Pulse shaping strategies for electroceuticals: a comprehensive survey of the use of interphase gaps in miniature stimulation systems.

OBJECTIVE Interphase gaps (IPGs) are among the most commonly suggested pulse shape variations to try to enhance neural stimulation efficiency by reducing the action potential (AP) suppressing effect of an early anodic hyperpolarization. The majority of published literature on the effect of IPGs is based on investigations of monopolar stimulation configurations. However, many contemporary neuromodulation applications including the emerging field of electroceutical devices operate in a bipolar electrode configuration. METHODS We investigated the effect of IPGs and asymmetric biphasic current controlled pulses with reduced anodic amplitude on neural activation in both principal electrode configurations in a rodent in-vivo nerve muscle preparation. RESULTS In the monopolar electrode configuration, our findings of 10.9 1.5% decreased stimulation amplitude with 200's IPGs in biphasic pulses of 40's phase width are in agreement with published literature in this configuration. Surprisingly, using the bipolar configuration, opposite effects of IPGs were observed and neural activation required up to 18.6 3.1% (phase width 100's, IPG=1000's) higher amplitudes. Electroneurogram recordings of the stimulated nerve revealed temporal differences in AP generation between the monopolar and bipolar configuration. In the bipolar configuration excitation first occurred in response to the middle field transition of biphasic pulses. CONCLUSION This is the first study to report consistently increased amplitude requirements with IPGs in bipolar stimulation configurations. SIGNIFICANCE Our findings must be taken into consideration when designing stimulation waveforms for neuromodulation devices that operate in a bipolar mode to avoid increased amplitude requirements that result in increased energy consumption.