Douglas B. McCreery

Charge density and charge per phase as cofactors in neural injury induced by electrical stimulation

Stimulating electrodes of various sizes were used to investigate the interactions of two stimulus parameters, charge density and charge per phase, in determining the threshold of neural injury induced by electrical stimulation. Platinum electrodes ranging in size from 0.002 to 0.5 cm/sup 2/ were implanted over the parietal cortex of adult cats. Ten days after implantation, the electrodes were pulsed continuously for 7 h using charge-balanced, current-regulated, symmetric pulse pairs 400 mu s per phase in duration and at a repetition rate of 50 Hz. The results show that charge density (as measured at the surface of the stimulating electrode) and charge per phase interact in a synergistic manner to determine the threshold of stimulation-induced neural injury. This interaction occurs over a wide range of both parameters: for charge density from at least 10 to 800 mu C/cm/sup 2/, and for charge per phase from at least 0.05 to 5.0 mu C per phase. The significance of these findings in elucidating the mechanisms underlying stimulation-induced injury is discussed.<<ETX>>

Stability of the interface between neural tissue and chronically implanted intracortical microelectrodes

The stability of the interface between neural tissue and chronically implanted microelectrodes is very important for obtaining reliable control signals for neuroprosthetic devices. Stability is also crucial for chronic microstimulation of the cerebral cortex. However, changes of the electrode-tissue interface can be caused by a variety of mechanisms. In the present study, intracortical microelectrode arrays were implanted into the pericruciate gyrus of cats and neural activities were recorded on a regular basis for several months. An algorithm based on cluster analysis and interspike interval analysis was developed to sort the extracellular action potentials into single units. We tracked these units based on their waveform and their response to somatic stimulation or stereotypical movements by the cats. Our results indicate that, after implantation, the electrode-tissue interface may change from day-to-day over the first 1-2 weeks, week-to-week for 1-2 months, and become quite stable thereafter. A stability index is proposed to quantify the stability of the electrode-tissue interface. The reasons for the pattern of changes are discussed.

Considerations for Safety with Chronically Implanted Nerve Electrodes

Summary: Electrical stimulation of cranial and peripheral nerves has been used to ameliorate a variety of neurologic disease states and neural injuries over the past 20 years. In this review, clinical applications and the histopathologic results of chronic implants in animals and humans are discussed, and the results of neural damage models developed at Huntington Medical Research Institutes are summarized. Chronically implanted electrode arrays may produce neural injury by either mechanical factors or by continuous, high‐frequency electrical stimulation. The margin of safety to avoid electrically induced injury may be increased by minimizing the frequency or total stimulation time, and by the use of an intermittent duty cycle. The protocols presently being used for the stimulation of the vagus nerve to effect inhibition of seizures appear to have an adequate margin of safety.

Histologic and physiologic evaluation of electrically stimulated peripheral nerve: Considerations for the selection of parameters

Helical electrodes were implanted around the left and right common peroneal nerves of cats. Three weeks after implantation one nerve was stimulated for 4–16 hours using charge-balanced, biphasic, constant current pulses. Compound action potentials (CAP) evoked by the stimulus were recorded from over the cauda equina before, during and after the stimulation. Light and electron microscopy evaluations were conducted at various times following the stimulation. The mere presence of the electrode invariably resulted in thickened epineurium and in some cases increased peripheral endoneurial connective tissue beneath the electrodes. Physiologic changes during stimulation included elevation of the electrical threshold of the large axons in the nerve. This was reversed within one week after stimulation at a frequency of 20 Hz, but often was not reversed following stimulation at 50–100 Hz. Continuous stimulation at 50 Hz for 8–16 hours at 400 μA or more resulted in neural damage characterized by endoneurial edema beginning within 48 hours after stimulation, and early axonal degeneration (EAD) of the large myelinated fibers, beginning by 1 week after stimulation. Neural damage due to electrical stimulation was decreased or abolished by reduction of the duration of stimulation, by stimulating at 20 Hz (vs. 50 Hz) or by use of an intermittent duty cycle. These results demonstrate that axons in peripheral nerves can be irreversely damaged by 8–16 hours of continuous stimulation at 50 Hz. However, the extent to which these axons may subsequently regenerate is uncertain. Therefore, protocols for functional electrical stimulation in human patients probably should be evaluated individually in animal studies.

Histological Evaluation of Neural Damage from Electrical Stimulation: Considerations for the Selection of Parameters for Clinical Application

The relationship of charge density per phase, or QD/ph (expressed in units of microcoulombs per cm2 per phase of the charge-balanced wave form), and total charge (QDt) to neural damage has been investigated by light and electron microscopy after surface stimulation of the parietal cortex in normal cats. QD/ph values ranging from 40 to 400 were achieved by varying several stimulus parameters. The least amount of neural damage in this study was observed at QD/ph 40). The extent of neural injury at stimulated sites increased with the charge density and was evident as disruption of cell membranes, intracytoplasmic vacoulation, an increasing glycogen content, the deposition of intracellular calcium hydroxyapatite, and neuronal and astrocytic degeneration. Although individual factors contributing to neural damage are isolated with difficulty, charge density and total charge seem to be predominant among the contributing parameters. In view of these findings, recommendations have been made for the selection of electrical stimulus parameters to be used in central nervous system prostheses.

Over-pulsing degrades activated iridium oxide films used for intracortical neural stimulation.

Microelectrodes using activated iridium oxide (AIROF) charge-injection coatings have been pulsed in cat cortex at levels from near-threshold for neural excitation to the reported in vitro electrochemical charge-injection limits of AIROF. The microelectrodes were subjected to continuous biphasic current pulsing, using an 0.4V (versus Ag|AgCl) anodic bias with equal cathodal and anodal pulse widths, for periods up to 7h at a frequency of either 50Hz or 100Hz. At charge densities of 3mC/cm(2), histology revealed iridium-containing deposits in tissue adjacent to the charge-injection sites and scanning electron microscopy of explanted electrodes revealed a thickened and poorly adherent AIROF coating. Microelectrodes pulsed at 2mC/cm(2) or less remained intact, with no histologic evidence of non-biologic deposits in the tissue. AIROF microelectrodes challenged in vitro under the same pulsing conditions responded similarly, with electrodes pulsed at 3mC/cm(2) showing evidence of AIROF delamination after only 100s of pulsing at 100Hz (10,000 pulses total), while electrodes pulsed at 2mC/cm(2) for 7h at 50Hz (1.3 x 10(6) pulses total) showed no evidence of damage. In vitro electrochemical potential transient measurements in buffered physiologic saline indicate that polarizing the AIROF beyond the potential window for electrolysis of water (-0.6 to 0.8V versus Ag|AgCl) results in the observed degradation.

Histopathologic evaluation of prolonged intracortical electrical stimulation

Chronic stimulating microelectrodes fabricated from platinum-30% iridium (Pt-30%Ir) or activated iridium were implanted in assemblies of three in the left sensorimotor cortex of the cat and pulsed continuously at currents of 10 to 320 microA (100 to 3200 microC/cm2 X ph, 2 to 64 nC/ph) for periods of 24 h or for 23 h/day for 7 days. The microelectrodes had beveled tips with uninsulated geometric surface areas of 20 X 10(-6) cm2. Neuronal activity evoked by the focal stimulation was monitored by recording compound action potentials from the ipsilateral pyramidal tract. By this criterion neuronal activation thresholds were 5 to 15 microA (50 to 150 microC/cm2 X ph, 1 to 3 nC/ph) for both types of electrodes. Histologic evaluations of tissue surrounding the electrode tips were carried out by either light or electron microscopy. No neural damage was induced by 24 or 161 h of pulsing using either type of electrode at currents of 10 to 80 microA. Neural damage attributable to electrical stimulation per se was observed in a few sites pulsed with 320 microA (3200 microC/cm2 X ph, 64 nC/ph, 16 A/cm2) with Pt-30%Ir but not activated iridium electrodes of the same size. Electrode dissolution appears to be best correlated with charge density and current density. Dissolution of the Pt-30%Ir microelectrode tip was observed by scanning electron microscopy at charge densities as low as 200 microC/cm2 X ph (1 A/cm2), whereas erosion of activated iridium microelectrodes occurred only at the highest charge and current densities (3200 microC/cm2 X ph, 16 A/cm2). Thus, the activated iridium electrode is superior to Pt-30%Ir for chronic stimulations, from the standpoint of electrode tip stability, because with the former, in contrast to the alloy, detectable erosion occurred only at an intensity well above that required for activation of nearby neurons.

Neuroprotection of Ischemic Brain by Vascular Endothelial Growth Factor Is Critically Dependent on Proper Dosage and May Be Compromised by Angiogenesis

Vascular endothelial growth factor (VEGF) is currently considered a potential pharmacologic agent for stroke therapy because of its strong neuroprotective and angiogenic capacities. Nonetheless, it is unclear how neuroprotection and angiogenesis by exogenous VEGF are related and whether they are concurrent events. In this study, the authors evaluated by stereology the effect of VEGF on neuronal and vascular volume densities of normal and ischemic brain cortices of adult male Sprague-Dawley rats. Ischemia was induced by a 4-hour occlusion of the middle cerebral artery. Low, intermediate, and high doses of VEGF165 were infused through the internal carotid artery for 7 days by an indwelling osmotic pump. The low and intermediate doses, which did not induce angiogenesis, significantly promoted neuroprotection of ischemic brains and did not damage neurons of normal brains. In contrast, the high dose that induced angiogenesis showed no neuroprotection of ischemic brains and damaged neurons of normal brains. These findings suggest that in vivo neuroprotection of ischemic brains by exogenous VEGF does not necessarily occur simultaneously with angiogenesis. Instead, neuroprotection may be greatly compromised by doses of VEGF capable of inducing angiogenesis. Stroke intervention efforts attempting to induce neuroprotection and angiogenesis concurrently through VEGF monotherapy should be approached with caution.

Comparison of neural damage induced by electrical stimulation with faradaic and capacitor electrodes.

Arrays of platinum (faradaic) and anodized, sintered tantalum pentoxide (capacitor) electrodes were implanted bilaterally in the subdural space of the parietal cortex of the cat. Two weeks after implantation both types of electrodes were pulsed for seven hours with identical waveforms consisting of controlled-current, chargebalanced, symmetric, anodic-first pulse pairs, 400 μsec/phase and a charge density of 80–100 μC/cm2 (microcoulombs per square cm) at 50 pps (pulses per second). One group of animals was sacrificed immediately following stimulation and a second smaller group one week after stimulation. Tissues beneath both types of pulsed electrodes were damaged, but the difference in damage for the two electrode types was not statistically significant. Tissue beneath unpulsed electrodes was normal. At the ultrastructural level, in animals killed immediately after stimulation, shrunken and hyperchromic neurons were intermixed with neurons showing early intracellular edema. Glial cells appeared essentially normal. In animals killed one week after stimulation most of the damaged neurons had recovered, but the presence of shrunken, vacuolated and degenerating neurons showed that some of the cells were damaged irreversibly. It is concluded that most of the neural damage from stimulations of the brain surface at the level used in this study derives from processes associated with passage of the stimulus current through tissue, such as neuronal hyperactivity rather than electrochemical reactions associated with current injection across the electrode-tissue interface, since such reactions occur only with the faradaic electrodes.

A characterization of the effects on neuronal excitability due to prolonged microstimulation with chronically implanted microelectrodes

Localized, long-lasting stimulation-induced depression of neuronal excitability (SIDNE) is a consequence of prolonged, high-frequency microstimulation in the central nervous system (CNS). It represents a persisting refractory state in the neurons and axons near the stimulating microelectrode, that occurs in the absence of histologically detectable tissue injury. It does not involve a change in synaptic efficacy and, in this respect, it differs from the more familiar phenomenon of long-term depression (LTD). Although SIDNE is ultimately reversible (after several days), it must be taken into account in the design of neural prostheses based on microstimulation in the central nervous system and in animal studies that require prolonged microstimulation in the CNS. In this study, we have characterized the phenomenon, using as the paradigm, iridium microelectrodes implanted chronically in the cats posteroventral cochlear nucleus. Although the SIDNE may persist for several days after the end of the stimulation protocol, it does not become more severe from day to day when the stimulation protocol is repeated on successive days. The severity of the SIDNE is strongly dependent upon both the instantaneous frequency and the duty cycle of the electrical stimulation. The character of the SIDNE, including its localization to the immediate vicinity of the stimulating microelectrodes, suggests that the phenomenon is a direct consequence of the prolonged electrical excitation of the neurons close to the microelectrode. The problem of designing microstimulation systems that allow high-frequency stimulation of a neural substrate, while minimizing SIDNE are discussed.