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Impact of neuroanatomical variations and electrode orientation on stimulus current in a device for migraine: a computational study

Salkim, E; Shiraz, A; Demosthenous, A; (2020) Impact of neuroanatomical variations and electrode orientation on stimulus current in a device for migraine: a computational study. Journal of Neural Engineering , 17 (1) , Article 016006. 10.1088/1741-2552/ab3d94. (In press). Green open access

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Abstract

Objective. Conventional treatment methods for migraine often have side effects. One treatment involves a wearable neuromodulator targeting frontal nerves. Studies based on this technique have shown limited efficacy and the existing setting can cause pain. These may be associated with neuroanatomical variations which lead to high levels of required stimulus current. The aim of this paper is to study the effect of such variations on the activation currents of the Cefaly neuromodulator. Also, using a different electrode orientation, the possibility of reducing activation current levels to avoid painful side-effects and improve efficacy, is explored. Approach. This paper investigates the effect of neuroanatomical variations and electrode orientation on the stimulus current thresholds using a computational hybrid model involving a volume conductor and an advanced nerve model. Ten human head models are developed considering statistical variations of key neuroanatomical features, to model a representative population. Main results. By simulating the required stimulus current level in the head models, it is shown that neuroanatomical variations have a significant impact on the outcome, which is not solely a function of one specific neuroanatomical feature. The stimulus current thresholds based on the conventional Cefaly system vary from 4.4 mA to 25.1 mA across all head models. By altering the electrode orientation to align with the nerve branches, the stimulus current thresholds are substantially reduced to between 0.28 mA and 15 mA, reducing current density near pain-sensitive structures which may lead to a higher level of patient acceptance, further improving the efficacy. Significance. Computational modeling based on statistically valid neuroanatomical parameters, covering a representative adult population, offers a powerful tool for quantitative comparison of the effect of the position of stimulating electrodes which is otherwise not possible in clinical studies.

Type: Article
Title: Impact of neuroanatomical variations and electrode orientation on stimulus current in a device for migraine: a computational study
Open access status: An open access version is available from UCL Discovery
DOI: 10.1088/1741-2552/ab3d94
Publisher version: https://doi.org/10.1088/1741-2552/ab3d94
Language: English
Additional information: Original content from this work may be used under the terms of the Creative Commons Attribution 3.0 licence. Any further distribution of this work must maintain attribution to the author(s) and the title of the work, journal citation and DOI. For more information see: http://creativecommons.org/licenses/by/3.0/
Keywords: Computational models, electrode orientation, frontal nerve, migraine, neuromodulator, neurostimulation, neuroanatomical variations
UCL classification: UCL
UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > UCL BEAMS
UCL > Provost and Vice Provost Offices > UCL BEAMS > Faculty of Engineering Science
UCL > Provost and Vice Provost Offices > UCL BEAMS > Faculty of Engineering Science > Dept of Electronic and Electrical Eng
URI: https://discovery.ucl.ac.uk/id/eprint/10087424
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