Arrays for deep brain microstimulation and recording

描述(申请人提供)：脑深部结构电刺激(DBS)已发展成为治疗晚期帕金森氏症和特发性震颤的有效方法。DBS还被评估为治疗其他神经疾病的一种方法，似乎对几种类型的肌张力障碍和多动障碍以及难治性颞叶癫痫的治疗有用。丘脑底核已成为DBS治疗晚期帕金森病和某些其他运动障碍的首选靶点。许多研究已经证明了包括人类在内的许多物种的STN的一种地形组织。与目前临床上使用的深部脑阵列相比，能够访问这种拓扑结构的临床设备很可能在运动障碍的治疗方面提供更多的机会和灵活性。目前的设备使用大电极，电刺激的范围很广，可能远远超出STN的边界，这可能是STN中经常伴随着脑深部刺激的许多副作用的原因。分布在靶核中的刺激微电极阵列将允许精确控制刺激的空间分布，从而使DBS治疗更好地个体化，并降低副作用的发生率。然而，用于临床DBS的新型阵列必须保留目前临床使用的设备的所有功能，并提供新的功能。我们的目标是开发微电极阵列技术，这种微电极阵列适用于慢性植入人类丘脑底核(STN)、苍白球内段，也许还有大脑深部的其他靶点，能够从单个神经元单位进行慢性记录，并能够提供局部微刺激和“雕刻”刺激，与目前临床使用的阵列相比，可以更好地控制刺激的空间模式，但与目前的临床阵列完全“向后兼容”。除了临床适用性，这项技术还可以用于动物研究，旨在了解大脑深部刺激可以改善帕金森氏症和其他运动障碍症状的机制。这项技术将改善帕金森氏症和其他运动障碍患者的生活质量。

DESCRIPTION (provided by applicant): Electrical stimulation in deep brain structures (DBS) has developed into an effective treatment for advanced Parkinson's disease and essential tremor. DBS also is being evaluated as a treatment for other neurological conditions and appears to be useful in the treatment of several types of dystonias and hyperkinetic disorders and for intractable temporal lobe epilepsy. The subthalamic nucleus has become the preferred target for the treatment of advanced Parkinson's Disease and certain other motor disorders by DBS. Numerous studies have demonstrated a topographic organization of the STN of many species, including humans. It is likely that a clinical device that can access this topology will afford greater opportunities and flexibility in the treatment of motor disorders than is possible with the deep brain arrays now in clinical use. The present devices use macroelectrodes, and the electrical stimulation tends to spread quite broadly, and may extend well beyond the boundaries of the STN, which may account for many of the side effects that often accompany deep brain stimulation in the STN. An array of stimulating microelectrodes distributed through the target nucleus would permit precise control of the spatial distribution of the stimulation, allowing for better individualization of DBS therapy and a lower incidence of side effects. However, a novel array for clinical DBS must retain all of the functionality of the devices now in clinical use, as well as providing new capabilities. Our objective is develop the technology for arrays of microelectrodes that are suitable for chronic implantation into the human subthalamic nucleus (STN), the internal segment of the globus pallidus, and perhaps other targets in the deep brain, are able to record chronically from single neuronal units, and can deliver localized microstimulation and "sculpted" stimulation with much better control of the spatial pattern of stimulation than is possible with the arrays now in clinical use, but are fully "backward compatible" with the present clinical arrays. In addition to its clinical applicability, this technology can be used in animal studies aimed at understanding the mechanisms by which deep brain stimulation can ameliorate the symptoms of Parkinson's Disease and other movement disorders. This technology will improve quality of life for persons afflicted with Parkinson's Disease and other movement disorders.