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Characterization of the stimulus waveforms generated by implantable pulse generators for deep brain stimulation.

ABSTRACT: OBJECTIVE:To determine the circuit elements required to theoretically describe the stimulus waveforms generated by an implantable pulse generator (IPG) during clinical deep brain stimulation (DBS). METHODS:We experimentally interrogated the Medtronic Activa PC DBS IPG and defined an equivalent circuit model that accurately captured the output of the IPG. We then compared the detailed circuit model of the clinical stimulus waveforms to simplified representations commonly used in computational models of DBS. We quantified the errors associated with these simplifications using theoretical activation thresholds of myelinated axons in response to DBS. RESULTS:We found that the detailed IPG model generated substantial differences in activation thresholds compared to simplified models. These differences were largest for bipolar stimulation with long pulse widths. Average errors were ?3 to 24% for voltage-controlled stimulation and ?2 to 11% for current-controlled stimulation. CONCLUSIONS:Our results demonstrate the importance of including basic circuit elements (e.g. blocking capacitors, lead wire resistance, electrode capacitance) in model analysis of DBS. SIGNIFICANCE:Computational models of DBS are now commonly used in academic research, industrial technology development, and in the selection of clinical stimulation parameters. Incorporating a realistic representation of the IPG output is necessary to improve the accuracy and utility of these clinical and scientific tools.

SUBMITTER: Lempka SF

PROVIDER: S-EPMC5856638 | biostudies-literature | 2018 Apr

REPOSITORIES: biostudies-literature

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Characterization of the stimulus waveforms generated by implantable pulse generators for deep brain stimulation.

Lempka Scott F SF Howell Bryan B Gunalan Kabilar K Machado Andre G AG McIntyre Cameron C CC

Clinical neurophysiology : official journal of the International Federation of Clinical Neurophysiology 20180131 4

<h4>Objective</h4>To determine the circuit elements required to theoretically describe the stimulus waveforms generated by an implantable pulse generator (IPG) during clinical deep brain stimulation (DBS).<h4>Methods</h4>We experimentally interrogated the Medtronic Activa PC DBS IPG and defined an equivalent circuit model that accurately captured the output of the IPG. We then compared the detailed circuit model of the clinical stimulus waveforms to simplified representations commonly used in co ...[more]

PMID: 29448149

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Project description:Precision targeting of specific white matter bundles that traverse the subcallosal cingulate (SCC) has been linked to efficacy of deep brain stimulation (DBS) for treatment resistant depression (TRD). Methods to confirm optimal target engagement in this heterogenous region are now critical to establish an objective treatment protocol. As yet unexamined are the time-frequency features of the SCC evoked potential (SCC-EP), including spectral power and phase-clustering. We examined these spectral features-evoked power and phase clustering-in a sample of TRD patients (n = 8) with implanted SCC stimulators. Electroencephalogram (EEG) was recorded during wakeful rest. Location of electrical stimulation in the SCC target region was the experimental manipulation. EEG was analyzed at the surface level with an average reference for a cluster of frontal sensors and at a time window identified by prior study (50-150 ms). Morlet wavelets generated indices of evoked power and inter-trial phase clustering. Enhanced phase clustering at theta frequency (4-7 Hz) was observed in every subject and was significantly correlated with SCC-EP magnitude, but only during left SCC stimulation. Stimulation to dorsal SCC evinced stronger phase clustering than ventral SCC. There was a weak correlation between phase clustering and white matter density. An increase in evoked delta power (2-4 Hz) was also coincident with SCC-EP, but was less consistent across participants. DBS evoked time-frequency features index mm-scale changes to the location of stimulation in the SCC target region and correlate with structural characteristics implicated in treatment optimization. Results also imply a shared generative mechanism (inter-trial phase clustering) between evoked potentials evinced by electrical stimulation and evoked potentials evinced by auditory/visual stimuli and behavioral tasks. Understanding how current injection impacts downstream cortical activity is essential to building new technologies that adapt treatment parameters to individual differences in neurophysiology.

Dataset Information

Characterization of the stimulus waveforms generated by implantable pulse generators for deep brain stimulation.

Publications

Characterization of the stimulus waveforms generated by implantable pulse generators for deep brain stimulation.

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