Selective Mapping of Deep Brain Stimulation Lead Currents Using Acoustoelectric Imaging

Review of directional leads, stimulation patterns and programming strategies for deep brain stimulation

Deep brain stimulation (DBS) is a well-established treatment for both neurological and psychiatric disorders. Directional DBS has the potential to minimize stimulation-induced side effects and maximize clinical benefits. Many new directional leads, stimulation patterns and programming strategies have been developed in recent years. Therefore, it is necessary to review new progress in directional DBS. This paper summarizes progress for directional DBS from the perspective of directional DBS leads, stimulation patterns, and programming strategies which are three key elements of DBS systems. Directional DBS leads are reviewed in electrode design and volume of tissue activated visualization strategies. Stimulation patterns are reviewed in stimulation parameters and advances in stimulation patterns. Programming strategies are reviewed in computational modeling, monopolar review, direction indicators and adaptive DBS. This review will provide a comprehensive overview of primary directional DBS leads, stimulation patterns and programming strategies, making it helpful for those who are developing DBS systems.

In Vivo Transcranial Acoustoelectric Brain Imaging of Different Deep Brain Stimulation Currents

Deep brain stimulation (DBS) is an effective treatment for neurologic disease and its clinical effect is highly dependent on the DBS leads localization and current stimulating state. However, standard human brain imaging modalities could not provide direct feedback on DBS currents spatial distribution and dynamic changes. Acoustoelectric brain imaging (AEBI) is an emerging neuroimaging method that can directly map current density distribution. Here, we investigate in vivo AEBI of different DBS currents to explore the potential of DBS visualization using AEBI. According to the typical DBS stimulus parameters, four types of DBS currents, including time pattern, waveform, frequency, and amplitude are designed to implement AEBI experiments in living rat brains. Based on acoustoelectric (AE) signals, the AEBI images of each type DBS current are explored and the resolution is quantitatively analyzed for performance evaluation. Furtherly, the AE signals are decoded to characterize DBS currents from multiple perspectives, including time-frequency domain, spatial distribution, and amplitude comparation. The results show that in vivo transcranial AEBI can accurately locate the DBS contact position with a millimeter spatial resolution (< 2 mm) and millisecond temporal resolution (< 10 ms). Besides, the decoded AE signal at DBS contact position is capable of describing the corresponding DBS current characteristics and identifying current pattern changes. This study first validates that AEBI can localize in vivo DBS contact and characterize different DBS currents. AEBI is expected to develop into a noninvasive DBS real-time monitoring technology with high spatiotemporal resolution.

Acoustoelectric brain imaging with different conductivities and acoustic distributions

Objective: Acoustoelectric brain imaging (AEBI) is a promising imaging method for mapping brain biological current densities with high spatiotemporal resolution. Currently, it is still challenging to achieve human AEBI with an unclear acoustoelectric (AE) signal response of medium characteristics, particularly in conductivity and acoustic distribution. This study introduces different conductivities and acoustic distributions into the AEBI experiment, and clarifies the response interaction between medium characteristics and AEBI performance to address these key challenges. Approach: AEBI with different conductivities is explored by the imaging experiment, potential measurement, and simulation on a pig's fat, muscle, and brain tissue. AEBI with different acoustic distributions is evaluated on the imaging experiment and acoustic field measurement through a deep and surface transmitting model built on a human skullcap and pig brain tissue. Main results: The results show that conductivity is not only inversely proportional to the AE signal amplitude but also leads to a higher AEBI spatial resolution as it increases. In addition, the current source and sulcus can be located simultaneously with a strong AE signal intensity. The transcranial focal zone enlargement, pressure attenuation in the deep-transmitting model, and ultrasound echo enhancement in the surface-transmitting model cause a reduced spatial resolution, FFT-SNR, and timing correlation of AEBI. Under the comprehensive effect of conductivity and acoustics, AEBI with skull finally shows reduced imaging performance for both models compared with no-skull AEBI. On the contrary, the AE signal amplitude decreases in the deep-transmitting model and increases in the surface-transmitting model. Significance: This study reveals the response interaction between medium characteristics and AEBI performance, and makes an essential step toward developing AEBI as a practical neuroimaging technique.

Acoustoelectric Time-Reversal for Ultrasound Phase-Aberration Correction

Acoustoelectric imaging (AEI) is a technique that combines ultrasound (US) with radio frequency recording to detect and map local current source densities. This study demonstrates a new method called acoustoelectric time reversal (AETR), which uses AEI of a small current source to correct for phase aberrations through a skull or other US-aberrating layers with applications to brain imaging and therapy. Simulations conducted at three different US frequencies (0.5, 1.5, and 2.5 MHz) were performed through media layered with different sound speeds and geometries to induce aberrations of the US beam. Time delays of the acoustoelectric (AE) signal from a monopole within the medium were calculated for each element to enable corrections using AETR. Uncorrected aberrated beam profiles were compared with those after applying AETR corrections, which demonstrated a strong recovery (29%-100%) of lateral resolution and increases in focal pressure up to 283%. To further demonstrate the practical feasibility of AETR, we further conducted bench-top experiments using a 2.5 MHz linear US array to perform AETR through 3-D-printed aberrating objects. These experiments restored lost lateral restoration up to 100% for the different aberrators and increased focal pressure up to 230% after applying AETR corrections. Cumulatively, these results highlight AETR as a powerful tool for correcting focal aberrations in the presence of a local current source with applications to AEI, US imaging, neuromodulation, and therapy.

An adaptive acoustoelectric signal decoding algorithm based on Fourier fitting for brain function imaging

Acousticelectric brain imaging (ABI), which is based on the acoustoelectric (AE) effect, is a potential brain function imaging method for mapping brain electrical activity with high temporal and spatial resolution. To further enhance the quality of the decoded signal and the resolution of the ABI, the decoding accuracy of the AE signal is essential. An adaptive decoding algorithm based on Fourier fitting (aDAF) is suggested to increase the AE signal decoding precision. The envelope of the AE signal is first split into a number of harmonics by Fourier fitting in the suggested aDAF. The least square method is then utilized to adaptively select the greatest harmonic component. Several phantom experiments are implemented to assess the performance of the aDAF, including 1-source with various frequencies, multiple-source with various frequencies and amplitudes, and multiple-source with various distributions. Imaging resolution and decoded signal quality are quantitatively evaluated. According to the results of the decoding experiments, the decoded signal amplitude accuracy has risen by 11.39% when compared to the decoding algorithm with envelope (DAE). The correlation coefficient between the source signal and the decoded timing signal of aDAF is, on average, 34.76% better than it was for DAE. Finally, the results of the imaging experiment show that aDAF has superior imaging quality than DAE, with signal-to noise ratio (SNR) improved by 23.32% and spatial resolution increased by 50%. According to the experiments, the proposed aDAF increased AE signal decoding accuracy, which is vital for future research and applications related to ABI.

In Vivo Transcranial Acoustoelectric Brain Imaging of Different Steady-State Visual Stimulation Paradigms

OBJECTIVE

Based on the acoustoelectric (AE) effect, transcranial acoustoelectric brain imaging (tABI) is of potential for brain functional imaging with high temporal and spatial resolution. With nonlinear and non-steady-state, brain electrical signal is microvolt level which makes the development of tABI more difficult. This study demonstrates for the first time in vivo tABI of different steady-state visual stimulation paradigms.

METHOD

To obtain different brain activation maps, we designed three steady-state visual stimulation paradigms, including binocular, left eye and right eye stimulations. Then, tABI was implemented with one fixed recording electrode. And, based on decoded signal power spectrum (tABI-power) and correlation coefficient between steady-state visual evoked potential (SSVEP) and decoded signal (tABI-cc) respectively, two imaging methods were investigated. To quantitatively evaluate tABI spatial resolution performance, ECoG was implemented at the same time. Finally, we explored the performance of tABI transient imaging.

RESULTS

Decoded AE signal of activation region is consistent with SSVEP in both time and frequency domains, while that of the nonactivated region is noise. Besides, with transcranial measurement, tABI has a millimeter-level spatial resolution (< 3mm). Meanwhile, it can achieve millisecond-level (125ms) transient brain activity imaging.

CONCLUSION

Experiment results validate tABI can realize brain functional imaging under complex paradigms and is expected to develop into a brain functional imaging method with high spatiotemporal resolution.

Biological current source imaging method based on acoustoelectric effect: A systematic review

Neuroimaging can help reveal the spatial and temporal diversity of neural activity, which is of utmost importance for understanding the brain. However, conventional non-invasive neuroimaging methods do not have the advantage of high temporal and spatial resolution, which greatly hinders clinical and basic research. The acoustoelectric (AE) effect is a fundamental physical phenomenon based on the change of dielectric conductivity that has recently received much attention in the field of biomedical imaging. Based on the AE effect, a new imaging method for the biological current source has been proposed, combining the advantages of high temporal resolution of electrical measurements and high spatial resolution of focused ultrasound. This paper first describes the mechanism of the AE effect and the principle of the current source imaging method based on the AE effect. The second part summarizes the research progress of this current source imaging method in brain neurons, guided brain therapy, and heart. Finally, we discuss the problems and future directions of this biological current source imaging method. This review explores the relevant research literature and provides an informative reference for this potential non-invasive neuroimaging method.

In vivo acoustoelectric imaging for high-resolution visualization of cardiac electric spatiotemporal dynamics

Acoustoelectric cardiac imaging (ACI) is a hybrid modality that exploits the interaction of an ultrasonic pressure wave and the resistivity of tissue to map current densities in the heart. This study demonstrates for the first time in vivo ACI in a swine model. ACI measured beat-to-beat variability (n=20) of the peak of the cardiac activation wave at one location of the left ventricle as 5.32±0.74µV, 3.26±0.54mm below the epicardial surface, and 2.67±0.56ms before the peak of the local electrogram. Cross-sectional ACI images exhibited propagation velocities of 0.192±0.061m/s along the epicardial-endocardial axis with an SNR of 24.9 dB. This study demonstrates beat-to-beat and multidimensional ACI, which might reveal important information to help guide electroanatomic mapping procedures during ablation therapy.

Recent advances in bioelectronics chemistry

Research in bioelectronics is highly interdisciplinary, with many new developments being based on techniques from across the physical and life sciences. Advances in our understanding of the fundamental chemistry underlying the materials used in bioelectronic applications have been a crucial component of many recent discoveries. In this review, we highlight ways in which a chemistry-oriented perspective may facilitate novel and deep insights into both the fundamental scientific understanding and the design of materials, which can in turn tune the functionality and biocompatibility of bioelectronic devices. We provide an in-depth examination of several developments in the field, organized by the chemical properties of the materials. We conclude by surveying how some of the latest major topics of chemical research may be further integrated with bioelectronics.

Recent advances in bioelectronics chemistry

Research in bioelectronics is highly interdisciplinary, with many new developments being based on techniques from across the physical and life sciences. Advances in our understanding of the fundamental chemistry underlying the materials used in bioelectronic applications have been a crucial component of many recent discoveries. In this review, we highlight ways in which a chemistry-oriented perspective may facilitate novel and deep insights into both the fundamental scientific understanding and the design of materials, which can in turn tune the functionality and biocompatibility of bioelectronic devices. We provide an in-depth examination of several developments in the field, organized by the chemical properties of the materials. We conclude by surveying how some of the latest major topics of chemical research may be further integrated with bioelectronics.

Acoustoelectric imaging of deep dipoles in a human head phantom for guiding treatment of epilepsy

OBJECTIVE

This study employs a human head model with real skull to demonstrate the feasibility of transcranial acoustoelectric brain imaging (tABI) as a new modality for electrical mapping of deep dipole sources during treatment of epilepsy with much better resolution and accuracy than conventional mapping methods.

APPROACH

This technique exploits an interaction between a focused ultrasound (US) beam and tissue resistivity to localize current source densities as deep as 63 mm at high spatial resolution (1 to 4 mm) and resolve fast time-varying currents with sub-ms precision.

MAIN RESULTS

Detection thresholds through a thick segment of the human skull at biologically safe US intensities was below 0.5 mA and within range of strong currents generated by the human brain.

SIGNIFICANCE

This work suggests that 4D tABI may emerge as a revolutionary modality for real-time high-resolution mapping of neuronal currents for the purpose of monitoring, staging, and guiding treatment of epilepsy and other brain disorders characterized by abnormal rhythms.

High resolution transcranial acoustoelectric imaging of current densities from a directional deep brain stimulator

OBJECTIVE

New innovations in deep brain stimulation (DBS) enable directional current steering-allowing more precise electrical stimulation of the targeted brain structures for Parkinson's disease, essential tremor and other neurological disorders. While intra-operative navigation through MRI or CT approaches millimeter accuracy for placing the DBS leads, no existing modality provides feedback of the currents as they spread from the contacts through the brain tissue. In this study, we investigate transcranial acoustoelectric imaging (tAEI) as a new modality to non-invasively image and characterize current produced from a directional DBS lead. tAEI uses ultrasound (US) to modulate tissue resistivity to generate detectable voltage signals proportional to the local currents.

APPROACH

An 8-channel directional DBS lead (Infinity 6172ANS, Abbott Inc) was inserted inside three adult human skulls submerged in 0.9% NaCl. A 2.5 MHz linear array delivered US pulses through the transtemporal window and focused near the contacts on the lead, while a custom amplifier and acquisition system recorded the acoustoelectric (AE) interaction used to generate images.

MAIN RESULTS

tAEI detected monopolar current with stimulation pulses as short as 100 µs with an SNR ranging from 10-27 dB when using safe US pressure (mechanical indices  <0.78) and injected current of ~2 mA peak amplitude. Adjacent contacts were discernable along the length and within each ring of the lead with a mean radial separation between contacts of 2.10 and 1.34 mm, respectively.

SIGNIFICANCE

These results demonstrate the feasibility of tAEI for high resolution mapping of directional DBS currents using clinically-relevant stimulation parameters. This new modality may improve the accuracy for placing the DBS leads, guide calibration and programming, and monitor long-term performance of DBS for treatment of Parkinson's disease.