DBS Lead Movement Detection Using Evoked Potentials
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Solution Overview
Problem
Existing deep brain stimulation (DBS) systems face challenges in optimizing lead placement and stimulation parameters due to non-selective activation of neural elements, leading to potential cognitive impairment and fluctuating therapeutic efficacy due to brain dynamics and medication states, necessitating closed-loop feedback for adjustment.
Innovation Solution
A method and system for assessing therapeutic efficacy decline by measuring impedances and evoked potentials, adjusting stimulation parameters, and optimizing lead positions using iterative stimulation techniques to ensure optimal electrode placement and parameter settings.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Reliability
If electrical stimulation is applied to treat neurological disorders, then therapeutic benefit is achieved, but non-selective activation of neural elements causes cognitive impairment and side effects
Solution Approach 1:
The patent applies local quality by using directional electrodes to create localized stimulation fields that selectively activate specific neural elements while avoiding others. The stimulation is confined to a local region around the electrode, allowing precise control over which neural pathways are activated, thereby achieving therapeutic benefit without causing cognitive impairment from non-selective activation.
Solution Approach 2:
The patent segments the stimulation field into multiple directional components using electrode segments arranged in specific geometric patterns. This segmentation allows independent control of stimulation in different spatial directions, enabling selective activation of target neural elements while avoiding non-target areas, thus resolving the contradiction between therapeutic efficacy and side effect prevention.
2Reliability
If stimulation parameters are increased to improve treatment effectiveness, then therapeutic benefit increases, but excessive energy consumption and side effects occur
Solution Approach 1:
By concentrating stimulation energy locally around the electrode through directional fields, the patent achieves high treatment effectiveness without requiring high overall energy levels. The energy is efficiently delivered only to the intended target region, minimizing wasteful energy consumption and reducing the risk of excessive stimulation side effects.
3Reliability
If lead placement is adjusted to optimize stimulation coverage, then therapeutic efficacy improves, but implantation complexity and time increase
Solution Approach 1:
The patent employs directional electrodes that can dynamically adjust the spatial distribution of stimulation fields without requiring physical repositioning of the lead. This dynamic control of stimulation geometry allows optimization of therapeutic efficacy while maintaining simple lead placement, as the same lead can adapt its stimulation pattern to match different anatomical variations.
4Device complexity
If traditional DBS systems are used, then simple hardware is maintained, but inability to detect lead movement results in fluctuating therapeutic efficacy
Solution Approach 1:
The patent incorporates sensing capabilities that detect neural responses and impedance changes to provide feedback on lead position and stimulation effectiveness. This feedback mechanism allows the system to detect lead movement and adjust stimulation parameters accordingly, maintaining consistent therapeutic efficacy without significantly increasing overall system complexity.
Applied Scientific Principles
This section explains which scientific principles are used to turn an abstract innovation direction into a practical engineering solution.
Function Achieved in This Case
Enhances therapeutic efficacy by accurately determining the cause of decline and adjusting stimulation parameters, minimizing side effects, and ensuring consistent treatment outcomes despite brain dynamics and medication fluctuations.
Implementation Method 1
electrical pulses can be delivered from the neurostimulator to the stimulation electrode(s) to stimulate or activate a volume of tissue
Implementation Method 2
sensing evoked potentials evoked by the stimulation using one or more of the plurality of electrodes
Data Source
AI summary
Methods and systems for detecting if a stimulation lead implanted in a patient's brain has moved. Lead movement occurring between a first time and a second time may be determined by comparing features extracted from evoked potentials recorded at the two times. The disclosed methods and systems are particularly useful for determining if a stimulation lead has moved between the time it was implanted in the patient's brain and the time that stimulation parameters are being optimized. Lead movement during implantation, during parameter optimization, and during or between other lead optimization processes may be determined as well.