Electroosmosis Based Novel Treatment Approach for Cerebral Edema.

Teng Wang,Svein Kleiven,Xiaogai Li

doi:10.1109/tbme.2020.3045916

Teng Wang, Svein Kleiven + Show 1 more

Open Access

https://doi.org/10.1109/tbme.2020.3045916

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Abstract

Cerebral edema characterized as an abnormal accumulation of interstitial fluid has not been treated effectively. We propose a novel edema treatment approach to drive edematous fluid out of the brain by direct current utilizing brain tissue's electroosmotic property. A finite element (FE) head model is developed and employed to assess the feasibility of the approach. First, the capacity of the model for electric field prediction is validated against human experiments. Second, two electrode configurations (S and D-montage) are designed to evaluate the distribution of the electric field, electroosmotic flow (EOF), current density, and temperature across the brain under an applied direct current. The S-montage is shown to induce an average EOF velocity of 7e-4 mm/s underneath the anode by a voltage of 15 V, and the D-montage induces a velocity of 9e-4 mm/s by a voltage of 5 V. Meanwhile, the brain temperature in both configurations is below 38 °C, which is within the safety range. Further, the magnitude of EOF is proportional to the electric field, and the EOF direction follows the current flow from anode to cathode. The EOF velocity in the white matter is significantly higher than that in the gray matter under the anode where the fluid is to be drawn out. The proposed electroosmosis based approach allows alleviating brain edema within the critical time window by direct current. The approach may be further developed as a new treatment solely or as a complement to existing conventional treatments of edema.

Highlights

C EREBRAL edema is defined as the accumulation of water in extracellular and intracellular spaces, leading to high morbidity and mortality [1], [2]
The correlation coefficients between measured and predicted values are 0.96 for voltage (Fig. 2(b)) and 0.81 for electric field (Fig. 2(d)), respectively, suggesting a reasonable capability of the model to predict the spatial distribution of voltage and the electric field comparing with human experiments reported earlier by Huang et al [39]
We propose a novel approach for edema treatment based on electroosmosis by an applied direct current

Summary

Introduction

C EREBRAL edema is defined as the accumulation of water in extracellular and intracellular spaces, leading to high morbidity and mortality [1], [2]. Current treatments for cerebral edema are limited and mainly to ameliorate the outcome of brain swelling [1]. Osmotherapy has been regarded as the most useful pharmacologic therapy to draw water out of the brain into the vascular compartment by creating an osmotic gradient between the brain and the blood system This is accomplished by intravenous administration of osmotic agents, such as mannitol and hypertonic saline, resulting in high serum osmolality to shift excess water from the brain into intravascular space. This approach may cause side effects such as renal failure and decreased cerebral perfusion [2], [5]. The treatment of cerebral edema is still an arduous task

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