Temporal pattern of electrical stimulation is a new dimension of therapeutic innovation

Artificial activation of the nervous system requires selection of appropriate stimulation parameters including stimulation amplitude, stimulation pulse duration, and stimulation pulse repetition rate. The temporal pattern of stimulation, i.e., the timing between stimulation pulses, is a novel dimension of stimulation parameter tuning. The effects evoked by artificial activation of the nervous system are dependent on the pattern of stimulation, and different patterns of stimulation, even when delivered at the same average rate, evoke different functional effects, different changes in synaptic plasticity, and even different patterns of gene expression. Non-regular temporal patterns of stimulation offer the opportunity to improve the efficacy and efficiency of therapeutic stimulation as well as to manipulate other processes in the nervous system. The potential design space for sequences of varying interpulse intervals is exceedingly large and sound approaches to design stimulation patterns are required as an empirical approach is not practical.