Kashyap Varun, Ashby Mark, Stanslaski Scott, Nguyen Kevin, Hageman Kristin, Chang Yao-Chuan, Khalessi Alexander A
Department of Research and Technology, Medtronic Neurovascular, Irvine , California , USA.
Department of Research and Technology, Medtronic Neuromodulation, Minneapolis , Minnesota , USA.
Oper Neurosurg (Hagerstown). 2025 Jan 1;28(1):79-87. doi: 10.1227/ons.0000000000001226. Epub 2024 Jun 13.
Deep brain stimulation (DBS) has developed into an effective therapy for several disease states including treatment-resistant Parkinson disease and medically intractable essential tremor, as well as segmental, generalized and cervical dystonia, and obsessive-compulsive disorder (OCD). Dystonia and OCD are approved with Humanitarian Device Exemption. In addition, DBS is also approved for the treatment of epilepsy in the anterior nucleus of the thalamus. Although overall considered an effective treatment for Parkinson disease and epilepsy, a number of specific factors determine the treatment success for DBS including careful patient selection, effective postoperative programming of DBS devices and accurate electrode placement. Furthermore, invasiveness of the procedure is a rate limiter for patient adoption. It is desired to explore a less invasive way to deliver DBS therapy.
Here, we report for the first time the direct comparison of endovascular and parenchymal DBS in a triplicate ovine model using the anterior nucleus of the thalamus as the parenchymal target for refractory epilepsy.
Triplicate ovine studies show comparable sensing resolution and stimulation performance of endovascular DBS with parenchymal DBS.
The results from this feasibility study opens up a new frontier for minimally invasive DBS therapy.
脑深部电刺激术（DBS）已发展成为一种针对多种疾病状态的有效治疗方法，包括难治性帕金森病、药物难治性特发性震颤，以及节段性、全身性和颈部肌张力障碍，还有强迫症（OCD）。肌张力障碍和强迫症已获得人道主义器械豁免批准。此外，DBS还被批准用于治疗丘脑前核的癫痫。尽管总体上被认为是治疗帕金森病和癫痫的有效方法，但许多特定因素决定了DBS的治疗成功与否，包括仔细的患者选择、DBS设备术后有效的程控以及电极的精确放置。此外，该手术的侵入性是限制患者接受治疗的一个因素。人们期望探索一种侵入性较小的方式来进行DBS治疗。
在此，我们首次在一个一式三份的绵羊模型中，以丘脑前核作为难治性癫痫的实质靶点，对血管内DBS和实质DBS进行了直接比较。
一式三份的绵羊研究表明，血管内DBS与实质DBS在传感分辨率和刺激性能方面具有可比性。
这项可行性研究的结果为微创DBS治疗开辟了一个新领域。
