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Wearable sensor-driven responsive deep brain stimulation for essential tremor.

Stephanie Cernera1, Jose D Alcantara1, Enrico Opri1

  • 1J. Crayton Pruitt Department of Biomedical Engineering, Gainesville, FL, USA.

Brain Stimulation
|September 21, 2021
PubMed
Summary
This summary is machine-generated.

Responsive deep brain stimulation (rDBS) using electromyography (EMG) signals offers essential tremor (ET) therapy equivalent to continuous DBS (cDBS). This EMG-driven rDBS reduces energy use, extending neurostimulator battery life.

Keywords:
Deep brain stimulationElectromyographyEssential tremorResponsive stimulationWearable sensors

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Area of Science:

  • Neurology
  • Biomedical Engineering

Background:

  • Continuous deep brain stimulation (cDBS) is effective for essential tremor (ET) but causes side effects and has limited battery life.
  • Adverse effects of cDBS include postural instability and dysarthria, impacting patient quality of life.
  • Practical limitations of cDBS, such as implantable neurostimulator (INS) battery life, necessitate more efficient therapeutic approaches.

Purpose of the Study:

  • To develop and evaluate a physiology-driven responsive deep brain stimulation (rDBS) system for ET.
  • To personalize ET therapy using electromyography (EMG) signals for targeted stimulation.
  • To assess the efficacy and energy efficiency of EMG-driven rDBS compared to cDBS.

Main Methods:

  • Ten ET participants received rDBS using a Medtronic Nexus-D telemetry wand.
  • Two rDBS paradigms were tested: single-sensor (one EMG) and multi-sensor (two or more EMGs).
  • Algorithms utilized tremor frequency band power from EMG sensors, trained on kinetic and postural data during DBS off and cDBS states.

Main Results:

  • Both single-sensor and multi-sensor EMG-driven rDBS achieved clinical tremor suppression equivalent to cDBS.
  • EMG-driven rDBS paradigms consumed less total electrical energy than cDBS.
  • Reduced energy consumption in rDBS significantly increases the battery life of the INS.

Conclusions:

  • EMG-driven rDBS provides clinically equivalent tremor suppression to cDBS for ET.
  • Responsive DBS significantly reduces energy consumption, enhancing INS longevity.
  • Dynamic rDBS paradigms offer a solution to the limitations of traditional continuous DBS systems.