Computational Field Shaping for Deep Brain Stimulation With Thousands of Contacts in a Novel Electrode Geometry

Willsie, Andrew; Dorval, Alan D.

doi:10.1111/ner.12330

Cited by 13 publications

(9 citation statements)

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“…Having only eight electrode contacts is a great advantage in programming the stimulation settings when monopolar stimulation is used. For a HD lead with a large number of electrode contacts programming the stimulation settings with a trial‐and‐error approach will not suffice in clinical practice . For a 32 HD lead, which was used in a proof of concept study the test stimulation was limited to four standard steering directions, because of time constraints .…”

Section: Discussionmentioning

confidence: 99%

“…Until now the technology for DBS has not changed tremendously over the years . Lately however, technological developments have been reported in terms of new stimulation paradigms , closed‐loop DBS , independent current source stimulators , and directional steering‐DBS with high density and eight channel lead designs . Most of the new technologies are still in an early development phase, although some of the technologies are already used in clinic.…”

Section: Introductionmentioning

confidence: 99%

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Avoiding Internal Capsule Stimulation With a New Eight-Channel Steering Deep Brain Stimulation Lead

Dijk

Verhagen

Bour

et al. 2018

Neuromodulation: Technology at the Neural Interface

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Avoiding Internal Capsule Stimulation With a New Eight-Channel Steering Deep Brain Stimulation Lead

Dijk

Verhagen

Bour

et al. 2018

Neuromodulation: Technology at the Neural Interface

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“…When the bus lines were swapped, there was a notable shift in the voltage field, and this demonstrates how the μDBS is able to recruit contacts to separate bus lines simultaneously (Figure 6C). We have previously shown through computational modeling that the μDBS is capable of precise field steering given instances where lead placement error has resulted in suboptimal lead placement off from its target by a few millimeters (Willsie and Dorval, 2015a). Our directional steering work using the μDBS corroborates other studies for different directional lead designs which have shown that smaller, directional contacts are able to activate neural structures while avoiding side-effect-inducing regions (Contarino et al, 2014; Pollo et al, 2014; Steigerwald et al, 2016; Dembek et al, 2017).…”

Section: Discussionmentioning

confidence: 99%

The μDBS: Multiresolution, Directional Deep Brain Stimulation for Improved Targeting of Small Diameter Fibers

Anderson

Lanka

et al. 2019

Front. Neurosci.

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Directional deep brain stimulation (DBS) leads have recently been approved and used in patients, and growing evidence suggests that directional contacts can increase the therapeutic window by redirecting stimulation to the target region while avoiding side-effect-inducing regions. We outline the design, fabrication, and testing of a novel directional DBS lead, the μDBS, which utilizes microscale contacts to increase the spatial resolution of stimulation steering and improve the selectivity in targeting small diameter fibers. We outline the steps of fabrication of the μDBS, from an integrated circuit design to post-processing and validation testing. We tested the onboard digital circuitry for programming fidelity, characterized impedance for a variety of electrode sizes, and demonstrated functionality in a saline bath. In a computational experiment, we determined that reduced electrode sizes focus the stimulation effect on small, nearby fibers. Smaller electrode sizes allow for a relative decrease in small-diameter axon thresholds compared to thresholds of large-diameter fibers, demonstrating a focusing of the stimulation effect within small, and possibly therapeutic, fibers. This principle of selectivity could be useful in further widening the window of therapy. The μDBS offers a unique, multiresolution design in which any combination of microscale contacts can be used together to function as electrodes of various shapes and sizes. Multiscale electrodes could be useful in selective neural targeting for established neurological targets and in exploring novel treatment targets for new neurological indications.

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“…These designs take advantage of the innumerable possible electrode orientations to maximize the efficacy of stimulation with surrounding anatomical structures (Figure 3 ; Beriault et al, 2012 ; Van Dijk et al, 2015 ). This notion of current-steering has given rise to multiple investigations (Contarino et al, 2014 ; Bour et al, 2015 ; Timmerman et al, 2015 ; Willsie and Dorval, 2015 ) and combining these engineering designs with computational models, such as those looking at the volume of tissue activated, could also prove to be useful in surgical planning and subsequent electrode programming. However, additional studies with long-term follow-up will be necessary to better determine the efficacy of such technologies.…”

Section: Mechanism Of Action Of Dbsmentioning

confidence: 99%

Computational Modeling and Neuroimaging Techniques for Targeting during Deep Brain Stimulation

et al. 2016

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Accurate surgical localization of the varied targets for deep brain stimulation (DBS) is a process undergoing constant evolution, with increasingly sophisticated techniques to allow for highly precise targeting. However, despite the fastidious placement of electrodes into specific structures within the brain, there is increasing evidence to suggest that the clinical effects of DBS are likely due to the activation of widespread neuronal networks directly and indirectly influenced by the stimulation of a given target. Selective activation of these complex and inter-connected pathways may further improve the outcomes of currently treated diseases by targeting specific fiber tracts responsible for a particular symptom in a patient-specific manner. Moreover, the delivery of such focused stimulation may aid in the discovery of new targets for electrical stimulation to treat additional neurological, psychiatric, and even cognitive disorders. As such, advancements in surgical targeting, computational modeling, engineering designs, and neuroimaging techniques play a critical role in this process. This article reviews the progress of these applications, discussing the importance of target localization for DBS, and the role of computational modeling and novel neuroimaging in improving our understanding of the pathophysiology of diseases, and thus paving the way for improved selective target localization using DBS.

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Computational Field Shaping for Deep Brain Stimulation With Thousands of Contacts in a Novel Electrode Geometry

Cited by 13 publications

References 50 publications

Avoiding Internal Capsule Stimulation With a New Eight-Channel Steering Deep Brain Stimulation Lead

Avoiding Internal Capsule Stimulation With a New Eight-Channel Steering Deep Brain Stimulation Lead

The μDBS: Multiresolution, Directional Deep Brain Stimulation for Improved Targeting of Small Diameter Fibers

Computational Modeling and Neuroimaging Techniques for Targeting during Deep Brain Stimulation

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