Differences among implanted pulse generator waveforms cause variations in the neural response to deep brain stimulation
Differences among implanted pulse generator waveforms cause variations in the neural response to deep brain stimulation
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DOI：
10.1016/j.clinph.2007.05.061
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发表时间：
2007-08-01
影响因子：
4.7
通讯作者：
McIntyre, Cameron C.
中科院分区：
文献类型：
--
作者：
Butson, Christopher R.;McIntyre, Cameron C.
目的：两种不同的Medtronic植入式脉冲发生器（IPG）型号目前用于脑深部电刺激（DBS）的临床应用：Soletra和Kinetra。本研究的目的是评估和比较每个IPG model.Methods产生的刺激波形：我们记录了波形从广泛的刺激参数设置在每个IPG模型，并将它们与理想化的波形，坚持在编程设备中指定的参数。然后，我们使用以前发表的计算模型来预测的神经反应的各种刺激waveforms.Results：由IPG产生的刺激波形不同于在以前的理论和临床研究中假设的理想化波形，和波形不同的IPG模型。这些差异在更高的频率和更长的脉冲宽度更大，并导致高达0.4 V的变化激活阈值为模型轴突位于3分钟从DBS电极contact.Conclusions：刺激波形的具体细节直接影响神经反应DBS，并应占在理论和实验研究的DBS。意义：虽然DBS参数的临床选择是基于行为结果针对每位患者进行个性化的，但刺激参数设置和临床阈值测量的科学分析会受到先前未识别的错误源的影响，除非考虑IPG产生的实际波形。(c)2007年国际临床神经生理学联合会。由Elsevier爱尔兰有限公司出版。保留所有权利。
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 min 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. (c) 2007 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.