Christopher R Butson1, Cameron C McIntyre. 1. Department of Biomedical Engineering, Cleveland Clinic Foundation, 9500 Euclid Avenue, ND20, Cleveland, OH 44195, USA.
Abstract
OBJECTIVE: Two different Medtronic implantable pulse generator (IPG) models are currently used in clinical applications of deep brain stimulation (DBS): Soletra and Kinetra. The goal of this study was to evaluate and compare the stimulation waveforms produced by each IPG model. METHODS: We recorded waveforms from a broad range of stimulation parameter settings in each IPG model, and compared them to idealized waveforms that adhered to the parameters specified in the programming device. We then used a previously published computational model to predict the neural response to the various stimulation waveforms. RESULTS: The stimulation waveforms produced by the IPGs differed from the idealized waveforms assumed in previous theoretical and clinical studies, and the waveforms differed among the IPG models. These differences were greater at higher frequencies and longer pulse widths, and caused variations of up to 0.4 V in activation thresholds for model axons located 3 mm from the DBS electrode contact. CONCLUSIONS: The specific details of the stimulation waveform directly affect the neural response to DBS and should be accounted for in theoretical and experimental studies of DBS. SIGNIFICANCE: While the clinical selection of DBS parameters is individualized to each patient based on behavioral outcomes, scientific analysis of stimulation parameter settings and clinical threshold measurements are subject to a previously unrecognized source of error unless the actual waveforms produced by the IPG are accounted for.
OBJECTIVE: Two different Medtronic implantable pulse generator (IPG) models are currently used in clinical applications of deep brain stimulation (DBS): Soletra and Kinetra. The goal of this study was to evaluate and compare the stimulation waveforms produced by each IPG model. METHODS: We recorded waveforms from a broad range of stimulation parameter settings in each IPG model, and compared them to idealized waveforms that adhered to the parameters specified in the programming device. We then used a previously published computational model to predict the neural response to the various stimulation waveforms. RESULTS: The stimulation waveforms produced by the IPGs differed from the idealized waveforms assumed in previous theoretical and clinical studies, and the waveforms differed among the IPG models. These differences were greater at higher frequencies and longer pulse widths, and caused variations of up to 0.4 V in activation thresholds for model axons located 3 mm from the DBS electrode contact. CONCLUSIONS: The specific details of the stimulation waveform directly affect the neural response to DBS and should be accounted for in theoretical and experimental studies of DBS. SIGNIFICANCE: While the clinical selection of DBS parameters is individualized to each patient based on behavioral outcomes, scientific analysis of stimulation parameter settings and clinical threshold measurements are subject to a previously unrecognized source of error unless the actual waveforms produced by the IPG are accounted for.
Authors: A L Benabid; P Pollak; C Gervason; D Hoffmann; D M Gao; M Hommel; J E Perret; J de Rougemont Journal: Lancet Date: 1991-02-16 Impact factor: 79.321
Authors: Christopher R Butson; Scott E Cooper; Jaimie M Henderson; Barbara Wolgamuth; Cameron C McIntyre Journal: Neuroimage Date: 2010-10-23 Impact factor: 6.556
Authors: Scott F Lempka; Bryan Howell; Kabilar Gunalan; Andre G Machado; Cameron C McIntyre Journal: Clin Neurophysiol Date: 2018-01-31 Impact factor: 3.708
Authors: Anneke M M Frankemolle; Jennifer Wu; Angela M Noecker; Claudia Voelcker-Rehage; Jason C Ho; Jerrold L Vitek; Cameron C McIntyre; Jay L Alberts Journal: Brain Date: 2010-01-07 Impact factor: 13.501