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Temperature increases by kilohertz frequency spinal cord stimulation.

Adantchede L Zannou1, Niranjan Khadka1, Dennis Q Truong1

  • 1Department of Biomedical Engineering, The City College of New York, New York, NY, 10031, USA.

Brain Stimulation
|November 29, 2018
PubMed
Summary
This summary is machine-generated.

Kilohertz frequency spinal cord stimulation (kHz-SCS) generates heat in spinal tissues, with higher frequencies causing more significant temperature increases. This tissue heating, driven by joule heat, may influence SCS clinical outcomes and inform lead placement strategies.

Keywords:
Bioheat modelingFEMHigh rate biphasic spinal cord stimulationMechanismSafetyTemperature

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Area of Science:

  • Biomedical Engineering
  • Neuroscience
  • Medical Physics

Background:

  • Kilohertz frequency spinal cord stimulation (kHz-SCS) delivers more power than conventional SCS due to increased duty cycles (pulse compression).
  • This increased power deposition raises concerns about potential tissue heating via joule heat, which could affect clinical outcomes.

Purpose of the Study:

  • To investigate the role of tissue heating in kHz-SCS by characterizing temperature changes during various SCS protocols.
  • To develop and validate a heat-transfer model for SCS leads based on joule heating principles.

Main Methods:

  • Temperature increases around an experimental SCS lead were measured using fiber optic probes in a bath phantom.
  • A SCS lead heat-transfer model was developed and validated against experimental data.
  • The validated model was used to predict temperature changes in a detailed human spinal cord model under varied stimulation parameters.

Main Results:

  • The bio-heat model confirmed that SCS waveform power directly correlates with tissue heating at the spinal cord and surrounding tissues.
  • Predicted temperature increases at the dorsal spinal cord ranged from 0.18-1.72°C for 10 kHz stimulation, 0.09-0.22°C for 1 kHz, and <0.05°C for 50 Hz.
  • Tissue heating increased superlinearly with stimulation power, making it sensitive to pulse amplitude and frequency changes; temperature profiles were more uniform than electric fields.

Conclusions:

  • Tissue heating is an inherent consequence of kHz-SCS and may significantly impact both short- and long-term clinical outcomes.
  • Understanding and potentially leveraging tissue heating could lead to distinct strategies for optimizing SCS lead positioning and programming.