title: Alteration of neural action potential patterns by axonal stimulation: the importance of stimulus location.
abstract: OBJECTIVE
  Stimulation of peripheral nerves is often superimposed on ongoing motor and sensory activity in the same axons, without a quantitative model of the net action potential train at the axon endpoint.
  
  
  METHODS
  We develop a model of action potential patterns elicited by superimposing constant frequency axonal stimulation on the action potentials arriving from a physiologically activated neural source. The model includes interactions due to collision block, resetting of the neural impulse generator, and the refractory period of the axon at the point of stimulation.
  
  
  RESULTS
  Both the mean endpoint firing rate and the probability distribution of the action potential firing periods depend strongly on the relative firing rates of the two sources and the intersite conduction time between them. When the stimulus rate exceeds the neural rate, neural action potentials do not reach the endpoint and the rate of endpoint action potentials is the same as the stimulus rate, regardless of the intersite conduction time. However, when the stimulus rate is less than the neural rate, and the intersite conduction time is short, the two rates partially sum. Increases in stimulus rate produce non-monotonic increases in endpoint rate and continuously increasing block of neurally generated action potentials. Rate summation is reduced and more neural action potentials are blocked as the intersite conduction time increases. At long intersite conduction times, the endpoint rate simplifies to being the maximum of either the neural or the stimulus rate.
  
  
  CONCLUSIONS
  This study highlights the potential of increasing the endpoint action potential rate and preserving neural information transmission by low rate stimulation with short intersite conduction times. Intersite conduction times can be decreased with proximal stimulation sites for muscles and distal stimulation sites for sensory endings. The model provides a basis for optimizing experiments and designing neuroprosthetic interventions involving motor or sensory stimulation.
authors.affiliation: Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH 44106, USA. Cleveland Functional Electrical Stimulation (FES) Center, Cleveland, OH 44106 USA.
authors.forename: Patrick E
authors.initials: PE
authors.lastname: Crago
authors.forename: Nathaniel S
authors.initials: NS
authors.lastname: Makowski
mesh_terms: D000200:Action Potentials / Q000502:physiology*; D001369:Axons / Q000502:physiology*; D003198:Computer Simulation; D004558:Electric Stimulation / Q000379:methods*; D006801:Humans; D008959:Models, Neurological; D009431:Neural Conduction / Q000502:physiology*; D010525:Peripheral Nerves / Q000502:physiology*