Electrode and Pulse Generator Considerations

FIGURE 6.5 Post-operative x-ray of the first patient ever implanted for chronic deep brain stimulation, showing silver wiring and electrode adapted to a radio-frequency coupled spinal cord receiver. (J. Neurosurg. 47 184-194, 1977.) FIGURE 6.5 Post-operative x-ray of the first patient ever implanted for chronic deep brain stimulation, showing silver wiring and electrode adapted to a radio-frequency coupled spinal cord receiver. (J. Neurosurg. 47 184-194, 1977.) to remain in its original...

Description and Implementation of Technology

The RNS system consists of an implantable responsive neurostimulator (Figure 5.1), electrode leads, a wireless telemetry wand, a patient data transmitter, and a physician programmer. The neurostimulator is designed with a thickness and curvature matching that of the skull so that it replaces an identically shaped section of bone that is surgically removed. During implant, a craniectomy the same size and shape of the neurostimulator is made, and the neurostimulator is placed into a ferrule that...

Vpl Stimulation And Pag Stimulation And Cingular

FIGURE 6.1 Stimulation paths through the paraventricular and pariaquiductal gray (PVG, PAG) in five patients all patients received pain relief in the PVG. AQ aqueduct of Sylvius, TH thalamus, COS superior colliculus, COI inferior colliculus, RU nucleus rubber. (J. Neurosurg. 47 178-183, 1977.) FIGURE 6.1 Stimulation paths through the paraventricular and pariaquiductal gray (PVG, PAG) in five patients all patients received pain relief in the PVG. AQ aqueduct of Sylvius, TH thalamus, COS superior...

Conclusion

The field of neuroprosthetics today is in its infancy. Currently, research is only beginning to crack the electrical information encoding the information in a human's thoughts. Despite the field's youth, early advances have already demonstrated that these platforms can be utilized to significantly enhance an impaired user's ability to interact with his her environment. Each of the reviewed signal platforms has the potential to substantively improve the manner in which patients with spinal cord...

Longevity

Longevity is of prime importance in a chronic electrode that will be implanted in a young adult human for a lifetime that can extend beyond fifty years. Clearly, the NE is ahead in this respect so far 5 , although recent reports from Donoghue's lab show a few signals enduring for years 10 . In all animal and human subjects, the signals from the NE continued until the preparation was destroyed or the subject died. The NE has endured in two humans for more than four years Kennedy et al.,...

Optical Stimulation

Optical Stimulation

The basis of this work is that delivery of pulsed laser light can be used for contact-free, damage-free, artifact-free stimulation of discrete populations of neural fibers. We have previously shown that a pulsed, low-energy laser beam elicits compound nerve and muscle action potentials, with resultant muscle contraction, which is indistinguishable from responses obtained with conventional bipolar, electrical stimulation of the rat sciatic nerve in vivo (Wells et al., 2005a). The stimulation...

Historical Summary of the Use of ISMS

As early as the 1940s, Renshaw conducted experiments using penetration electrodes to stimulate moto-neurons in the ventral gray matter of the spinal cord to demonstrate the time required for electrical excitation to cross a synapse (Renshaw, 1940). Intraspinal microstimulation has also been used for many years as an electrophysiological technique to demonstrate the reflex circuitry within the cord (Jankowska and Roberts, 1972). In the late 1960s, ISMS was explored in animal experiments as a...

Info

DBS, deep brain stimulation CS, cortical stimulation VNS, vagus nerve stimulation PNS, peripheral nerve stimulation SCS, spinal cord stimulation * Humanitarian Device Exemption (HDE) status ** HDE status pending DBS, deep brain stimulation CS, cortical stimulation VNS, vagus nerve stimulation PNS, peripheral nerve stimulation SCS, spinal cord stimulation * Humanitarian Device Exemption (HDE) status ** HDE status pending though it was one of the earliest indications for DBS studies. Spinal cord...

Peripheral Cortical and Deep Brain Stimulation

Although this chapter concentrates on the technique of SCS, it must be noted that neurostimulation can be used successfully at other locations in the peripheral and central nervous systems to provide analgesia. Peripheral nerve stimulation was introduced by Wall, Sweet, and others38 in the mid-1960s. This technique has shown efficacy for peripheral nerve injury pain syndromes as well as CRPS, with the use of a carefully implanted paddle lead utilizing a fascial graft to help anchor the lead...

MCS and Trigeminal Neuropathic Pain

Trigeminal neuropathic facial pain is a syndrome of severe, constant facial pain related to disease of, or injury to, the trigeminal nerve or ganglion. Causes of trigeminal neuropathic pain can include injury from sinus or dental surgery, skull and or facial trauma, or intentional destruction for therapeutic reasons (deafferentation), as well as intrinsic pathology of any part of the trigeminal system (Burchiel, 2003). Despite extensive studies, no significant advances have occurred in its...