Seminars

Electrical stimulation for treatment of neurological disorders, diseases, or injuries has relied on controlling the effects of stimulation through selection of stimulation amplitude, pulse duration, and pulse repetition frequency. I introduce a new parameter dimension – the temporal pattern of stimulation – and demonstrate that temporal patterns of stimulation can be used as a probe to understand brain function and therapeutic mechanisms and as a design parameter to increases the efficacy and energy efficiency of neural stimulation therapies. Our finding that the effects of deep brain stimulation (DBS) were dependent on the temporal pattern of stimulation, in addition to the frequency of stimulation, inspired the design of novel temporal patterns of DBS. Patterns were developed that treat the symptoms of PD more effectively than conventional regularly patterned DBS or enable equivalent treatment of symptoms but with a substantial reduction in the required energy. This latter innovation is an important consideration for the size, recharge frequency, and battery life of implanted pulse generators. The results demonstrate the utility of a new dimension of neural stimulation parameters – the timing between stimulation pulses – to increase the efficacy and efficiency of neural stimulation therapies.

ACKNOWLEDGMENTS

Collaborators on our work on deep brain stimulation include Christina Behrend, David Brocker, Chuck Dorval, Brandon Swan, and Dennis Turner at Duke University and Robert Gross at Emory University, and this work is supported by NIH grant R37 NS040894.