Technical aspects of neurostimulation: Focus on equipment, electric field modeling, and stimulation protocols

D C W Klooster; A J A de Louw; A P Aldenkamp; R M H Besseling; R M C Mestrom; S Carrette; S Zinger; J W M Bergmans; W H Mess; K Vonck; E Carrette; L E M Breuer; A Bernas; A G Tijhuis; P Boon

doi:10.1016/j.neubiorev.2016.02.016

Technical aspects of neurostimulation: Focus on equipment, electric field modeling, and stimulation protocols

Neurosci Biobehav Rev. 2016 Jun:65:113-41. doi: 10.1016/j.neubiorev.2016.02.016. Epub 2016 Mar 26.

Authors

D C W Klooster¹, A J A de Louw², A P Aldenkamp³, R M H Besseling⁴, R M C Mestrom⁵, S Carrette⁶, S Zinger⁷, J W M Bergmans⁸, W H Mess⁹, K Vonck¹⁰, E Carrette¹¹, L E M Breuer¹², A Bernas¹³, A G Tijhuis¹⁴, P Boon¹⁵

Affiliations

¹ Kempenhaeghe Academic Center for Epileptology, P.O. Box 61, 5590 AB Heeze, The Netherlands; Department of Electrical Engineering, University of Technology Eindhoven, P.O. Box 513, 5600 MB Eindhoven, The Netherlands. Electronic address: d.c.w.klooster@tue.nl.
² Kempenhaeghe Academic Center for Epileptology, P.O. Box 61, 5590 AB Heeze, The Netherlands; Department of Electrical Engineering, University of Technology Eindhoven, P.O. Box 513, 5600 MB Eindhoven, The Netherlands; Department of Neurology, Maastricht University Medical Center, P.O. Box 5800, 6202 AZ Maastricht, The Netherlands. Electronic address: louwa@kempenhaeghe.nl.
³ Kempenhaeghe Academic Center for Epileptology, P.O. Box 61, 5590 AB Heeze, The Netherlands; Department of Electrical Engineering, University of Technology Eindhoven, P.O. Box 513, 5600 MB Eindhoven, The Netherlands; Department of Neurology, Maastricht University Medical Center, P.O. Box 5800, 6202 AZ Maastricht, The Netherlands; School for Mental Health and Neuroscience, Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands; Department of Neurology, Ghent University Hospital, De Pintelaan 185, 9000 Ghent, Belgium. Electronic address: aldenkampb@kempenhaeghe.nl.
⁴ Department of Electrical Engineering, University of Technology Eindhoven, P.O. Box 513, 5600 MB Eindhoven, The Netherlands. Electronic address: r.m.h.besseling@tue.nl.
⁵ Department of Electrical Engineering, University of Technology Eindhoven, P.O. Box 513, 5600 MB Eindhoven, The Netherlands. Electronic address: r.m.c.mestrom@tue.nl.
⁶ Department of Neurology, Ghent University Hospital, De Pintelaan 185, 9000 Ghent, Belgium. Electronic address: sofie.carrette@ugent.be.
⁷ Kempenhaeghe Academic Center for Epileptology, P.O. Box 61, 5590 AB Heeze, The Netherlands; Department of Electrical Engineering, University of Technology Eindhoven, P.O. Box 513, 5600 MB Eindhoven, The Netherlands. Electronic address: s.zinger@tue.nl.
⁸ Department of Electrical Engineering, University of Technology Eindhoven, P.O. Box 513, 5600 MB Eindhoven, The Netherlands. Electronic address: j.w.m.bergmans@tue.nl.
⁹ Departments of Clinical Neurophysiology, Maastricht University Medical Center, P.O. Box 5800, 6202 AZ Maastricht, The Netherlands. Electronic address: werner.mess@mumc.nl.
¹⁰ Department of Neurology, Ghent University Hospital, De Pintelaan 185, 9000 Ghent, Belgium. Electronic address: kristl.vonck@ugent.be.
¹¹ Department of Neurology, Ghent University Hospital, De Pintelaan 185, 9000 Ghent, Belgium. Electronic address: evelien.carrette@ugent.be.
¹² Kempenhaeghe Academic Center for Epileptology, P.O. Box 61, 5590 AB Heeze, The Netherlands. Electronic address: breuerl@kempenhaeghe.nl.
¹³ Department of Electrical Engineering, University of Technology Eindhoven, P.O. Box 513, 5600 MB Eindhoven, The Netherlands. Electronic address: a.bernas@tue.nl.
¹⁴ Department of Electrical Engineering, University of Technology Eindhoven, P.O. Box 513, 5600 MB Eindhoven, The Netherlands. Electronic address: a.g.tijhuis@tue.nl.
¹⁵ Kempenhaeghe Academic Center for Epileptology, P.O. Box 61, 5590 AB Heeze, The Netherlands; Department of Electrical Engineering, University of Technology Eindhoven, P.O. Box 513, 5600 MB Eindhoven, The Netherlands; Department of Neurology, Ghent University Hospital, De Pintelaan 185, 9000 Ghent, Belgium. Electronic address: paul.boon@ugent.be.

PMID: 27021215
DOI: 10.1016/j.neubiorev.2016.02.016

Abstract

Neuromodulation is a field of science, medicine, and bioengineering that encompasses implantable and non-implantable technologies for the purpose of improving quality of life and functioning of humans. Brain neuromodulation involves different neurostimulation techniques: transcranial magnetic stimulation (TMS), transcranial direct current stimulation (tDCS), vagus nerve stimulation (VNS), and deep brain stimulation (DBS), which are being used both to study their effects on cognitive brain functions and to treat neuropsychiatric disorders. The mechanisms of action of neurostimulation remain incompletely understood. Insight into the technical basis of neurostimulation might be a first step towards a more profound understanding of these mechanisms, which might lead to improved clinical outcome and therapeutic potential. This review provides an overview of the technical basis of neurostimulation focusing on the equipment, the present understanding of induced electric fields, and the stimulation protocols. The review is written from a technical perspective aimed at supporting the use of neurostimulation in clinical practice.

Keywords: Deep brain stimulation; Electric field modeling; Neurostimulation; Stimulation equipment; Stimulation parameters; Stimulation protocol; Transcranial direct current stimulation; Transcranial magnetic stimulation; Vagus nerve stimulation.

Publication types

Review

MeSH terms

Electric Stimulation Therapy*
Humans
Quality of Life