Switching from constant voltage to constant current in deep brain stimulation: a multicenter experience of mixed implants for movement disorders

Preda, Francesca; Cavandoli, Clarissa; Lettieri, Christian; Pilleri, Manuela; Antonini, Angelo; Eleopra, Roberto; Mondani, Massimo; Martinuzzi, Andrea; Sarubbo, Silvio; Ghisellini, G.; Trezza, Andrea; Cavallo, Michele Alessandro; Landi, Andrea; Sensi, Mariachiara

doi:10.1111/ene.12835

Cited by 39 publications

(25 citation statements)

References 22 publications

(68 reference statements)

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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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“…Recent innovations in DBS signal delivery (Fasano and Lozano, 2015) include regulated current vs. regulated voltage waveforms (Lempka et al, 2010; Preda et al, 2016), differing stimulation waveforms (Foutz and McIntyre, 2010; Wongsarnpigoon and Grill, 2010), and different temporal patterns of stimulation (Brocker et al, 2013; Adamchic et al, 2014). …”

Section: Dbs Innovationsmentioning

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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“…Clinical stimulation devices, for example, those used in deep brain stimulation, traditionally utilized constant-voltage (voltage-controlled) stimulation due to its simplicity in implementation [45], [46]. In constant voltage stimulation, power supplies or DC voltage sources such as V D D and V S S are directly connected to the electrode as shown in Fig.…”

Section: A Constant-voltage Stimulationmentioning

confidence: 99%

A Fully Integrated RF-Powered Energy-Replenishing Current-Controlled Stimulator

Ha¹,

Kim

Park

et al. 2019

IEEE Trans. Biomed. Circuits Syst.

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This paper presents a fully-integrated currentcontrolled stimulator that is powered directly from on-chip coil antenna and achieves adiabatic energy-replenishing operation without any bulky external components. Adiabatic supply voltages, which can reach a differential range of up to 7.2 V, are directly generated from an on-chip 190-MHz resonant LC tank via a selfcascading/folding rectifier network, bypassing the losses that would otherwise be introduced by the 0.8 V system supply-generating rectifier and regulator. The stimulator occupies 0.22 mm 2 in a 180 nm silicon-on-insulator process and produces differential currents up to 145 µA. Using a charge replenishing scheme, the stimulator redirects the charges accumulated across the electrodes to the system power supplies for 63.1% of stimulation energy recycling. To benchmark the efficiency of stimulation, a figure of merit termed the stimulator efficiency factor (SEF) is introduced. The adiabatic power rails and energy replenishment scheme enabled our stimulator to achieve an SEF of 6.0.

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Switching from constant voltage to constant current in deep brain stimulation: a multicenter experience of mixed implants for movement disorders

Abstract: Replacing CV with CC IPGs is a safe and effective procedure. Longer follow-up is necessary to better clarify the impact of CC stimulation on clinical outcome after chronic stimulation in CV mode.

Cited by 39 publications

References 22 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

A Fully Integrated RF-Powered Energy-Replenishing Current-Controlled Stimulator

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