H C F Martens1, E Toader2, M M J Decré2, D J Anderson3, R Vetter3, D R Kipke3, Kenneth B Baker4, Matthew D Johnson5, Jerrold L Vitek4. 1. Philips Research, High Tech Campus 34, 5656 AE, Eindhoven, The Netherlands. Electronic address: hubert.martens@philips.com. 2. Philips Research, High Tech Campus 34, 5656 AE, Eindhoven, The Netherlands. 3. Neuronexus Technologies, 3985 Research Park Dr. Suite 100, Ann Arbor, MI 48108, USA. 4. Cleveland Clinic, Department of Neurosciences, NC30, 8900 Euclid Ave., Cleveland, OH 44195, USA; University of Minnesota, Department of Neurology, 516 Delaware Street SE, Minneapolis, MN 55455, USA. 5. Cleveland Clinic, Department of Neurosciences, NC30, 8900 Euclid Ave., Cleveland, OH 44195, USA; University of Minnesota, Department of Biomedical Engineering, 7-105 NHH, 312 Church Street SE, Minneapolis, MN 55455, USA.
Abstract
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.
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.
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