Related Experiment Video
Updated: May 26, 2026
Open-Source Real-Time Closed-Loop Electrical Threshold Tracking for Translational Pain Research
Published on: April 21, 2023
Real-Time Paresthesia Steering Using ContinuousElectric Field Adjustment. Part I: IntraoperativePerformance
John Oakley1, Clayton Varga, Elliot Krames
1Yellowstone Neurosurgical Associates, Billings, Montana; Pasadena Rehabilitation Institute, Pasadena, California; Pacific Pain Treatment Center, San Francisco, California; and Advanced Bionics Corporation, Valencia, California.
This study introduces continuous electric field adjustment (CEFA), a new neurostimulation technique for spinal cord stimulation. CEFA allows dynamic, real-time steering of paresthesia for chronic pain management, proving efficient and comfortable for patients.
Area of Science:
- Neurology
- Biomedical Engineering
- Pain Management
Background:
- Spinal cord stimulation (SCS) is a key therapy for chronic pain.
- Current SCS programming methods can be time-consuming and may not precisely target pain regions.
- A need exists for more dynamic and efficient methods to optimize SCS therapy.
Purpose of the Study:
- To evaluate the performance and efficiency of a novel current-shifting programming technique, continuous electric field adjustment (CEFA), for SCS.
- To assess the ability of CEFA to dynamically steer paresthesia coverage in real-time.
- To determine the intraoperative time required for paresthesia assessment using CEFA.
Main Methods:
- A multicenter study was conducted using a new neurostimulation system employing the CEFA technique.
- CEFA involves adjusting the distribution of anodic and cathodic current among multi-contact array electrodes to steer the electric field.
- Paresthesia coverage was assessed in patients undergoing SCS lead implantation for chronic pain.
Main Results:
- CEFA enabled real-time, dynamic steering of paresthesia coverage to different body regions.
- Paresthesia was maintained comfortably throughout the adjustment process for all patients.
- The technique proved time-efficient, with a median assessment time of 4.1 minutes for 71 combinations on an 8-contact lead across 18 patients.
Conclusions:
- Continuous electric field adjustment (CEFA) is a novel, effective, and time-efficient technique for optimizing spinal cord stimulation.
- CEFA allows for precise, real-time control of paresthesia coverage, enhancing patient comfort and potentially improving therapeutic outcomes.
- This technique represents a significant advancement in SCS programming for chronic pain management.
