# Open-source computational modeling of Spinal Cord Stimulation (SCS) to enhance dissemination of 1R01NS112996

> **NIH NIH R01** · CITY COLLEGE OF NEW YORK · 2021 · $314,000

## Abstract

Project Summary / Abstract (unchanged from original proposal, except supplement in red)
There is a need to understand the mechanisms of neural stimulation technologies (RFA-NS-18-018). The impact
of such research increases with both the clinical relevance of a neuromodulation technology and the extent
mechanisms are unknown. Spinal Cord Stimulation at kHz frequencies (kHz SCS) has undergone a meteoric
clinical and market rise, in the absence of an accepted mechanistic hypothesis. The most peculiar feature of kHz
SCS mechanistically is that rapid biphasic stimulation undermines traditional mechanisms of electrical
stimulation. But, we note this same feature of rapid pulsing results in high stimulation power leading to our
hypothesis that kHz SCS increases tissue temperature. Our proposal that a clinically-established implanted
electrical stimulation device would unexpectantly function by joule heating is disruptive and innovative and so
requires, as the first step, to establish the degree of temperature increase during kHz SCS. To this end, our
research plan develops state-of-the-art tools for multi-physics bioheat modeling (Aim 1), multi-compartment 3D-
lattice phantom verification (Aim 2), and validation in a swine model (Aim 3) to methodically test the hypothesis
that kHz SCS produces a 0.5-2 oC temperature rise. The multi-physics model (Aim 1) will be state-of-the-at in
anatomical resolution, internal lead architecture, and the first to couple joule heat, heat conduction and
convection (CSF flow), metabolism, and blood flow perfusion. The heat phantom (Aim 2) will be the first for spinal
cord stimulation based on novel 3D-lattice printed compartments. The swine model (Aim 3) is selected for
anatomical similarities to the human spinal cord and vertebral canal, and will include a custom fabricated
combination lead/sensor array for in vivo temperature mapping. The most peculiar clinical feature of kHz SCS is
lack of paresthesia, associated with conventional SCS. We will develop a dorsal horn network model of heating-
based analgesia (Aim 4) by integrating experimentally validated temperature increases, pain processing network
dynamics, and membrane sensitivity to temperature (Q10). We hypothesize a 0.5-2 0C temperature rise
generates pain relief through the same final MoA as conventional SCS (gate-control) but without pacing
associated paresthesia. While device design, disease models, and clinical trials are explicitly outside RFA scope,
establishing a novel MoA and state-of-the-art tools developed in each Aim implicitly drive and underpin such
developments. Directly RFA responsive, we “improve understanding of the neurobiological underpinnings of
existing methods and lay the foundation for the next generation technologies by developing models (Aim 1, 4),
systems (Aim 2), and procedures (Aim 3) to guide the design of better neuromodulation tools”. Indeed, because
the heating MoA is fundamentally innovative, new tools are needed. Responsive to NOT...

## Key facts

- **NIH application ID:** 10413556
- **Project number:** 3R01NS112996-01A1S1
- **Recipient organization:** CITY COLLEGE OF NEW YORK
- **Principal Investigator:** MAROM BIKSON
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $314,000
- **Award type:** 3
- **Project period:** 2021-07-01 → 2023-04-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10413556

## Citation

> US National Institutes of Health, RePORTER application 10413556, Open-source computational modeling of Spinal Cord Stimulation (SCS) to enhance dissemination of 1R01NS112996 (3R01NS112996-01A1S1). Retrieved via AI Analytics 2026-06-01 from https://api.ai-analytics.org/grant/nih/10413556. Licensed CC0.

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