Fabrication and initial testing of the μDBS: a novel Deep Brain Stimulation electrode with thousands of individually controllable contacts

Willsie, Andrew; Dorval, Alan D.

doi:10.1007/s10544-015-9961-x

Cited by 17 publications

(12 citation statements)

References 48 publications

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“…Access to these parameters is particularly important for addressing ET that does not respond to conventional DBS parameters [ 12 ] or develops habituation [ 13 , 24 ]. Deep-learning modalities might be able to further refine this approach to avoid supra-therapeutic stimulation, minimize battery consumption, and enable the titration of more complex devices [ 46 , 47 ]. The role of the individual DBS parameters in tremor control remains elusive.…”

Section: Discussionmentioning

confidence: 99%

Optimal Parameters of Deep Brain Stimulation in Essential Tremor: A Meta-Analysis and Novel Programming Strategy

Bogdan

Laar

Oterdoom

et al. 2020

JCM

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The programming of deep brain stimulation (DBS) parameters for tremor is laborious and empirical. Despite extensive efforts, the end-result is often suboptimal. One reason for this is the poorly understood relationship between the stimulation parameters’ voltage, pulse width, and frequency. In this study, we aim to improve DBS programming for essential tremor (ET) by exploring a new strategy. At first, the role of the individual DBS parameters in tremor control was characterized using a meta-analysis documenting all the available parameters and tremor outcomes. In our novel programming strategy, we applied 10 random combinations of stimulation parameters in eight ET-DBS patients with suboptimal tremor control. Tremor severity was assessed using accelerometers and immediate and sustained patient-reported outcomes (PRO’s), including the occurrence of side-effects. The meta-analysis showed no substantial relationship between individual DBS parameters and tremor suppression. Nevertheless, with our novel programming strategy, a significantly improved (accelerometer p = 0.02, PRO p = 0.02) and sustained (p = 0.01) tremor suppression compared to baseline was achieved. Less side-effects were encountered compared to baseline. Our pilot data show that with this novel approach, tremor control can be improved in ET patients with suboptimal tremor control on DBS. In addition, this approach proved to have a beneficial effect on stimulation-related complications.

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Section: Discussionmentioning

confidence: 99%

Optimal Parameters of Deep Brain Stimulation in Essential Tremor: A Meta-Analysis and Novel Programming Strategy

Bogdan

Laar

Oterdoom

et al. 2020

JCM

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“…It is important to note that the DBS arrays reported here did not have the spatial resolution to make inferences on the optimal spatial scale of electrode sizes and configurations for current steering or LFP recordings. DBS arrays with even higher site density [40] and computational models of high-density DBS arrays [12] may be able to better probe this question. However, the DBS array dimensions in this study did show improved functional resolution over current DBS lead designs.…”

Section: Discussionmentioning

confidence: 99%

A Novel Lead Design for Modulation and Sensing of Deep Brain Structures

Connolly

Vetter

Hetke

et al. 2016

IEEE Trans. Biomed. Eng.

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Goal Develop and characterize the functionality of a novel thin-film probe technology with a higher density of electrode contacts than are currently available with commercial deep brain stimulation (DBS) lead technology. Such technology has potential to enhance the spatial precision of DBS and enable a more robust approach to sensing local field potential activity in the context of adaptive DBS strategies. Methods Thin-film planar arrays were microfabricated and then assembled on a cylindrical carrier to achieve a lead with 3D conformation. Using an integrated and removable stylet, the arrays were chronically implanted in the subthalamic nucleus and globus pallidus in two parkinsonian non-human primates. Results This study provides the first in vivo data from chronically implanted DBS arrays for translational non-human primate studies. Stimulation through the arrays induced a decrease in parkinsonian rigidity, and directing current around the lead showed an orientation dependency for eliciting motor capsule side effects. The array recordings also showed that oscillatory activity in the basal ganglia is heterogeneous at a smaller scale than detected by current DBS lead technology. Conclusion These 3D DBS arrays provide an enabling tool for future studies that seek to monitor and modulate deep brain activity through chronically implanted leads. Significance DBS lead technology with a higher density of electrode contacts have potential to enable sculpting DBS current flow and sensing biomarkers of disease and therapy.

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“…Commercially available and emerging DBS leads such as Vercise TM DBS Directional Lead (Boston Scientific), Infinity TM DBS system (St. Jude Medical), directSTIM TM (Aleva Neurotherapeutics) [13], and SureStim1 TM (Medtronic, Ltd.) [14] may include 8 or up to 40 electrode contacts together with implantable pulse generators that can deliver multiple independent stimulation pulses and record local field potentials [15, 16]. In addition, Willsie and Dorval [17, 18] presented DBS leads with thousands of individually controllable contacts. Such technology brings new possibilities for shaping the stimulation field as well as electrophysiological exploration of the target area and surroundings.…”

Section: Introductionmentioning

confidence: 99%

Prediction of Electrode Contacts for Clinically Effective Deep Brain Stimulation in Essential Tremor

Åström

Samuelsson

Roothans

et al. 2018

Stereotact Funct Neurosurg

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Background/Aim: Deep brain stimulation (DBS) is an established neurosurgical treatment that can be used to alleviate symptoms in essential tremor (ET) and other movement disorders. The aim was to develop a method and software tool for the prediction of effective DBS electrode contacts based on probabilistic stimulation maps (PSMs) in patients with ET treated with caudal zona incerta (cZi) DBS. Methods: A total of 33 patients (37 leads) treated with DBS were evaluated with the Essential Tremor Rating Scale (ETRS) 12 months after surgery. In addition, hand tremor and hand function (ETRS items 5/6 and 11–14) were evaluated for every contact during stimulation with best possible outcome without inducing side effects. Prediction of effective DBS electrode contacts was carried out in a retrospective leave-one-out manner based on PSMs, simulated stimulation fields, and a scoring function. Electrode contacts were ranked according to their likelihood of being included in the clinical setting. Ranked electrode contacts were compared to actual clinical settings. Results: Predictions made by the software tool showed that electrode contacts with rank 1 matched the clinically used contacts in 60% of the cases. Contacts with a rank of 1–2 and 1–3 matched the clinical contacts in 83 and 94% of the cases, respectively. Mean improvement of hand tremor and hand function was 79 ± 21% and 77 ± 22% for the clinically used and the predicted electrode contacts, respectively. Conclusions: Effective electrode contacts can be predicted based on PSMs in patients treated with cZi DBS for ET. Predictions may in the future be used to reduce the number of clinical assessments that are carried out before a satisfying stimulation setting is defined.

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Fabrication and initial testing of the μDBS: a novel Deep Brain Stimulation electrode with thousands of individually controllable contacts

Cited by 17 publications

References 48 publications

Optimal Parameters of Deep Brain Stimulation in Essential Tremor: A Meta-Analysis and Novel Programming Strategy

Optimal Parameters of Deep Brain Stimulation in Essential Tremor: A Meta-Analysis and Novel Programming Strategy

A Novel Lead Design for Modulation and Sensing of Deep Brain Structures

Prediction of Electrode Contacts for Clinically Effective Deep Brain Stimulation in Essential Tremor

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