Biomedical subjects

Johannes J Struijk

Publications and source records attributed to Johannes J Struijk.

10 recordsLinked to original sources

PubMed2006

Long QT syndrome genotyping by electrocardiography: fact, fiction, or something in between?

Diagnosis of long QT syndrome (LQTS) is difficult. A prolonged QT interval is easily overlooked, and in 10% of all patients with LQTS, the QT interval is normal. Genotyping is unfortunately not able to detect all patients and healthy subjects correctly. Although QT prolongation is the most used risk parameter, there is no clear correlation between the prolonged QT interval and the risk of arrhythmias in drug-induced LQTS. Quantification of T-wave morphology is a promising method that is able to provide more information about repolarization than QT prolongation alone. It is a fact that ECG evaluation can serve as a guide for genotyping and can reduce the costs by suggesting which gene to start sequencing, but it is fiction that the ECG can replace genotyping.

Calcium Channels↗

PubMed2006

Model-based evaluation of the short-circuited tripolar cuff configuration.

Recordings of neural information for use as feedback in functional electrical stimulation are often contaminated with interfering signals from muscles and from stimulus pulses. The cuff electrode used for the neural recording can be optimized to improve the S/I ratio. In this work, we evaluate a model of both the nerve signal and the interfering signals recorded by a cuff, and subsequently use this model to study the signal to interference ratio of different cuff designs and to evaluate a recently introduced short-circuited tripolar cuff configuration. The results of the model showed good agreement with results from measurements in rabbits and confirmed the superior performance of the short-circuited tripolar configuration as compared with the traditionally used tripolar configuration.

Action Potentials↗

PubMed2006

Closed-loop control of the heart rate by electrical stimulation of the vagus nerve.

Stimulation of the vagus nerve potentially decreases the risk of sudden cardiac death. An improvement of the technique would be its regulation using the heart rate (HR) as a feedback variable. We address the possibility of closed-loop control of the HR, focusing on the stimulation parameters, nerve fibre populations and the reproducibility of the cardiovascular response. The response to electrical stimulation of the vagus nerve was studied in seven acute experiments on pigs. Feedback regulation of the HR over periods of 5 min was carried out. Three main populations of myelinated fibres were found. The performance of the controller was significantly better at amplitudes higher than those needed for stimulation of the myelinated components only. A 18% change in the duration of the RR interval could be controlled in all experiments. The possibility of closed-loop control of the HR seems to be promising.

Action Potentials↗

PubMed2006

Focality assessment in transcranial magnetic stimulation with double and cone coils.

To evaluate the performance with respect to selectivity of the effect of the wings bending in the cone coil relative to the double coil in transcranial magnetic stimulation. The focal area and the width vector of the central lobe of the induced electrical field distributed along an elliptic surface approximating the cortex were computed for four coil models. The models represented the real coils, the double B70 and the cone B80 Medtronic, and their corresponding simulated flat coils (B70flat and B80flat). A response function was evaluated in 10 subjects for distal and proximal muscles of the upper limb by stimulation of the motor cortex along a line approximating the central sulcus. The width of the response function, at the level of the center of gravity, provided a quantitative measure for coil focality. The focal area for B70, B70flat, B80, and B80flat calculated from the model was 31.4, 32.2, 94.4, and 50.6 cm2, respectively. The width of the central lobe along the stimulation line was: 36.2, 37, 46, and 48.6 mm, respectively. Mean values of focality measure obtained experimentally were in distal muscles, 5.06 RPU (relative position units) for B70 and 5.99 RPU for B80; in proximal muscles, 4.11 RPU for B70 and 5.13 RPU for B80, with a mean RPU value of 11.13 mm. The difference, a 19% focality measure increase in B80 relative to B70 in distal muscles, was statistically significant (P < 0.001). The focality was demonstrated to be highest for the double coil. The width of the central lobe of the induced electrical field distribution is well reflected in the width of the response function. The increase in B80 is mainly due to wing geometry and relative placement of wings and is not due to the wing bending. The width of the central lobe characterizes the spread of the induced current below the wing junction, and it is a better focality estimator than the focal area for cone coils.

Electric Conductivity↗

PubMed2005

Current density imaging and electrically induced skin burns under surface electrodes.

The origin of electrical burns under gel-type surface electrodes is a controversial topic that is not well understood. To investigate the phenomenon, we have developed an excised porcine skin-gel model, and used low-frequency current density imaging (LFCDI) to determine the current density (CD) distribution through the skin before and after burns were induced by application of electrical current (200 Hz, 70% duty cycle, 20-35 mA monophasic square waveform applied to the electrodes for 30-135 min). The regions of increased CD correlate well with the gross morphological changes (burns) observed. The measurement is sensitive enough to show regions of high current densities in the pre-burn skin, that correlate with areas were burn welts were produced, thus predicting areas where burns are likely to occur. Statistics performed on 28 skin patches revealed a charge dependency of the burn areas and a relatively uniform distribution. The results do not support a thermal origin of the burns but rather electro-chemical mechanisms. We found a statistically significant difference between burn area coverage during anodic and cathodic experiments.

Animals↗

PubMed2004

Different pulse shapes to obtain small fiber selective activation by anodal blocking--a simulation study.

The aim of this study was to investigate whether it is possible to reduce a charge per pulse, which is needed for selective nerve stimulation. Simulation is performed using a two-part simulation model: a volume conductor model to calculate the electrical potential distribution inside a tripolar cuff electrode and a human fiber model to simulate the fiber response to simulation. Selective stimulation is obtained by anodal block. To obtain anodal block of large fibers, long square pulses (> 350 micros) with a relatively high currents (1-2.5 mA) are usually required. These pulses might not be safe for a long-term application because of a high charge per pulse. In this study, several pulse shapes are proposed that have less charge per pulse compared with the conventional square pulse and would therefore be safer in a chronic application. Compared with the conventional square pulse, it was possible to reduce the charge with all proposed pulse shapes, but the best results are obtained with a combination of a square depolarizing pulse and a blocking pulse. The charge per pulse was up to 32% less with that pulse shape than with a square pulse. Using a hyperpolarizing anodal prepulse preceding a square pulse, it was not possible to block nerve fibers in a whole nerve bundle and to obtain reduction of a charge per phase. Reduction of the charge could be achieved only with spatially selective blocking. The charge per phase was larger for the combination of a hyperpolarizing anodal prepulse and a two-step pulse than for the two-step pulse alone.

Action Potentials↗

PubMed2003

Artefact reduction with alternative cuff configurations.

In nerve cuff electrode recordings of neural signals, the pick-up of interfering signals can be reduced by choosing appropriate cuff configurations. In the traditionally used tripolar configuration, short circuiting of the end electrodes is expected to reduce the field inside the cuff from interfering signals. A model study suggests that moving the end electrodes toward the center of the cuff reduces the pick-up of interfering signals. In this paper, these properties are studied in more detail using a rabbit model. In addition, a new cuff configuration is suggested, which has an additional set of short circuited end electrodes. The total improvement of signal-to-noise ratio in the new configuration as compared with the traditionally used tripolar configuration was 73% for muscle signals and 127% for the stimulus pulse.

Action Potentials↗

PubMed2003

Skin contact forces extracted from human nerve signals--a possible feedback signal for FES-aided control of standing.

In this paper, information about stance related skin contact forces was extracted from nerve cuff electrode recordings of human neural signals. Forces measured under the heel during standing were scaled and applied to the innervation area of the sural nerve on the side of the foot using a hand held force probe. The neural response to the stimuli was measured with a cuff chronically implanted around the sural nerve in one hemiplegic person. An artificial neural network was used for extraction of the applied force from the recorded nerve signal. The results showed that it is possible to extract information about absolute skin contact forces from the nerve signal with an average goodness of fit of 69.3% for all trials and 82.2% for the more dynamic trials. This information may be applicable as feedback signal in control of standing.

Action Potentials↗

PubMed2002

Signal strength versus cuff length in nerve cuff electrode recordings.

When a nerve cuff electrode is used for the recording of signals from peripheral nerves, cuff dimensions have to be chosen. Traditionally, the peak-to-peak amplitude of the single-fiber action potential (SFAP) is optimized through the choice of cuff diameter and cuff length. In this paper, the dependency of the root-mean-square (RMS) value of the nerve signal on the cuff dimensions was studied and compared with the peak-to-peak value of the SFAP. A simple approximation for signal optimization by cuff dimensioning is suggested. The results were obtained from modeled SFAPs and from the electroneurogram (ENG) created by superimposed SFAPs, obtained from an inhomogeneous volume conductor model. The results show that the RMS value of the nerve signal is considerably more sensitive to the cuff length than the SFAP peak-to-peak amplitude, and that the RMS of the ENG is a linear function of the fiber diameter.

Action Potentials↗

PubMed1994

Perception threshold and electrode position for spinal cord stimulation.

The perception threshold for epidural spinal cord stimulation in chronic pain management was analyzed on 3,923 testing data obtained from 136 implanted patients. The initial areas of paresthesiae due to stimulation were recorded and reported as the stimulation map according to the location of electrodes. Measurement of dorsal thickness of the cerebrospinal fluid (CSF) layer was obtained from 26 subjects using magnetic resonance imaging (MRI). The results indicate that the perception threshold is a function of the spinal level of the implanted electrodes, of the mediolateral position in the spinal canal and the contact separation of electrode. Differences in perception threshold at various vertebral levels are mainly due to varying depths of the dorsal CSF layer. The medially placed electrodes caudal to the mid-cervical levels have a higher perception threshold than more laterally placed ones. The electrodes at high and mid-cervical levels, however, have a smaller perception threshold if placed medially. The information obtained from this investigation has important implications for the design of a new-generation stimulation system and clinical application to maximize the longevity of the power source.

Adult↗