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Medical device implants for neuromodulation
Published in Ze Zhang, Mahmoud Rouabhia, Simon E. Moulton, Conductive Polymers, 2018
Recently developed closed-loop DBS systems enable the sensing and recording of brain activity while simultaneously providing targeted DBS therapy (Stypulkowski et al. 2013). Closed-loop DBS systems utilize a biomarker to monitor a patient’s disease state, and then modulate the delivery of stimulus pulses based on abnormal brain activity (Stypulkowski et al. 2014). Implantable closed-loop neurostimulation systems have been used to treat several disorders, including pain, epilepsy, and Parkinson’s disease. For example, a closed-loop SCS system for pain, the RestoreSensor system (Medtronic), has been granted FDA approval to provide online adjustments in stimulation according to a patient’s body position. A second example is the FDA-approved RNS System for epilepsy. In this system, a neurostimulator is implanted in the cranium and connected to one or two recording and stimulating leads that are surgically positioned at the seizure foci in the brain. When abnormal brain activity is detected, electrical stimulation is applied to the foci of the seizure.
Advanced Optical Imaging in the Study of Acute and Chronic Response to Implanted Neural Interfaces
Published in Yu Chen, Babak Kateb, Neurophotonics and Brain Mapping, 2017
Cristin G. Welle, Daniel X. Hammer
Implanted medical devices that interface with the nervous system are currently used to diagnose and treat a wide variety of neurological and psychiatric disorders and impairments. The acceptance of these devices is likely to grow over the next decade to the extent that they are demonstrated to provide benefit to patients who are resistant to treatment by pharmaceutical or other interventions. Neurostimulation devices treat medical conditions such as chronic pain, Parkinson’s disease, essential tremor, epilepsy, hearing loss, and urinary incontinence, among others. There are an estimated 800,000 implanted neurostimulation devices in patients worldwide, and the market share is expected to grow (Medtech Insight 2013). Neural recording devices, which detect neural signals, are currently marketed for epilepsy monitoring and brain mapping. Several medical devices recently approved by the U.S. Food and Drug Administration (FDA) include both stimulation and recording elements. These include a closed-loop system, the NeuroPace Responsive Neurostimulation System for epilepsy, which detects brain electrical signals and provides stimulation to interrupt seizures. Similarly, the Inspire Upper Airway stimulation system to treat sleep apnea detects ventilatory effort and responds with stimulation of the hypoglossal nerve to open the airway. The closed-loop detection/therapy combination of neural sensing and stimulation in a single device platform has the potential to increase the therapeutic potency of future devices.
Restoration: Nanotechnology in Tissue Replacement and Prosthetics
Published in Harry F. Tibbals, Medical Nanotechnology and Nanomedicine, 2017
Nanofabrication is increasing the resolution and capabilities of neurostimulation devices. Neurostimulation is used medically for cardiac pacemaking, deep brain stimulation to control tremors in Parkinson’s disease, management of chronic pain, stimulation of tissue healing, prevention and reversal of nerve degeneration, and other conditions and therapies, including chronic neuropathy, diabetic neuroarthropathy, and cardiomyoplasty.
The RNS System: brain-responsive neurostimulation for the treatment of epilepsy
Published in Expert Review of Medical Devices, 2021
Beata Jarosiewicz, Martha Morrell
For people with drug-resistant focal epilepsy that have failed, declined, or are not candidates for resective or ablative surgery, neurostimulation is a promising treatment option [17–19]. Three types of neurostimulation devices are currently approved in the US by the FDA: vagus nerve stimulation (VNS®; LivaNova, Inc.), thalamic deep brain stimulation (DBS; Medtronic, Inc.), and responsive neurostimulation (RNS® System; NeuroPace, Inc.).