anode.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Brown, J. A., andBarbaro, N. M. (2003): ‘Motor cortex stimulation for central and neuropathic pain: current status’,Pain,104, pp. 431–435
Garcia-Larrea, L., Peyron, R., Mertens, P., Gregoire, M. C., Lavenne, F., Le Bars, D., Convers, P., Mauguière, F., Sindou, M., andLaurent, B. (1999): ‘Electrical stimulation of motor cortex for pain control: a combined PET-scan and electrophysiological study’,Pain,83, pp. 259–273
Gorman, A. L. F. (1966): ‘Differential patterns of activation of the pyramidal system elicited by surface anodal and cathodal cortical stimulation’,J. Neurophysiol.,29, pp. 547–564
Graf von Keyserlingk, D., andSchram, U. (1984): ‘Diameter of axons and thickness of myelin sheaths of pyramidal tract fibres in the adult human medullary pyramid’,Anat. Anz.,157, pp. 97–111
Haberly, L. B., andShepherd, G. M. (1973): ‘Current-density analysis of summed evoked potentials in Opossum prepyriform cortex’,J. Neurophysiol.,36, pp. 789–803
Hern, E. C., Landgren, S., Phillips, C. G., andPorter, R. (1962): ‘Selective excitation of corticofugal neurones by surface anodal stimulation of the Baboon's motor cortex’,J. Physiol. (London),161, pp. 73–90
Hoeltzell, P. B., andDykes, R. W. (1979): ‘Conductivity in the somatosensory cortex of the cat: evidence for cortical anisotropy’,Brain Res.,177, pp. 61–82
Jiang, D. F. (1990): ‘Study of some morphologic aspects of the human dura mater’,Chin. J. Surg.,28, pp. 108–109, p. 128
McComb, J. G., Withers, G. J., andDavis, R. L. (1981): ‘Cortical damage from Zenker's solution applied to the dura mater’,Neurosurg.,8, pp. 68–71
McNeal, D. R. (1976): ‘Analysis of a model for excitation of myelinated nerve’,IEEE Trans. Biomed. Eng.,23, pp. 329–337
Na, J., Kakei, S., andShinoda, Y. (1997): ‘Cerebellar input to corticothalamic neurons in layers V and VI in the motor cortex’,Neurosci. Res.,28, pp. 77–91
Nguyen, J.-P., Lefaucheur, J.-P., Decq, P., Uchiyama, T., Carpentier, A., Fontaine, D., Brugières, P., Pollin, B., Fève, A., Rostaing, S., Cesaro, P., andKeravel, Y. (1999): ‘Chronic motor cortex stimulation in the treatment of central and neurophatic pain. Correlations between clinical, electrophysiological and anatomical data’,Pai,82, pp. 245–251
Nguyen, J. P., Lefaucheur, J. P., Le Guerinel, C., Eizenbaum, J. F., Nakano, N., Carpentier, A., Brugieres, P., Pollin, B., Rostaing, S., andKeravel, Y. (1900): ‘Motor cortex stimulation in the treatment of central and neuropathic pain’,Arch. Med. Res.,31, pp. 263–265
Nieuwenhuys, R., Voogd, J., andvan Huijzen, C. (1988): ‘The human central nervous system A synopsis and atlas, 3rd edn’ (Springer Verlag, Berlin, 1988)
Nowak, L. G., andBullier, J. (1998): ‘Axons, but not cell bodies, are activated by electrical in cortical gray matter’,Exp. Brain Res.,118, pp. 477–488
Ohye, C. (1990): ‘Thalamus’, inPaxinos, G. (Ed.): ‘The human nervous system’ (Academic Press, San Diego, New York, 1990), Chap. 17, pp. 439–468
Phillips, C. G., andPorter, R. (1962): ‘Unifocal and bifocal stimulation of the motor cortex’,J. Physiol. (London),162, pp. 532–538
Pirotte, B., Voordecker, P., Joffroy, F., Massager, N., Wikler, D., Baleriaux, D., Levivier, M., andBrotchi, J. (2001): ‘The Zeiss-MKM system for frameless image-guided approach in epidural motor cortex stimulation for central neuropathic pain’,Neurosurg. Focus,11 (3): Article 3, pp. 1–6
Porter, R. (1963): ‘Focal stimulation of hypoglossal neurones in the cat’,J. Physiol. (London),169, pp. 630–640
Rattay, F. (1986): ‘Analysis of models for external stimulation of axons’,IEEE Trans. Biomed. Eng.,33, pp. 974–977
Rattay, F. (1999): ‘The basic mechanism for the electrical stimulation of the nervous system’,Neurosci.,2, pp. 335–346
Smith, H., Joint, C., Schlugman, D., Sandi, D., Stein, J., andAziz, T. Z. (2001): ‘Motor cortex stimulation for neuropathic pain’,Neurosurg. Focus,11, (3): Article 2, pp. 1–9
Struijk, J. J., Holsheimer, J., van der Heide, G. G., andBoom, H. B. K. (1992): ‘Recruitment of dorsal column fibers in spinal cord stimulation: Influence of collateral branching’,IEEE Trans. Biomed. Eng.,39, pp. 903–912
Tang, Y., andNyengaard, J. R. (1997): ‘A stereological method for estimating the total length and size of myelin fibers in human brain white matter’,J. Neurosci. Methods,73, pp. 193–200.
Truex, R. C., andCarpenter, M. B. (1964): ‘Human anatomy’ (The Williams & Wilkins Company, Baltimore, 1964)
Tsubokawa, T., Katayama, Y., Yamamoto, T., Hirayama, T., andKoyama, S. (1993): ‘Chronic motor cortex stimulation in patients with thalamic pain’,J. Neurosurg.,78, pp. 393–401
Villiger, L. (1940): ‘Gehirn und Rückenmark’ (Wilhelm Engelmann Verlag, Leipzig, 1940)
Wesselink, W. A., Holsheimer, J., andBoom, H. B. K. (1999): ‘A model of the electrical behaviour of myelinated sensory nerve fibres based on human data’,Med. Biol. Eomput.,37, pp. 228–235
Zeffiro, T. A. (1990): ‘Motor cortex’, inPaxions, G. (Ed.): ‘The human nervous system’ (Academic Press, San Diego, New York 1990), Chap. 23, pp. 803–810
Zilles, K. (1990): ‘Cortex’, inPaxions, G. (Ed.): ‘The human nervous system’ (Academic Press, San Diego, New York, 1990), Chap. 22, pp. 757–802
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Manola, L., Roelofsen, B.H., Holsheimer, J. et al. Modelling motor cortex stimulation for chronic pain control: Electrical potential field, activating functions and responses of simple nerve fibre models. Med. Biol. Eng. Comput. 43, 335–343 (2005). https://doi.org/10.1007/BF02345810
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF02345810