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深部脑刺激器(DBS)系统的研究

Investigation of a Deep Brain Stimulator (DBS) System.

作者信息

Whitestone Jennifer, Salih Anmar, Goswami Tarun

机构信息

Department of Biomedical, Industrial and Human Factors Engineering, Wright State University, Dayton, OH 45435, USA.

Department of Orthopedic Surgery, Sports Medicine and Rehabilitation, Miami Valley Hospital, Dayton, OH 45409, USA.

出版信息

Bioengineering (Basel). 2023 Oct 3;10(10):1160. doi: 10.3390/bioengineering10101160.

Abstract

A deep brain stimulator (DBS) device is a surgically implanted system that delivers electrical impulses to specific targets in the brain to treat abnormal movement disorders. A DBS is like a cardiac pacemaker, but instead of sending electrical signals to the heart, it sends them to the brain instead. When DBS leads and extension wires are exposed in the biological environment, this can adversely affect impedance and battery life, resulting in poor clinical outcomes. A posthumously extracted DBS device was evaluated using visual inspection and optical microscopy as well as electrical and mechanical tests to quantify the damage leading to its impairment. The implantable pulse generator (IPG) leads, a component of the DBS, contained cracks, delamination, exfoliations, and breakage. Some aspects of in vivo damage were observed in localized areas discussed in this paper. The duration of the time in months that the DBS was in vivo was estimated based on multiple regression analyses of mechanical property testing from prior research of pacemaker extensions. The test results of three DBS extensions, when applied to the regressions, were used to estimate the in vivo duration in months. This estimation approach may provide insight into how long the leads can function effectively before experiencing mechanical failure. Measurements of the extension coils demonstrated distortion and stretching, demonstrating the changes that may occur in vivo. These changes can alter the impedance and potentially reduce the effectiveness of the clinical treatment provided by the DBS system. Ultimately, as both DBSs and pacemakers use the same insulation and lead materials, the focus of this paper is to develop a proof of concept demonstrating that the mechanical properties measured from pacemaker extensions and leads extracted posthumously of known duration, measured in months while in vivo, can be used to predict the duration of DBS leads of unknown lifespan. The goal is to explore the validity of the proposed model using multiple regression of mechanical properties.

摘要

深部脑刺激器(DBS)装置是一种通过手术植入的系统,它向大脑中的特定靶点传递电脉冲,以治疗异常运动障碍。DBS类似于心脏起搏器,但它不是向心脏发送电信号,而是向大脑发送电信号。当DBS电极和延长线暴露在生物环境中时,这会对阻抗和电池寿命产生不利影响,从而导致临床效果不佳。对一个死后取出的DBS装置进行了评估,采用了目视检查、光学显微镜检查以及电气和机械测试,以量化导致其受损的损伤情况。DBS的一个组成部分,即可植入脉冲发生器(IPG)电极,出现了裂缝、分层、剥落和断裂。本文讨论了在局部区域观察到的一些体内损伤情况。根据先前对起搏器延长线的研究中机械性能测试的多元回归分析,估计了DBS在体内的时间(以月为单位)。将三个DBS延长线的测试结果应用于回归分析,以估计体内时间(以月为单位)。这种估计方法可能有助于深入了解电极在发生机械故障之前能够有效工作多长时间。对延长线圈的测量显示出变形和拉伸,表明体内可能发生的变化。这些变化会改变阻抗,并可能降低DBS系统提供的临床治疗效果。最终,由于DBS和起搏器都使用相同的绝缘和电极材料,本文的重点是建立一个概念验证,证明从已知体内时间(以月为单位)的死后取出的起搏器延长线和电极测量得到的机械性能,可用于预测未知使用寿命的DBS电极的持续时间。目标是使用机械性能的多元回归来探索所提出模型的有效性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b321/10604713/8544b0296bf6/bioengineering-10-01160-g001.jpg

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