The Rationale Driving the Evolution of Deep Brain Stimulation to Constant-Current Devices
Objective Deep brain stimulation (DBS) is an effective therapy for the treatment of a number of movement and neuropsychiatric disorders. The effectiveness of DBS is dependent on the density and location of stimulation in a given brain area. Adjustments are made to optimize clinical benefits and mini...
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| Veröffentlicht in: | Neuromodulation (Malden, Mass.) Mass.), 2015-02, Vol.18 (2), p.85-89 |
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| creator | Bronstein, Jeff M. Tagliati, Michele McIntyre, Cameron Chen, Robert Cheung, Tyler Hargreaves, Eric L. Israel, Zvi Moffitt, Michael Montgomery, Erwin B. Stypulkowski, Paul Shils, Jay Denison, Timothy Vitek, Jerrold Volkman, Jens Wertheimer, Jeffrey Okun, Michael S. |
| description | Objective
Deep brain stimulation (DBS) is an effective therapy for the treatment of a number of movement and neuropsychiatric disorders. The effectiveness of DBS is dependent on the density and location of stimulation in a given brain area. Adjustments are made to optimize clinical benefits and minimize side effects. Until recently, clinicians would adjust DBS settings using a voltage mode, where the delivered voltage remained constant. More recently, a constant‐current mode has become available where the programmer sets the current and the stimulator automatically adjusts the voltage as impedance changes.
Methods
We held an expert consensus meeting to evaluate the current state of the literature and field on constant‐current mode versus voltage mode in clinical brain‐related applications.
Results/Conclusions
There has been little reporting of the use of constant‐current DBS devices in movement and neuropsychiatric disorders. However, as impedance varies considerably between patients and over time, it makes sense that all new devices will likely use constant current. |
| doi_str_mv | 10.1111/ner.12227 |
| format | Article |
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Deep brain stimulation (DBS) is an effective therapy for the treatment of a number of movement and neuropsychiatric disorders. The effectiveness of DBS is dependent on the density and location of stimulation in a given brain area. Adjustments are made to optimize clinical benefits and minimize side effects. Until recently, clinicians would adjust DBS settings using a voltage mode, where the delivered voltage remained constant. More recently, a constant‐current mode has become available where the programmer sets the current and the stimulator automatically adjusts the voltage as impedance changes.
Methods
We held an expert consensus meeting to evaluate the current state of the literature and field on constant‐current mode versus voltage mode in clinical brain‐related applications.
Results/Conclusions
There has been little reporting of the use of constant‐current DBS devices in movement and neuropsychiatric disorders. However, as impedance varies considerably between patients and over time, it makes sense that all new devices will likely use constant current.</description><identifier>ISSN: 1094-7159</identifier><identifier>EISSN: 1525-1403</identifier><identifier>DOI: 10.1111/ner.12227</identifier><identifier>PMID: 25171762</identifier><language>eng</language><publisher>United States: Blackwell Publishing Ltd</publisher><subject>Biophysical Phenomena - physiology ; Brain - physiology ; Brain Diseases - therapy ; Deep brain stimulation ; Deep Brain Stimulation - instrumentation ; Deep Brain Stimulation - methods ; Electric Impedance ; Humans ; impedance ; Medical treatment ; Parkinson's disease ; Time Factors ; voltage</subject><ispartof>Neuromodulation (Malden, Mass.), 2015-02, Vol.18 (2), p.85-89</ispartof><rights>2014 International Neuromodulation Society</rights><rights>2014 International Neuromodulation Society.</rights><rights>Copyright © 2015 International Neuromodulation Society</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c5607-b9577fe5dc64fd76336c55ea981a579f8e0b7732bd2ecebe0f9853537d27e62b3</citedby><cites>FETCH-LOGICAL-c5607-b9577fe5dc64fd76336c55ea981a579f8e0b7732bd2ecebe0f9853537d27e62b3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27923,27924</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25171762$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Bronstein, Jeff M.</creatorcontrib><creatorcontrib>Tagliati, Michele</creatorcontrib><creatorcontrib>McIntyre, Cameron</creatorcontrib><creatorcontrib>Chen, Robert</creatorcontrib><creatorcontrib>Cheung, Tyler</creatorcontrib><creatorcontrib>Hargreaves, Eric L.</creatorcontrib><creatorcontrib>Israel, Zvi</creatorcontrib><creatorcontrib>Moffitt, Michael</creatorcontrib><creatorcontrib>Montgomery, Erwin B.</creatorcontrib><creatorcontrib>Stypulkowski, Paul</creatorcontrib><creatorcontrib>Shils, Jay</creatorcontrib><creatorcontrib>Denison, Timothy</creatorcontrib><creatorcontrib>Vitek, Jerrold</creatorcontrib><creatorcontrib>Volkman, Jens</creatorcontrib><creatorcontrib>Wertheimer, Jeffrey</creatorcontrib><creatorcontrib>Okun, Michael S.</creatorcontrib><title>The Rationale Driving the Evolution of Deep Brain Stimulation to Constant-Current Devices</title><title>Neuromodulation (Malden, Mass.)</title><addtitle>Neuromodulation: Technology at the Neural Interface</addtitle><description>Objective
Deep brain stimulation (DBS) is an effective therapy for the treatment of a number of movement and neuropsychiatric disorders. The effectiveness of DBS is dependent on the density and location of stimulation in a given brain area. Adjustments are made to optimize clinical benefits and minimize side effects. Until recently, clinicians would adjust DBS settings using a voltage mode, where the delivered voltage remained constant. More recently, a constant‐current mode has become available where the programmer sets the current and the stimulator automatically adjusts the voltage as impedance changes.
Methods
We held an expert consensus meeting to evaluate the current state of the literature and field on constant‐current mode versus voltage mode in clinical brain‐related applications.
Results/Conclusions
There has been little reporting of the use of constant‐current DBS devices in movement and neuropsychiatric disorders. However, as impedance varies considerably between patients and over time, it makes sense that all new devices will likely use constant current.</description><subject>Biophysical Phenomena - physiology</subject><subject>Brain - physiology</subject><subject>Brain Diseases - therapy</subject><subject>Deep brain stimulation</subject><subject>Deep Brain Stimulation - instrumentation</subject><subject>Deep Brain Stimulation - methods</subject><subject>Electric Impedance</subject><subject>Humans</subject><subject>impedance</subject><subject>Medical treatment</subject><subject>Parkinson's disease</subject><subject>Time Factors</subject><subject>voltage</subject><issn>1094-7159</issn><issn>1525-1403</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqN0c1u1DAUBWALgWgpLHgBZIlNWaT1T-ybLOl0WpBGAypFFWwsJ7kBl0w82M5A3x5Pp-0CCQlvbMXfPZJzCHnJ2RHP63jEcMSFEPCI7HMlVMFLJh_nM6vLAriq98izGK8Z41ALeEr2hOLAQYt98uXyO9ILm5wf7YD0NLiNG7_RlL_ON36YthfU9_QUcU1PgnUj_ZTcahpuR2jydObHmOyYitkUAo4p041rMT4nT3o7RHxxtx-Qz2fzy9m7YvHh_P3s7aJolWZQNLUC6FF1rS77DrSUulUKbV1xq6DuK2QNgBRNJ7DFBllfV0oqCZ0A1KKRB-Rwl7sO_ueEMZmViy0Ogx3RT9FwDVKCAq3-g-pScFFJnunrv-i1n0L-R1ulqpKxirOs3uxUG3yMAXuzDm5lw43hzGyrMbkac1tNtq_uEqdmhd2DvO8ig-Md-OUGvPl3klnOL-4ji92Eiwl_P0zY8MPkR4MyV8tz8_FscaKWV18NyD8LY6Wr</recordid><startdate>201502</startdate><enddate>201502</enddate><creator>Bronstein, Jeff M.</creator><creator>Tagliati, Michele</creator><creator>McIntyre, Cameron</creator><creator>Chen, Robert</creator><creator>Cheung, Tyler</creator><creator>Hargreaves, Eric L.</creator><creator>Israel, Zvi</creator><creator>Moffitt, Michael</creator><creator>Montgomery, Erwin B.</creator><creator>Stypulkowski, Paul</creator><creator>Shils, Jay</creator><creator>Denison, Timothy</creator><creator>Vitek, Jerrold</creator><creator>Volkman, Jens</creator><creator>Wertheimer, Jeffrey</creator><creator>Okun, Michael S.</creator><general>Blackwell Publishing Ltd</general><general>Elsevier Limited</general><scope>BSCLL</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TK</scope><scope>K9.</scope><scope>7X8</scope></search><sort><creationdate>201502</creationdate><title>The Rationale Driving the Evolution of Deep Brain Stimulation to Constant-Current Devices</title><author>Bronstein, Jeff M. ; Tagliati, Michele ; McIntyre, Cameron ; Chen, Robert ; Cheung, Tyler ; Hargreaves, Eric L. ; Israel, Zvi ; Moffitt, Michael ; Montgomery, Erwin B. ; Stypulkowski, Paul ; Shils, Jay ; Denison, Timothy ; Vitek, Jerrold ; Volkman, Jens ; Wertheimer, Jeffrey ; Okun, Michael S.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c5607-b9577fe5dc64fd76336c55ea981a579f8e0b7732bd2ecebe0f9853537d27e62b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Biophysical Phenomena - physiology</topic><topic>Brain - physiology</topic><topic>Brain Diseases - therapy</topic><topic>Deep brain stimulation</topic><topic>Deep Brain Stimulation - instrumentation</topic><topic>Deep Brain Stimulation - methods</topic><topic>Electric Impedance</topic><topic>Humans</topic><topic>impedance</topic><topic>Medical treatment</topic><topic>Parkinson's disease</topic><topic>Time Factors</topic><topic>voltage</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Bronstein, Jeff M.</creatorcontrib><creatorcontrib>Tagliati, Michele</creatorcontrib><creatorcontrib>McIntyre, Cameron</creatorcontrib><creatorcontrib>Chen, Robert</creatorcontrib><creatorcontrib>Cheung, Tyler</creatorcontrib><creatorcontrib>Hargreaves, Eric L.</creatorcontrib><creatorcontrib>Israel, Zvi</creatorcontrib><creatorcontrib>Moffitt, Michael</creatorcontrib><creatorcontrib>Montgomery, Erwin B.</creatorcontrib><creatorcontrib>Stypulkowski, Paul</creatorcontrib><creatorcontrib>Shils, Jay</creatorcontrib><creatorcontrib>Denison, Timothy</creatorcontrib><creatorcontrib>Vitek, Jerrold</creatorcontrib><creatorcontrib>Volkman, Jens</creatorcontrib><creatorcontrib>Wertheimer, Jeffrey</creatorcontrib><creatorcontrib>Okun, Michael S.</creatorcontrib><collection>Istex</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Neurosciences Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>Neuromodulation (Malden, Mass.)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Bronstein, Jeff M.</au><au>Tagliati, Michele</au><au>McIntyre, Cameron</au><au>Chen, Robert</au><au>Cheung, Tyler</au><au>Hargreaves, Eric L.</au><au>Israel, Zvi</au><au>Moffitt, Michael</au><au>Montgomery, Erwin B.</au><au>Stypulkowski, Paul</au><au>Shils, Jay</au><au>Denison, Timothy</au><au>Vitek, Jerrold</au><au>Volkman, Jens</au><au>Wertheimer, Jeffrey</au><au>Okun, Michael S.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The Rationale Driving the Evolution of Deep Brain Stimulation to Constant-Current Devices</atitle><jtitle>Neuromodulation (Malden, Mass.)</jtitle><addtitle>Neuromodulation: Technology at the Neural Interface</addtitle><date>2015-02</date><risdate>2015</risdate><volume>18</volume><issue>2</issue><spage>85</spage><epage>89</epage><pages>85-89</pages><issn>1094-7159</issn><eissn>1525-1403</eissn><abstract>Objective
Deep brain stimulation (DBS) is an effective therapy for the treatment of a number of movement and neuropsychiatric disorders. The effectiveness of DBS is dependent on the density and location of stimulation in a given brain area. Adjustments are made to optimize clinical benefits and minimize side effects. Until recently, clinicians would adjust DBS settings using a voltage mode, where the delivered voltage remained constant. More recently, a constant‐current mode has become available where the programmer sets the current and the stimulator automatically adjusts the voltage as impedance changes.
Methods
We held an expert consensus meeting to evaluate the current state of the literature and field on constant‐current mode versus voltage mode in clinical brain‐related applications.
Results/Conclusions
There has been little reporting of the use of constant‐current DBS devices in movement and neuropsychiatric disorders. However, as impedance varies considerably between patients and over time, it makes sense that all new devices will likely use constant current.</abstract><cop>United States</cop><pub>Blackwell Publishing Ltd</pub><pmid>25171762</pmid><doi>10.1111/ner.12227</doi><tpages>5</tpages></addata></record> |
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| source | MEDLINE; Alma/SFX Local Collection |
| subjects | Biophysical Phenomena - physiology Brain - physiology Brain Diseases - therapy Deep brain stimulation Deep Brain Stimulation - instrumentation Deep Brain Stimulation - methods Electric Impedance Humans impedance Medical treatment Parkinson's disease Time Factors voltage |
| title | The Rationale Driving the Evolution of Deep Brain Stimulation to Constant-Current Devices |
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