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Richter B, Mace Z, Hays ME, Adhikari S, Pham HQ, Sclabassi RJ, Kolber B, Yerneni SS, Campbell P, Cheng B, Tomycz N, Whiting DM, Le TQ, Nelson TL, Averick S. Development and Characterization of Novel Conductive Sensing Fibers for In Vivo Nerve Stimulation. SENSORS (BASEL, SWITZERLAND) 2021; 21:7581. [PMID: 34833660 PMCID: PMC8619502 DOI: 10.3390/s21227581] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 11/03/2021] [Accepted: 11/07/2021] [Indexed: 12/11/2022]
Abstract
Advancements in electrode technologies to both stimulate and record the central nervous system's electrical activities are enabling significant improvements in both the understanding and treatment of different neurological diseases. However, the current neural recording and stimulating electrodes are metallic, requiring invasive and damaging methods to interface with neural tissue. These electrodes may also degrade, resulting in additional invasive procedures. Furthermore, metal electrodes may cause nerve damage due to their inherent rigidity. This paper demonstrates that novel electrically conductive organic fibers (ECFs) can be used for direct nerve stimulation. The ECFs were prepared using a standard polyester material as the structural base, with a carbon nanotube ink applied to the surface as the electrical conductor. We report on three experiments: the first one to characterize the conductive properties of the ECFs; the second one to investigate the fiber cytotoxic properties in vitro; and the third one to demonstrate the utility of the ECF for direct nerve stimulation in an in vivo rodent model.
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Affiliation(s)
- Bertram Richter
- System Department of Neurosurgery, Allegheny Health Network, Pittsburgh, PA 15212, USA; (B.R.); (Z.M.); (R.J.S.); (B.C.); (N.T.); (D.M.W.)
| | - Zachary Mace
- System Department of Neurosurgery, Allegheny Health Network, Pittsburgh, PA 15212, USA; (B.R.); (Z.M.); (R.J.S.); (B.C.); (N.T.); (D.M.W.)
- Computational Diagnostics, Inc., Pittsburgh, PA 15213, USA
| | - Megan E. Hays
- Department of Chemistry, Oklahoma State University, Stillwater, OK 74078, USA; (M.E.H.); (S.A.); (T.L.N.)
| | - Santosh Adhikari
- Department of Chemistry, Oklahoma State University, Stillwater, OK 74078, USA; (M.E.H.); (S.A.); (T.L.N.)
| | - Huy Q. Pham
- Department of Biomedical Engineering, North Dakota State University, Fargo, ND 58102, USA;
| | - Robert J. Sclabassi
- System Department of Neurosurgery, Allegheny Health Network, Pittsburgh, PA 15212, USA; (B.R.); (Z.M.); (R.J.S.); (B.C.); (N.T.); (D.M.W.)
- Computational Diagnostics, Inc., Pittsburgh, PA 15213, USA
| | - Benedict Kolber
- Department of Neuroscience, University of Texas at Dallas, Richardson, TX 75080, USA;
| | - Saigopalakrishna S. Yerneni
- Department of Biomedical Engineering, Carnegie Mellon University, Pittsburgh, PA 15217, USA; (S.S.Y.); (P.C.)
| | - Phil Campbell
- Department of Biomedical Engineering, Carnegie Mellon University, Pittsburgh, PA 15217, USA; (S.S.Y.); (P.C.)
| | - Boyle Cheng
- System Department of Neurosurgery, Allegheny Health Network, Pittsburgh, PA 15212, USA; (B.R.); (Z.M.); (R.J.S.); (B.C.); (N.T.); (D.M.W.)
| | - Nestor Tomycz
- System Department of Neurosurgery, Allegheny Health Network, Pittsburgh, PA 15212, USA; (B.R.); (Z.M.); (R.J.S.); (B.C.); (N.T.); (D.M.W.)
| | - Donald M. Whiting
- System Department of Neurosurgery, Allegheny Health Network, Pittsburgh, PA 15212, USA; (B.R.); (Z.M.); (R.J.S.); (B.C.); (N.T.); (D.M.W.)
| | - Trung Q. Le
- Department of Industrial and Manufacturing Engineering, North Dakota State University, Fargo, ND 58102, USA
| | - Toby L. Nelson
- Department of Chemistry, Oklahoma State University, Stillwater, OK 74078, USA; (M.E.H.); (S.A.); (T.L.N.)
| | - Saadyah Averick
- System Department of Neurosurgery, Allegheny Health Network, Pittsburgh, PA 15212, USA; (B.R.); (Z.M.); (R.J.S.); (B.C.); (N.T.); (D.M.W.)
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Marquardt RJ, Levin KH. Electrodiagnostic Assessment of Radiculopathies. Neurol Clin 2021; 39:983-995. [PMID: 34602222 DOI: 10.1016/j.ncl.2021.06.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This article discusses the electrodiagnostic assessment of radiculopathy. Relevant anatomy initially is reviewed followed by discussion surrounding the approach to nerve conduction studies and needle electrode examination when it comes to radiculopathy evaluation. Pitfalls of the electrodiagnosis versus clinical diagnosis of radiculopathy and the definitions of acute versus chronic, and active versus inactive, are reviewed.
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Affiliation(s)
- Robert J Marquardt
- Neuromuscular Center, Department of Neurology, Cleveland Clinic, 9500 Euclid Avenue, Desk S90, Cleveland, OH 44195, USA
| | - Kerry H Levin
- Neuromuscular Center, Department of Neurology, Cleveland Clinic, 9500 Euclid Avenue, Desk S90, Cleveland, OH 44195, USA.
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Meiling JB, Moman R, Pagan-Rosado R, Kinzelman-Vesely E, Hunt C, Hooten WM. Electromyography and Therapeutic Response to Lumbosacral Epidural Steroid Injections: A Systematic Review. J Pain Res 2021; 14:2851-2858. [PMID: 34539187 PMCID: PMC8445100 DOI: 10.2147/jpr.s327504] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Accepted: 08/21/2021] [Indexed: 11/23/2022] Open
Abstract
The association between electromyography (EMG)-confirmed lumbosacral (LS) radiculopathy and pain outcomes following epidural steroid injection (ESI) has not been systematically summarized. The primary objective of this systematic review was to summarize the effects of EMG-confirmed LS radiculopathy on pain intensity following ESI. A secondary objective was to summarize the effects of EMG-confirmed LS radiculopathy on physical functioning following ESI. An a priori protocol was registered and a database search conducted by a reference librarian from January 2000 through December 2020. The search was date-limited to ensure the results of the systematic review represented contemporary clinical practice. Study-inclusion criteria included randomized trials, prospective and retrospective studies, cross-sectional studies, case series, and case reports, age ≥18 years, and use of EMG as a prognostic tool prior to an ESI. Two independent reviewers screened all titles, abstracts, and full texts. Data were extracted using a templated electronic database. The risk of bias was assessed using the Risk of Bias in Nonrandomized Studies of Interventions tool and certainty in evidence assessed using the Grading of Recommendations, Assessment, Development, and Evaluation approach. Due to clinical heterogeneity in study characteristics, a meta-analysis was not performed. A total of 454 studies were screened, and eight nonrandomized studies met the inclusion criteria. Five studies had a moderate risk of bias, two serious risks, and one a critical risk. The key findings included four of eight nonrandomized studies reporting a significant association between EMG-confirmed radiculopathy and ESI response and four of eight nonrandomized studies reporting no significant association. Important sources of bias limited interpretation of individual study findings, and multiple sources of clinical heterogeneity limited between-study comparisons. The findings of this systematic review demonstrate that associations existed between EMG-confirmed LS radiculopathy and pain outcomes after ESI in some, but not all studies. These results should be carefully interpreted with full understanding of the risk of bias and very low certainty in evidence that characterize the nonrandomized studies comprising this systematic review.
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Affiliation(s)
- James B Meiling
- Department of Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, MN, USA
| | - Rajat Moman
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN, USA
| | - Robert Pagan-Rosado
- Department of Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, MN, USA
| | | | - Christine Hunt
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN, USA.,Division of Pain Medicine, Mayo Clinic, Rochester, MN, USA
| | - W Michael Hooten
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN, USA.,Division of Pain Medicine, Mayo Clinic, Rochester, MN, USA
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