IEEE Trans Neural Syst Rehabil Eng. 2018 Jan;26(1):69-76. doi: 10.1109/TNSRE.2017.2769707.
Deep brain stimulation (DBS) is a neurosurgical treatment in, e.g., Parkinson's Disease. Electrical stimulation in DBS is delivered to a certain target through electrodes implanted into the brain. Recent developments aiming at better stimulation target coverage and lesser side effects have led to an increase in the number of contacts in a DBS lead as well as higher hardware complexity. This paper proposes an optimization-based approach to alleviation of the fault impact on the resulting therapeutical effect in field steering DBS. Faulty contacts could be an issue given recent trends of increasing number of contacts in DBS leads. Hence, a fault detection/alleviation scheme, such as the one proposed in this paper, is necessary ensure resilience in the chronic stimulation. Two alternatives are considered and compared with the stimulation prior to the fault: one using higher amplitudes on the remaining contacts and another with alleviating contacts in the neighborhood of the faulty one. Satisfactory compensation for a faulty contact can be achieved in both ways. However, to designate alleviating contacts, a model-based optimization procedure is necessary. Results suggest that stimulating with more contacts yields configurations that are more robust to contact faults, though with reduced selectivity.
深部脑刺激 (DBS) 是一种神经外科治疗方法，例如用于帕金森病的治疗。DBS 中的电刺激通过植入大脑的电极传递到特定的目标。为了实现更好的刺激目标覆盖范围和更少的副作用，最近的发展导致 DBS 引线中的触点数量增加，硬件复杂性也提高。本文提出了一种基于优化的方法，以减轻场导向 DBS 中故障对治疗效果的影响。考虑到 DBS 引线中触点数量增加的趋势，故障触点可能是一个问题。因此，需要像本文所提出的故障检测/缓解方案一样，以确保在慢性刺激中具有弹性。考虑了两种替代方案，并与故障前的刺激进行了比较：一种是在剩余触点上使用更高的幅度，另一种是在故障触点附近缓解触点。这两种方法都可以对故障触点进行令人满意的补偿。然而，要指定缓解触点，需要进行基于模型的优化过程。结果表明，使用更多的触点进行刺激可以产生对触点故障更具鲁棒性的配置，尽管选择性降低。
