NRV: An open framework for in silico evaluation of peripheral nerve electrical stimulation strategies

Electrical stimulation of peripheral nerves has been used in various pathological contexts for rehabilitation purposes or to alleviate the symptoms of neuropathologies, thus improving the overall quality of life of patients. However, the development of novel therapeutic strategies is still a challenging issue requiring extensive in vivo experimental campaigns and technical development. To facilitate the design of new stimulation strategies, we provide a fully open source and self-contained software framework for the in silico evaluation of peripheral nerve electrical stimulation. Our modeling approach, developed in the popular and well-established Python language, uses an object-oriented paradigm to map the physiological and electrical context. The framework is designed to facilitate multi-scale analysis, from single fiber stimulation to whole multifascicular nerves. It also allows the simulation of complex strategies such as multiple electrode combinations and waveforms ranging from conventional biphasic pulses to more complex modulated kHz stimuli. In addition, we provide automated support for stimulation strategy optimization and handle the computational backend transparently to the user. Our framework has been extensively tested and validated with several existing results in the literature.Author summary: Electrical stimulation of the peripheral nervous system is a powerful therapeutic approach for treating and alleviating patients suffering from a large variety of disorders, including loss of motor control or loss of sensation. Electrical stimulation works by connecting the neural target to a neurostimulator through an electrode that delivers a stimulus to modulate the electrical activity of the targeted nerve fiber population. Therapeutic efficacy is directly influenced by electrode design, placement, and stimulus parameters. Computational modeling approaches have proven to be an effective way to select the appropriate stimulation parameters. Such an approach is, however, poorly accessible to inexperienced users as it typically requires the use of multiple commercial software and/or development in different programming languages. Here, we describe a Python-based framework that aims to provide an open-source turnkey solution to any end user. The framework we developed is based on open-source packages that are fully encapsulated, thus transparent to the end-user. The framework is also being developed to enable simulation of granular complexity, from rapid first-order simulation to the evaluation of complex stimulation scenarios requiring a deeper understanding of the ins and outs of the framework.