Method for Use of Depolarizing Pre-Pulses to Increase the Maximum Comfortable Stimulation Level of Neurostimulation
Publication Date: 2003-Jan-09
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Depolarizing Pre-Pulses (DPPs) disable Dorsal Root (DR) fibers, thereby enabling a broad effective range of stimulation of Dorsal Column (DC) fibers. Spinal Cord Stimulation (SCS) systems generally target DC fibers for stimulation. However, neighboring DR fibers are generally more responsive to the stimulation, and limit the threshold for comfortable stimulation. Long duration sub-threshold depolarizing pre-pulses cause the effective h-gate of the sodium channels of the DR fibers to close, but do not cause the effective m-gate of the sodium channels of the DR fibers to open. Because the DC fibers are less responsive than the DR fibers (primarily due to their closer proximity to the stimulating electrodes), the sub-threshold pulses do not cause the effective h-gate of the sodium channels of the DC fibers to close. Normal stimulation pulses may then be applied over a broad range of stimulation levels without undesirable side effects associated with DR fiber stimulation.