Deep Brain Stimulation Programming Strategies: Segmented Leads, Independent Current Sources and Future Technology

Expert Rev Med Devices. 2021 Jul 30. doi: 10.1080/17434440.2021.1962286. Online ahead of print.ABSTRACTINTRODUCTION: Advances in neuromodulation and deep brain stimulation (DBS) technologies have facilitated opportunities for improved clinical benefit and side effect management. New technologies have however, added complexity to clinic-based DBS programming.AREAS COVERED: In this article, we review basic basal ganglia physiology, proposed mechanisms of action and technical aspects of DBS. We discuss novel DBS technologies for movement disorders including the role of advanced imaging software, lead design, IPG design, novel programming techniques including directional stimulation and coordinated reset neuromodulation. Additional topics include the use of potential biomarkers such as local field potentials, electrocorticography and adaptive stimulation. We will also discuss future directions including optogeneticically inspired DBS.EXPERT OPINION: The introduction of DBS for the management of movement disorders has expanded treatment options. In parallel with our improved understanding of brain physiology and neuroanatomy, new technologies have emerged to address challenges associated with neuromodulation, including variable effectiveness, side effects, and programming complexity. Advanced functional neuroanatomy, improved imaging, real-time neurophysiology, improved electrode designs and novel programming techniques have collectively been driving improvements in DBS outcomes.P...
Source: Expert Review of Medical Devices - Category: Medical Devices Authors: Source Type: research