Subthreshold Stimulation
Electrical stimulation delivered below the threshold for conscious sensation, used in modern neurostimulation paradigms.
Full Definition
Subthreshold stimulation refers to electrical stimulation parameters set below the sensory threshold, meaning patients do not feel paresthesia or other sensations during active stimulation. This approach contrasts with traditional 'paresthesia-based' stimulation where patients experience tingling sensations overlapping their pain areas. Subthreshold stimulation can be delivered using various waveforms including burst patterns, high-frequency stimulation, or differential target multiplexed programming. The mechanism of action is thought to involve modulation of neural circuits without generating action potentials in sensory fibers. Clinical studies have demonstrated that subthreshold approaches can provide effective pain relief while eliminating position-dependent stimulation changes and allowing patients to participate in activities like driving without sensation interference.
Usage
Usage note: Emphasize the lack of conscious sensation rather than just low amplitude.
In Context
- "The patient preferred subthreshold stimulation as it eliminated position-dependent sensation changes." — Follow-up assessment
- "Subthreshold paradigms may offer advantages in patients who find paresthesia distracting or uncomfortable." — Clinical guidelines