DBS Lead Sensing Adapter for Selective Intraoperative Neural Recording
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Solution Overview
Problem
Existing deep brain stimulation (DBS) systems face challenges in optimizing electrode placement and stimulation parameters, leading to non-selective activation of neural elements, which can result in undesirable side effects such as diminished cognitive function due to the spread of current to non-target areas, particularly in the subthalamic nucleus.
Innovation Solution
The system includes an operating room (OR) cable and a sensing adapter that facilitate precise electrical stimulation by connecting electrode leads to off-lead electrode connectors, such as patch electrodes, allowing for more selective stimulation and sensing of neural responses, thereby improving lead positioning and parameter selection.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Reliability
If DBS electrodes are placed in the subthalamic nucleus to treat Parkinson's disease, then motor symptoms are improved, but cognitive function deteriorates due to non-selective current spread to non-target neural elements
Solution Approach 1:
The patent divides the stimulation electrode into multiple segmented contacts along the lead, allowing independent or selective activation of specific contacts. This segmentation enables more precise targeting of the subthalamic nucleus while avoiding current spread to adjacent cognitive pathways, thus resolving the contradiction between therapeutic efficacy and cognitive side effects
Solution Approach 2:
The patent implements directionally selective electrode contacts that concentrate current flow in specific spatial directions. By orienting contacts to project current preferentially toward motor pathways while minimizing current spread to cognitive regions, the system achieves local quality enhancement that improves motor symptoms without compromising cognitive function
2Reliability
If stimulation amplitude is increased to improve therapeutic coverage, then treatment efficacy is enhanced, but energy consumption increases and non-target tissue stimulation occurs
Solution Approach 1:
The directionally selective contacts concentrate current flow in specific directions, improving the efficiency of current delivery to target tissue. This allows achieving adequate treatment coverage at lower overall amplitude settings, thereby reducing energy consumption while maintaining therapeutic efficacy
Solution Approach 2:
By activating only specific segmented contacts rather than all contacts simultaneously, the system delivers stimulation more efficiently to the target region. This selective activation reduces the total energy required while maintaining adequate coverage of the therapeutic volume
3Reliability
If wide pulse duration is used to enhance stimulation effect, then therapeutic benefit is improved, but energy consumption increases
Solution Approach 1:
The directionally selective contacts improve the spatial precision of current delivery, increasing the proportion of current that reaches target tissue versus non-target tissue. This enhanced current efficiency allows for reduced pulse duration while maintaining stimulation effectiveness, thereby reducing energy consumption
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
This approach enhances the precision of DBS by minimizing energy consumption and side effects, ensuring optimal therapeutic benefits while reducing non-target tissue stimulation, thus improving patient outcomes.
Implementation Method 1
the electrical field generated by DBS is non-discriminately applied to all neural elements surrounding the electrodes
Implementation Method 2
sensing electrodes positioned at the distal end of the electrode lead... the ETS is configured to sense evoked neural responses
Data Source
AI summary
Systems for facilitating electrical stimulation within a patient's brain and of recording electrical activity within a patient's brain during the implantation of electrode leads in the patient's brain are described. The systems include a modified operating room (OR) cable and/or a sensing adapter that provide electrical connections with the electrode lead(s) and also provide electrical connections to off-lead electrodes that may be configured in electrical contact on the patient's body remote from the electrodes of the electrode lead(s). The off-lead electrodes may be reference electrodes, for example.