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Thompson N, Ravagli E, Mastitskaya S, Challita R, Hadaya J, Iacoviello F, Shah Idil A, Shearing PR, Ajijola OA, Ardell JL, Shivkumar K, Holder D, Aristovich K. Anatomical and functional organization of cardiac fibers in the porcine cervical vagus nerve allows spatially selective efferent neuromodulation. bioRxiv 2024:2024.01.09.574861. [PMID: 38260584 PMCID: PMC10802425 DOI: 10.1101/2024.01.09.574861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/24/2024]
Abstract
Cardiac disease progression reflects the dynamic interaction between adversely remodeled neurohumoral control systems and an abnormal cardiac substrate. Vagal nerve stimulation (VNS) is an attractive neuromodulatory option to dampen this dynamic interaction; however, it is limited by off-target effects. Spatially-selective VNS (sVNS) offers a promising solution to induce cardioprotection while mitigating off-target effects by specifically targeting pre-ganglionic parasympathetic efferent cardiac fibers. This approach also has the potential to enhance therapeutic outcomes by eliminating time-consuming titration required for optimal VNS. Recent studies have demonstrated the independent modulation of breathing rate, heart rate, and laryngeal contraction through sVNS. However, the spatial organization of afferent and efferent cardiac-related fibers within the vagus nerve remains unexplored. By using trial-and-error sVNS in vivo in combination with ex vivo micro-computed tomography fascicle tracing, we show the significant spatial separation of cardiac afferent and efferent fibers (179±55° SD microCT, p<0.05 and 200±137° SD, p<0.05 sVNS - degrees of separation across a cross-section of nerve) at the mid-cervical level. We also show that cardiac afferent fibers are located in proximity to pulmonary fibers consistent with recent findings of cardiopulmonary convergent neurons and circuits. We demonstrate the ability of sVNS to selectively elicit desired scalable heart rate decrease without stimulating afferent-related reflexes. By elucidating the spatial organization of cardiac-related fibers within the vagus nerve, our findings pave the way for more targeted neuromodulation, thereby reducing off-target effects and eliminating the need for titration. This, in turn, will enhance the precision and efficacy of VNS therapy in treating cardiac pathology, allowing for improved therapeutic efficacy.
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Affiliation(s)
- Nicole Thompson
- EIT and Neurophysiology Research Group, Department of Medical Physics and Biomedical Engineering, University College London, London, United Kingdom
| | - Enrico Ravagli
- EIT and Neurophysiology Research Group, Department of Medical Physics and Biomedical Engineering, University College London, London, United Kingdom
| | - Svetlana Mastitskaya
- EIT and Neurophysiology Research Group, Department of Medical Physics and Biomedical Engineering, University College London, London, United Kingdom
| | - Ronald Challita
- UCLA Cardiac Arrhythmia Center and Neurocardiology Research Program of Excellence, David Geffen School of Medicine at UCLA, Los Angeles, California, USA
| | - Joseph Hadaya
- UCLA Cardiac Arrhythmia Center and Neurocardiology Research Program of Excellence, David Geffen School of Medicine at UCLA, Los Angeles, California, USA
| | - Francesco Iacoviello
- Electrochemical Innovation Lab, Department of Chemical Engineering, University College London, London, United Kingdom
| | - Ahmad Shah Idil
- EIT and Neurophysiology Research Group, Department of Medical Physics and Biomedical Engineering, University College London, London, United Kingdom
| | - Paul R. Shearing
- Electrochemical Innovation Lab, Department of Chemical Engineering, University College London, London, United Kingdom
| | - Olujimi A. Ajijola
- UCLA Cardiac Arrhythmia Center and Neurocardiology Research Program of Excellence, David Geffen School of Medicine at UCLA, Los Angeles, California, USA
| | - Jeffrey L. Ardell
- UCLA Cardiac Arrhythmia Center and Neurocardiology Research Program of Excellence, David Geffen School of Medicine at UCLA, Los Angeles, California, USA
| | - Kalyanam Shivkumar
- UCLA Cardiac Arrhythmia Center and Neurocardiology Research Program of Excellence, David Geffen School of Medicine at UCLA, Los Angeles, California, USA
| | - David Holder
- EIT and Neurophysiology Research Group, Department of Medical Physics and Biomedical Engineering, University College London, London, United Kingdom
| | - Kirill Aristovich
- EIT and Neurophysiology Research Group, Department of Medical Physics and Biomedical Engineering, University College London, London, United Kingdom
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Mason K, Aristovich K, Holder D. Non-invasive imaging of neural activity with magnetic detection electrical impedance tomography (MDEIT): a modelling study. Physiol Meas 2023; 44:114003. [PMID: 37832564 DOI: 10.1088/1361-6579/ad0358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 10/13/2023] [Indexed: 10/15/2023]
Abstract
Objectives.(1) Develop a computational pipeline for three-dimensional fast neural magnetic detection electrical impedance tomography (MDEIT), (2) determine whether constant current or constant voltage is preferable for MDEIT, (3) perform reconstructions of simulated neural activity in a human head model with realistic noise and compare MDEIT to EIT and (4) perform a two-dimensional study in a saline tank for MDEIT with optically pumped magnetometers (OPMs) and compare reconstruction algorithms.Approach.Forward modelling and image reconstruction were performed with a realistic model of a human head in three dimensions and at three noise levels for four perturbations representing neural activity. Images were compared using the error in the position and size of the reconstructed perturbations. Two-dimensional MDEIT was performed in a saline tank with a resistive perturbation and one OPM. Six reconstruction algorithms were compared using the error in the position and size of the reconstructed perturbations.Main results.A computational pipeline was developed in COMSOL Multiphysics, reducing the Jacobian calculation time from months to days. MDEIT reconstructed images with a lower reconstruction error than EIT with a mean difference of 7.0%, 5.5% and 11% for three noise cases representing current noise, reduced current source noise and reduced current source and magnetometer noise. A rank analysis concluded that the MDEIT Jacobian was less rank-deficient than the EIT Jacobian. Reconstructions of a phantom in a saline tank had a best reconstruction error of 13%, achieved using 0th-order Tikhonov regularisation with simulated noise-based correction.Significance.This study demonstrated that three-dimensional MDEIT for neural imaging is feasible and that MDEIT reconstructed superior images to EIT, which can be explained by the lesser rank deficiency of the MDEIT Jacobian. Reconstructions of a perturbation in a saline tank demonstrated a proof of principle for two-dimensional MDEIT with OPMs and identified the best reconstruction algorithm.
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Affiliation(s)
- Kai Mason
- Dept. of Medical Physics and Biomedical Engineering, University College London, Gower St, London, United Kingdom
| | - Kirill Aristovich
- Dept. of Medical Physics and Biomedical Engineering, University College London, Gower St, London, United Kingdom
| | - David Holder
- Dept. of Medical Physics and Biomedical Engineering, University College London, Gower St, London, United Kingdom
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Ravagli E, Ardell J, Holder D, Aristovich K. A combined cuff electrode array for organ-specific selective stimulation of vagus nerve enabled by Electrical Impedance Tomography. Front Med Technol 2023; 5:1122016. [PMID: 37138728 PMCID: PMC10149952 DOI: 10.3389/fmedt.2023.1122016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Accepted: 03/20/2023] [Indexed: 05/05/2023] Open
Abstract
Previously developed spatially-selective Vagus Nerve Stimulation (sVNS) allows the targeting of specific nerve fascicles through current steering in a multi-electrode nerve cuff but relies on a trial-and-error strategy to identify the relative orientation between electrodes and fascicles. Fast Neural Electrical Impedance Tomography (FN-EIT) has been recently used for imaging neural traffic in the vagus nerves of pigs in a cross-correlation study with sVNS and MicroCT fascicle tracking. FN-EIT has the potential for allowing targeted sVNS; however, up to now, stimulation and imaging have been performed with separate electrode arrays. In this study, different options were evaluated in-silico to integrate EIT and stimulation into a single electrode array without affecting spatial selectivity. The original pig vagus EIT electrode array geometry was compared with a geometry integrating sVNS and EIT electrodes, and with direct use of sVNS electrodes for EIT imaging. Modelling results indicated that both new designs could achieve image quality similar to the original electrode geometry in all tested markers (e.g., co-localisation error <100 µm). The sVNS array was considered to be the simplest due to the lower number of electrodes. Experimental results from testing evoked EIT imaging of recurrent laryngeal activity using electrodes from the sVNS cuff returned a signal-to-noise ratio similar to our previous study (3.9 ± 2.4 vs. 4.1 ± 1.5, N = 4 nerves from 3 pigs) and a lower co-localisation error (≈14% nerve diameter vs. ≈25%, N = 2 nerves from 2 pigs). Performing FN-EIT and sVNS on the same nerve cuff will facilitate translation to humans, simplify surgery and enable targeted neuromodulation strategies.
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Affiliation(s)
- Enrico Ravagli
- Department of Medical Physics and Biomedical Engineering, University College London, London, United Kingdom
- Correspondence: Enrico Ravagli
| | - Jeffrey Ardell
- Department of Medicine, CardiacArrhythmia Centre, University of California Los Angeles, Los Angeles, CA, United States
| | - David Holder
- Department of Medical Physics and Biomedical Engineering, University College London, London, United Kingdom
| | - Kirill Aristovich
- Department of Medical Physics and Biomedical Engineering, University College London, London, United Kingdom
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Thompson N, Ravagli E, Mastitskaya S, Iacoviello F, Stathopoulou TR, Perkins J, Shearing PR, Aristovich K, Holder D. Organotopic organization of the porcine mid-cervical vagus nerve. Front Neurosci 2023; 17:963503. [PMID: 37205051 PMCID: PMC10185768 DOI: 10.3389/fnins.2023.963503] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 04/04/2023] [Indexed: 05/21/2023] Open
Abstract
Introduction Despite detailed characterization of fascicular organization of somatic nerves, the functional anatomy of fascicles evident in human and large mammal cervical vagus nerve is unknown. The vagus nerve is a prime target for intervention in the field of electroceuticals due to its extensive distribution to the heart, larynx, lungs, and abdominal viscera. However, current practice of the approved vagus nerve stimulation (VNS) technique is to stimulate the entire nerve. This produces indiscriminate stimulation of non-targeted effectors and undesired side effects. Selective neuromodulation is now a possibility with a spatially-selective vagal nerve cuff. However, this requires the knowledge of the fascicular organization at the level of cuff placement to inform selectivity of only the desired target organ or function. Methods and results We imaged function over milliseconds with fast neural electrical impedance tomography and selective stimulation, and found consistent spatially separated regions within the nerve correlating with the three fascicular groups of interest, suggesting organotopy. This was independently verified with structural imaging by tracing anatomical connections from the end organ with microCT and the development of an anatomical map of the vagus nerve. This confirmed organotopic organization. Discussion Here we show, for the first time, localized fascicles in the porcine cervical vagus nerve which map to cardiac, pulmonary and recurrent laryngeal function (N = 4). These findings pave the way for improved outcomes in VNS as unwanted side effects could be reduced by targeted selective stimulation of identified organ-specific fiber-containing fascicles and the extension of this technique clinically beyond the currently approved disorders to treat heart failure, chronic inflammatory disorders, and more.
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Affiliation(s)
- Nicole Thompson
- Department of Medical Physics and Biomedical Engineering, University College London, London, United Kingdom
- *Correspondence: Nicole Thompson,
| | - Enrico Ravagli
- Department of Medical Physics and Biomedical Engineering, University College London, London, United Kingdom
| | - Svetlana Mastitskaya
- Department of Medical Physics and Biomedical Engineering, University College London, London, United Kingdom
| | - Francesco Iacoviello
- Electrochemical Innovations Lab, Department of Chemical Engineering, University College London, London, United Kingdom
| | | | - Justin Perkins
- Department of Clinical Science and Services, The Royal Veterinary College, Hatfield, United Kingdom
| | - Paul R. Shearing
- Electrochemical Innovations Lab, Department of Chemical Engineering, University College London, London, United Kingdom
| | - Kirill Aristovich
- Department of Medical Physics and Biomedical Engineering, University College London, London, United Kingdom
| | - David Holder
- Department of Medical Physics and Biomedical Engineering, University College London, London, United Kingdom
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Wu HHL, Collier J, Crosby L, Holder D, Trautt E, Lewis D, Poulikakos D, Chinnadurai R. Peritoneal dialysis-associated peritonitis presenting with Ralstonia pickettii infection: A novel series of three cases during the COVID-19 pandemic. Semin Dial 2023; 36:70-74. [PMID: 36480217 PMCID: PMC9877823 DOI: 10.1111/sdi.13133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2022] [Revised: 11/07/2022] [Accepted: 11/20/2022] [Indexed: 12/13/2022]
Abstract
Peritoneal dialysis (PD)-associated peritonitis secondary to Ralstonia infection is very rare. Ralstonia pickettii is an organism that can grow in contaminated saline, water, chlorhexidine, and other medical products used in laboratories and the clinical setting. Infective endocarditis, prosthetic joint, and severe chest infections are previously reported with R. pickettii infection. We report a novel series of three cases diagnosed with PD-associated peritonitis caused by R. pickettii, where the cases appeared consecutively to our unit during a span of 4 weeks. During the COVID-19 pandemic, there were increased uses of non-sterile gloves by clinical staff as a form of personal protective equipment throughout patient interaction and PD exchange, as recommended by local hospital policy for all staff attending to patient care. A multidisciplinary team root cause analysis of our cases suggested non-sterile gloves being the likely source of environmental contamination, leading to PD-associated peritonitis caused by R. pickettii in this scenario.
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Affiliation(s)
- Henry H. L. Wu
- Dimitrios Poulikakos, Rajkumar Chinnadurai ‐ Faculty of Biology, Medicine and HealthUniversity of ManchesterManchesterUK
| | - Joanne Collier
- Department of Renal Medicine, Salford Care OrganisationNorthern Care Alliance NHS Foundation TrustSalfordUK
| | - Laurie Crosby
- Department of Renal Medicine, Salford Care OrganisationNorthern Care Alliance NHS Foundation TrustSalfordUK
| | - David Holder
- Department of Microbiology, Salford Care OrganisationNorthern Care Alliance NHS Foundation TrustSalfordUK
| | - Elizabeth Trautt
- Department of Microbiology, Salford Care OrganisationNorthern Care Alliance NHS Foundation TrustSalfordUK
| | - David Lewis
- Department of Renal Medicine, Salford Care OrganisationNorthern Care Alliance NHS Foundation TrustSalfordUK
| | - Dimitrios Poulikakos
- Department of Renal Medicine, Salford Care OrganisationNorthern Care Alliance NHS Foundation TrustSalfordUK
| | - Rajkumar Chinnadurai
- Department of Renal Medicine, Salford Care OrganisationNorthern Care Alliance NHS Foundation TrustSalfordUK
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Vasquez‐Rios V, Buckman C, Cortright L, Tumin D, Leonard S, Holder D. Medicaid expansion and adolescents' readiness for transition to adult health insurance. World Med & Health Policy 2022. [DOI: 10.1002/wmh3.482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
| | - Cierra Buckman
- Department of Pediatrics East Carolina University Greenville North Carolina USA
| | - Lindsay Cortright
- Department of Pediatrics East Carolina University Greenville North Carolina USA
| | - Dmitry Tumin
- Department of Pediatrics East Carolina University Greenville North Carolina USA
| | - Sarah Leonard
- Department of Pediatrics East Carolina University Greenville North Carolina USA
| | - David Holder
- Department of Pediatrics East Carolina University Greenville North Carolina USA
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Thompson N, Ravagli E, Mastitskaya S, Iacoviello F, Perkins J, Shearing P, Aristovich K, Holder D. Fascicular Organisation and Neuroanatomy of the Porcine and Human Vagus Nerves: Allowing for Spatially Selective Vagus Nerve Stimulation. FASEB J 2022. [DOI: 10.1096/fasebj.2022.36.s1.r3366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Nicole Thompson
- Medical Physics and Biomedical EngineeringUniversity College LondonLondon
| | - Enrico Ravagli
- Medical Physics and Biomedical EngineeringUniversity College LondonLondon
| | | | | | - Justin Perkins
- Clinical Sciences and ServicesRoyal Veterinary CollegeHatfield
| | | | - Kirill Aristovich
- Medical Physics and Biomedical EngineeringUniversity College LondonLondon
| | - David Holder
- Medical Physics and Biomedical EngineeringUniversity College LondonLondon
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Tarotin I, Mastitskaya S, Ravagli E, Perkins JD, Holder D, Aristovich K. Overcoming temporal dispersion for measurement of activity-related impedance changes in unmyelinated nerves. J Neural Eng 2022; 19. [PMID: 35413701 DOI: 10.1088/1741-2552/ac669a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2022] [Accepted: 04/11/2022] [Indexed: 11/11/2022]
Abstract
Objective.Fast neural electrical impedance tomography is an imaging technique that has been successful in visualising electrically evoked activity of myelinated fibres in peripheral nerves by measurement of the impedance changes (dZ) accompanying excitation. However, imaging of unmyelinated fibres is challenging due to temporal dispersion (TP) which occurs due to variability in conduction velocities of the fibres and leads to a decrease of the signal below the noise with distance from the stimulus. To overcome TP and allow electrical impedance tomography imaging in unmyelinated nerves, a new experimental and signal processing paradigm is required allowing dZ measurement further from the site of stimulation than compound neural activity is visible. The development of such a paradigm was the main objective of this study.Approach.A finite element-based statistical model of TP in porcine subdiaphragmatic nerve was developed and experimentally validatedex-vivo. Two paradigms for nerve stimulation and processing of the resulting data-continuous stimulation and trains of stimuli, were implemented; the optimal paradigm for recording dispersed dZ in unmyelinated nerves was determined.Main results.While continuous stimulation and coherent spikes averaging led to higher signal-to-noise ratios (SNRs) at close distances from the stimulus, stimulation by trains was more consistent across distances and allowed dZ measurement at up to 15 cm from the stimulus (SNR = 1.8 ± 0.8) if averaged for 30 min.Significance.The study develops a method that for the first time allows measurement of dZ in unmyelinated nerves in simulation and experiment, at the distances where compound action potentials are fully dispersed.
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Affiliation(s)
- Ilya Tarotin
- Department of Medical Physics and Biomedical Engineering, University College London, Gower Street, London WC1E 6BT, United Kingdom
| | - Svetlana Mastitskaya
- Department of Medical Physics and Biomedical Engineering, University College London, Gower Street, London WC1E 6BT, United Kingdom
| | - Enrico Ravagli
- Department of Medical Physics and Biomedical Engineering, University College London, Gower Street, London WC1E 6BT, United Kingdom
| | - Justin D Perkins
- Clinical Science and Services, Royal Veterinary College, Hawkshead Lane, Hatfield, United Kingdom
| | - David Holder
- Department of Medical Physics and Biomedical Engineering, University College London, Gower Street, London WC1E 6BT, United Kingdom
| | - Kirill Aristovich
- Department of Medical Physics and Biomedical Engineering, University College London, Gower Street, London WC1E 6BT, United Kingdom
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Ravagli E, Mastitskaya S, Thompson N, Welle EJ, Chestek CA, Aristovich K, Holder D. Fascicle localisation within peripheral nerves through evoked activity recordings: A comparison between electrical impedance tomography and multi-electrode arrays. J Neurosci Methods 2021; 358:109140. [PMID: 33774053 PMCID: PMC8249910 DOI: 10.1016/j.jneumeth.2021.109140] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2020] [Revised: 03/07/2021] [Accepted: 03/12/2021] [Indexed: 01/25/2023]
Abstract
BACKGROUND The lack of understanding of fascicular organisation in peripheral nerves limits the potential of vagus nerve stimulation therapy. Two promising methods may be employed to identify the functional anatomy of fascicles within the nerve: fast neural electrical impedance tomography (EIT), and penetrating multi-electrode arrays (MEA). These could provide a means to image the compound action potential within fascicles in the nerve. NEW METHOD We compared the ability to localise fascicle activity between silicon shanks (SS) and carbon fibre (CF) multi-electrode arrays and fast neural EIT, with micro-computed tomography (MicroCT) as an independent reference. Fast neural EIT in peripheral nerves was only recently developed and MEA technology has been used only sparingly in nerves and not for source localisation. Assessment was performed in rat sciatic nerves while evoking neural activity in the tibial and peroneal fascicles. RESULTS Recorded compound action potentials were larger with CF compared to SS (∼700 μV vs ∼300 μV); however, background noise was greater (6.3 μV vs 1.7 μV) leading to lower SNR. Maximum spatial discrimination between Centres-of-Mass of fascicular activity was achieved by fast neural EIT (402 ± 30 μm) and CF MEA (414 ± 123 μm), with no statistical difference between MicroCT (625 ± 17 μm) and CF (p > 0.05) and between CF and EIT (p > 0.05). Compared to CF MEAs, SS MEAs had a lower discrimination power (103 ± 51 μm, p < 0.05). COMPARISON WITH EXISTING METHODS EIT and CF MEAs showed localisation power closest to MicroCT. Silicon MEAs adopted in this study failed to discriminate fascicle location. Re-design of probe geometry may improve results. CONCLUSIONS Nerve EIT is an accurate tool for assessment of fascicular position within nerves. Accuracy of EIT and CF MEA is similar to the reference method. We give technical recommendations for performing multi-electrode recordings in nerves.
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Affiliation(s)
- Enrico Ravagli
- Medical Physics and Biomedical Engineering, University College London, UK.
| | | | - Nicole Thompson
- Medical Physics and Biomedical Engineering, University College London, UK
| | - Elissa J Welle
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, USA
| | - Cynthia A Chestek
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, USA
| | - Kirill Aristovich
- Medical Physics and Biomedical Engineering, University College London, UK
| | - David Holder
- Medical Physics and Biomedical Engineering, University College London, UK
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Mastitskaya S, Thompson N, Holder D. Selective Vagus Nerve Stimulation as a Therapeutic Approach for the Treatment of ARDS: A Rationale for Neuro-Immunomodulation in COVID-19 Disease. Front Neurosci 2021; 15:667036. [PMID: 33927594 PMCID: PMC8076564 DOI: 10.3389/fnins.2021.667036] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Accepted: 03/23/2021] [Indexed: 12/15/2022] Open
Abstract
Acute respiratory distress syndrome (ARDS) is the most severe form of acute lung injury. It is induced by sepsis, aspiration, and pneumonia, including that caused by SARS coronavirus and human influenza viruses. The main pathophysiological mechanism of ARDS is a systemic inflammatory response. Vagus nerve stimulation (VNS) can limit cytokine production in the spleen and thereby dampen any systemic inflammation and inflammation-induced tissue damage in the lungs and other organs. However, the effects of increased parasympathetic outflow to the lungs when non-selective VNS is applied may result in bronchoconstriction, increased mucus secretion and enhance local pulmonary inflammatory activity; this may outweigh the beneficial systemic anti-inflammatory action of VNS. Organ/function-specific therapy can be achieved by imaging of localized fascicle activity within the vagus nerve and selective stimulation of identified organ-specific fascicles. This may be able to provide selective neuromodulation of different pathways within the vagus nerve and offer a novel means to improve outcome in ARDS. This has motivated this review in which we discuss the mechanisms of anti-inflammatory effects of VNS, progress in selective VNS techniques, and a possible application for ARDS.
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Affiliation(s)
- Svetlana Mastitskaya
- Department of Medical Physics and Biomedical Engineering, University College London, London, United Kingdom
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Witkowska-Wrobel A, Aristovich K, Crawford A, Perkins JD, Holder D. Imaging of focal seizures with Electrical Impedance Tomography and depth electrodes in real time. Neuroimage 2021; 234:117972. [PMID: 33757909 PMCID: PMC8204270 DOI: 10.1016/j.neuroimage.2021.117972] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2020] [Revised: 01/31/2021] [Accepted: 03/12/2021] [Indexed: 11/26/2022] Open
Abstract
Intracranial EEG is the current gold standard technique for localizing seizures for surgery, but it can be insensitive to tangential dipole or distant sources. Electrical Impedance Tomography (EIT) offers a novel method to improve coverage and seizure onset localization. The feasibility of EIT has been previously assessed in a computer simulation, which revealed an improved accuracy of seizure detection with EIT compared to intracranial EEG. In this study, slow impedance changes, evoked by cell swelling occurring over seconds, were reconstructed in real time by frequency division multiplexing EIT using depth and subdural electrodes in a swine model of epilepsy. EIT allowed to generate repetitive images of ictal events at similar time course to fMRI but without its significant limitations. EIT was recorded with a system consisting of 32 parallel current sources and 64 voltage recorders. Seizures triggered with intracranial injection of benzylpenicillin (BPN) in five pigs caused a repetitive peak impedance increase of 3.4 ± 1.5 mV and 9.5 ± 3% (N =205 seizures); the impedance signal change was seen already after a single, first seizure. EIT enabled reconstruction of the seizure onset 9 ± 1.5 mm from the BPN cannula and 7.5 ± 1.1 mm from the closest SEEG contact (p<0.05, n =37 focal seizures in three pigs) and it could address problems with sampling error in intracranial EEG. The amplitude of the impedance change correlated with the spread of the seizure on the SEEG (p <<0.001, n =37). The results presented here suggest that combining a parallel EIT system with intracranial EEG monitoring has a potential to improve the diagnostic yield in epileptic patients and become a vital tool in improving our understanding of epilepsy.
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Affiliation(s)
| | - Kirill Aristovich
- Medical Physics and Biomedical Engineering, University College London, UK
| | - Abbe Crawford
- Royal Veterinary College, Hawkshead Lane, North Mymms, Hatfield, Hertfordshire AL9 7TA, UK
| | - Justin D Perkins
- Royal Veterinary College, Hawkshead Lane, North Mymms, Hatfield, Hertfordshire AL9 7TA, UK
| | - David Holder
- Medical Physics and Biomedical Engineering, University College London, UK
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Aristovich K, Donega M, Fjordbakk C, Tarotin I, Chapman CAR, Viscasillas J, Stathopoulou TR, Crawford A, Chew D, Perkins J, Holder D. Model-based geometrical optimisation and in vivo validation of a spatially selective multielectrode cuff array for vagus nerve neuromodulation. J Neurosci Methods 2021; 352:109079. [PMID: 33516735 DOI: 10.1016/j.jneumeth.2021.109079] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Revised: 01/10/2021] [Accepted: 01/15/2021] [Indexed: 12/22/2022]
Abstract
BACKGROUND Neuromodulation by electrical stimulation of the human cervical vagus nerve may be limited by adverse side effects due to stimulation of off-target organs. It may be possible to overcome this by spatially selective stimulation of peripheral nerves. Preliminary studies have shown this is possible using a cylindrical multielectrode human-sized nerve cuff in vagus nerve selective neuromodulation. NEW METHOD The model-based optimisation method for multi-electrode geometric design is presented. The method was applied for vagus nerve cuff array and suggested two rings of 14 electrodes, 3 mm apart, with 0.4 mm electrode width and separation and length 0.5-3 mm, with stimulation through a pair in the same radial position on the two rings. The electrodes were fabricated using PDMS-embedded stainless steel foil and PEDOT: pTS coating. RESULTS In the cervical vagus nerve in anaesthetised sheep, it was possible to selectively reduce the respiratory breath rate (RBR) by 85 ± 5% without affecting heart rate, or selectively reduce heart rate (HR) by 20 ± 7% without affecting respiratory rate. The cardiac- and pulmonary-specific sites on the nerve cross-sectional perimeter were localised with a radial separation of 105 ± 5 degrees (P < 0.01, N = 24 in 12 sheep). CONCLUSIONS Results suggest organotopic or function-specific organisation of neural fibres in the cervical vagus nerve. The optimised electrode array demonstrated selective electrical neuromodulation without adverse side effects. It may be possible to translate this to improved treatment by electrical autonomic neuromodulation for currently intractable conditions.
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Affiliation(s)
- Kirill Aristovich
- Medical Physics and Biomedical Engineering, University College London, UK.
| | - Matteo Donega
- Neuromodulation, Galvani Bioelectronics, Stevenage, UK
| | | | - Ilya Tarotin
- Medical Physics and Biomedical Engineering, University College London, UK
| | | | | | | | | | - Daniel Chew
- Neuromodulation, Galvani Bioelectronics, Stevenage, UK
| | | | - David Holder
- Medical Physics and Biomedical Engineering, University College London, UK
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Ravagli E, Mastitskaya S, Thompson N, Iacoviello F, Shearing PR, Perkins J, Gourine AV, Aristovich K, Holder D. Imaging fascicular organization of rat sciatic nerves with fast neural electrical impedance tomography. Nat Commun 2020; 11:6241. [PMID: 33288760 PMCID: PMC7721735 DOI: 10.1038/s41467-020-20127-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Accepted: 11/13/2020] [Indexed: 02/06/2023] Open
Abstract
Imaging compound action potentials (CAPs) in peripheral nerves could help avoid side effects in neuromodulation by selective stimulation of identified fascicles. Existing methods have low resolution, limited imaging depth, or are invasive. Fast neural electrical impedance tomography (EIT) allows fascicular CAP imaging with a resolution of <200 µm, <1 ms using a non-penetrating flexible nerve cuff electrode array. Here, we validate EIT imaging in rat sciatic nerve by comparison to micro-computed tomography (microCT) and histology with fluorescent dextran tracers. With EIT, there are reproducible localized changes in tissue impedance in response to stimulation of individual fascicles (tibial, peroneal and sural). The reconstructed EIT images correspond to microCT scans and histology, with significant separation between the fascicles (p < 0.01). The mean fascicle position is identified with an accuracy of 6% of nerve diameter. This suggests fast neural EIT can reliably image the functional fascicular anatomy of the nerves and so aid selective neuromodulation.
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Affiliation(s)
- Enrico Ravagli
- Department of Medical Physics and Biomedical Engineering, University College London, London, UK
| | - Svetlana Mastitskaya
- Department of Medical Physics and Biomedical Engineering, University College London, London, UK.
| | - Nicole Thompson
- Department of Medical Physics and Biomedical Engineering, University College London, London, UK
| | - Francesco Iacoviello
- Electrochemical Innovation Laboratory, Department of Chemical Engineering, University College London, London, UK
| | - Paul R Shearing
- Electrochemical Innovation Laboratory, Department of Chemical Engineering, University College London, London, UK
| | - Justin Perkins
- Clinical Science and Services, Royal Veterinary College, Hawkshead Lane, Hatfield, UK
| | - Alexander V Gourine
- Centre for Cardiovascular and Metabolic Neuroscience, Department of Neuroscience, Physiology and Pharmacology, University College London, London, UK
| | - Kirill Aristovich
- Department of Medical Physics and Biomedical Engineering, University College London, London, UK
| | - David Holder
- Department of Medical Physics and Biomedical Engineering, University College London, London, UK
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Kim JP, Lee W, Suh J, Lee H, Lee K, Ahn HY, Seo MJ, Ryu ST, Aristovich K, Holder D, Kim SJ. A 10 nV/rt Hz noise level 32-channel neural impedance sensing ASIC for local activation imaging on nerve section. Annu Int Conf IEEE Eng Med Biol Soc 2020; 2020:4012-4015. [PMID: 33018879 DOI: 10.1109/embc44109.2020.9176708] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
A 10 nV/rt Hz noise level 32-channel neural impedance sensing ASIC is presented for the application of local activation imaging in nerve section. It is increasingly known that the monitoring and control of nerve signals can improve physical and mental health. Major nerves, such as the vagus nerve and the sciatic nerve, consist of a bundle of fascicles. Therefore, to accurately control a particular application without any side effects, we need to know exactly which fascicle was activated. The only way to find locally activated fascicle is to use electrical impedance tomography (EIT). The ASIC to be introduced is designed for neural EIT applications. A neural impedance sensing ASIC was implemented using CMOS 180-nm process technology. The integrated input referred noise was calculated to be 0.46 μVrms (noise floor 10.3 nVrms/rt Hz) in the measured noise spectrum. At an input of 80 mV, the squared correlation coefficient for linear regression was 0.99998. The amplification gain uniformity of 32 channels was in the range of + 0.23% and - 0.29%. Using the resistor phantom, the simplest model of nerve, it was verified that a single readout channel could detect a signal-to- noise ratio of 75.6 dB or more. Through the reservoir phantom, real-time EIT images were reconstructed at a rate of 8.3 frames per second. The developed ASIC has been applied to in vivo experiments with rat sciatic nerves, and signal processing is currently underway to obtain activated nerve cross-sectional images. The developed ASIC was also applied to in-vivo experiments with rat sciatic nerves, and signal processing is currently underway to obtain locally activated nerve cross-sectional images.
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Thompson N, Ravagli E, Mastitskaya S, Iacoviello F, Aristovich K, Perkins J, Shearing PR, Holder D. MicroCT optimisation for imaging fascicular anatomy in peripheral nerves. J Neurosci Methods 2020; 338:108652. [PMID: 32179090 PMCID: PMC7181190 DOI: 10.1016/j.jneumeth.2020.108652] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Revised: 02/24/2020] [Accepted: 02/25/2020] [Indexed: 01/25/2023]
Abstract
BACKGROUND Due to the lack of understanding of the fascicular organisation, vagus nerve stimulation (VNS) leads to unwanted off-target effects. Micro-computed tomography (microCT) can be used to trace fascicles from periphery and image fascicular anatomy. NEW METHOD In this study, we present a simple and reproducible method for imaging fascicles in peripheral nerves with iodine staining and microCT for the determination of fascicular anatomy and organisation. RESULTS At the determined optimal pre-processing steps and scanning parameters, the microCT protocol allowed for segmentation and tracking of fascicles within the nerves. This was achieved after 24 hours and 120 hours of staining with Lugol's solution (1% total iodine) for rat sciatic and pig vagus nerves, respectively, and the following scanning parameters: 4 μm voxel size, 35 kVp energy, 114 μA current, 4 W power, 0.25 fps in 4 s exposure time, 3176 projections and a molybdenum target. COMPARISON WITH EXISTING METHOD(S) This optimised method for imaging fascicles provides high-resolution, three-dimensional images and full imaging penetration depth not obtainable with methods typically used such as histology, magnetic resonance imaging and optical coherence tomography whilst obviating time-consuming pre-processing methods, the amount of memory required, destruction of the samples and the cost associated with current microCT methods. CONCLUSION The optimised microCT protocol facilitates segmentation and tracking of the fascicles within the nerve. The resulting segmentation map of the functional anatomical organisation of the vagus nerve will enable selective VNS ultimately allowing for the avoidance of the off-target effects and improving its therapeutic efficacy.
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Affiliation(s)
- Nicole Thompson
- EIT and Neurophysiology Lab, Medical Physics and Biomedical Engineering, University College London, Gower Street, London, WC1E 6BT, United Kingdom.
| | - Enrico Ravagli
- EIT and Neurophysiology Lab, Medical Physics and Biomedical Engineering, University College London, Gower Street, London, WC1E 6BT, United Kingdom
| | - Svetlana Mastitskaya
- EIT and Neurophysiology Lab, Medical Physics and Biomedical Engineering, University College London, Gower Street, London, WC1E 6BT, United Kingdom
| | - Francesco Iacoviello
- Electrochemical Innovation Lab, Chemical Engineering, University College London, Gower Street, London, WC1E 6BT, United Kingdom
| | - Kirill Aristovich
- EIT and Neurophysiology Lab, Medical Physics and Biomedical Engineering, University College London, Gower Street, London, WC1E 6BT, United Kingdom
| | - Justin Perkins
- Clinical Science and Services, The Royal Veterinary College, Hawkshead Lane, Hatfield, AL9 7TA, United Kingdom
| | - Paul R Shearing
- Electrochemical Innovation Lab, Chemical Engineering, University College London, Gower Street, London, WC1E 6BT, United Kingdom
| | - David Holder
- EIT and Neurophysiology Lab, Medical Physics and Biomedical Engineering, University College London, Gower Street, London, WC1E 6BT, United Kingdom
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Tarotin I, Mastitskaya S, Hannan S, Ravagli E, Aristovich K, Holder D. SPARC: Method for Overcoming Temporal Dispersion in Unmyelinated Nerves for Imaging C Fibres with Electrical Impedance Tomography (EIT). FASEB J 2020. [DOI: 10.1096/fasebj.2020.34.s1.05498] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Thompson N, Ravagli E, Mastitskaya S, Iacoviello F, Aristovich K, Perkins J, Shearing PR, Holder D. Determining the Fascicular Anatomy of the Porcine Vagus Nerve with MicroCT. FASEB J 2020. [DOI: 10.1096/fasebj.2020.34.s1.06750] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Ravagli E, Mastitskaya S, Thompson N, Aristovich K, Holder D. Optimization of the electrode drive pattern for imaging fascicular compound action potentials in peripheral nerve with fast neural electrical impedance tomography. Physiol Meas 2019; 40:115007. [PMID: 31694004 PMCID: PMC7214787 DOI: 10.1088/1361-6579/ab54eb] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
OBJECTIVE The main objective of this study was to investigate which injection pattern led to the best imaging of fascicular compound activity in fast neural EIT of peripheral nerve using an external cylindrical 2 × 14-electrodes cuff. Specifically, the study addressed the identification of the optimal injection pattern and of the optimal region of the reconstructed volume to image fascicles. APPROACH The effect of three different measurement protocol features (transversal/longitudinal injection, drive electrode spacing, referencing configuration) over imaging was investigated in simulation with the use of realistic impedance changes and noise levels. Image-based metrics were employed to evaluate the quality of the reconstructions over the reconstruction domain. The optimal electrode addressing protocol suggested by the simulations was validated in vivo on the tibial and peroneal fascicles of rat sciatic peripheral nerves (N = 3) against MicroCT reference images. MAIN RESULTS Injecting current transversally, with spacing of ⩾4 electrodes apart (⩾100°) and single-ring referencing of measurements, led to the best overall localization when reconstructing on the edge of the electrode array closest to the reference. Longitudinal injection protocols led to a higher SNR of the reconstructed image but poorer localization. All in vivo EIT recordings had statistically significant impedance variations (p < 0.05). Overall, fascicle center-of-mass (CoM) localization error was estimated at 141 ± 56 µm (-26 ± 94 µm and 5 ± 29° in radial coordinates). Significant difference was found (p < 0.05) between mean angular location of the tibial and peroneal CoMs. SIGNIFICANCE This study gives the reader recommendations for performing fast neural EIT of fascicular compound activity using the most effective protocol features.
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Affiliation(s)
- Enrico Ravagli
- Medical Physics and Biomedical Engineering, University College London, London, United Kingdom
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Montaner L, Azzoni L, Papasavvas E, Tebas P, Mounzer K, Howell B, Holder D, Chomont N, Kuri Cervantes L, Betts M. Baseline inducible HIV P24 is associated with viral control during interferon-α monotherapy with ART interruption. J Virus Erad 2019. [DOI: 10.1016/s2055-6640(20)30158-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Thompson N, Mastitskaya S, Holder D. Avoiding off-target effects in electrical stimulation of the cervical vagus nerve: Neuroanatomical tracing techniques to study fascicular anatomy of the vagus nerve. J Neurosci Methods 2019; 325:108325. [PMID: 31260728 PMCID: PMC6698726 DOI: 10.1016/j.jneumeth.2019.108325] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Revised: 06/25/2019] [Accepted: 06/26/2019] [Indexed: 12/11/2022]
Abstract
Vagus nerve stimulation (VNS) is a promising therapy for treatment of various conditions that are resistant to standard medication, such as heart failure, epilepsy, and depression. The vagus nerve is a complex nerve providing afferent and efferent innervation of the pharynx, larynx, heart, tracheobronchial tree and lungs, oesophagus, stomach, liver, pancreas, small intestine and proximal colon. It is therefore a prime target for intervention for VNS. Surprisingly, the fascicular organisation of the vagus nerve at the cervical level is still not well understood. This, along with the current stimulation techniques, results in the entire nerve being stimulated, which leads to unwanted off-target effects. Neuronal tracing is a promising method to delineate the organ-specific innervation by the vagus nerve, thereby providing valuable insight into the fascicular anatomy. In this review we discuss the current knowledge of vagus nerve anatomy and neuronal tracers used for mapping of its organ-specific projections in various species. Efferent vagal projections are a chain of two neurones (pre- and postganglionic), while afferent projections consist of only one pseudounipolar neurone with one branch terminating in the target organ/tissue directly and another in the brainstem. It would be feasible to retrogradely trace the afferent fibres from their respective visceral targets and identify them at the cervical level using non-transsynaptic neuronal tracers. Using this to create a map of the functional anatomical organisation of the vagus nerve will enable selective VNS ultimately allowing for the avoidance of the off-target effects and improving overall efficacy.
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Affiliation(s)
- Nicole Thompson
- Department of Medical Physics and Biomedical Engineering, University College London, London, United Kingdom.
| | - Svetlana Mastitskaya
- Department of Medical Physics and Biomedical Engineering, University College London, London, United Kingdom
| | - David Holder
- Department of Medical Physics and Biomedical Engineering, University College London, London, United Kingdom
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Hannan S, Faulkner M, Aristovich K, Avery J, Holder D. Investigating the safety of fast neural electrical impedance tomography in the rat brain. Physiol Meas 2019; 40:034003. [DOI: 10.1088/1361-6579/ab0d53] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Avery J, Dowrick T, Witkowska-Wrobel A, Faulkner M, Aristovich K, Holder D. Simultaneous EIT and EEG using frequency division multiplexing. Physiol Meas 2019; 40:034007. [DOI: 10.1088/1361-6579/ab0bbc] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Tarotin I, Aristovich K, Holder D. Effect of dispersion in nerve on compound action potential and impedance change: a modelling study. Physiol Meas 2019; 40:034001. [DOI: 10.1088/1361-6579/ab08ce] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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Chapman CAR, Aristovich K, Donega M, Fjordbakk CT, Stathopoulou TR, Viscasillas J, Avery J, Perkins JD, Holder D. Electrode fabrication and interface optimization for imaging of evoked peripheral nervous system activity with electrical impedance tomography (EIT). J Neural Eng 2018; 16:016001. [PMID: 30444215 DOI: 10.1088/1741-2552/aae868] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
OBJECTIVE Non-invasive imaging techniques are undoubtedly the ideal methods for continuous monitoring of neural activity. One such method, fast neural electrical impedance tomography (EIT) has been developed over the past decade in order to image neural action potentials with non-penetrating electrode arrays. APPROACH The goal of this study is two-fold. First, we present a detailed fabrication method for silicone-based multiple electrode arrays which can be used for epicortical or neural cuff applications. Secondly, we optimize electrode material coatings in order to achieve the best accuracy in EIT reconstructions. MAIN RESULTS The testing of nanostructured electrode interface materials consisting of platinum, iridium oxide, and PEDOT:pTS in saline tank experiments demonstrated that the PEDOT:pTS coating used in this study leads to more accurate reconstruction dimensions along with reduced phase separation between recording channels. The PEDOT:pTS electrodes were then used in vivo to successfully image and localize the evoked activity of the recurrent laryngeal fascicle from within the cervical vagus nerve. SIGNIFICANCE These results alongside the simple fabrication method presented here position EIT as an effective method to image neural activity.
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Affiliation(s)
- Christopher A R Chapman
- Department of Medical Physics and Biomedical Engineering, University College London, Gower Street, London WC1E 6BT, United Kingdom
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Hannan S, Faulkner M, Aristovich K, Avery J, Walker M, Holder D. Imaging fast electrical activity in the brain during ictal epileptiform discharges with electrical impedance tomography. Neuroimage Clin 2018; 20:674-684. [PMID: 30218899 PMCID: PMC6140294 DOI: 10.1016/j.nicl.2018.09.004] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/27/2018] [Revised: 07/27/2018] [Accepted: 09/02/2018] [Indexed: 12/19/2022]
Abstract
Electrical Impedance Tomography (EIT) is an emerging medical imaging technique which can produce tomographic images of internal impedance changes within an object using non-penetrating surface electrodes. It has previously been used to image impedance changes due to neuronal depolarisation during evoked potentials in the rat somatosensory cortex with a resolution of 2 ms and <200 μm, using an epicortical electrode array. The purpose of this work was to use this technique to elucidate the intracortical spatiotemporal trajectory of ictal spike-and-wave discharges (SWDs), induced by electrical stimulation in an acute rat model of epilepsy, throughout the cerebral cortex. Seizures lasting 16.5 ± 5.3 s with repetitive 2-5 Hz SWDs were induced in five rats anaesthetised with fentanyl-isoflurane. Transfer impedance measurements were obtained during each seizure with a 57-electrode epicortical array by applying 50 μA current at 1.7 kHz to two electrodes and recording voltages from all remaining electrodes. Images were reconstructed from averaged SWD-related impedance traces obtained from EIT measurements in successive seizures. We report the occurrence of reproducible impedance changes during the initial spike phase, which had an early onset in the whisker barrel cortex and spread posteriorly, laterally and ventrally over 20 ms (p < 0.03125, N = 5). These findings, which confirm and extend knowledge of SWD initiation and expression, suggest that EIT is a valuable neuroimaging tool for improving understanding of neural circuits implicated in epileptic phenomena.
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Affiliation(s)
- Sana Hannan
- Department of Medical Physics and Biomedical Engineering, University College London, UK.
| | - Mayo Faulkner
- Department of Medical Physics and Biomedical Engineering, University College London, UK
| | - Kirill Aristovich
- Department of Medical Physics and Biomedical Engineering, University College London, UK
| | - James Avery
- Department of Medical Physics and Biomedical Engineering, University College London, UK
| | | | - David Holder
- Department of Medical Physics and Biomedical Engineering, University College London, UK
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Faulkner M, Hannan S, Aristovich K, Avery J, Holder D. Feasibility of imaging evoked activity throughout the rat brain using electrical impedance tomography. Neuroimage 2018; 178:1-10. [DOI: 10.1016/j.neuroimage.2018.05.022] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2018] [Revised: 04/26/2018] [Accepted: 05/08/2018] [Indexed: 10/16/2022] Open
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Aristovich K, Donegá M, Blochet C, Avery J, Hannan S, Chew DJ, Holder D. Imaging fast neural traffic at fascicular level with electrical impedance tomography: proof of principle in rat sciatic nerve. J Neural Eng 2018; 15:056025. [DOI: 10.1088/1741-2552/aad78e] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Hannan S, Faulkner M, Aristovich K, Avery J, Holder D. Frequency-dependent characterisation of impedance changes during epileptiform activity in a rat model of epilepsy. Physiol Meas 2018; 39:085003. [DOI: 10.1088/1361-6579/aad5f4] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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Acheampong C, Davis C, Holder D, Averett P, Savitt T, Campbell K. An Exploratory Study of Stress Coping and Resiliency of Black Men at One Medical School: A Critical Race Theory Perspective. J Racial Ethn Health Disparities 2018; 6:214-219. [DOI: 10.1007/s40615-018-0516-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Revised: 07/05/2018] [Accepted: 07/10/2018] [Indexed: 11/30/2022]
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Goren N, Avery J, Dowrick T, Mackle E, Witkowska-Wrobel A, Werring D, Holder D. Multi-frequency electrical impedance tomography and neuroimaging data in stroke patients. Sci Data 2018; 5:180112. [PMID: 29969115 PMCID: PMC6029572 DOI: 10.1038/sdata.2018.112] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2017] [Accepted: 04/16/2018] [Indexed: 11/26/2022] Open
Abstract
Electrical Impedance Tomography (EIT) is a non-invasive imaging technique, which has the potential to expedite the differentiation of ischaemic or haemorrhagic stroke, decreasing the time to treatment. Whilst demonstrated in simulation, there are currently no suitable imaging or classification methods which can be successfully applied to human stroke data. Development of these complex methods is hindered by a lack of quality Multi-Frequency EIT (MFEIT) data. To address this, MFEIT data were collected from 23 stroke patients, and 10 healthy volunteers, as part of a clinical trial in collaboration with the Hyper Acute Stroke Unit (HASU) at University College London Hospital (UCLH). Data were collected at 17 frequencies between 5 Hz and 2 kHz, with 31 current injections, yielding 930 measurements at each frequency. This dataset is the most comprehensive of its kind and enables combined analysis of MFEIT, Electroencephalography (EEG) and Computed Tomography (CT) or Magnetic Resonance Imaging (MRI) data in stroke patients, which can form the basis of future research into stroke classification.
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Affiliation(s)
- Nir Goren
- Medical Physics & Biomedical Engineering, University College London, London WC1E 6BT, UK
| | - James Avery
- Medical Physics & Biomedical Engineering, University College London, London WC1E 6BT, UK
| | - Thomas Dowrick
- Medical Physics & Biomedical Engineering, University College London, London WC1E 6BT, UK
| | - Eleanor Mackle
- Medical Physics & Biomedical Engineering, University College London, London WC1E 6BT, UK
| | - Anna Witkowska-Wrobel
- Medical Physics & Biomedical Engineering, University College London, London WC1E 6BT, UK
| | - David Werring
- Stroke Research Centre, Department of Brain repair and Rehabilitation, University College London Institute of Neurology, London WC1N 3BG, UK
| | - David Holder
- Medical Physics & Biomedical Engineering, University College London, London WC1E 6BT, UK
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Abstract
OBJECTIVE Currently, there is no imaging method that is able to distinguish the functional activity inside nerves. Such a method would be essential for understanding peripheral nerve physiology and would allow precise neuromodulation of organs these nerves supply. Electrical impedance tomography (EIT) is a method that produces images of electrical impedance change (dZ) of an object by injecting alternating current and recording surface voltages. It has been shown to be able to image fast activity in the brain and large peripheral nerves. To image inside small autonomic nerves, mostly containing unmyelinated fibers, it is necessary to maximize SNR and optimize the EIT parameters. An accurate model of the nerve is required to identify these optimal parameters as well as to validate data obtained in the experiments. METHODS In this study, we developed two three-dimensional models of unmyelinated fibers: Hodgkin-Huxley (HH) squid giant axon (single and multiple) and mammalian C-nociceptor. A coupling feedback system was incorporated into the models to simulate direct and alternating current application and simultaneously record external field during action potential propagation. RESULTS Parameters of the developed models were varied to study their influence on the recorded impedance changes; the optimal parameters were identified. The negative dZ was found to monotonically decrease with frequency for both HH and C fiber models, in accordance with the experimental data. CONCLUSION AND SIGNIFICANCE The accurate realistic model of unmyelinated nerve allows the optimization of EIT parameters and matches literature and experimental results.
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Witkowska-Wrobel A, Aristovich K, Faulkner M, Avery J, Holder D. Feasibility of imaging epileptic seizure onset with EIT and depth electrodes. Neuroimage 2018; 173:311-321. [DOI: 10.1016/j.neuroimage.2018.02.056] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2017] [Revised: 02/22/2018] [Accepted: 02/26/2018] [Indexed: 11/27/2022] Open
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Aristovich K, Donega M, Avery J, Chew D, Holder D. F36. Imaging fascicle traffic in peripheral nerve using fast neural EIT. Clin Neurophysiol 2018. [DOI: 10.1016/j.clinph.2018.04.199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
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Hannan S, Faulkner M, Aristovich K, Holder D. T16. Imaging propagation of ictal spike-and-wave activity in the cerebral cortex over milliseconds with fast neural electrical impedance tomography. Clin Neurophysiol 2018. [DOI: 10.1016/j.clinph.2018.04.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
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Witkowska-Wrobel A, Aristovich K, Avery J, Faulkner M, Holder D. T15. Imaging fast neuronal depolarization in 3D during seizures with electrical impedance tomography and scalp and intracranial depth electrodes. Clin Neurophysiol 2018. [DOI: 10.1016/j.clinph.2018.04.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Faulkner M, Hannan S, Aristovich K, Avery J, Holder D. Characterising the frequency response of impedance changes during evoked physiological activity in the rat brain. Physiol Meas 2018; 39:034007. [DOI: 10.1088/1361-6579/aab01f] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Abstract
OBJECTIVE The most commonly used EIT paradigm (time division multiplexing) limits the temporal resolution of impedance images due to the need to switch between injection electrodes. Advances have previously been made using frequency division multiplexing (FDM) to increase temporal resolution, but in cases where a fixed range of frequencies is available, such as imaging fast neural activity, an upper limit is placed on the total number of simultaneous injections. The use of phase division multiplexing (PDM) where multiple out of phase signals can be injected at each frequency is investigated to increase temporal resolution. APPROACH TDM, FDM and PDM were compared in head tank experiments, to compare transfer impedance measurements and spatial resolution between the three techniques. A resistor phantom paradigm was established to investigate the imaging of one-off impedance changes, of magnitude 1% and with durations as low as 500 µs (similar to those seen in nerve bundles), using both PDM and TDM approaches. MAIN RESULTS In head tank experiments, a strong correlation (r > 0.85 and p < 0.001) was present between the three sets of measured transfer impedances, and no statistically significant difference was found in reconstructed image quality. PDM was able to image impedance changes down to 500 µs in the phantom experiments, while the minimum duration imaged using TDM was 5 ms. SIGNIFICANCE PDM offers a possible solution to the imaging of fast moving impedance changes (such as in nerves), where the use of triggering or coherent averaging is not possible. The temporal resolution presents an order of magnitude improvement of the TDM approach, and the approach addresses the limited spatial resolution of FDM by increasing the number of simultaneous EIT injections.
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Affiliation(s)
- T Dowrick
- Department of Medical Physics & Biomedical Engineering, University College London, London, United Kingdom
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Eiber C, Avery J, Holder D, McEwan A. Feasibility study of imaging fast neural activity in retinal tissue using Electrical Impedance Tomography. Annu Int Conf IEEE Eng Med Biol Soc 2017; 2017:529-532. [PMID: 29059926 DOI: 10.1109/embc.2017.8036878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Electrical Impedance Tomography has been recently applied to image fast neural activity in the somatosensory cerebral cortex. This non-invasive imaging modality has the unique advantage of high spatial-temporal resolution in millimeters over milliseconds. This work was designed to test an existing 32-channel EIT system, a modified UCL ScouseTom, and to discuss the feasibility of imaging neural activity in retinal tissue through computer simulation. The finite element method was used to model a retinal slice with a realistic conductivity-depth profile of the macaque eye. The conductivity perturbation was simulated in five different layers of the model. 5μVRMS white noise was added to boundary voltages. Simulation results showed that it is feasible to apply EIT in retinal tissue but the injection current is near threshold of unwanted phosphenes induction. Therefore the suggested future work are validating threshold current through animal experiments, developing electrodes with low contact impedance and mitigating noise through averaging.
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Avery J, Aristovich K, Low B, Holder D. Reproducible 3D printed head tanks for electrical impedance tomography with realistic shape and conductivity distribution. Physiol Meas 2017; 38:1116-1131. [PMID: 28530209 DOI: 10.1088/1361-6579/aa6586] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVE Electrical impedance tomography (EIT) has many promising applications in brain injury monitoring. To evaluate both instrumentation and reconstruction algorithms, experiments are first performed in head tanks. Existing methods, whilst accurate, produce a discontinuous conductivity, and are often made by hand, making it hard for other researchers to replicate. APPROACH We have developed a method for constructing head tanks directly in a 3D printer. Conductivity was controlled through perforations in the skull surface, which allow for saline to pass through. Varying the diameter of the holes allowed for the conductivity to be controlled with 3% error for the target conductivity range. Taking CT and MRI segmentations as a basis, this method was employed to create an adult tank with a continuous conductivity distribution, and a neonatal tank with fontanelles. MAIN RESULTS Using 3D scanning a geometric accuracy of 0.21 mm was recorded, equal to that of the precision of the 3D printer used. Differences of 6.1% ± 6.4% (n = 11 in 4 tanks) compared to simulations were recorded in c. 800 boundary voltages. This may be attributed to the morphology of the skulls increasing tortuosity effects and hole misalignment. Despite significant differences in errors between three repetitions of the neonatal tank, images of a realistic perturbation could still be reconstructed with different tanks used for the baseline and perturbation datasets. SIGNIFICANCE These phantoms can be reproduced by any researcher with access to a 'hobbyist' 3D printer in a matter of days. All design files have been released using an open source license to encourage reproduction and modification.
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Faulkner M, Jehl M, Aristovich K, Avery J, Witkowska-Wrobel A, Holder D. Optimisation of current injection protocol based on a region of interest. Physiol Meas 2017; 38:1158-1175. [DOI: 10.1088/1361-6579/aa69d7] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Avery J, Dowrick T, Faulkner M, Goren N, Holder D. A Versatile and Reproducible Multi-Frequency Electrical Impedance Tomography System. Sensors (Basel) 2017; 17:E280. [PMID: 28146122 PMCID: PMC5336119 DOI: 10.3390/s17020280] [Citation(s) in RCA: 53] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/05/2016] [Accepted: 01/25/2017] [Indexed: 11/16/2022]
Abstract
A highly versatile Electrical Impedance Tomography (EIT) system, nicknamed the ScouseTom, has been developed. The system allows control over current amplitude, frequency, number of electrodes, injection protocol and data processing. Current is injected using a Keithley 6221 current source, and voltages are recorded with a 24-bit EEG system with minimum bandwidth of 3.2 kHz. Custom PCBs interface with a PC to control the measurement process, electrode addressing and triggering of external stimuli. The performance of the system was characterised using resistor phantoms to represent human scalp recordings, with an SNR of 77.5 dB, stable across a four hour recording and 20 Hz to 20 kHz. In studies of both haeomorrhage using scalp electrodes, and evoked activity using epicortical electrode mats in rats, it was possible to reconstruct images matching established literature at known areas of onset. Data collected using scalp electrode in humans matched known tissue impedance spectra and was stable over frequency. The experimental procedure is software controlled and is readily adaptable to new paradigms. Where possible, commercial or open-source components were used, to minimise the complexity in reproduction. The hardware designs and software for the system have been released under an open source licence, encouraging contributions and allowing for rapid replication.
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Affiliation(s)
- James Avery
- Department Medical Physics and Biomedical Engineering, University College London, London WC1E 6BT, UK.
| | - Thomas Dowrick
- Department Medical Physics and Biomedical Engineering, University College London, London WC1E 6BT, UK.
| | - Mayo Faulkner
- Department Medical Physics and Biomedical Engineering, University College London, London WC1E 6BT, UK.
| | - Nir Goren
- Department Medical Physics and Biomedical Engineering, University College London, London WC1E 6BT, UK.
| | - David Holder
- Department Medical Physics and Biomedical Engineering, University College London, London WC1E 6BT, UK.
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44
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Packham B, Barnes G, Dos Santos GS, Aristovich K, Gilad O, Ghosh A, Oh T, Holder D. Empirical validation of statistical parametric mapping for group imaging of fast neural activity using electrical impedance tomography. Physiol Meas 2016; 37:951-67. [PMID: 27203477 PMCID: PMC5717540 DOI: 10.1088/0967-3334/37/6/951] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Electrical impedance tomography (EIT) allows for the reconstruction of internal conductivity from surface measurements. A change in conductivity occurs as ion channels open during neural activity, making EIT a potential tool for functional brain imaging. EIT images can have >10 000 voxels, which means statistical analysis of such images presents a substantial multiple testing problem. One way to optimally correct for these issues and still maintain the flexibility of complicated experimental designs is to use random field theory. This parametric method estimates the distribution of peaks one would expect by chance in a smooth random field of a given size. Random field theory has been used in several other neuroimaging techniques but never validated for EIT images of fast neural activity, such validation can be achieved using non-parametric techniques. Both parametric and non-parametric techniques were used to analyze a set of 22 images collected from 8 rats. Significant group activations were detected using both techniques (corrected p < 0.05). Both parametric and non-parametric analyses yielded similar results, although the latter was less conservative. These results demonstrate the first statistical analysis of such an image set and indicate that such an analysis is an approach for EIT images of neural activity.
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Affiliation(s)
- B Packham
- Department of Medical Physics & Bioengineering, University College London, UK
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45
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Abstract
The differentiation of haemorrhagic from ischaemic stroke using electrical impedance tomography (EIT) requires measurements at multiple frequencies, since the general lack of healthy measurements on the same patient excludes time-difference imaging methods. It has previously been shown that the inaccurate modelling of electrodes constitutes one of the largest sources of image artefacts in non-linear multi-frequency EIT applications. To address this issue, we augmented the conductivity Jacobian matrix with a Jacobian matrix with respect to electrode movement. Using this new algorithm, simulated ischaemic and haemorrhagic strokes in a realistic head model were reconstructed for varying degrees of electrode position errors. The simultaneous recovery of conductivity spectra and electrode positions removed most artefacts caused by inaccurately modelled electrodes. Reconstructions were stable for electrode position errors of up to 1.5 mm standard deviation along both surface dimensions. We conclude that this method can be used for electrode model correction in multi-frequency EIT.
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Affiliation(s)
- Markus Jehl
- University College London, London WC1E 6BT, UK
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Dowrick T, Blochet C, Holder D. In vivobioimpedance changes during haemorrhagic and ischaemic stroke in rats: towards 3D stroke imaging using electrical impedance tomography. Physiol Meas 2016; 37:765-84. [DOI: 10.1088/0967-3334/37/6/765] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
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Singh H, Cooper R, Lee CW, Dempsey L, Brigadoi S, Edwards A, Airantzis D, Everdell N, Michell A, Holder D, Austin T, Hebden J. Neurovascular Interactions in the Neurologically Compromised Neonatal Brain. Adv Exp Med Biol 2016; 876:485-492. [PMID: 26782249 DOI: 10.1007/978-1-4939-3023-4_61] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Neurological brain injuries such as hypoxic ischaemic encephalopathy (HIE) and associated conditions such as seizures have been associated with poor developmental outcome in neonates. Our limited knowledge of the neurological and cerebrovascular processes underlying seizures limits their diagnosis and timely treatment. Diffuse optical tomography (DOT) provides haemodynamic information in the form of changes in concentration of de/oxygenated haemoglobin, which can improve our understanding of seizures and the relationship between neural and vascular processes. Using simultaneous EEG-DOT, we observed distinct haemodynamic changes which are temporally correlated with electrographic seizures. Here, we present DOT-EEG data from two neonates clinically diagnosed as HIE. Our results highlight the wealth of mutually-informative data that can be obtained using DOT-EEG techniques to understand neurovascular coupling in HIE neonates.
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Affiliation(s)
- H Singh
- neoLAB, The Evelyn Perinatal Imaging Centre, Rosie Hospital, Cambridge, UK. .,BORL, Department of Medical Physics and Bioengineering, UCL, London, UK.
| | - R Cooper
- neoLAB, The Evelyn Perinatal Imaging Centre, Rosie Hospital, Cambridge, UK.,BORL, Department of Medical Physics and Bioengineering, UCL, London, UK
| | - C W Lee
- neoLAB, The Evelyn Perinatal Imaging Centre, Rosie Hospital, Cambridge, UK.,Neonatal Unit, Rosie Hospital, Cambridge University Hospitals, Cambridge, UK
| | - L Dempsey
- neoLAB, The Evelyn Perinatal Imaging Centre, Rosie Hospital, Cambridge, UK.,BORL, Department of Medical Physics and Bioengineering, UCL, London, UK
| | - S Brigadoi
- neoLAB, The Evelyn Perinatal Imaging Centre, Rosie Hospital, Cambridge, UK.,BORL, Department of Medical Physics and Bioengineering, UCL, London, UK
| | - A Edwards
- neoLAB, The Evelyn Perinatal Imaging Centre, Rosie Hospital, Cambridge, UK.,Neonatal Unit, Rosie Hospital, Cambridge University Hospitals, Cambridge, UK
| | - D Airantzis
- neoLAB, The Evelyn Perinatal Imaging Centre, Rosie Hospital, Cambridge, UK.,Neonatal Unit, Rosie Hospital, Cambridge University Hospitals, Cambridge, UK
| | - N Everdell
- neoLAB, The Evelyn Perinatal Imaging Centre, Rosie Hospital, Cambridge, UK.,BORL, Department of Medical Physics and Bioengineering, UCL, London, UK
| | - A Michell
- neoLAB, The Evelyn Perinatal Imaging Centre, Rosie Hospital, Cambridge, UK.,Neonatal Unit, Rosie Hospital, Cambridge University Hospitals, Cambridge, UK
| | - D Holder
- neoLAB, The Evelyn Perinatal Imaging Centre, Rosie Hospital, Cambridge, UK.,Neonatal Unit, Rosie Hospital, Cambridge University Hospitals, Cambridge, UK
| | - T Austin
- neoLAB, The Evelyn Perinatal Imaging Centre, Rosie Hospital, Cambridge, UK.,Neonatal Unit, Rosie Hospital, Cambridge University Hospitals, Cambridge, UK
| | - J Hebden
- neoLAB, The Evelyn Perinatal Imaging Centre, Rosie Hospital, Cambridge, UK.,BORL, Department of Medical Physics and Bioengineering, UCL, London, UK
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48
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Abstract
Electrical impedance tomography (EIT) is a promising medical imaging technique which could aid differentiation of haemorrhagic from ischaemic stroke in an ambulance. One challenge in EIT is the ill-posed nature of the image reconstruction, i.e., that small measurement or modelling errors can result in large image artefacts. It is therefore important that reconstruction algorithms are improved with regard to stability to modelling errors. We identify that wrongly modelled electrode positions constitute one of the biggest sources of image artefacts in head EIT. Therefore, the use of the Fréchet derivative on the electrode boundaries in a realistic three-dimensional head model is investigated, in order to reconstruct electrode movements simultaneously to conductivity changes. We show a fast implementation and analyse the performance of electrode position reconstructions in time-difference and absolute imaging for simulated and experimental voltages. Reconstructing the electrode positions and conductivities simultaneously increased the image quality significantly in the presence of electrode movement.
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Affiliation(s)
- Markus Jehl
- University College London, London WC1E 6BT, UK
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Jehl M, Dedner A, Betcke T, Aristovich K, Klöfkorn R, Holder D. A fast parallel solver for the forward problem in electrical impedance tomography. IEEE Trans Biomed Eng 2015; 62:126-37. [PMID: 25069109 DOI: 10.1109/tbme.2014.2342280] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Electrical impedance tomography (EIT) is a noninvasive imaging modality, where imperceptible currents are applied to the skin and the resulting surface voltages are measured. It has the potential to distinguish between ischaemic and haemorrhagic stroke with a portable and inexpensive device. The image reconstruction relies on an accurate forward model of the experimental setup. Because of the relatively small signal in stroke EIT, the finite-element modeling requires meshes of more than 10 million elements. To study the requirements in the forward modeling in EIT and also to reduce the time for experimental image acquisition, it is necessary to reduce the run time of the forward computation. We show the implementation of a parallel forward solver for EIT using the Dune-Fem C++ library and demonstrate its performance on many CPU's of a computer cluster. For a typical EIT application a direct solver was significantly slower and not an alternative to iterative solvers with multigrid preconditioning. With this new solver, we can compute the forward solutions and the Jacobian matrix of a typical EIT application with 30 electrodes on a 15-million element mesh in less than 15 min. This makes it a valuable tool for simulation studies and EIT applications with high precision requirements. It is freely available for download.
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50
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Zhou Z, Dowrick T, Malone E, Avery J, Li N, Sun Z, Xu H, Holder D. Multifrequency electrical impedance tomography with total variation regularization. Physiol Meas 2015; 36:1943-61. [PMID: 26245292 DOI: 10.1088/0967-3334/36/9/1943] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Multifrequency electrical impedance tomography (MFEIT) reconstructs the distribution of conductivity by exploiting the dependence of tissue conductivity on frequency. MFEIT can be performed on a single instance of data, making it promising for applications such as stroke and cancer imaging, where it is not possible to obtain a 'baseline' measurement of healthy tissue. A nonlinear MFEIT algorithm able to reconstruct the volume fraction distribution of tissue rather than conductivities has been developed previously. For each volume, the fraction of a certain tissue should be either 1 or 0; this implies that the sharp changes of the fractions, representing the boundaries of tissue, contain all the relevant information. However, these boundaries are blurred by traditional regularization methods using [Formula: see text] norm. The total variation (TV) regularization can overcome this problem, but it is difficult to solve due to its non-differentiability. Because the fraction must be between 0 and 1, this imposes a constraint on the MFEIT method based on the fraction model. Therefore, a constrained optimization method capable of dealing with non-differentiable problems is required. Based on the primal and dual interior point method, we propose a new constrained TV regularized method to solve the fraction reconstruction problem. The noise performance of the new MFEIT method is analysed using simulations on a 2D cylindrical mesh. Convergence performance is also analysed through experiments using a cylindrical tank. Finally, simulations on an anatomically realistic head-shaped mesh are demonstrated. The proposed MFEIT method with TV regularization shows higher spatial resolution, particularly at the edges of the perturbation, and stronger noise robustness, and its image noise and shape error are 20% to 30% lower than the traditional fraction method.
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Affiliation(s)
- Zhou Zhou
- National University of Defense Technology, Changsha, 410073, People's Republic of China. University College London, London, WC1E 6BT, UK
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