| 1. |
- Cubo, Rubén, et al.
(författare)
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Calculating Deep Brain Stimulation Amplitudes and Power Consumption by Constrained Optimization
- 2019
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Ingår i: Journal of Neural Engineering. - : IOP Publishing. - 1741-2560 .- 1741-2552. ; 16:1
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Tidskriftsartikel (refereegranskat)abstract
- Objective: Deep brain stimulation (DBS) consists of delivering electrical stimuli to a brain target via an implanted lead to treat neurological and psychiatric conditions. Individualized stimulation is vital to ensure therapeutic results, since DBS may otherwise become ineffective or cause undesirable side effects. Since the DBS pulse generator is battery-driven, power consumption incurred by the stimulation is important. In this study, target coverage and power consumption are compared over a patient population for clinical and model-based patient-specific settings calculated by constrained optimization.Approach: Brain models for five patients undergoing bilateral DBS were built. Mathematical optimization of activated tissue volume was utilized to calculate stimuli amplitudes, with and without specifying the volumes, where stimulation was not allowed to avoid side effects. Power consumption was estimated using measured impedance values and battery life under both clinical and optimized settings.Results: It was observed that clinical settings were generally less aggressive than the ones suggested by unconstrained model-based optimization, especially under asymmetrical stimulation. The DBS settings satisfying the constraints were close to the clinical values.Significance: The use of mathematical models to suggest optimal patient-specific DBS settings that observe technological and safety constraints can save time in clinical practice. It appears though that the considered safety constraints based on brain anatomy depend on the patient and further research into it is needed. This work highlights the need of specifying the brain volumes to be avoided by stimulation while optimizing the DBS amplitude, in contrast to minimizing general stimuli overspill, and applies the technique to a cohort of patients. It also stresses the importance of considering power consumption in DBS optimization, since it increases with the square of the stimuli amplitude and also critically affects battery life through pulse frequency and duty cycle.
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| 2. |
- Medvedev, Alexander, 1958-, et al.
(författare)
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Control-Engineering Perspective on Deep Brain Stimulation : Revisited
- 2019
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Ingår i: 2019 American Control Conference (ACC). - 9781538679265 - 9781538679272 - 9781538679289 - 9781538679012 ; , s. 860-865
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Konferensbidrag (refereegranskat)abstract
- Deep brain stimulation (DBS) is a an established therapy in neurological and mental disorders making use of electrical pulses chronically delivered to a certain disease-specific neural target through surgically implanted electrodes. The therapeutical effect of DBS is highly individual and depends on the target coverage by the stimuli and the amount of spill beyond it. This can be suitably formulated as an optimization problem. Since the biological mechanism underlying the DBS therapy is mainly unknown, and due to high inter-patient and intra-patient variability of the DBS effect, a pragmatic approach to the DBS programming is to consider the process as tuning of a control system for the symptoms. Such a technology assumes that the symptoms are accurately quantified. The paper summarizes the progress in the individualized DBS and presents the results of a limited clinical study making use of the proposed DBS programming approach.
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