SignificanceNeuromodulation devices are rapidly evolving for the treatment of neurological diseases and conditions. Injury from implantation or long-term use without obvious functional losses is often only detectable through terminal histology. New technologies are needed that assess the peripheral nervous system (PNS) under normal and diseased or injured conditions.AimWe aim to demonstrate an imaging and stimulation platform that can elucidate the biological mechanisms and impacts of neurostimulation in the PNS and apply it to the sciatic nerve to extract imaging metrics indicating electrical overstimulation.ApproachA sciatic nerve injury model in a 15-rat cohort was observed using a newly developed imaging and stimulation platform that can detect electrical overstimulation effects with polarization-sensitive optical coherence tomography. The sciatic nerve was electrically stimulated using a custom-developed nerve holder with embedded electrodes for 1 h, followed by a 1-h recovery period, delivered at above-threshold Shannon model k-values in experimental groups: sham control (SC, n = 5, 0.0 mA / 0 Hz), stimulation level 1 (SL1, n = 5, 3.4 mA / 50 Hz, and k = 2.57), and stimulation level 2 (SL2, n = 5, 6.8 mA / 100 Hz, and k = 3.17).ResultsThe stimulation and imaging system successfully captured study data across the cohort. When compared to a SC after a 1-week recovery, the fascicle closest to the stimulation lead showed an average change of +4 % / − 309 % (SL1/SL2) in phase retardation and −79 % / − 148 % in optical attenuation relative to SC. Analysis of immunohistochemistry (IHC) shows a +1 % / − 36 % difference in myelin pixel counts and −13 % / + 29 % difference in axon pixel counts, and an overall increase in cell nuclei pixel count of +20 % / + 35 % . These metrics were consistent with IHC and hematoxylin/eosin tissue section analysis.ConclusionsThe poststimulation changes observed in our study are manifestations of nerve injury and repair, specifically degeneration and angiogenesis. Optical imaging metrics quantify these processes and may help evaluate the safety and efficacy of neuromodulation devices.
Peripheral nerve fascicle tracing and longitudinal analysis of the damaging effects of electrical overstimulation using novel polarization sensitive optical coherence tomography (PS-OCT) based biomarkers currently require manual image segmentation to determine the boundaries of the nerve tissue within the acquired OCT volume. We developed an algorithm for automated peripheral nerve tissue classification based on image segmentation of the multimodal swept-source PS-OCT volumes. We compare the performance of density-based and neural network-based classifiers, and demonstrate results on fixed nerve tissues as well as on in vivo acquired data from a rat sciatic nerve and mini-pig vagus nerve.
A 32-channel CR-OCT system was developed to facilitate a data-efficient acquisition of three-dimensional imaging data in laparoscopy. The system consists of a frequency comb source, a high-power doped-fiber optical amplifier, an all fiber-based, 32-channel interferometer, a 32-beam MEMs-based forward-looking 2D laparoscopic probe, and 32-channel detection channels. A novel phase and polarization modulation circuit was included to allow complex and polarization-resolved fringe detection. The system operated at an effective A-line of 10 MHz. We demonstrate video-rate volumetric CR-OCT imaging of a patterned sample and polarization-sensitive imaging of ex vivo tissues.
The study of choroidal blood flow is severely limited by the deficiencies of existing flow imaging methods. We introduce a new framework and acquisition protocol for optical coherence tomography (OCT) flowmetry in the choroid. Our approach quantifies choroidal flow by applying a robust mathematical analysis to signals that are dynamically forward scattered (DFS) by choroidal vessels and reflected from static scatterers in the sclera. This DFS approach provides robust and quantitative flow measurements that are immune to angle and gradient artifacts. We further demonstrate a visualization of flow mapping in a healthy human eye.
Radiation concerns preclude the use of fluoroscopy guidance in lumbar puncture procedures performed on pregnant women or other at-risk groups. We have developed an alternative method for guidance based on a simple, unscanned polarization-sensitive optical coherence tomography needle tip probe. Using the porcine spine as a model, we show that the polarization signals returned by the probe allow each layer from the skin to the subarachnoid space to be uniquely identified in situ. Combining these signals with needle-tip tracking using Doppler methods provides real-time anatomical localization of the needle tip.
We demonstrate wide-field intraoperative in vivo PS-OCT and OCT-A imaging of non-human primate (NHP) peripheral nerves using a portable OCT prototype. Imaging was performed on healthy and surgically repaired (12 months after graft surgery) radial nerves in upper extremity of rhesus macaques (n=17) over surgically exposed nerve segments of up to 8 cm in length. We describe the capabilities and challenges of PS-OCT and OCT-A in assessing NHP peripheral nerves. Further, guided by imaging of NHP peripheral nerves, we discuss the required advancements in core polarimetry techniques to enhance the prospects of clinical utility of PS-OCT in peripheral nerve imaging.
Peripheral nerves connect and relay information between the central nervous system and its target organs. Small arteries traverse the epineurium and are responsible for supplying blood to the axons and cells within the nerves. Constriction or damage to these vessels can reduce perfusion leading to ischemic insults. Peripheral nerve electrostimulation has been approved for the treatment of epilepsy, depression and migraines, and is also being studied for the treatment of rheumatoid arthritis, Crohn’s disease, polycystic ovary syndrome, and type II diabetes. While the safety and efficacy of currently approved medical devices is well established, next generation devices may require novel stimulation parameters that pose additional risks. Therefore it is important to develop new methods to assess stimulation-induced nerve injury. To that end, we have begun to explore optical imaging based biomarkers, including optical coherence tomography angiography (OCT-A) to quantify changes in vascular morphology and blood flow during stimulation. We imaged the rat sciatic nerve in vivo with a 1300 nm OCT-A system. A 3-D printed nerve stabilizer with embedded platinum disc electrode was used to align the nerve for imaging during electrostimulation. Electrostimulation at either 40 or 400 µC/cm2 was applied for 1 hour. Images were acquired before, during and after stimulation. With higher electrostimulation parameters, blood vessels close to electrode site showed constriction. Immunohistochemical assessment was performed to correlate nerve injury to observed vascular changes. Optical imaging biomarkers have the potential to help assess the safety of novel electrodes and electrostimulation paradigms.
A severe traumatic injury to a peripheral nerve often requires surgical graft repair. However, functional recovery after these surgical repairs is often unsatisfactory. To improve interventional procedures, it is important to understand the regeneration of the nerve grafts. The rodent sciatic nerve is commonly used to investigate these parameters. However, the ability to longitudinally assess the reinnervation of injured nerves are limited, and to our knowledge, no methods currently exist to investigate the timing of the revascularization in functional recovery.
In this work, we describe the development and use of angiographic and polarization-sensitive (PS) optical coherence tomography (OCT) to visualize the vascularization, demyelination and remyelination of peripheral nerve healing after crush and transection injuries, and across a variety of graft repair methods. A microscope was customized to provide 3.6 cm fields of view along the nerve axis with a capability to track the nerve height to maintain the nerve within the focal plane. Motion artifact rejection was implemented in the angiography algorithm to reduce degradation by bulk respiratory motion in the hindlimb site. Vectorial birefringence imaging methods were developed to significantly enhance the accuracy of myelination measurements and to discriminate birefringent contributions from the myelin and epineurium. These results demonstrate that the OCT platform has the potential to reveal new insights in preclinical studies and may ultimately provide a means for clinical intra-surgical assessment of peripheral nerve function.
Alterations in lymphatic network function contribute to the lymphedema development, cancer progression and impairment in regional immune function. However, there are limited tools available to directly measure lymphatic vessel function and transport in vivo. Existing approaches such as fluorescence recovery after photo-bleaching (FRAP) require injection of exogenous labels which intrinsically alter the physiology of the local lymphatic network. A label-free approach to imaging lymph flow in vivo would provide direct and unaltered measurements of lymphatic vessel transport and could catalyze research in lymphatic biology. Here, we demonstrate and validate the use of Doppler optical coherence tomography (DOCT) to measure lymph flow in vivo at speeds as low as 50µm/s. Compared to blood, lymph is relatively acellular (under normal conditions), but contains similar soluble components to blood plasma. We demonstrate that the small but detectable scattering signal from lymph can be used to extract fluid velocity using a dedicated algorithm optimized for Doppler analysis in low signal-to-noise settings (0 to 6 dB typical). We demonstrate the accuracy of this technique by comparing DOCT to FRAP measurements, using an intralipid lymph proxy in microfluidic devices and in vivo in the mouse ear. Finally, we demonstrate the label free measurement of lymph speed in the hind-limb of mice with a temporal resolution of 0.25s that agree well with prior literature reports. We anticipate that DOCT can become a powerful new tool in preclinical lymphatic biology research—including the relationship between lymphatic function and metastasis formation—with the potential to later expand also to clinical settings.
In this study, we present an angiographic system comprised from a novel 18.9 MHz swept wavelength source integrated with a MEMs-based 23.7 kHz fast-axis scanner. The system provides rapid acquisition of frames and volumes on which a range of Doppler and intensity-based angiographic analyses can be performed. Interestingly, the source and data acquisition computer can be directly phase-locked to provide an intrinsically phase stable imaging system supporting Doppler measurements without the need for individual A-line triggers or post-processing phase calibration algorithms. The system is integrated with a 1.8 Gigasample (GS) per second acquisition card supporting continuous acquisition to computer RAM for 10 seconds. Using this system, we demonstrate phase-stable acquisitions across volumes acquired at 60 Hz frequency. We also highlight the ability to perform c-mode angiography providing volume perfusion measurements with 30 Hz temporal resolution. Ultimately, the speed and phase-stability of this laser and MEMs scanner platform can be leveraged to accelerate OCT-based angiography and both phase-sensitive and phase-insensitive extraction of blood flow velocity.
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