Multisite Deep Brain Stimulation Using Evoked Response Feedback
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Solution Overview
Problem
Current deep brain stimulation (DBS) systems are limited in their ability to provide versatile and flexible stimulation at multiple neural targets, which can vary across patients, leading to suboptimal therapeutic outcomes and side effects.
Innovation Solution
The development of multisite DBS systems that can stimulate multiple brain targets, such as the subthalamic nucleus (STN) and globus pallidus internus (GPi), simultaneously or sequentially, using evoked responses (ERs) to feedback control and optimize stimulation settings.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Adaptability or versatility
If single-target DBS is used, then the device complexity is low, but the adaptability to different patients and conditions is insufficient
Solution Approach 1:
The DBS system is designed to provide versatile stimulation at multiple neural targets (STN, GPi, PPN, PSA) using the same device architecture. The system can adapt to different patients and conditions by selecting appropriate targets and adjusting stimulation parameters, eliminating the need for multiple specialized devices while maintaining low complexity through standardized hardware and software control mechanisms.
Solution Approach 2:
The system employs dynamic control of stimulation parameters including amplitude, pulse width, frequency, and electrode selection based on real-time feedback from evoked responses. This dynamic adaptability allows the same device to optimize therapy for different patients and clinical conditions without requiring complex reconfiguration, achieving versatility through programmable flexibility rather than hardware complexity.
2Reliability
If multiple neural targets are stimulated simultaneously, then the therapeutic effect is maximized, but the device complexity increases
Solution Approach 1:
The patent combines stimulation of multiple neural targets (STN and GPi) into a single integrated DBS system with unified control. By merging the functionality of multiple targets into one device, the system achieves enhanced therapeutic effect through coordinated multi-site stimulation while avoiding the complexity of separate devices. The controller manages all targets through a single interface, simplifying the overall system architecture.
Solution Approach 2:
The system uses evoked response feedback from each stimulated target to automatically adjust stimulation parameters. Sensors detect neural responses from STN, GPi, and other targets, and the controller modulates amplitude, frequency, and electrode selection based on this feedback. This closed-loop control enables reliable therapeutic effect optimization without requiring complex manual programming or multiple independent control systems.
3Manufacturing precision
If evoked response feedback control is implemented, then the manufacturing precision of stimulation settings is improved, but the device complexity increases
Solution Approach 1:
The system implements evoked response feedback control where sensors detect neural responses to stimulation and the controller automatically adjusts stimulation parameters to achieve optimal therapeutic effect. This feedback mechanism improves the precision of stimulation settings by continuously monitoring and adjusting based on actual neural responses, while the integrated controller keeps device complexity manageable through unified signal processing and control algorithms.
Solution Approach 2:
The DBS system performs self-adjustment of stimulation parameters based on real-time evoked response monitoring. The controller automatically modulates amplitude, pulse width, and frequency without requiring external intervention or complex programming, enabling precise optimization of therapy settings. This self-service capability improves manufacturing precision of stimulation delivery while maintaining simplicity through autonomous control.
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 enables a broader stimulation field, maximizes therapeutic effect, and minimizes side effects by modulating evoked responses across multiple targets, leading to improved patient outcomes.
Implementation Method 1
In response to electrostimulation of a neural target, an evoked response (ER) may be sensed locally, at a location distant away from the stimulation site
Data Source
AI summary
Systems and methods for providing evoked response-guided multisite deep brain stimulation (DSB) at various brain targets are disclosed. An exemplary system comprises at least one multielectrode lead, an electrostimulator to provide electrostimulation to a neural target, a sensing circuit to sense an evoked response (ER) to electrostimulation, and a controller circuit. In response to electrostimulation of a first neural target according to a first stimulation setting, the controller circuit collects an ER from a first sensing location, and determines or adjusts a second stimulation setting for stimulating a second neural target based on the sensed ER at the first neural target. The second neural target can be stimulated according to the second stimulation setting to modulate the ER to the electrostimulation at the first neural target, and to produce a desired therapeutic outcome in the patient.