植入式脉冲发生器产生的深部脑刺激刺激波形的特性。
Characterization of the stimulus waveforms generated by implantable pulse generators for deep brain stimulation.
机构信息
Center for Neurological Restoration, Cleveland Clinic, Cleveland, OH, USA; Research Service, Louis Stokes Cleveland Veterans Affairs Medical Center, Cleveland, OH, USA; Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, USA; Biointerfaces Institute, University of Michigan, Ann Arbor, MI, USA.
Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH, USA.
出版信息
Clin Neurophysiol. 2018 Apr;129(4):731-742. doi: 10.1016/j.clinph.2018.01.015. Epub 2018 Jan 31.
OBJECTIVE
To determine the circuit elements required to theoretically describe the stimulus waveforms generated by an implantable pulse generator (IPG) during clinical deep brain stimulation (DBS).
METHODS
We experimentally interrogated the Medtronic Activa PC DBS IPG and defined an equivalent circuit model that accurately captured the output of the IPG. We then compared the detailed circuit model of the clinical stimulus waveforms to simplified representations commonly used in computational models of DBS. We quantified the errors associated with these simplifications using theoretical activation thresholds of myelinated axons in response to DBS.
RESULTS
We found that the detailed IPG model generated substantial differences in activation thresholds compared to simplified models. These differences were largest for bipolar stimulation with long pulse widths. Average errors were ∼3 to 24% for voltage-controlled stimulation and ∼2 to 11% for current-controlled stimulation.
CONCLUSIONS
Our results demonstrate the importance of including basic circuit elements (e.g. blocking capacitors, lead wire resistance, electrode capacitance) in model analysis of DBS.
SIGNIFICANCE
Computational models of DBS are now commonly used in academic research, industrial technology development, and in the selection of clinical stimulation parameters. Incorporating a realistic representation of the IPG output is necessary to improve the accuracy and utility of these clinical and scientific tools.
目的
确定理论描述植入式脉冲发生器 (IPG) 在临床深部脑刺激 (DBS) 期间产生的刺激波形所需的电路元件。
方法
我们对美敦力 Activa PC DBS IPG 进行了实验性询问，并定义了一个准确捕获 IPG 输出的等效电路模型。然后，我们将临床刺激波形的详细电路模型与 DBS 计算模型中常用的简化表示进行了比较。我们使用 DBS 反应中髓鞘轴突的理论激活阈值来量化这些简化的相关误差。
结果
我们发现，与简化模型相比，详细的 IPG 模型在激活阈值方面产生了很大的差异。对于具有长脉冲宽度的双极刺激，这些差异最大。电压控制刺激的平均误差约为 3%至 24%，电流控制刺激的平均误差约为 2%至 11%。
结论
我们的结果表明，在 DBS 的模型分析中包含基本电路元件（例如，阻断电容器、引线电阻、电极电容）的重要性。
意义
DBS 的计算模型现在常用于学术研究、工业技术开发和临床刺激参数的选择。为了提高这些临床和科学工具的准确性和实用性，必须对 IPG 输出进行真实的表示。
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