Deep Brain Stimulation Devices: A Brief Technical History and Review
Dr. Robert J. Coffey, Medtronic, Inc., 7000 Central Avenue NE, Minneapolis, MN 55432, USA. E-mail: [email protected]
Abstract
Deep brain stimulation (DBS)—a broadly accepted therapeutic modality with tens of thousands of patients currently implanted—is the application of implantable electrical stimulation devices to treat neurological disorders. Approved indications include involuntary movement disorders; investigational applications include epilepsy, selected psychiatric disorders, and other conditions. DBS differs fundamentally from functional electrical stimulation and sensory prosthetics in that DBS therapies do not substitute for or replace injured tissues, organs, or body functions. DBS—targeted to particular brain nuclei or pathways that are specific for the disorder under treatment—influences brain function and behavioral output in ways that can relieve symptoms and improve the overall functioning of the patient. We will briefly review the history and present status of DBS from a technical and device-oriented perspective, with an eye toward future advances.
REFERENCES
- 1 Delgado JMR. Chronic implantation of intracerebral electrodes in animals. In: DE Sheer, ed. Electrical Stimulation of the Brain. An Interdisciplinary Survey of Neurobehavioral Integrative Systems. Austin, TX: University of Texas Press, 1961; 25–36.
- 2 Gol A. Relief of pain by electrical stimulation of the septal area. J Neurol Sci 1967; 5: 115–20. (Cited by Sweet WH. Intracerebral stimulation for relief of chronic pain. In: Youmans JR, ed. Neurological Surgery, 2nd Edition. Philadelphia, PA: WB Saunders, 1982;739–48.)
- 3
Heath RG.
Studies in Schizophrenia. Cambridge, MA: Harvard University Press, 1954. (Cited by Sweet WH. Intracerebral stimulation for relief of chronic pain. In: Youmans JR, ed. Neurological Surgery, 2nd Edition. Philadelphia, PA: WB Saunders, 1982;739–48.)
10.4159/harvard.9780674594548 Google Scholar
- 4 Heath RG, Mickle WA. Evaluation of seven years' experience with depth electrode studies in human patients. In: ER Ramey, DS O'Doherty, eds. Electrical Studies on the Unanesthetized Brain. New York: Hoeber, 1960; 214–47.
- 5 Olds J. Differentiation of reward systems in the brain by self-stimulation technics. In: ER Ramey, DS O'Doherty, eds. Electrical Studies on the Unanesthetized Brain. New York: Hoeber, 1960; 17–51.
- 6 Pool JL, Clark WD, Hudson P, LombardoM. Hypothalamic-hypophysical Interrelationships. Springfield, IL: Charles C. Thomas, 1956. (Cited by Sweet WH. Intracerebral stimulation for relief of chronic pain. In: Youmans JR, ed. Neurological Surgery, 2nd Edition. Philadelphia, PA: WB Saunders, 1982;739–48.)
- 7 Sheer DE. Electrical Stimulation of the Brain. An Interdisciplinary Survey of Neurobehavioral Integrative Systems. Austin, TX: University of Texas Press, 1961.
- 8 Gybels JM, Sweet WH. Deep brain stimulation. In: PL Gildenberg, ed. Neurosurgical Treatment of Persistent Pain, Pain and Headache, Vol. 11. Basel: Karger, 1989; 303–17.
- 9 Melzack R, Wall PD. Pain mechanisms: a new theory. Science 1965; 150: 971–9.
- 10 Shealy CN, Mortimer JT, Reswick JB. Electrical inhibition of pain by stimulation of the dorsal columns: preliminary clinical report. Anesth Analg 1967; 46: 489–91.
- 11 Mazars GJ, Merienne L, Ciolocca C. Traitement de certain types de douleurs pars de stimulateurs thalamiques implantables. Neurochirurgie 1974; 20: 117–24.
- 12 Hosobuchi Y, Adams JE, Rutkin B. Chronic thalamic stimulation for the control of facial anesthesia dolorosa. Arch Neurol 1973; 29: 158–61.
- 13 Mortimer JT, Shealy CN, Wheeler C. Experimental nondestructive electrical stimulation of the brain and spinal cord. J Neurosurg 1970; 32: 553–9.
- 14 Reynolds DV. Surgery in the rat during electrical analgesia induced by focal brain stimulation. Science 1969; 164: 444–5.
- 15 Coffey RJ. Deep brain stimulation for chronic pain: the results of two multi-center trials and a structured review. Pain Med 2001; 2: 183–92.
- 16 Hamani C, Schwalb JM, Rezai AR, Dostrovsky JO, Davis KD, Lozano AM. Deep brain stimulation for chronic neuropathic pain: long-term outcome and the incidence of insertional effect. Pain 2006; 25: 188–96.
- 17 Coffey RJ, Lozano AM. Neurostimulation for chronic non-cancer pain: an evaluation of clinical evidence, and recommendations for future trial designs. J Neurosurg 2006; 105: 175–89.
- 18 Medtronic Pain Therapies. Important safety information and risks. SynchroMed II and IsoMed drug infusion system brief summary. Available at: http://www.medtronic.com/neuro/paintherapies/pain_treatment_ladder/safety.html. Accessed January 28, 2008.
- 19 Alexander GE, DeLong MR, Strick PL. Parallel organization of functionally segregated circuits linking basal ganglia and cortex. Ann Rev Neurosci 1986; 9: 357–81.
- 20 Boon P, Vonck K, De Herdt V, et al. Deep brain stimulation in patients with refractory temporal lobe epilepsy. Epilepsia 2007; 48: 1551–60.
- 21 Haber SN, Kunishio K, Mizobuchi M, Lynd-BaItal E. The orbital and medial prefrontal circuit through the primate basal ganglia. J Neurosci 1995; 75: 4851–67.
- 22 Hodaie M, Wennberg RA, Dostrovsky JO, Lozano AM. Chronic anterior thalamus stimulation for intractable epilepsy. Epilepsia 2002; 43: 603–8.
- 23 Leone M, Franzini A, Bussone G. Stereotactic stimulation of posterior hypothalamic gray matter in a patient with intractable cluster headache. N Engl J Med 2001; 345: 1428–9.
- 24 Mayberg HS, Lozano AM, Voon V, et al. Deep brain stimulation for treatment-resistant depression. Neuron 2005; 45: 651–60.
- 25 Nuttin BJ, Gabriëls LA, Cosyns PR, et al. Long-term electrical capsular stimulation in patients with obsessive-compulsive disorder. Neurosurgery 2003; 52: 1263–74.
- 26 Rauch SL, Dougherty DD, Malone D, et al. A functional neuroimaging investigation of deep brain stimulation in patients with obsessive-compulsive disorder. J Neurosurg 2006; 104: 558–65.
- 27 Sani S, Jobe K, Smith A, Kordower JH, Bakay RA. Deep brain stimulation for treatment of obesity in rats. J Neurosurg 2007; 107: 809–13.
- 28 Vandewalle V, Van Der Linden C, Groenewegen HJ, Caemaert J. Stereotactic treatment of Gilles de la Tourette syndrome by high frequency stimulation of thalamus. Lancet 1999; 353: 724.
- 29 Benabid AL, Pollak P, Louveau A, Henry S, De Rougemont J. Combined (thalamotomy and stimulation) stereotactic surgery of the VIM thalamic nucleus for bilateral Parkinson disease. Appl Neurophysiol 1987; 50: 344–6.
- 30 Shatin D, Mullett K, Hults G. Totally implantable spinal cord stimulation for chronic pain: design and efficacy. Pacing Clin Electrophysiol 1986; 9: 577–83.
- 31 Dodge HW. Surgical problems and practical indications for a depth electrographic procedure. In: ER Ramey, DS O'Doherty, eds. Electrical Studies on the Unanesthetized Brain. New York: Hoeber, 1960; 262–74.
- 32 Sheatz GC. Electrode holders in chronic preparations: a. Multilead techniques for large and small animals. In: DE Sheer, ed. Electrical Stimulation of the Brain. An Interdisciplinary Survey of Neurobehavioral Integrative Systems. Austin, TX: University of Texas Press, 1961; 45–50.
- 33 Spiegel EA, Wycis HT. Chronic implantation of intracerebral electrodes in humans. In: DE Sheer, ed. Electrical Stimulation of the Brain. An Interdisciplinary Survey of Neurobehavioral Integrative Systems. Austin, TX: University of Texas Press, 1961; 37–44.
- 34 Adams JE, Hosobuchi Y, Fields H. Stimulation of internal capsule for relief of chronic pain. J Neurosurg 1974; 41: 740–4.
- 35 Pinneo LR, Kaplan JN, Elpel EA, Reynolds PC, Glick JH. Experimental brain prosthesis for stroke. Stroke 1972; 3: 16–26.
- 36 Nashold BS, Wilson WP, Boone E. Depth recordings and stimulation of the human brain: a twenty year experience. In: T Rasmussen, R Marino, eds. Functional Neurosurgery. New York: Raven, 1979; 181–95.
- 37 Lilly JC. Injury and excitation by electric currents: a. The balanced pulse-pair waveform. In: DE Sheer, ed. Electrical Stimulation of the Brain. An Interdisciplinary Survey of Neurobehavioral Integrative Systems. Austin, TX: University of Texas Press, 1961; 60–4.
- 38 Meissner W, Gross CE, Harnack D, Bioulac B, Benazzouz A. Deep brain stimulation for Parkinson's disease: potential risk of tissue damage associated with external stimulation. Ann Neurol 2004; 55: 449–50. Erratum. Ann Neurol 2004;56:309.
- 39 Nutt JG, Anderson VC, Peacock JH, Hammerstad JP, Burchiel KJ. DBS and diathermy interaction induces severe CNS damage. Neurology 2001; 56: 1384–6.
- 40 MRI Guidelines for Medtronic Deep Brain Stimulation Systems. Available at: http://www.medtronic.com/physician/activa/mri.html. Accessed January 28, 2008.
- 41 Rezai AR, Phillips M, Baker KB, et al. Neurostimulation system used for deep brain stimulation (DBS): MR safety issues and implications of failing to follow safety recommendations. Invest Radiol 2004; 39: 300–3.
- 42 Coffey RJ. Re: neurostimulation system used for deep brain stimulation (DBS): MR safety issues and implications of failing to follow safety recommendations. Invest Radiol 2004; 39: 304.
- 43 Elsevier, Inc. Brain Stimulation journal homepage. Available at: http://www.brainstimjrnl.com/home. Accessed February 18, 2008.
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