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<p>Optimizing stimulation protocols for peripheral neuromodulation often depends on patient feedback, which can result in inconsistent clinical outcomes. Here we present a closed-loop control system for peripheral nerve stimulation (PNS) that utilizes evoked compound action potential (ECAP) feedback to regulate stimulation parameters, addressing the limitations of traditional methods. Unlike established closed-loop control techniques in the central nervous system, such as local field potential and spike analysis, a comparable approach for the peripheral nervous system remains underdeveloped. ECAPs can be consistently observed across peripheral nerves, providing a reliable measure of nerve activation. We developed a fully implantable device and neural interface for tibial nerve stimulation (TNS) that incorporates the proposed closed-loop system. This TNS system shows promise as a PNS treatment for alleviating overactive bladder symptoms. In a rat model, the system demonstrated longer micturition intervals and greater effectiveness compared to conventional motor response-based control.</p>

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Precise control of tibial nerve stimulation for bladder regulation via evoked compound action potential feedback mechanisms

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年5月2日

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  • Young-Soo Lim,
  • Ji Hong Kim,
  • Junho Kim,
  • MinhDuc Hoang,
  • Wonok Kang,
  • Mattew Koh,
  • Won Hyuk Choi,
  • Steve Park,
  • Unyong Jeong,
  • Do Hwan Kim,
  • Sung-Min Park

摘要

Optimizing stimulation protocols for peripheral neuromodulation often depends on patient feedback, which can result in inconsistent clinical outcomes. Here we present a closed-loop control system for peripheral nerve stimulation (PNS) that utilizes evoked compound action potential (ECAP) feedback to regulate stimulation parameters, addressing the limitations of traditional methods. Unlike established closed-loop control techniques in the central nervous system, such as local field potential and spike analysis, a comparable approach for the peripheral nervous system remains underdeveloped. ECAPs can be consistently observed across peripheral nerves, providing a reliable measure of nerve activation. We developed a fully implantable device and neural interface for tibial nerve stimulation (TNS) that incorporates the proposed closed-loop system. This TNS system shows promise as a PNS treatment for alleviating overactive bladder symptoms. In a rat model, the system demonstrated longer micturition intervals and greater effectiveness compared to conventional motor response-based control.