Algorithms for Programming DBS Systems for ET
University of Minnesota
25 participants
Oct 1, 2019
INTERVENTIONAL
Conditions
Summary
Deep brain stimulation (DBS) targeting the Vim thalamus (ventralis intermedius nucleus) is an FDA-approved neuromodulation therapy for treating postural and action tremor in individuals with essential tremor (ET). The success of this treatment, however, is highly dependent on the ability of clinicians to identify therapeutic stimulation settings through a laborious programming process. There is a strong and growing clinical need for new approaches to provide clinicians with more efficient guidance on how to titrate stimulation settings. This study will leverage subject-specific computational models that can predict neural activation of axonal pathways adjacent to the active electrode(s) and implicated in the therapeutic mechanisms of Vim-DBS to in turn guide clinicians with which stimulation settings are likely to be the most therapeutic on tremor.
Eligibility
Inclusion Criteria5
- diagnosis of ET
- medication-refractory tremor
- VIM-DBS implant (unilateral or bilateral)
- T MRI pre-operative scan under Dr. Harel's IRB (institutional review board) protocol (#1210M22183)
- Post-operative CT scan
Exclusion Criteria4
- history of musculoskeletal disorders that affect movement of the limbs
- other significant neurological disorder
- prior history of stereotactic neurosurgery (other than VIM-DBS surgery)
- pregnancy
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Interventions
This study consists of testing additional model-derived DBS settings during initial and regular follow-up clinical visits every 6 months for up to 2 years in which individuals with DBS implants are re-evaluated by a clinician to make sure that the stimulation settings employed during the previous clinical visit remain therapeutic. It is important to note that this study is post-surgical and all procedures (i.e. stimulation settings that will be tested in the clinic) are within the FDA-approved range of stimulation settings available on the implanted pulse generator.
Locations(1)
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NCT03984643