Peripheral nerve stimulation by gradient switching fields in magnetic resonance imaging

Experimental validation of a PNS-optimized whole-body gradient coil

PURPOSE

Peripheral nerve stimulation (PNS) limits the usability of state-of-the-art whole-body and head-only MRI gradient coils. We used detailed electromagnetic and neurodynamic modeling to set an explicit PNS constraint during the design of a whole-body gradient coil and constructed it to compare the predicted and experimentally measured PNS thresholds to those of a matched design without PNS constraints.

METHODS

We designed, constructed, and tested two actively shielded whole-body Y-axis gradient coil winding patterns: YG1 is a conventional symmetric design without PNS-optimization, whereas YG2's design used an additional constraint on the allowable PNS threshold in the head-imaging landmark, yielding an asymmetric winding pattern. We measured PNS thresholds in 18 healthy subjects at five landmark positions (head, cardiac, abdominal, pelvic, and knee).

RESULTS

The PNS-optimized design YG2 achieved 46% higher average experimental thresholds for a head-imaging landmark than YG1 while incurring a 15% inductance penalty. For cardiac, pelvic, and knee imaging landmarks, the PNS thresholds increased between +22% and +35%. For abdominal imaging, PNS thresholds did not change significantly between YG1 and YG2 (-3.6%). The agreement between predicted and experimental PNS thresholds was within 11.4% normalized root mean square error for both coils and all landmarks. The PNS model also produced plausible predictions of the stimulation sites when compared to the sites of perception reported by the subjects.

CONCLUSION

The PNS-optimization improved the PNS thresholds for the target scan landmark as well as most other studied landmarks, potentially yielding a significant improvement in image encoding performance that can be safely used in humans.

A full-head model to investigate intra and extracochlear electric fields in cochlear implant stimulation

Objective.Despite the widespread use and technical improvement of cochlear implant (CI) devices over past decades, further research into the bioelectric bases of CI stimulation is still needed. Various stimulation modes implemented by different CI manufacturers coexist, but their true clinical benefit remains unclear, probably due to the high inter-subject variability reported, which makes the prediction of CI outcomes and the optimal fitting of stimulation parameters challenging. A highly detailed full-head model that includes a cochlea and an electrode array is developed in this study to emulate intracochlear voltages and extracochlear current pathways through the head in CI stimulation.Approach.Simulations based on the finite element method were conducted under monopolar, bipolar, tripolar (TP), and partial TP modes, as well as for apical, medial, and basal electrodes. Variables simulated included: intracochlear voltages, electric field (EF) decay, electric potentials at the scalp and extracochlear currents through the head. To better understand CI side effects such as facial nerve stimulation, caused by spurious current leakage out from the cochlea, special emphasis is given to the analysis of the EF over the facial nerve.Main results.The model reasonably predicts EF magnitudes and trends previously reported in CI users. New relevant extracochlear current pathways through the head and brain tissues have been identified. Simulated results also show differences in the magnitude and distribution of the EF through different segments of the facial nerve upon different stimulation modes and electrodes, dependent on nerve and bone tissue conductivities.Significance.Full-head models prove useful tools to model intra and extracochlear EFs in CI stimulation. Our findings could prove useful in the design of future experimental studies to contrast FNS mechanisms upon stimulation of different electrodes and CI modes. The full-head model developed is freely available for the CI community for further research and use.

From Voxels to Physiology: A Review of Diffusion Magnetic Resonance Imaging Applications in Skeletal Muscle

Skeletal muscle has a classic structure function relationship; both skeletal muscle microstructure and architecture are directly related to force generating capacity. Biopsy, the gold standard for evaluating muscle microstructure, is highly invasive, destructive to muscle, and provides only a small amount of information about the entire volume of a muscle. Similarly, muscle fiber lengths and pennation angles, key features of muscle architecture predictive of muscle function, are traditionally studied via cadaveric dissection. Noninvasive techniques such as diffusion magnetic resonance imaging (dMRI) offer quantitative approaches to study skeletal muscle microstructure and architecture. Despite its prevalence in applications for musculoskeletal research, clinical adoption is hindered by a lack of understanding regarding its sensitivity to clinically important biomarkers such as muscle fiber cross-sectional area. This review aims to elucidate how dMRI has been utilized to study skeletal muscle, covering fundamentals of muscle physiology, dMRI acquisition techniques, dMRI modeling, and applications where dMRI has been leveraged to noninvasively study skeletal muscle changes in response to disease, aging, injury, and human performance. LEVEL OF EVIDENCE: 5 TECHNICAL EFFICACY: Stage 2.

Orthopedic implants affect the electric field induced by switching gradients in MRI

PURPOSE

To investigate whether the risk of peripheral nerve stimulation increases in the presence of bulky metallic prostheses implanted in a patient's body.

METHODS

A computational tool was used to calculate the electric field (E-field) induced in a realistic human model due to the action of gradient fields. The calculations were performed both on the original version of the anatomical model and on a version modified through "virtual surgery" to incorporate knee, hip, and shoulder prostheses. Five exam positions within a body gradient coil and one position using a head gradient coil were simulated, subjecting the human model to the readout gradient from an EPI sequence. The induced E-field in models with and without prostheses was compared, focusing on the nerves and all other tissues (both including and excluding the bones from the analysis).

RESULTS

In the nerves, the most pronounced increase in the E-field (+24%) was observed around the knee implant during an abdominal MRI (Y axis readout). When extending the analysis to encompass all tissues (excluding bones), the greatest amplification (+360%) occurred around the knee implant during pelvic MRI (Z axis readout). Notable increases in E-field peaks were also identified around the shoulder and hip implants in multiple scenarios.

CONCLUSION

Based on the presented results, further investigations aimed at quantifying the threshold of nerve stimulation in the presence of bulky implants are desirable.

Trigeminal nerve direct current stimulation causes sustained increase in neural activity in the rat hippocampus

Transcranial direct current stimulation (tDCS) is a noninvasive neuromodulation method that can modulate many brain functions including learning and memory. Recent evidence suggests that tDCS memory effects may be caused by co-stimulation of scalp nerves such as the trigeminal nerve (TN), and not the electric field in the brain. The TN gives input to brainstem nuclei, including the locus coeruleus that controls noradrenaline release across brain regions, including hippocampus. However, the effects of TN direct current stimulation (TN-DCS) are currently not well understood. In this study we hypothesized that TN-DCS manipulates hippocampal activity via an LC-noradrenergic bottom-up pathway. We recorded neural activity in rat hippocampus using multichannel silicon probes. We applied 3 minutes of 0.25 mA or 1 mA TN-DCS, monitored hippocampal activity for up to 1 hour and calculated spikes-rate and spike-field coherence metrics. Subcutaneous injections of xylocaine were used to block TN and intraperitoneal injection of clonidine to block the LC pathway. We found that 1 mA TN-DCS caused a significant increase in hippocampal spike-rate lasting 45 minutes in addition to significant changes in spike-field coherence, while 0.25 mA TN-DCS did not. TN blockage prevented spike-rate increases, confirming effects were not caused by the electric field in the brain. When 1 mA TN-DCS was delivered during clonidine blockage no increase in spike-rate was observed, suggesting an important role for the LC-noradrenergic pathway. These results provide a neural basis to support a tDCS TN co-stimulation mechanism. TN-DCS emerges as an important tool to potentially modulate learning and memory.

Highlights

Trigeminal nerve direct current stimulation (TN-DCS) boosts hippocampal spike ratesTN-DCS alters spike-field coherence in theta and gamma bands across the hippocampus.Blockade experiments indicate that TN-DCS modulated hippocampal activity via the LC-noradrenergic pathway.TN-DCS emerges as a potential tool for memory manipulation.

Figure Graphic Abstract

Reinterpreting published tDCS results in terms of a cranial and cervical nerve co-stimulation mechanism

Transcranial direct current stimulation (tDCS) is a non-invasive neuromodulation method that has been used to alter cognition in hundreds of experiments. During tDCS, a low-amplitude current is delivered via scalp electrodes to create a weak electric field in the brain. The weak electric field causes membrane polarization in cortical neurons directly under the scalp electrodes. It is generally assumed that this mechanism causes the observed effects of tDCS on cognition. However, it was recently shown that some tDCS effects are not caused by the electric field in the brain but rather via co-stimulation of cranial and cervical nerves in the scalp that also have neuromodulatory effects that can influence cognition. This peripheral nerve co-stimulation mechanism is not controlled for in tDCS experiments that use the standard sham condition. In light of this new evidence, results from previous tDCS experiments could be reinterpreted in terms of a peripheral nerve co-stimulation mechanism. Here, we selected six publications that reported tDCS effects on cognition and attributed the effects to the electric field in the brain directly under the electrode. We then posed the question: given the known neuromodulatory effects of cranial and cervical nerve stimulation, could the reported results also be understood in terms of tDCS peripheral nerve co-stimulation? We present our re-interpretation of these results as a way to stimulate debate within the neuromodulation field and as a food-for-thought for researchers designing new tDCS experiments.

Peripheral nerve stimulation informed design of a high-performance asymmetric head gradient coil

PURPOSE

Peripheral nerve stimulation (PNS) limits the image encoding performance of both body gradient coils and the latest generation of head gradients. We analyze a variety of head gradient design aspects using a detailed PNS model to guide the design process of a new high-performance asymmetric head gradient to raise PNS thresholds and maximize the usable image-encoding performance.

METHODS

A novel three-layer coil design underwent PNS optimization involving PNS predictions of a series of candidate designs. The PNS-informed design process sought to maximize the usable parameter space of a coil with <10% nonlinearity in a 22 cm region of linearity, a relatively large inner diameter (44 cm), maximum gradient amplitude of 200 mT/m, and a high slew rate of 900 T/m/s. PNS modeling allowed identification and iterative adjustment of coil features with beneficial impact on PNS such as the number of winding layers, shoulder accommodation strategy, and level of asymmetry. PNS predictions for the final design were compared to measured thresholds in a constructed prototype.

RESULTS

The final head gradient achieved up to 2-fold higher PNS thresholds than the initial design without PNS optimization and compared to existing head gradients with similar design characteristics. The inclusion of a third intermediate winding layer provided the additional degrees of freedom necessary to improve PNS thresholds without significant sacrifices to the other design metrics.

CONCLUSION

Augmenting the design phase of a new high-performance head gradient coil by PNS modeling dramatically improved the usable image-encoding performance by raising PNS thresholds.

Peripheral nerve stimulation: A neuromodulation-based approach

Recent technological improvements have positioned us at the threshold of innovative discoveries that will assist in new perspectives and avenues of research. Increased attention has been directed towards peripheral nerve stimulation, particularly of the vagus, trigeminal, or greater occipital nerve, due to their unique pathway that engages neural circuits within networks involved in higher cognitive processes. Here, we question whether the effects of transcutaneous electrical stimulation are mediated by synergistic interactions of multiple neuromodulatory networks, considering this pathway is shared by more than one neuromodulatory system. By spotlighting this attractive transcutaneous pathway, this opinion piece aims to acknowledge the contributions of four vital neuromodulators and prompt researchers to consider them in future investigations or explanations.

Analysis of Numerical Artifacts Using Tetrahedral Meshes in Low Frequency Numerical Dosimetry

Anatomical realistic voxel models of human beings are commonly used in numerical dosimetry to evaluate the human exposure to low-frequency electromagnetic fields. The downside of these models is that they do not correctly reproduce the boundaries of curved surfaces. The stair-casing approximation errors introduce computational artifacts in the evaluation of the induced electric field and the use of post-processing filtering methods is essential to mitigate these errors. With a suitable exposure scenario, this paper shows that tetrahedral meshes make it possible to remove stair-casing errors. However, using tetrahedral meshes is not a sufficient condition to completely remove artifacts, because the quality of the tetrahedral mesh plays an important role. The analyses carried out show that in real exposure scenarios, other sources of artifacts cause peak values of the induced electric field even with regular meshes. In these cases, the adoption of filtering techniques cannot be avoided.

Progress in Understanding Radiofrequency Heating and Burn Injuries for Safer MR Imaging

RF electromagnetic wave exposure during MRI scans induces heat and occasionally causes burn injuries to patients. Among all the types of physical injuries that have occurred during MRI examinations, RF burn injuries are the most common ones. The number of RF burn injuries increases as the static magnetic field of MRI systems increases because higher RFs lead to higher heating. The commonly believed mechanisms of RF burn injuries are the formation of a conductive loop by the patient's posture or cables, such as an electrocardiogram lead; however, the mechanisms of RF burn injuries that occur at the contact points, such as the bore wall and the elbow, remain unclear. A comprehensive understanding of RF heating is needed to address effective countermeasures against all RF burn injuries for safe MRI examinations. In this review, we summarize the occurrence of RF burn injury cases by categorizing RF burn injuries reported worldwide in recent decades. Safety standards and regulations governing RF heating that occurs during MRI examinations are presented, along with their theoretical and physiological backgrounds. The experimental assessment techniques for RF heating are then reviewed, and the development of numerical simulation techniques is explained. In addition, a comprehensive theoretical interpretation of RF burn injuries is presented. By including the results of recent experimental and numerical simulation studies on RF heating, this review describes the progress achieved in understanding RF heating from the standpoint of MRI burn injury prevention.

Exposure of Infants to Gradient Fields in a Baby MRI Scanner

In pediatric magnetic resonance imaging (MRI), infants are exposed to rapid, time-varying gradient magnetic fields, leading to electric fields induced in the body of infants and potential safety risks (e.g. peripheral nerve stimulation). In this numerical study, the in situ electric fields in infants induced by small-sized gradient coils for a 1.5 T MRI scanner were evaluated. The gradient coil set was specially designed for the efficient imaging of infants within a small-bore (baby) scanner. The magnetic flux density and induced electric fields by the small x, y, z gradient coils in an infant model (8-week-old with a mass of 4.3 kg) were computed using the scalar potential finite differences method. The gradient coils were driven by a 1 kHz sinusoidal waveform and also a trapezoidal waveform with a 250 µs rise time. The model was placed at different scan positions, including the head area (position I), chest area (position II), and body center (position III). It was found that the induced electric fields in most tissues exceeded the basic restrictions of the ICNIRP 2010 guidelines for both waveforms. The electric fields were similar in the region of interest for all coil types and model positions but different outside the imaging region. The y-coil induced larger electric fields compared with the x- and z- coils. © 2022 Bioelectromagnetics Society.

Evaluation of Peripheral Electrostimulation Thresholds in Human Model for Uniform Magnetic Field Exposure

The external field strength according to the international guidelines and standards for human protection are derived to prevent peripheral nerve system pain at frequencies from 300-750 Hz to 1 MHz. In this frequency range, the stimulation is attributable to axon electrostimulation. One limitation in the current international guidelines is the lack of respective stimulation thresholds in the brain and peripheral nervous system from in vivo human measurements over a wide frequency range. This study investigates peripheral stimulation thresholds using a multi-scale computation based on a human anatomical model for uniform exposure. The nerve parameters are first adjusted from the measured data to fit the peripheral nerve in the trunk. From the parameters, the external magnetic field strength to stimulate the nerve was estimated. Here, the conservativeness of protection limits of the international guidelines and standards for peripheral stimulation was confirmed. The results showed a margin factor of 4-6 and 10-24 times between internal and external protection limits of Institute of Electrical and Electronics Engineers standard (IEEE C95.1) and International Commission on Non-Ionizing Radiation Protection guidelines, with the computed pain thresholds.

Assessment of Human Exposure (Including Interference to Implantable Devices) to Low-Frequency Electromagnetic Field in Modern Microgrids, Power Systems and Electric Transports

Electromagnetic field emissions of modern power systems have increased in complexity if the many power conversion forms by means of power electronics and static converters are considered. In addition, the installed electric power has grown in many everyday applications such as wireless charging of vehicles, home integrated photovoltaic systems, high-performance electrified transportation systems, and so on. Attention must then be shifted to include harmonics and commutation components on one side, as well as closer interaction with humans, that concretizes in impact on physiological functions and interference to implantable medical devices and hearing aids. The panorama is complex in that standards and regulations have also increased significantly or underwent extensive revisions in the last 10 years or so. For assessment, the straightforward application of the limits of exposure is hindered by measurement problems (time or frequency domain methods, positioning errors, impact of uncertainty) and complex scenarios of exposure (multiple sources, large field gradient, time-varying emissions). This work considers thus both the clarification of the principles of interaction for each affected system (including humans) and the discussion of the large set of related normative and technical documents, deriving a picture of requirements and constraints. The methods of assessment are discussed in a metrological perspective using a range of examples.

The effect of high-definition transcranial direct current stimulation intensity on motor performance in healthy adults: a randomized controlled trial

Background

The results of transcranial direct current stimulation (tDCS) studies that seek to improve motor performance for people with neurological disorders, by targeting the primary motor cortex, have been inconsistent. One possible reason, among others, for this inconsistency, is that very little is known about the optimal protocols for enhancing motor performance in healthy individuals. The best way to optimize stimulation protocols for enhancing tDCS effects on motor performance by means of current intensity modulation has not yet been determined. We aimed to determine the effect of current intensity on motor performance using–for the first time–a montage optimized for maximal focal stimulation via anodal high-definition tDCS (HD-tDCS) on the right primary motor cortex in healthy subjects.

Methods

Sixty participants randomly received 20-min HD-tDCS at 1.5, 2 mA, or sham stimulation. Participants’ reaching performance with the left hand on a tablet was tested before, during, and immediately following stimulation, and retested after 24 h.

Results

In the current montage of HD-tDCS, movement time did not differ between groups in each timepoint. However, only after HD-tDCS at 1.5 mA did movement time improve at posttest as compared to pretest. This reduction in movement time from pretest to posttest was significantly greater compared to HD-tDCS 2 mA. Following HD-tDCS at 1.5 mA and sham HD-tDCS, but not 2 mA, movement time improved at retest compared to pretest, and at posttest and retest compared to the movement time during stimulation. In HD-tDCS at 2 mA, the negligible reduction in movement time from the course of stimulation to posttest was significantly lower compared to sham HD-tDCS. Across all groups, reaction time improved in retest compared to pretest and to the reaction time during stimulation, and did not differ between groups in each timepoint.

Conclusions

It appears that 2 mA in this particular experimental setup inhibited the learning effects. These results suggest that excitatory effects induced by anodal stimulation do not hold for every stimulation intensity, information that should be taken into consideration when translating tDCS use from the realm of research into more optimal neurorehabilitation.

Trial registration: Clinical Trials Gov, NCT04577768. Registered 6 October 2019 -Retrospectively registered, https://register.clinicaltrials.gov/prs/app/action/SelectProtocol?sid=S000A9B3&selectaction=Edit&uid=U0005AKF&ts=8&cx=buucf0.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12984-021-00899-z.

Transcranial alternating current stimulation entrains alpha oscillations by preferential phase synchronization of fast-spiking cortical neurons to stimulation waveform

Computational modeling and human studies suggest that transcranial alternating current stimulation (tACS) modulates alpha oscillations by entrainment. Yet, a direct examination of how tACS interacts with neuronal spiking activity that gives rise to the alpha oscillation in the thalamo-cortical system has been lacking. Here, we demonstrate how tACS entrains endogenous alpha oscillations in head-fixed awake ferrets. We first show that endogenous alpha oscillations in the posterior parietal cortex drive the primary visual cortex and the higher-order visual thalamus. Spike-field coherence is largest for the alpha frequency band, and presumed fast-spiking inhibitory interneurons exhibit strongest coupling to this oscillation. We then apply alpha-tACS that results in a field strength comparable to what is commonly used in humans (<0.5 mV/mm). Both in these ferret experiments and in a computational model of the thalamo-cortical system, tACS entrains alpha oscillations by following the theoretically predicted Arnold tongue. Intriguingly, the fast-spiking inhibitory interneurons exhibit a stronger entrainment response to tACS in both the ferret experiments and the computational model, likely due to their stronger endogenous coupling to the alpha oscillation. Our findings demonstrate the in vivo mechanism of action for the modulation of the alpha oscillation by tACS.

tDCS peripheral nerve stimulation: a neglected mode of action?

Transcranial direct current stimulation (tDCS) is a noninvasive neuromodulation method widely used by neuroscientists and clinicians for research and therapeutic purposes. tDCS is currently under investigation as a treatment for a range of psychiatric disorders. Despite its popularity, a full understanding of tDCS's underlying neurophysiological mechanisms is still lacking. tDCS creates a weak electric field in the cerebral cortex which is generally assumed to cause the observed effects. Interestingly, as tDCS is applied directly on the skin, localized peripheral nerve endings are exposed to much higher electric field strengths than the underlying cortices. Yet, the potential contribution of peripheral mechanisms in causing tDCS's effects has never been systemically investigated. We hypothesize that tDCS induces arousal and vigilance through peripheral mechanisms. We suggest that this may involve peripherally-evoked activation of the ascending reticular activating system, in which norepinephrine is distributed throughout the brain by the locus coeruleus. Finally, we provide suggestions to improve tDCS experimental design beyond the standard sham control, such as topical anesthetics to block peripheral nerves and active controls to stimulate non-target areas. Broad adoption of these measures in all tDCS experiments could help disambiguate peripheral from true transcranial tDCS mechanisms.

Radiation protection in non-ionizing and ionizing body composition assessment procedures

Body composition assessment (BCA) represents a valid instrument to evaluate nutritional status through the quantification of lean and fat tissue, in healthy subjects and sick patients. According to the clinical indication, body composition (BC) can be assessed by different modalities. To better analyze radiation risks for patients involved, BCA procedures can be divided into two main groups: the first based on the use of ionizing radiation (IR), involving dual energy X-ray absorptiometry (DXA) and computed tomography (CT), and others based on non-ionizing radiation (NIR) [magnetic resonance imaging (MRI)]. Ultrasound (US) techniques using mechanical waves represent a separate group. The purpose of our study was to analyze publications about IR and NIR effects in order to make physicians aware about the risks for patients undergoing medical procedures to assess BCA providing to guide them towards choosing the most suitable method. To this end we reported the biological effects of IR and NIR and their associated risks, with a special regard to the excess risk of death from radio-induced cancer. Furthermore, we reported and compared doses obtained from different IR techniques, giving practical indications on the optimization process. We also summarized current recommendations and limits for techniques employing NIR and US. The authors conclude that IR imaging procedures carry relatively small individual risks that are usually justified by the medical need of patients, especially when the optimization principle is applied. As regards NIR imaging procedures, a few studies have been conducted on interactions between electromagnetic fields involved in MR exam and biological tissue. To date, no clear link exists between MRI or associated magnetic and pulsed radio frequency (RF) fields and subsequent health risks, whereas acute effects such as tissue burns and phosphenes are well-known; as regards the DNA damage and the capability of NIR to break chemical bonds, they are not yet robustly demonstrated. MRI is thus considered to be very safe for BCA as well US procedures.

Dosimetric analysis of hands exposure during handling of strong permanent magnets

Workers in a production line for synchronous motors occasionally reported tingling sensations or a feeling of numbness in their hands when handling strong permanent magnets. As the magnetic flux density (B) and its gradients along and close to the surface of the permanent magnets were expected to be comparably high and the movements of the workers' hands may therefore cause relevant induction inside the tissue, a detailed dosimetric analysis of the in situ electric field inside the hands (E_i) of the workers was carried out. The time derivate of the magnetic flux density (dB/dt) occurring along the hands was determined based on time domain measurements using a specially developed 'measurement glove' containing 12 Hall sensors. Based on these measurement results temporal peak electric field strength (E_i) induced inside a newly developed high resolution anatomical hand models were numerically computed, using the scalar potential finite difference (SPFD) method. The highest measured dB/dt along the palmar side of the hand was 51.2 T s^-1. The corresponding worst case temporal peak value of the maximum of the E_i averaged over 2 × 2 × 2 mm³ in soft tissue was 2.0 V m^-1, which is a factor of 1.8 higher than the applicable exposure limit value, but still below the range of 3.8-6.2 V m^-1 which is presently assumed the range of lowest stimulation threshold for peripheral nerves. Our analysis did therefore not provide an indication that the perception reported by the workers are due to tissue stimulation in the sense of provoking action potentials.

Transcranial magnetic stimulation safety from operator exposure perspective

A simulated model of a commercial transcranial magnetic stimulation (TMS) coil is analyzed to determine electromagnetic field (EMF) exposure for an operator while holding or adjusting the coil. Induced EMF strengths are calculated using a commercial figure-8 coil geometry and pulse configuration, with geometrical representations of the subject's head and the operator's head, torso, and hand. Exposure levels are compared to experimental results in the literature and international guidelines for occupational EMF exposure limits. Exposure limit guidelines of 0.8 V/m rms are exceeded at approximately 24.6 cm from the coil for the torso model and at 20.3 cm for the head model measured perpendicular to the plane of the coil. In the plane of the coil, the operator can approach closer without exceeding guidelines. The results in the hand model along the edge of the coil give 9.9 V/m and 88.5 V/m for average and peak field strength, respectively. A discussion of the potential consequences of operator exposure to fields exceeding published guidelines concludes that since the guidelines are only concerned with acute effects and do not suggest any potential chronic effects, occupational exposure in the context of delivering TMS treatment may be considered reasonable. Graphical abstract A model of an operator's head/torso was moved in space relative to a standard TMS coil and subject. Positions at which safety guidelines are exceeded were calculated. The maximum induced electric field was also calculated in a hand model placed in a position commonly used to hold TMS coils during treatments.

Investigating the Feasibility of Epicranial Cortical Stimulation Using Concentric-Ring Electrodes: A Novel Minimally Invasive Neuromodulation Method

BACKGROUND

Invasive cortical stimulation (ICS) is a neuromodulation method in which electrodes are implanted on the cortex to deliver chronic stimulation. ICS has been used to treat neurological disorders such as neuropathic pain, epilepsy, movement disorders and tinnitus. Noninvasive neuromodulation methods such as transcranial magnetic stimulation and transcranial electrical stimulation (TES) show great promise in treating some neurological disorders and require no surgery. However, only acute stimulation can be delivered. Epicranial current stimulation (ECS) is a novel concept for delivering chronic neuromodulation through subcutaneous electrodes implanted on the skull. The use of concentric-ring ECS electrodes may allow spatially focused stimulation and offer a less invasive alternative to ICS.

OBJECTIVES

Demonstrate ECS proof-of-concept using concentric-ring electrodes in rats and then use a computational model to explore the feasibility and limitations of ECS in humans.

METHODS

ECS concentric-ring electrodes were implanted in 6 rats and pulsatile stimulation delivered to the motor cortex. An MRI based electro-anatomical human head model was used to explore different ECS concentric-ring electrode designs and these were compared with ICS and TES.

RESULTS

Concentric-ring ECS electrodes can selectively stimulate the rat motor cortex. The computational model showed that the concentric-ring ECS electrode design can be optimized to achieve focused cortical stimulation. In general, focality was less than ICS but greater than noninvasive transcranial current stimulation.

CONCLUSION

ECS could be a promising minimally invasive alternative to ICS. Further work in large animal models and patients is needed to demonstrate feasibility and long-term stability.

Benchmark of different assessment methods for non-sinusoidal magnetic field exposure in the context of European Directive 2013/35/EU

For the assessment of non-sinusoidal magnetic fields the European EMF Directive 2013/35/EU specified the Weighted Peak Method in Time Domain (WPM-TD) as the reference method. However, also other scientifically validated methods are allowed, provided that they lead to approximately equivalent and comparable results. In the non-binding guide for practical implementation of 2013/35/EU three methods alternative to the WPM-TD are described, i.e. the Weighted Peak Method in Frequency Domain (WPM-FD), the Multiple Frequency Rule (MFR), and an alternative Time Domain Assessment Method (TDAM). In this paper the results of a benchmark comparison of these assessment methods, based on 12 different time domain signals of magnetic induction, measured close to real devices and nine additional generic waveforms, are presented. The results demonstrated that assessments obtained with WPM-TD and WPM-FD can be considered approximately equivalent (maximum deviation 3.4 dB). The MFR systematically overestimates exposure, due to its inherently conservative definitions. In contrast, the TDAM significantly and systematically underestimates exposure up to a factor of 22 (26.8 dB) for the considered waveforms. The main reasons for this exposure underestimation by the TDAM are the introduction of an inappropriate time averaging, and the fact that the characteristic time parameter τ _p,min, describing the minimum duration of all field changes dB/dt of the waveform is derived independently from the extent of the field change in the definitions of the TDAM. Consequently, we recommend not to use the TDAM as presently published in the non-binding guide to 2013/35/EU, as its application would be in contradiction with the underlying aim of 2013/35/EU, i.e. a harmonised level of occupational safety with respect to exposure to electromagnetic fields.

tACS motor system effects can be caused by transcutaneous stimulation of peripheral nerves

Transcranial alternating current stimulation (tACS) is a noninvasive neuromodulation method which has been shown to modulate hearing, motor, cognitive and memory function. However, the mechanisms underpinning these findings are controversial, as studies show that the current reaching the cortex may not be strong enough to entrain neural activity. Here, we propose a new hypothesis to reconcile these opposing results: tACS effects are caused by transcutaneous stimulation of peripheral nerves in the skin and not transcranial stimulation of cortical neurons. Rhythmic activity from peripheral nerves then entrains cortical neurons. A series of experiments in rats and humans isolated the transcranial and transcutaneous mechanisms and showed that the reported effects of tACS on the motor system can be caused by transcutaneous stimulation of peripheral nerves. Whether or not the transcutaneous mechanism will generalize to tACS effects on other systems is debatable but should be investigated.

Transcranial alternating current stimulation (tACS) uses weak electrical currents, applied to the head, to modulate brain activity. Here, the authors show that contrary to previous assumptions, the effects of tACS on the brain may be mediated by its effect on peripheral nerves in the skin, not direct.

Sensitivity analysis of neurodynamic and electromagnetic simulation parameters for robust prediction of peripheral nerve stimulation

Peripheral nerve stimulation (PNS) has become an important limitation for fast MR imaging using the latest gradient hardware. We have recently developed a simulation framework to predict PNS thresholds and stimulation locations in the body for arbitrary coil geometries to inform the gradient coil optimization process. Our approach couples electromagnetic field simulations in realistic body models to a neurodynamic model of peripheral nerve fibers. In this work, we systematically analyze the impact of key parameters on the predicted PNS thresholds to assess the robustness of the simulation results. We analyze the sensitivity of the simulated thresholds to variations of the most important simulation parameters, including parameters of the electromagnetic field simulations (dielectric tissue properties, body model size, position, spatial resolution, and coil model discretization) and parameters of the neurodynamic simulation (length of the simulated nerves, position of the nerve model relative to the extracellular potential, temporal resolution of the nerve membrane dynamics). We found that for the investigated setup, the subject-dependent parameters (e.g. tissue properties or body size) can affect PNS prediction by up to ~26% when varied in a natural range. This is in accordance with the standard deviation of ~30% reported in human subject studies. Parameters related to numerical aspects can cause significant simulation errors (>30%), if not chosen cautiously. However, these perturbations can be controlled to yield errors below 5% for all investigated parameters without an excessive increase in computation time. Our sensitivity analysis shows that patient-specific parameter fluctuations yield PNS threshold variations similar to the variations observed in experimental PNS studies. This may become useful to estimate population-average PNS thresholds and understand their standard deviation. Our analysis indicates that the simulated PNS thresholds are numerically robust, which is important for ranking different MRI gradient coil designs or assessing different PNS mitigation strategies.

Prediction of peripheral nerve stimulation thresholds of MRI gradient coils using coupled electromagnetic and neurodynamic simulations

PURPOSE

As gradient performance increases, peripheral nerve stimulation (PNS) is becoming a significant constraint for fast MRI. Despite its impact, PNS is not directly included in the coil design process. Instead, the PNS characteristics of a gradient are assessed on healthy subjects after prototype construction. We attempt to develop a tool to inform coil design by predicting the PNS thresholds and activation locations in the human body using electromagnetic field simulations coupled to a neurodynamic model. We validate the approach by comparing simulated and experimentally determined thresholds for 3 gradient coils.

METHODS

We first compute the electric field induced by the switching fields within a detailed electromagnetic body model, which includes a detailed atlas of peripheral nerves. We then calculate potential changes along the nerves and evaluate their response using a neurodynamic model. Both a male and female body model are used to study 2 body gradients and 1 head gradient.

RESULTS

There was good agreement between the average simulated thresholds of the male and female models with the experimental average (normalized root-mean-square error: <10% and <5% in most cases). The simulation could also interrogate thresholds above those accessible by the experimental setup and allowed identification of the site of stimulation.

CONCLUSIONS

Our simulation framework allows accurate prediction of gradient coil PNS thresholds and provides detailed information on location and "next nerve" thresholds that are not available experimentally. As such, we hope that PNS simulations can have a potential role in the design phase of high performance MRI gradient coils.

Numerical assessment of low-frequency dosimetry from sampled magnetic fields

Low-frequency dosimetry is commonly assessed by evaluating the electric field in the human body using the scalar potential finite difference method. This method is effective only when the sources of the magnetic field are completely known and the magnetic vector potential can be analytically computed. The aim of the paper is to present a rigorous method to characterize the source term when only the magnetic flux density is available at discrete points, e.g. in case of field measurements. The method is based on the solution of the discrete magnetic curl equation. The system is restricted to the independent set of magnetic fluxes and circulations of magnetic vector potential using the topological information of the computational mesh. The solenoidality of the magnetic flux density is preserved using a divergence-free interpolator based on vector radial basis functions. The analysis of a benchmark problem shows that the complexity of the proposed algorithm is linearly dependent on the number of elements with a controllable accuracy. The method proposed in this paper also proves to be useful and effective when applied to a real world scenario, where the magnetic flux density is measured in proximity of a power transformer. A 8 million voxel body model is then used for the numerical dosimetric analysis. The complete assessment is completed in less than 5 min, that is more than acceptable for these problems.

Predicting Magnetostimulation Thresholds in the Peripheral Nervous System using Realistic Body Models

Rapid switching of applied magnetic fields in the kilohertz frequency range in the human body induces electric fields powerful enough to cause Peripheral Nerve Stimulation (PNS). PNS has become one of the main constraints on the use of high gradient fields for fast imaging with the latest MRI gradient technology. In recent MRI gradients, the applied fields are powerful enough that PNS limits their application in fast imaging sequences like echo-planar imaging. Application of Magnetic Particle Imaging (MPI) to humans is similarly PNS constrained. Despite its role as a major constraint, PNS considerations are only indirectly incorporated in the coil design process, mainly through using the size of the linear region as a proxy for PNS thresholds or by conducting human experiments after constructing coil prototypes. We present for the first time, a framework to simulate PNS thresholds for realistic coil geometries to directly address PNS in the design process. Our PNS model consists of an accurate body model for electromagnetic field simulations, an atlas of peripheral nerves, and a neurodynamic model to predict the nerve responses to imposed electric fields. With this model, we were able to reproduce measured PNS thresholds of two leg/arm solenoid coils with good agreement.

Acquisition of electrocardiogram signals during magnetic resonance imaging

The recording of the electrocardiogram (ECG) during magnetic resonance imaging (MRI) acquisition is of great interest and importance. Firstly, MRI acquisition is a relatively slow process, which therefore complicates the imaging of moving organs. Cardiac MRI requires the development of strategies for acquiring high quality images, which is mainly achieved by synchronising the image acquisition with a specific time during the cardiac cycle. The ECG is used to monitor the heart's activity, and the detection of the largest and steepest peak in the cardiac cycle (the QRS complex) triggers the acquisition of slices of the k-space. Secondly, patients undergoing an MRI examination need to be monitored for safety during the procedure, and therefore ECG signals are used to track their cardiovascular state in real time. However, there are significant barriers to the accurate observation and processing of the ECG during MRI acquisition. In particular, the flow of charged blood particles through the large applied magnetic field leads to an extra current source, known as the magnetohdrodymanic (MHD) effect. This review article discusses these barriers and state-of-the-art solutions. An overview of the relevant technology including hardware and applications are described. The development of new software tools for the processing of the ECG signals acquired during MRI is also detailed. These developments include the design of specific QRS detection algorithms, which are able to distinguish QRS complexes from the MHD effect but also the gradient artefacts. Different techniques for the suppression of the gradient artefacts are also presented as well as the most challenging problem to-date-the problem of separating the MHD effect from the ECG. The article concludes by summarising the advantages of using ECG signals during MRI, but also presents the current limitations of modern analysis techniques in this domain. The most promising avenues of research are also discussed and suggestions for new methodological analyses for the development of this field are given.

Magnetic Field Reference Levels for Arbitrary Periodic Waveforms for Prevention of Peripheral Nerve Stimulation

Guidelines for prevention of peripheral nerve stimulation from exposure to low frequency magnetic fields have been developed by standard-setting bodies. Exposure limits or reference levels (RLs) are typically set in terms of the maximum root-mean-square amplitude of a sinusoidal waveform; however, environmental flux densities are often periodic, non-sinusoidal waveforms. This work presents a procedure for deriving RLs for any generalized periodic waveform using the empirical nerve-stimulation threshold data obtained from human volunteer MRI experiments. For this purpose, the "Law of Electrostimulation" (LOE), which sets forth conditions of a waveform necessary to trigger the action potential required to depolarize cell membranes, is applied to various waveforms. The results of the LOE analysis are waveform-specific, amplitude thresholds of stimulation that are found in terms of the empirically-derived rheobase threshold time-rate-of-change flux density and chronaxie from trapezoidal pulse MRI experiments. The thresholds are converted to amplitude RLs in two asymptotic frequency regimes as per the usual practice in standard setting. The resulting RLs have the same frequency dependence as in existing standards (i.e., inverse-frequency below a transition frequency and flat above). It is shown that the transition frequency is dependent only on the shape of the waveform. Both sinusoidal and non-sinusoidal waveforms have identical peak-to-peak amplitude RLs above their respective transition frequencies. Below these frequencies, all peak-to-peak amplitude RLs have the same functional dependence on frequency when the frequency is normalized to the waveform-specific transition frequency. This results in simple criteria for testing the amplitude of any arbitrary periodic waveform against potential for stimulation. These criteria are compared to guidance given for non-sinusoidal waveforms in the ICNIRP 1 Hz-100 kHz exposure standard.

Electromagnetic computation and modeling in MRI

Electromagnetic (EM) computational modeling is used extensively during the development of a Magnetic Resonance Imaging (MRI) scanner, its installation, and use. MRI, which relies on interactions between nuclear magnetic moments and the applied magnetic fields, uses a range of EM tools to optimize all of the magnetic fields required to produce the image. The main field magnet is designed to exacting specifications but challenges in manufacturing, installation, and use require additional tools to maintain target operational performance. The gradient magnetic fields, which provide the primary signal localization mechanism, are designed under another set of complex design trade-offs which include conflicting imaging performance specifications and patient physiology. Gradients are largely impervious to external influences, but are also used to enhance main field operational performance. The radiofrequency (RF) magnetic fields, which are used to elicit the signals fundamental to the MR image, are a challenge to optimize for a host of reasons that include patient safety, image quality, cost optimization, and secondary signal localization capabilities. This review outlines these issues and the EM modeling used to optimize MRI system performance.

Inconsistency of a recently proposed method for assessing magnetic field exposure for protection against peripheral nerve stimulation in occupational situations

A non-binding guide to practical implementation of European Directive 2013/35/EU concerning the limitation of occupational exposure against electromagnetic fields has been published recently. With regard to exposure assessment this guide proposes practically applicable assessment methods for non-uniform and non-sinusoidal environmental electric and magnetic fields, respectively. For non-sinusoidal magnetic fields in the low frequency range this guide proposes a time domain assessment (TDA) method, claimed to reduce the overestimation of exposure inherent to other assessment methods while being based on fundamental physiological principles regarding nerve stimulation. In the present paper we demonstrate that the proposed TDA method is not consistent with the obvious underlying principles of directive 2013/35/EU. Based on practically relevant waveforms and general considerations it can be shown that external magnetic fields may be deemed compliant by the TDA method although the underlying exposure limit values defined in 2013/35/EU may be exceeded. We therefore strongly recommend that the TDA method is removed from the guide for implementing 2013/35/EU as soon as possible.

Low-frequency electrical dosimetry: research agenda of the IEEE International Committee on Electromagnetic Safety

This article treats unsettled issues in the use of numerical models of electrical dosimetry as applied to international limits on human exposure to low-frequency (typically  <  100 kHz) electromagnetic fields and contact current. The perspective in this publication is that of Subcommittee 6 of IEEE-ICES (International Committee on Electromagnetic Safety) Technical Committee 95. The paper discusses 25 issues needing attention, fitting into three general categories: induction models; electrostimulation models; and human exposure limits. Of these, 9 were voted as 'high priority' by members of Subcommittee 6. The list is presented as a research agenda for refinements in numerical modeling with applications to human exposure limits. It is likely that such issues are also important in medical and electrical product safety design applications.

Investigation of assumptions underlying current safety guidelines on EM-induced nerve stimulation

An intricate network of a variety of nerves is embedded within the complex anatomy of the human body. Although nerves are shielded from unwanted excitation, they can still be stimulated by external electromagnetic sources that induce strongly non-uniform field distributions. Current exposure safety standards designed to limit unwanted nerve stimulation are based on a series of explicit and implicit assumptions and simplifications. This paper demonstrates the applicability of functionalized anatomical phantoms with integrated coupled electromagnetic and neuronal dynamics solvers for investigating the impact of magnetic resonance exposure on nerve excitation within the full complexity of the human anatomy. The impact of neuronal dynamics models, temperature and local hot-spots, nerve trajectory and potential smoothing, anatomical inhomogeneity, and pulse duration on nerve stimulation was evaluated. As a result, multiple assumptions underlying current safety standards are questioned. It is demonstrated that coupled EM-neuronal dynamics modeling involving realistic anatomies is valuable to establish conservative safety criteria.

Numerically simulated exposure of children and adults to pulsed gradient fields in MRI

PURPOSE

To determine exposure to gradient switching fields of adults and children in a magnetic resonance imaging (MRI) scanner by evaluating internal electric fields within realistic models of adult male, adult female, and child inside transverse and longitudinal gradient coils, and to compare these results with compliance guidelines.

MATERIALS AND METHODS

Patients inside x-, y-, and z-gradient coils were simulated using anatomically realistic models of adult male, adult female, and child. The induced electric fields were computed for 1 kHz sinusoidal current with a magnitude of 1 A in the gradient coils. Rheobase electric fields were then calculated and compared to the International Commission on Non-Ionizing Radiation Protection (ICNIRP) 2004 and International Electrotechnical Commission (IEC) 2010 guidelines. The effect of the human body, coil type, and skin conductivity on the induced electric field was also investigated.

RESULTS

The internal electric fields are within the first level controlled operating mode of the guidelines and range from 2.7V m^-1 to 4.5V m^-1 , except for the adult male inside the y-gradient coil (induced field reaches 5.4V m^-1 ).The induced electric field is sensitive to the coil type (electric field in the skin of adult male: 4V m^-1 , 4.6V m^-1 , and 3.8V m^-1 for x-, y-, and z-gradient coils, respectively), the human body model (electric field in the skin inside y-gradient coil: 4.6V m^-1 , 4.2V m^-1 , and 3V m^-1 for adult male, adult female, and child, respectively), and the skin conductivity (electric field 2.35-4.29% higher for 0.1S m^-1 skin conductivity compared to 0.2S m^-1 ).

CONCLUSION

The y-gradient coil induced the largest fields in the patients. The highest levels of internal electric fields occurred for the adult male model. J. Magn. Reson. Imaging 2016;44:1360-1367.

Dosimetric Uncertainties: Magnetic Field Coupling to Peripheral Nerve

The International Commission on Non-ionizing Radiation Protection (ICNIRP) and the Institute for Electrical and Electronic Engineers (IEEE) have established magnetic field exposure limits for the general public between 400 Hz (ICNIRP)/759 Hz (IEEE) and 100 kHz to protect against adverse effects associated with peripheral nerve stimulation (PNS). Despite apparent common purpose and similarly stated principles, the two sets of limits diverge between 3.35-100 kHz by a factor of about 7.7 with respect to PNS. To address the basis for this difference and the more general issue of dosimetric uncertainty, this paper combines experimental data of PNS thresholds derived from human subjects exposed to magnetic fields together with published estimates of induced in situ electric field PNS thresholds to evaluate dosimetric relationships of external magnetic fields to induced fields at the threshold of PNS and the uncertainties inherent to such relationships. The analyses indicate that the logarithmic range of magnetic field thresholds constrains the bounds of uncertainty of in situ electric field PNS thresholds and coupling coefficients related to the peripheral nerve (the coupling coefficients define the dosimetric relationship of external field to induced electric field). The general public magnetic field exposure limit adopted by ICNIRP uses a coupling coefficient that falls above the bounds of dosimetric uncertainty, while IEEE's is within the bounds of uncertainty toward the lower end of the distribution. The analyses illustrate that dosimetric estimates can be derived without reliance on computational dosimetry and the associated values of tissue conductivity. With the limits now in place, investigative efforts would be required if a field measurement were to exceed ICNIRP's magnetic field limit (the reference level), even when there is a virtual certainty that the dose limit (the basic restriction) has not been exceeded. The constraints on the range of coupling coefficients described in this paper could facilitate a re-evaluation of ICNIRP and IEEE dose and exposure limits and possibly lead toward harmonization.

The relationship between anatomically correct electric and magnetic field dosimetry and publishe delectric and magnetic field exposure limits

Electric and magnetic field exposure limits published by International Commission for Non-Ionizing Radiation Protection and Institute of Electrical and Electronics Engineers are aimed at protection against adverse electrostimulation, which may occur by direct coupling to excitable tissue and, in the case of electric fields, through indirect means associated with surface charge effects (e.g. hair vibration, skin sensations), spark discharge and contact current. For direct coupling, the basic restriction (BR) specifies the not-to-be-exceeded induced electric field. The key results of anatomically based electric and magnetic field dosimetry studies and the relevant characteristics of excitable tissue were first identified. This permitted us to assess the electric and magnetic field exposure levels that induce dose in tissue equal to the basic restrictions, and the relationships of those exposure levels to the limits now in effect. We identify scenarios in which direct coupling of electric fields to peripheral nerve could be a determining factor for electric field limits.

Single shot trajectory design for region-specific imaging using linear and nonlinear magnetic encoding fields

It has recently been demonstrated that nonlinear encoding fields result in a spatially varying resolution. This work develops an automated procedure to design single-shot trajectories that create a local resolution improvement in a region of interest. The technique is based on the design of optimized local k-space trajectories and can be applied to arbitrary hardware configurations that employ any number of linear and nonlinear encoding fields. The trajectories designed in this work are tested with the currently available hardware setup consisting of three standard linear gradients and two quadrupolar encoding fields generated from a custom-built gradient insert. A field camera is used to measure the actual encoding trajectories up to third-order terms, enabling accurate reconstructions of these demanding single-shot trajectories, although the eddy current and concomitant field terms of the gradient insert have not been completely characterized. The local resolution improvement is demonstrated in phantom and in vivo experiments.

A simple analytical expression for the gradient induced potential on active implants during MRI

During magnetic resonance imaging, there is an interaction between the time-varying magnetic fields and the active implantable medical devices (AIMD). In this study, in order to express the nature of this interaction, simplified analytical expressions for the electric fields induced by time-varying magnetic fields are derived inside a homogeneous cylindrical volume. With these analytical expressions, the gradient induced potential on the electrodes of the AIMD can be approximately calculated if the position of the lead inside the body is known. By utilizing the fact that gradient coils produce linear magnetic field in a volume of interest, the simplified closed form electric field expressions are defined. Using these simplified expressions, the induced potential on an implant electrode has been computed approximately for various lead positions on a cylindrical phantom and verified by comparing with the measured potentials for these sample conditions. In addition, the validity of the method was tested with isolated frog leg stimulation experiments. As a result, these simplified expressions may help in assessing the gradient-induced stimulation risk to the patients with implants.

A finite difference method for the design of gradient coils in MRI--an initial framework

This paper proposes a finite-difference (FD)-based method for the design of gradient coils in MRI. The design method first uses the FD approximation to describe the continuous current density of the coil space and then employs the stream function method to extract the coil patterns. During the numerical implementation, a linear equation is constructed and solved using a regularization scheme. The algorithm details have been exemplified through biplanar and cylindrical gradient coil design examples. The design method can be applied to unusual coil designs such as ultrashort or dedicated gradient coils. The proposed gradient coil design scheme can be integrated into a FD-based electromagnetic framework, which can then provide a unified computational framework for gradient and RF design and patient-field interactions.

Physiologic and dosimetric considerations for limiting electric fields induced in the body by movement in a static magnetic field

Movement in a strong static magnetic field induces electric fields in a human body, which may result in various sensory perceptions such as vertigo, nausea, magnetic phosphenes, and a metallic taste in the mouth. These sensory perceptions have been observed by patients and medical staff in the vicinity of modern diagnostic magnetic resonance (MR) equipment and may be distracting if they were to affect the balance and eye-hand coordination of, for example, a physician carrying out a medical operation during MR scanning. The stimulation of peripheral nerve tissue by a more intense induced electric field is also theoretically possible but has not been reported to result from such movement. The main objective of this study is to consider generic criteria for limiting the slowly varying broadband (<10 Hz) electric fields induced by the motion of the body in the static magnetic field. In order to find a link between the static magnetic flux density and the time-varying induced electric field, the static magnetic field is converted to the homogeneous equivalent transient and sinusoidal magnetic fields exposing a stationary body. Two cases are considered: a human head moving in a non-uniform magnetic field and a head rotating in a homogeneous magnetic field. Then the electric field is derived from the magnetic flux rate (dB/dt) of the equivalent field by using computational dosimetric data published in the literature for various models of the human body. This conversion allows the plotting of the threshold electric field as a function of frequency for vertigo, phosphenes, and stimulation of peripheral nerves. The main conclusions of the study are: The basic restrictions for limiting exposure to extremely low frequency magnetic fields recommended by the International Commission on Non-Ionizing Radiation Protection ICNIRP in 1998 will prevent most cases of vertigo and other sensory perceptions that result from induced electric fields above 1 Hz, while limiting the static magnetic field below 2 T, as recently recommended by ICNIRP, provides sufficient protection below 1 Hz. People can experience vertigo when moving in static magnetic fields of between 2 and 8 T, but this may be controlled to some extent by slowing down head and/or body movement. In addition, limiting the static magnetic field below 8 T provides good protection against peripheral nerve stimulation.

Interaction of MRI field gradients with the human body

In this review, the effects of low-frequency electromagnetic fields encountered specifically during magnetic resonance imaging (MRI) are examined. The primary biological effect at frequencies of between 100 and 5000 Hz (typical of MRI magnetic field gradient switching) is peripheral nerve stimulation, the result of which can be a mild tingling and muscle twitching to a sensation of pain. The models for nerve stimulation and how they are related to the rate of change of magnetic field are examined. The experimental measurements, and analytic and computational modelling work in this area are reviewed. The review concludes with a discussion of current regulation in this area and current practice as both are applied to MRI.

Exposure of workers to pulsed gradients in MRI

PURPOSE

To numerically evaluate the electric field/current density magnitudes and spatial distributions in healthcare workers when they are standing close to the gradient coil windings near the magnetic resonance imaging (MRI) scanner ends.

MATERIALS AND METHODS

Anatomically realistic, whole-body male and female voxel phantoms are engaged to model the workers at various positions near the ends of three cylindrical gradient coils (x-, y-, and z-axis gradients). The numerical calculations of induced fields are based on an efficient, quasistatic finite-difference method.

RESULTS

The simulations show that it is possible to induce electric fields/current densities above levels recommended by the International Commission for Non-ionizing Radiation Protection (ICNIRP) and the Institute of Electrical and Electronics Engineers (IEEE) standards when the workers are standing close to the gradient coils and when two or three gradients are switched simultaneously, as is often the case.

CONCLUSION

The longitudinal gradient tends to induce more fields in workers than the transverse coils. The strongest levels of field exposure are observed when all three gradients are operated simultaneously and can be above regulations when the healthcare worker is close to the gradient coils. Other postures such as bending into the magnet shall be investigated in further studies.

Accounting for human variability and sensitivity in setting standards for electromagnetic fields

Biological sensitivity and variability are key issues for risk assessment and standard setting. Variability encompasses general inter-individual variations in population responses, while sensitivity relates to unusual or extreme responses based on genetic, congenital, medical, or environmental conditions. For risk assessment and standard setting, these factors affect estimates of thresholds for effects and dose-response relationships and inform efforts to protect the more sensitive members of the population, not just the typical or average person. While issues of variability and sensitivity can be addressed by experimental and clinical studies of electromagnetic fields, investigators have paid little attention to these important issues. This paper provides examples that illustrate how default assumptions regarding variability can be incorporated into estimates of 60-Hz magnetic field exposures with no risk of cardiac stimulation and how population thresholds and variability of peripheral nerve stimulation responses at 60-Hz can be estimated from studies of pulsed gradient magnetic fields in magnetic resonance imaging studies. In the setting of standards for radiofrequency exposures, the International Commission for Non-Ionizing Radiation Protection uses inter-individual differences in thermal sensitivity as one of the considerations in the development of "safety factors." However, neither the range of sensitivity nor the sufficiency or excess of the 10-fold and the additional 5-fold safety factors have been assessed quantitatively. Data on the range of responses between median and sensitive individuals regarding heat stress and cognitive function should be evaluated to inform a reassessment of these safety factors and to identify data gaps.

Assessment of non-sinusoidal, pulsed, or intermittent exposure to low frequency electric and magnetic fields

The correct assessment of non-sinusoidal, pulsed, or intermittent exposure to low frequency electric and magnetic fields already is a key issue in the occupational environment while becoming more and more important in the domain of the general public. The method presented provides a simple and safe solution for the assessment of arbitrary field types--including sinusoidal and continuous-wave signals--with frequencies up to several 100 kHz and has already proven its practicability and usefulness for more than 5 years. The concept is based on fundamental laws of physics and electrostimulation and well-established physiological data. It allows for a seamless and easy integration in any standard or guideline dealing with human safety in electric, magnetic, and electromagnetic fields. A very simple-to-use graphical version allows an easy and fast assessment of the exposure to non-sinusoidal, pulsed, or intermittent low-frequency magnetic fields without introducing a large overestimation of the exposure situation. A computer-based version makes a much more detailed signal analysis possible and can provide useful information for exposure reduction using modifications of the magnetic field's time parameters (e.g., rise/fall times).

Electric fields induced in the human body by time-varying magnetic field gradients in MRI: numerical calculations and correlation analysis

The spatial distributions of the electric fields induced in the human body by switched magnetic field gradients in MRI have been calculated numerically using the commercial software package, MAFIA, and the three-dimensional, HUGO body model that comprises 31 different tissue types. The variation of |J|, |E| and |B| resulting from exposure of the body model to magnetic fields generated by typical whole-body x-, y- and z-gradient coils has been analysed for three different body positions (head-, heart- and hips-centred). The magnetic field varied at 1 kHz, so as to produce a rate of change of gradient of 100 T m(-1) s(-1) at the centre of each coil. A highly heterogeneous pattern of induced electric field and current density was found to result from the smoothly varying magnetic field in all cases, with the largest induced electric fields resulting from application of the y-gradient, in agreement with previous studies. By applying simple statistical analysis to electromagnetic quantities within axial planes of the body model, it is shown that the induced electric field is strongly correlated to the local value of resistivity, and the induced current density exhibits even stronger correlation with the local conductivity. The local values of the switched magnetic field are however shown to bear little relation to the local values of the induced electric field or current density.