Abstract
Directional deep brain stimulation (DBS) leads have recently been approved and used in patients, and growing evidence suggests that directional contacts can increase the therapeutic window by redirecting stimulation to the target region while avoiding side-effect-inducing regions. We outline the design, fabrication, and testing of a novel directional DBS lead, the μDBS, which utilizes microscale contacts to increase the spatial resolution of stimulation steering and improve the selectivity in targeting small diameter fibers. We outline the steps of fabrication of the μDBS, from an integrated circuit design to post-processing and validation testing. We tested the onboard digital circuitry for programming fidelity, characterized impedance for a variety of electrode sizes, and demonstrated functionality in a saline bath. In a computational experiment, we determined that reduced electrode sizes focus the stimulation effect on small, nearby fibers. Smaller electrode sizes allow for a relative decrease in small-diameter axon thresholds compared to thresholds of large-diameter fibers, demonstrating a focusing of the stimulation effect within small, and possibly therapeutic, fibers. This principle of selectivity could be useful in further widening the window of therapy. The μDBS offers a unique, multiresolution design in which any combination of microscale contacts can be used together to function as electrodes of various shapes and sizes. Multiscale electrodes could be useful in selective neural targeting for established neurological targets and in exploring novel treatment targets for new neurological indications.
Highlights
Deep brain stimulation (DBS) is a widely accepted therapy for several movement disorders and an emerging therapy for psychiatric disorders and additional movement disorders
In the scope of this section, we examined the functionality of the μDBS by fabricating and testing single flat chips that have 216 contacts each
Our experimental configuration did not allow for a comprehensive mapping of the voltage field, these results demonstrate that the distinct electrodes on opposite sides of a μDBS chip are capable of properly stimulating with separate voltage signals
Summary
Deep brain stimulation (DBS) is a widely accepted therapy for several movement disorders and an emerging therapy for psychiatric disorders and additional movement disorders. Multiresolution, Directional Deep Brain Stimulation defines the classic lead design In this manuscript, we present a novel neurostimulation device that assembles multiresolution electrodes from microscale contacts to enable fine control of the stimulation volume and an improved capability to target small-diameter fibers. Moderate advances to the classic lead design involve contacts capable of directionally focusing stimulation, typically by having two of the four contacts subdivided into three smaller contacts each. These smaller, directional contacts allow for directional steering of the activation field to, ideally, activate the target structure while avoiding side-effect-inducing regions that might reduce the window of therapy
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