Modeling activation and block of autonomic nerves for analysis and design

FOCUS: Tools and Technologies
PRINCIPAL INVESTIGATOR(S): Warren Grill
INSTITUTION(S): Duke University
FUNDING PROGRAM(S): SPARC
NIH AWARD: OT2OD025340

Experiments to map physiological functions of autonomic nerves and the continued advance of bioelectronic therapies are limited by inadequate activation or block of targeted nerve fibers and unwanted co-activation or block of non-targeted nerve fibers. More fundamentally, the relationship between applied stimuli and the nerve fibers that are activated or blocked, how this relationship varies across individuals and species, and how these relationships can be controlled remain largely unknown. We will develop, implement and validate an efficient computational pipeline for simulation of electrical activation and block of different nerve fiber types within autonomic nerves. The pipeline will include segmentation of microanatomy from fixed nerve samples, three- dimensional finite-element models of electrodes positioned on nerves, and non-linear cable models of different nerve fiber types, enabling calculation of quantitative input-output maps of activation and block of specific nerve fibers. As key benchmarks of pipeline development and for the proposed analysis and design efforts, we will implement models of the cervical (VNc) and abdominal (VNa) vagus nerves in rat, in a SPARC-identified animal model, and in human. The VNc is an excellent test bed as it contains a broad spectrum of nerve fiber types, there are experimental data to facilitate model validation, and there are multiple applications of VNc stimulation where a lack of fiber selectivity limits the therapeutic window. The VNa is an excellent complement to the cervical VNc, as a prototypical autonomic nerve of a size comparable to many of the small autonomic nerves targeted by SPARC projects. We will use the models that emerge from the pipeline to achieve analysis and design goals to address critical gaps identified as SPARC priorities. Specifically, we will quantify of the effects of intra-species differences in nerve morphology on activation and block by building individual sample-specific models for each nerve and specie. These models will also be used to quantify inter-species differences in nerve fiber activation and block and to identify electrode designs and stimulation parameters that produce equivalent degrees of activation and block across species. We will combine the resulting models with engineering optimization to design approaches to increase the selectivity and efficiency of activation and block of different nerve fiber types. The outcomes will be a pipeline for modeling autonomic nerves, electrode geometries, and stimulation parameters, as well as tools that address the limitations of nerve stimulation selectivity and efficiency that hinder the continued advance of physiological mapping studies and the development of bioelectronic therapies.

Associated Content

Pig vagus nerve TH (tyrosine hydroxylase) and ChAT (choline acetyltransferase) positive fibers
Previously published as Duke_GrillPelot_OD025340_PigVagusNerve_TH_ChAT. The dataset provides immunohistological images of cross-sections of pig vagus nerves, identifying ChAT+ and TH+ fibers.
Quantified morphology of the pig vagus nerve with anti-fibronectin
Immunofluorescence micrographs of pig vagus nerves labeled with anti-fibronectin. Binary traces from segmentation to quantify effective nerve diameter, effective fascicle diameter, number of fascicles, and perineurium thickness.
Excitation properties of computational models of unmyelinated peripheral axons
Data and plotting code for excitation responses of multiple single compartment and multi-compartment models of peripheral unmyelinated axons
Anatomy and histology of the domestic pig in the context of vagus nerve stimulation
Incorporation of motor efferent branches of vagus into VNS activation
Pig vagus nerve stained with Masson's trichrome
Micrographs of cross sections of cervical and abdominal pig vagus nerve stained with Masson's trichrome.
Quantified morphology of the human vagus nerve with anti-claudin-1
Immunohistochemistry micrographs of human vagus nerves labeled with anti-claudin-1. Binary traces from segmentation to quantify effective nerve diameter, effective fascicle diameter, number of fascicles, and perineurium thickness.
Quantified morphology of the pig vagus nerve
Binary traces from segmentation of cross sections of cervical and subdiaphragmatic pig vagus nerves stained with Masson's trichrome. Quantified effective nerve diameter, effective fascicle diameter, and number of fascicles.
Human vagus nerve stained with Masson's trichrome
Micrographs of cross sections of cervical and abdominal human vagus nerve stained with Masson's trichrome.
Quantified morphology of the rat vagus nerve
Binary traces from segmentation of cross sections of cervical and subdiaphragmatic rat vagus nerves stained with Masson's trichrome. Quantified effective nerve diameter, effective fascicle diameter, number of fascicles, and perineurium thickness.
Electromyogram recordings in mice during vagus nerve stimulation
Acute physiological data describing muscle activation during VNS at different burst patterns and frequencies. This includes raw EMG files and quantified outcomes.
Electrocardiogram recordings in mice during vagus nerve stimulation
Acute physiological data describing heart rate modulation during VNS at different burst patterns and frequencies. this includes raw ECG files and quantified outcomes.
ASCENT Guided Mode Demo
Demo of the ASCENT pipeline on o²S²PARC, with a limited set of user-defined parameters
ASCENT Base
ASCENT software on o²S²PARC
Stimulation of the pig vagus nerve to modulate target effect versus side effect
This dataset contains the electroneurography, electromyography, and histology of pig vagus nerve, following vagus nerve stimulation with the ImThera stimulating cuff.
Validated computational models predict vagus nerve stimulation thresholds in preclinical animals and humans
Validated computational models of rat (Micro-Leads Neuro, n=1), pig (LivaNova, n=20), and human (LivaNova, n=9) vagus nerve stimulation, built with ASCENT v1.1.1, using histology to define nerve morphologies, and using the cuff electrodes and waveforms
Human cervical vagus nerve fascicle imaging with MicroCT
MicroCT imaging of the human cervical vagus nerve: slices at 0.5 cm spacing are provided across a 5 cm window representing the surgical window typical of vagus nerve stimulation. Derived data include fascicle morphometry, splitting and merging events.
Histology of pig cervical vagus nerve
Trichrome stained histology of the pig cervical vagus nerve at the region of vagus nerve stimulation (VNS).
Population of mock morphological models of vagus nerve stimulation with cuff electrodes for the purpose of studying the effect of fascicle diameter on activation threshold
Computational models and resulting activation thresholds of vagus nerve stimulation for simplified nerve morphologies, built with ASCENT v1.0.3. Modeled electrode designs include monopolar and clinical LivaNova helical cuffs.
Histology-based computational models of implanted human cervical vagus nerve stimulation with the LivaNova helical cuff electrode
Computational models and resulting activation thresholds of vagus nerve stimulation with the LivaNova helical cuff, built with ASCENT v1.1.1, using histology from nine human vagus nerves at the mid-cervical level.
Computational model of heart rate modulation in mice during vagus nerve stimulation
Network model of parasympathetic innervation of the sinoatrial node.
Computational model of vagus nerve stimulation in mice with bipolar cuff electrode
Computational model of vagus nerve stimulation in mice with a bipolar cuff electrode, built with ASCENT v1.1.4, using a generalized nerve morphology.
Pig-specific computational models of monopolar vagus nerve stimulation with a six-contact cuff electrode
Computational models of monopolar pig vagus nerve stimulation with a six-contact cuff, built with ASCENT v1.0.1, using the histology for six pigs in which electrophysiological outputs were recorded in vivo.
Electrode design characterization for electrophysiology from swine peripheral nervous system
Comparison of cuff, microelectrode, and intrafascicular electrode to make evoked compound action potential (ECAP) and naturally occurring activity recordings from the peripheral nervous system. Dataset from pigs (n=3) - a human-scale large animal model.
In vivo visualization of pig vagus nerve 'vagotopy' using ultrasound
Ultrasound images of the vagus nerve from within the surgical pocket in a pig model to visualize the bimodal organization, or 'vagotopy'.
Human vagus nerve TH- (tyrosine hydroxylase) and ChAT- (choline acetyltransferase) positive fibers
This dataset provides immunohistological images of cross sections of human vagus nerves, identifying ChAT+ and TH+ fibers.
Rat vagus nerve TH- (tyrosine hydroxylase) and ChAT- (choline acetyltransferase) positive fibers
This dataset provides immunohistological images of cross sections of rat vagus nerves, identifying ChAT+ and TH+ fibers.
Vagus nerve stimulation mapping in swine
VNS evoked vagus nerve compound action potential and neck muscle electromyography data via stimulation at a 1 mm disk electrode at many locations on vagus nerve
Sources of off-target effects for vagus nerve stimulation using the LivaNova clinical lead in swine
Vagus Nerve Stimulation evoked vagus nerve compound action potential and neck muscle electromyography data
Rat vagus nerve stained with Masson's trichrome
Micrographs of cross sections of cervical and abdominal rat vagus nerve stained with Masson's trichrome.