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Directional steering: A novel approach to deep brain stimulation
M Fiorella Contarino1, Lo J Bour2, Rens Verhagen2
1From the Departments of Neurology/Clinical Neurophysiology (M.F.C., L.J.B., R.V., M.A.J.L., R.M.A.d.B.) and Neurosurgery (P.v.d.M., P.R.S.), Academic Medical Center, University of Amsterdam, the Netherlands; and Department of Neurology (M.F.C.), Haga Teaching Hospital, The Hague, the Netherlands. p.r.schuurman@amc.nl m.f.contarino@amc.uva.nl.
Neurology
|August 24, 2014
Summary
This study shows that directional steering of deep brain stimulation (DBS) current is safe for Parkinson
Area of Science:
- Neurosurgery
- Neurology
- Biomedical Engineering
Background:
- Deep brain stimulation (DBS) is a key treatment for Parkinson disease.
- Current DBS systems use spherical stimulation, which may not precisely target therapeutic areas or avoid side effects.
Purpose of the Study:
- To evaluate the safety and efficacy of directional current steering using a novel 32-contact electrode in Parkinson disease patients.
- To determine if directional steering can modulate stimulation thresholds for therapeutic benefits and side effects.
Main Methods:
- A single-center, double-blind safety and performance study was conducted.
- Eight Parkinson disease patients underwent intraoperative evaluation of stimulation thresholds in spherical and various steering modes.
- Simultaneous local field potential recordings were made using all 32 electrode contacts.
Main Results:
- No adverse events were associated with the experimental device.
- Directional steering increased the threshold for 87% of side effects compared to spherical stimulation, widening the therapeutic window by up to 1.5 mA.
- Local field potential recordings provided spatiotemporal insights into neuronal activity.
Conclusions:
- Controlled current steering via DBS is safe and well-tolerated in Parkinson disease patients.
- Directional steering improves the therapeutic window and may enhance DBS effectiveness.
- This technology offers potential for novel applications and better exploration of brain pathophysiology.
