Infrared neural stimulation of human spinal nerve roots in vivo.

Infrared neural stimulation (INS) is a neurostimulation modality that uses pulsed infrared light to evoke artifact-free, spatially precise neural activity with a noncontact interface; however, the technique has not been demonstrated in humans. The objective of this study is to demonstrate the safety and efficacy of INS in humans in vivo. The feasibility of INS in humans was assessed in patients ([Formula: see text]) undergoing selective dorsal root rhizotomy, where hyperactive dorsal roots, identified for transection, were stimulated in vivo with INS on two to three sites per nerve with electromyogram recordings acquired throughout the stimulation. The stimulated dorsal root was removed and histology was performed to determine thermal damage thresholds of INS. Threshold activation of human dorsal rootlets occurred in 63% of nerves for radiant exposures between 0.53 and [Formula: see text]. In all cases, only one or two monitored muscle groups were activated from INS stimulation of a hyperactive spinal root identified by electrical stimulation. Thermal damage was first noted at [Formula: see text] and a [Formula: see text] safety ratio was identified. These findings demonstrate the success of INS as a fresh approach for activating human nerves in vivo and providing the necessary safety data needed to pursue clinically driven therapeutic and diagnostic applications of INS in humans.

Vocoder simulations of highly focused cochlear stimulation with limited dynamic range and discriminable steps.

OBJECTIVES: There is recent interest in focused stimulation of the cochlea via modalities such as tripolar electrical and infrared neural stimulation to improve speech in noise comprehension and music perception. The purpose of this work was to use vocoder-based simulations to investigate speech recognition for broad stimulation (standard monopolar paradigm) versus more focused stimulation under a variety of signal-to-noise ratios, dynamic ranges, and numbers of discriminable loudness steps. DESIGN: Vocoder simulations were used to assess the intelligibility of sentences, consonants, and vowels that were noise vocoded and presented to 7 normal-hearing listeners for identification. A novel aspect of the simulations presented here was the use of nonuniform quantization steps within the dynamic range to more closely simulate the Weber functions observed in cochlear implant users. Intelligibility was assessed for the different filter slopes under a variety of signal-to-noise ratio levels, dynamic ranges, and numbers of discriminable steps. RESULTS: Speech processed via vocoder simulations representing focused stimulation was found to be substantially more intelligible than speech processed via a monopolar electric vocoder simulation, with differences of up to 60 percentage points. There were no significant differences, however, seen between the two focused approaches (signal attenuations of 10 and 17 dB/mm) for the conditions investigated. Speech processed via the highly focused vocoder (17 dB/mm) was robust to constraints on small envelope dynamic range and small number of discriminable steps within the dynamic range, as high performance was maintained with at least a 5 dB dynamic range and eight or more discriminable steps. Significant drops in intelligibility were noted when the number of steps fell below eight. CONCLUSIONS: Highly focused stimulation-tripolar electrical and infrared neural stimulation-has potential for increased performance in noise compared with monopolar stimulation, but much work remains to bear this potential out and to take full advantage of each modality's strengths.

Analytical approaches for determining heat distributions and thermal criteria for infrared neural stimulation.

Infrared neural stimulation (INS) is becoming an important complementary tool to electrical stimulation. Since the mechanism of INS is photothermal, describing the laser-induced heat distribution is fundamental to determining the relationship between stimulation pulses and neural responses. This work developed both a framework describing the time evolution of the heat distribution induced by optical fluence and a new method to extract thermal criteria (e.g., temperature change and rate of change) for neural activation. To solve the general problem of describing the temperature distribution, a Green's function solution to the heat diffusion equation was determined and convolved with the optical fluence. This provided a solution in the form of a single integral over time, from which closed-form solutions can be determined for special cases. This work also yielded an expression for thermal relaxation time, which provides a rigorous description of thermal confinement for INS. The developed framework was then applied to experimental data from the cochlea to extract the minimum temperature increase and rate of that increase to stimulate the cochlear spiral ganglion. This result, and similar analyses applied to other neural systems, can then shed light on the fundamental mechanism for INS and aid the development of optical neuroprostheses.

Neural stimulation with optical radiation.

This paper reviews the existing research on infrared neural stimulation, a means of artificially stimulating neurons that has been proposed as an alternative to electrical stimulation. Infrared neural stimulation (INS) is defined as the direct induction of an evoked potential in response to a transient targeted deposition of optical energy. The foremost advantage of using optical radiation for neural stimulation is its spatial resolution. Exogenously applied or trans-genetically synthesized fluorophores are not used to achieve stimulation. Here, current work on INS is presented for motor nerves, sensory nerves, central nervous system, and in vitro preparations. A discussion follows addressing the mechanism of INS and its potential use in neuroprostheses. A brief review of neural depolarization involving other optical methods is also presented. Topics covered include optical stimulation concurrent with electrical stimulation, optical stimulation using exogenous fluorophores, and optical stimulation by transgenic induction of light-gated ion channels.

Optical cochlear implants: evaluation of surgical approach and laser parameters in cats.

Previous research has shown that neural stimulation with infrared radiation (IR) is spatially selective and illustrated the potential of IR in stimulating auditory neurons. The present work demonstrates the application of a miniaturized pulsed IR stimulator for chronic implantation in cats, quantifies its efficacy, and short-term safety in stimulating auditory neurons. IR stimulation of the neurons was achieved using an optical fiber inserted through a cochleostomy drilled in the basal turn of the cat cochlea and was characterized by measuring compound action potentials (CAPs). Neurons were stimulated with IR at various pulse durations, radiant exposures, and pulse repetition rates. Pulse durations as short as 50 mus were successful in evoking CAPs in normal as well as deafened cochleae. Continual stimulation was provided at 200 pulses per second, at 200 mW per pulse, and 100 mus pulse duration. Stable CAP amplitudes were observed for up to 10 h of continual IR stimulation. Combined with histological data, the results suggest that pulsed IR stimulation does not lead to detectable acute tissue damage and validate the stimulation parameters that can be used in future chronic implants based on pulsed IR.

Optically mediated nerve stimulation: Identification of injury thresholds.

BACKGROUND AND OBJECTIVE: Transient optical nerve stimulation is a promising new non-contact, spatially precise, artifact-free neural excitation technique useful in research and clinical settings. This study evaluates safety of this pulsed infrared laser technique by histopathologic examination of stimulated peripheral nerves. STUDY DESIGN/MATERIALS AND METHODS: Exposed rat sciatic nerves were functionally stimulated with the pulsed Holmium:YAG laser, previously validated as an effective tool for optical stimulation. Nerves were removed immediately and up to 2 weeks after stimulation and assessed histologically for thermal damage. Laser parameters studied include upper limits for radiant exposure, repetition rate, and duration of stimulation. RESULTS: Radiant exposures with <1% probability of thermal tissue damage (0.66-0.70 J/cm(2)) are significantly greater than radiant exposures required for reliable stimulation (0.34-0.48 J/cm(2)). The upper limit for safe laser stimulation repetition rate occurs near 5 Hz. Maximum duration for constant low repetition rate stimulation (2 Hz) is approximately 4 minutes with adequate tissue hydration. CONCLUSION: Results confirm that optical stimulation has the potential to become a powerful non-contact clinical and research tool for brief nerve stimulation with low risk of nerve thermal damage.