Distinct perceptive pathways selected with tonic and bursting patterns of thalamic stimulation.

Autor: Willsey MS; Department of Neurosurgery, University of Michigan, Ann Arbor, MI, USA; Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, USA. Electronic address: mwillsey@umich.edu., Lu CW; Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, USA., Nason SR; Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, USA., Malaga KA; Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, USA; Department of Biomedical Engineering, Bucknell University, Lewisburg, PA, USA., Lempka SF; Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, USA; Department of Anesthesiology, University of Michigan, Ann Arbor, MI, USA; Biointerfaces Institute, University of Michigan, Ann Arbor, MI, USA., Chestek CA; Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, USA; Department of Electrical Engineering, University of Michigan, Ann Arbor, MI, USA; Biointerfaces Institute, University of Michigan, Ann Arbor, MI, USA; Robotics Graduate Program, University of Michigan, Ann Arbor, MI, USA., Patil PG; Department of Neurosurgery, University of Michigan, Ann Arbor, MI, USA; Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, USA; Department of Neurology, University of Michigan, Ann Arbor, MI, USA; Department of Anesthesiology, University of Michigan, Ann Arbor, MI, USA. Electronic address: pgpatil@umich.edu.
Jazyk: angličtina
Zdroj: Brain stimulation [Brain Stimul] 2020 Sep - Oct; Vol. 13 (5), pp. 1436-1445. Date of Electronic Publication: 2020 Jul 23.
DOI: 10.1016/j.brs.2020.07.007
Abstrakt: Background: Novel patterns of electrical stimulation of the brain and spinal cord hold tremendous promise to improve neuromodulation therapies for diverse disorders, including tremor and pain. To date, there are limited numbers of experimental studies in human subjects to help explain how stimulation patterns impact the clinical response, especially with deep brain stimulation. We propose using novel stimulation patterns during electrical stimulation of somatosensory thalamus in awake deep brain stimulation surgeries and hypothesize that stimulation patterns will influence the sensory percept without moving the electrode.
Methods: In this study of 15 fully awake patients, the threshold of perception as well as perceptual characteristics were compared for tonic (trains of regularly-repeated pulses) and bursting stimulation patterns.
Results: In a majority of subjects, tonic and burst percepts were located in separate, non-overlapping body regions (i.e., face vs. hand) without moving the stimulating electrode (p < 0.001; binomial test). The qualitative features of burst percepts also differed from those of tonic-evoked percepts as burst patterns were less likely to evoke percepts described as tingling (p = 0.013; Fisher's exact test).
Conclusions: Because somatosensory thalamus is somatotopically organized, percept location can be related to anatomic thalamocortical pathways. Thus, stimulation pattern may provide a mechanism to select for different thalamocortical pathways. This added control could lead to improvements in neuromodulation - such as improved efficacy and side effect attenuation - and may also improve localization for sensory prostheses.
Competing Interests: Declaration of competing interest There are no competing interests.
(Copyright © 2020 The Author(s). Published by Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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