Spatial steering of deep brain stimulation volumes using a novel lead design

被引:136
作者
Martens, H. C. F. [1 ]
Toader, E. [1 ]
Decre, M. M. J. [1 ]
Anderson, D. J. [2 ]
Vetter, R. [2 ]
Kipke, D. R. [2 ]
Baker, Kenneth B. [3 ,4 ]
Johnson, Matthew D. [3 ,4 ,5 ]
Vitek, Jerrold L. [3 ,4 ]
机构
[1] Philips Res Labs, NL-5656 AE Eindhoven, Netherlands
[2] Neuronexus Technol, Ann Arbor, MI 48108 USA
[3] Cleveland Clin, Dept Neurosci, Cleveland, OH 44195 USA
[4] Univ Minnesota, Dept Neurol, Minneapolis, MN 55455 USA
[5] Univ Minnesota, Dept Biomed Engn, Minneapolis, MN 55455 USA
关键词
Deep brain stimulation; DBS; Computational model; Neural engineering; Activating function; Finite element method; Lead design; Electrode design; Neurostimulation; In vivo; Macaca mulatta; SUBTHALAMIC NUCLEUS STIMULATION; PARKINSONS-DISEASE; NEURAL STIMULATION; PALLIDUM; IMPLANTATION; TECHNOLOGY; MANAGEMENT; DISORDERS; ACCURACY;
D O I
10.1016/j.clinph.2010.07.026
中图分类号
R74 [神经病学与精神病学];
学科分类号
100204 [神经病学];
摘要
Objective: To investigate steering the volume of activated tissue (VTA) with deep brain stimulation (DBS) using a novel high spatial-resolution lead design. Methods: We examined the effect of asymmetric current-injection across the DBS-array on the VTA. These predictions were then evaluated acutely in a non-human primate implanted with the DBS-array, using motor side-effect thresholds as the metric for estimating VTA asymmetries. Results: Simulations show the DBS-array, with electrodes arranged together in a cylindrical configuration, can generate field distributions equivalent to commercial DBS leads, and these field distributions can be modulated using field-steering methods. Stimulation with implanted DBS-arrays showed directionally-selective muscle activation, presumably through spread of stimulation fields into portions of the corticospinal tract lying in the internal capsule. Conclusions: Our computational and experimental studies demonstrate that the DBS-array is capable of spatially selective stimulation. Displacing VTAs away from the lead's axis can be achieved using a single simple and intuitive control parameter. Significance: Optimal DBS likely requires non-uniform VTAs that may differentially affect a nucleus or fiber pathway. The DBS-array allows positioning VTAs with sub-millimeter precision, which is especially relevant for those patients with DBS leads placed in sub-optimal locations. This may present clinicians with an additional degree of freedom to optimize the DBS therapy. (c) 2010 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.
引用
收藏
页码:558 / 566
页数:9
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