Current steering to activate targeted neural pathways during deep brain stimulation of the subthalamic region.
Current steering to activate targeted neural pathways during deep brain stimulation of the subthalamic region.
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DOI：
10.1016/j.brs.2011.05.002
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发表时间：
2012-07
影响因子：
7.7
通讯作者：
McIntyre, Cameron C.
中科院分区：
文献类型：
--
作者：
Chaturvedi, Ashutosh;Foutz, Thomas J.;McIntyre, Cameron C.
关键词：
脑深部电刺激（DBS）已稳步发展成为许多神经系统疾病的既定手术治疗方法，最值得注意的是帕金森病（PD）。传统DBS技术依赖于具有单个源的电压控制刺激;然而，最近的工程进展提供了具有多个独立源的电流控制装置。这些新的刺激器向脑组织输送恒定电流，而不管电极周围发生的阻抗变化，并能够将电流更具体地引导到目标感兴趣区域。在这项研究中，我们检查了多个电极触点之间的电流转向的影响，以直接激活丘脑底区中的三个不同的神经群，这些神经群通常被刺激用于治疗PD：丘脑底核（BTH）的投射神经元、豆状束的苍白球内（GPi）纤维和内囊（IC）通道纤维。我们使用三维有限元电场模型，沿着详细的多室电缆模型的三个神经群体，以确定他们的激活使用范围广泛的刺激参数设置。我们的研究结果表明，神经群体的选择性激活在很大程度上取决于活性电极的位置。与单个电流源相比，通过使用多个独立源的电流引导实现了GPi和GPi群的更大激活（不激活任何副作用相关的IC纤维）。尽管有这种潜在优势，但这些理论预测是否产生可测量的临床效果，其重要性是否超过由更灵活的技术产生的扩展刺激参数搜索空间的增加的复杂性，仍有待观察。
Deep brain stimulation (DBS) has steadily evolved into an established surgical therapy for numerous neurological disorders, most notably Parkinson’s disease (PD). Traditional DBS technology relies on voltage-controlled stimulation with a single source; however, recent engineering advances are providing current-controlled devices with multiple independent sources. These new stimulators deliver constant current to the brain tissue, irrespective of impedance changes that occur around the electrode, and enable more specific steering of current towards targeted regions of interest. In this study, we examined the impact of current steering between multiple electrode contacts to directly activate three distinct neural populations in the subthalamic region commonly stimulated for the treatment of PD: projection neurons of the subthalamic nucleus (STN), globus pallidus internus (GPi) fibers of the lenticular fasiculus, and internal capsule (IC) fibers of passage. We used three-dimensional finite element electric field models, along with detailed multi-compartment cable models of the three neural populations to determine their activations using a wide range of stimulation parameter settings. Our results indicate that selective activation of neural populations largely depends on the location of the active electrode(s). Greater activation of the GPi and STN populations (without activating any side-effect related IC fibers) was achieved by current steering with multiple independent sources, compared to a single current source. Despite this potential advantage, it remains to be seen if these theoretical predictions result in a measurable clinical effect that outweighs the added complexity of the expanded stimulation parameter search space generated by the more flexible technology.
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影响因子：
4
作者：
Lempka SF;Miocinovic S;Johnson MD;Vitek JL;McIntyre CC
通讯作者：
McIntyre CC
影响因子：
1.7
作者：
Hunsche, Stefan;Sauner, Dieter;Treuer, Harald
通讯作者：
Treuer, Harald
影响因子：
158.5
作者：
Obeso, JA;Guridi, J;Wilkinson, S
通讯作者：
Wilkinson, S
影响因子：
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作者：
Moro, Elena;Poon, Yu-Yan W.;Lang, Anthony E.
通讯作者：
Lang, Anthony E.
DOI：
10.1007/s11548-009-0391-1
发表时间：
2010-05
影响因子：
3
作者：
Pallavaram, Srivatsan;Dawant, Benoit M.;Remple, Michael S.;Neimat, Joseph S.;Kao, Chris;Konrad, Peter E.;D'Haese, Pierre-Francois
通讯作者：
D'Haese, Pierre-Francois