Posterior Deep Brain Stimulation Lead Trajectory for Subthalamic Nucleus Targeting
Find Innovative SolutionsGenerate Solutions
Solution Overview
Problem
Conventional deep brain stimulation (DBS) methods for treating movement disorders, such as Parkinson's disease, dystonia, and tremor, face limitations due to the orthogonal trajectory of the trans-frontal approach, which restricts the field of stimulation, leading to variable and progressive symptom control and significant side effects like depression, anxiety, and speech disturbances, as they fail to effectively target the rostro-caudal functional topography of subthalamic and globus pallidus nuclei.
Innovation Solution
A posterior approach is adopted for inserting DBS leads from the occipito-temporal or occipito-parietal regions, passing laterally to the posterior horn of the lateral ventricle to contact the subthalamic nucleus or globus pallidus, allowing multiple electrode contacts along the rostro-caudal axis for precise stimulation and minimizing the risk of stimulating limbic or associative regions, thereby optimizing symptom control.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Ease of operation
If trans-frontal approach is used for DBS lead insertion, then the procedure is straightforward and commonly performed, but the orthogonal trajectory restricts the field of stimulation and fails to effectively target the rostro-caudal functional topography
Solution Approach 1:
The patent inverts the conventional trans-frontal approach by using a posterior approach instead. The lead is inserted from the occipito-temporal or occipito-parietal regions and advanced anteriorly along the rostro-caudal axis, rather than inserting from the frontal region posteriorly. This inversion of the insertion direction enables alignment with the functional topography of the target nuclei.
Solution Approach 2:
The patent changes the dimensional orientation of the lead trajectory from the conventional orthogonal (trans-frontal) approach to a longitudinal approach that aligns with the rostro-caudal axis. This dimensional change allows the lead to traverse the target nucleus along its functional gradient, enabling selective stimulation of different functional regions through appropriate electrode contacts.
2Ease of operation
If trans-frontal approach is used, then the procedure is simpler, but it stimulates limbic or associative regions causing side effects like depression, anxiety, and speech disturbances
Solution Approach 1:
The patent extracts or removes the harmful stimulation of limbic and associative regions by changing the lead trajectory. The posterior approach with anterior advancement allows the lead to contact the motor regions of the subthalamic nucleus and globus pallidus while avoiding the limbic and associative regions that would be stimulated by the conventional trans-frontal approach.
Solution Approach 2:
The patent applies local quality by enabling selective stimulation of specific functional regions within the target nuclei. The longitudinal trajectory allows different electrode contacts to target specific regions (e.g., dorsal versus ventral contacts for different functional outcomes) while avoiding adjacent regions that would produce unwanted side effects.
3Adaptability or versatility
If conventional DBS methods are used, then the treatment is widely available, but symptom control is variable and progressive due to inability to target rostro-caudal functional topography
Solution Approach 1:
The patent introduces dynamics by enabling flexible selection of stimulation parameters along the rostro-caudal axis. The longitudinal lead placement allows the clinician to dynamically adjust which electrode contacts are activated and to what extent, tailoring the stimulation to the patient's specific symptom profile and disease progression stage.
Solution Approach 2:
The patent enables parameter changes by aligning the lead trajectory with the functional topography, allowing different electrode contacts to target different functional regions. This permits systematic variation of stimulation parameters (contact selection, current intensity, pulse width) to optimize symptom control while minimizing side effects.
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 method enhances targeting accuracy to within 0.5 mm, reducing side effects and improving therapeutic benefit by allowing finer control over stimulation areas, enabling more effective treatment of movement disorders like Parkinson's, dystonia, and tremor with reduced risk of adverse effects.
Implementation Method 1
delivering pulsed electrical current to the tissue from an implanted pulse generator which is connected to the electrode
Data Source
AI summary
A method of treating a movement disorder using deep brain stimulation, the method comprising the step of inserting a lead having at least one electrode into the brain of a subject, the lead being inserted along a trajectory from the occipito-temporal or occipito-parietal regions, passing laterally to the posterior horn of the lateral ventricle to contact the subthalamic nucleus, the zona incerta or the globus pallidus.