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Applying a Sensing-Enabled System for Ensuring Safe Anterior Cingulate Deep Brain Stimulation for Pain
- Source :
- Brain Sciences, Volume 9, Issue 7, Brain Sciences, Vol 9, Iss 7, p 150 (2019)
- Publication Year :
- 2019
- Publisher :
- Multidisciplinary Digital Publishing Institute, 2019.
-
Abstract
- Deep brain stimulation (DBS) of the anterior cingulate cortex (ACC) was offered to chronic pain patients who had exhausted medical and surgical options. However, several patients developed recurrent seizures. This work was conducted to assess the effect of ACC stimulation on the brain activity and to guide safe DBS programming. A sensing-enabled neurostimulator (Activa PC + S) allowing wireless recording through the stimulating electrodes was chronically implanted in three patients. Stimulation patterns with different amplitude levels and variable ramping rates were tested to investigate whether these patterns could provide pain relief without triggering after-discharges (ADs) within local field potentials (LFPs) recorded in the ACC. In the absence of ramping, AD activity was detected following stimulation at amplitude levels below those used in chronic therapy. Adjustment of stimulus cycling patterns, by slowly ramping on/off (8-s ramp duration), was able to prevent ADs at higher amplitude levels while maintaining effective pain relief. The absence of AD activity confirmed from the implant was correlated with the absence of clinical seizures. We propose that AD activity in the ACC could be a biomarker for the likelihood of seizures in these patients, and the application of sensing-enabled techniques has the potential to advance safer brain stimulation therapies, especially in novel targets.
- Subjects :
- Deep brain stimulation
Brain activity and meditation
medicine.medical_treatment
Stimulation
Local field potential
Stimulus (physiology)
Article
lcsh:RC321-571
03 medical and health sciences
0302 clinical medicine
Medicine
lcsh:Neurosciences. Biological psychiatry. Neuropsychiatry
Anterior cingulate cortex
030304 developmental biology
seizures
0303 health sciences
local field potential
business.industry
General Neuroscience
Chronic pain
after-discharge
medicine.disease
deep brain stimulation
anterior cingulate cortex
medicine.anatomical_structure
Brain stimulation
Anesthesia
business
chronic pain
030217 neurology & neurosurgery
Subjects
Details
- Language :
- English
- ISSN :
- 20763425
- Database :
- OpenAIRE
- Journal :
- Brain Sciences
- Accession number :
- edsair.doi.dedup.....1c67cdf373f0211586551636b20850a3
- Full Text :
- https://doi.org/10.3390/brainsci9070150