Multiple-source current steering in subthalamic nucleus deep brain stimulation for Parkinson's disease (the VANTAGE study): a non-randomised, prospective, multicentre, open-label study

Timmermann, Lars; Jain, Roshini; Chen, Lung Chi; Maarouf, M.; Barbe, Michael T.; Allert, Niels; Brücke, Thomas; Kaiser, Iris; Beirer, Sebastian; Sejio, Fernando; Suárez, Emma; Lozano, Beatriz Rodríguez; Haegelen, Claire; Vérin, Marc; Porta, Mauro; Servello, Domenico; Gill, Steven; Whone, Alan; Dyck, Nic Van; Alesch, François

doi:10.1016/s1474-4422(15)00087-3

Cited by 143 publications

(98 citation statements)

References 27 publications

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“…For constant-voltage stimulation paradigms, the day-to-day changes in impedance caused by consolidation of the glial scar during the first three to six months post-implantation may dramatically alter the effective current reaching neural tissue 39 . As a result, most device manufacturers have moved towards constant-current stimulation paradigms where the charge density delivered by the stimulating electrode does not depend on day-to-day changes in impedance of the tissue/electrode interface 58,59 .…”

Section: Consequences Of Glial Encapsulationmentioning

confidence: 99%

Glial responses to implanted electrodes in the brain

et al. 2017

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The use of implants that can electrically stimulate or record electrophysiological or neurochemical activity in nervous tissue is rapidly expanding. Despite remarkable results in clinical studies and increasing market approvals, the mechanisms underlying the therapeutic effects of neuroprosthetic and neuromodulation devices, as well as their side effects and reasons for their failure, remain poorly understood. A major assumption has been that the signal-generating neurons are the only important target cells of neural-interface technologies. However, recent evidence indicates that the supporting glial cells remodel the structure and function of neuronal networks and are an effector of stimulation-based therapy. Here, we reframe the traditional view of glia as a passive barrier, and discuss their role as an active determinant of the outcomes of device implantation. We also discuss the implications that this has on the development of bioelectronic medical devices.

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Section: Consequences Of Glial Encapsulationmentioning

confidence: 99%

Glial responses to implanted electrodes in the brain

et al. 2017

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“…Another, “SureStim,” developed by Sapiens (Eindhoven, the Netherlands), has 32 contacts distributed evenly (Contarino et al, 2014). A third, Vercise PC, produced by Boston Scientific and recently approved for use in Europe (September 2015), uses an 8-contact directional lead—the VANTAGE study (Timmermann et al, 2015). These designs allow current to be shaped away from unintended targets while maintaining a larger therapeutic window to the intended target site(s).…”

Section: Development In Technology and Applicationmentioning

confidence: 99%

Proceedings of the Fourth Annual Deep Brain Stimulation Think Tank: A Review of Emerging Issues and Technologies

Deeb

Giordano

Rossi

et al. 2016

Front. Integr. Neurosci.

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This paper provides an overview of current progress in the technological advances and the use of deep brain stimulation (DBS) to treat neurological and neuropsychiatric disorders, as presented by participants of the Fourth Annual DBS Think Tank, which was convened in March 2016 in conjunction with the Center for Movement Disorders and Neurorestoration at the University of Florida, Gainesveille FL, USA. The Think Tank discussions first focused on policy and advocacy in DBS research and clinical practice, formation of registries, and issues involving the use of DBS in the treatment of Tourette Syndrome. Next, advances in the use of neuroimaging and electrochemical markers to enhance DBS specificity were addressed. Updates on ongoing use and developments of DBS for the treatment of Parkinson's disease, essential tremor, Alzheimer's disease, depression, post-traumatic stress disorder, obesity, addiction were presented, and progress toward innovation(s) in closed-loop applications were discussed. Each section of these proceedings provides updates and highlights of new information as presented at this year's international Think Tank, with a view toward current and near future advancement of the field.

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“…In tandem with improved understanding of disease-specific neural circuits, advanced MEMS devices offer means of stimulating the nervous system with more specificity and delicacy. For example, early iterations of DBS hardware are now making way for smaller, more complex and more sophisticated electrodes capable of better-targeted stimulation 29, 30…”

Section: Stimulatorsmentioning

confidence: 99%

Insinuating electronics in the brain

Hughes

2016

The Surgeon

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There is an expanding interface between electronic engineering and neurosurgery. Rapid advances in microelectronics and materials science, driven largely by consumer demand, are inspiring and accelerating development of a new generation of diagnostic, therapeutic, and prosthetic devices for implantation in the nervous system. This paper reviews some of the basic science underpinning their development and outlines some opportunities and challenges for their use in neurosurgery.

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Multiple-source current steering in subthalamic nucleus deep brain stimulation for Parkinson's disease (the VANTAGE study): a non-randomised, prospective, multicentre, open-label study

Cited by 143 publications

References 27 publications

Glial responses to implanted electrodes in the brain

Glial responses to implanted electrodes in the brain

Proceedings of the Fourth Annual Deep Brain Stimulation Think Tank: A Review of Emerging Issues and Technologies

Insinuating electronics in the brain

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