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Curr Opin Biomed Eng. 2017 Dec;4:97-105. doi: 10.1016/j.cobme.2017.09.001. Epub 2017 Sep 19.

Reengineering deep brain stimulation for movement disorders: Emerging technologies.

Author information

1
J. Crayton Pruitt Family Department of Biomedical Engineering, University of Florida, Gainesville, FL, USA.
2
Center for Movement Disorders and Neurorestoration, University of Florida, Gainesville, FL, USA.
3
Department of Neurosurgery, University of Florida, Gainesville, FL, USA.
4
Department of Neurology, University of Florida, Gainesville, FL, USA.

Abstract

Deep brain stimulation (DBS) is a neurosurgical technique, which consists of continuous delivery of an electrical pulse through chronically implanted electrodes connected to a neurostimulator, programmable in amplitude, pulse width, frequency, and stimulation channel. DBS is a promising treatment option for addressing severe and drug-resistant movement disorders. The success of DBS therapy is a combination of surgical implantation techniques, device technology, and clinical programming strategies. Changes in device settings require highly trained and experienced clinicians to achieve maximal therapeutic benefit for each targeted symptom, and optimization of stimulation parameters can take many visits. Thus, the development of innovative DBS technologies that can optimize the clinical implementation of DBS will lead to wider scale utilization. This review aims to present engineering approaches that have the potential to improve clinical outcomes of DBS, focusing on the development novel temporal patterns, innovative electrode designs, computational models to guide stimulation, closed-loop DBS, and remote programming.

KEYWORDS:

DBS; Deep brain stimulation; Movement disorders; Neuromodulation; Neurostimulator

Conflict of interest statement

Conflict of interest The University of Florida and not the authors receive device donations or grants from Medtronic, Boston Scientific, NeuroPace, Functional Neuromodulation, Abbvie, Allergan, and St. Jude Medical. Dr. Okun has received royalties for publications with Demos, Manson, Amazon, Smashwords, Books4Patients, and Cambridge. He has participated in CME and educational activities on movement disorders (in the last 36) months sponsored by PeerView, Prime, QuantiaMD, WebMD, MedNet, Henry Stewart, and by Vanderbilt University.

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