Current perspectives on the safe electrical stimulation of peripheral nerves with platinum electrodes

Abstract

This review details some peripheral nervous system (PNS) targets and electrode designs used for electrical stimulation. It investigates limitations in current knowledge of safe electrical stimulation and possible future electrode developments. Current PNS targets are large, leading to poor resolution and off-target side-effects. Most clinical devices are platinum or platinum/iridium embedded in an insulation material. Their safety is usually guided by the Shannon plot, which is not valid for the PNS. New electrode designs are needed to target smaller nerve fibers, enabling higher resolution electrical therapies with fewer off-target side-effects. Damage can occur through biological and electrochemical mechanisms. Greater mechanistic understanding is required to ensure safe and efficacious, long-term electrical stimulation with new electrode materials, geometries and stimulation waveforms.