Are Neurostimulators Reforming Neurological Treatment Patterns?

Advanced neurotechnology and neuroimaging developments sum up to factors that are contributing to the rapid use of neurostimulation therapies to treat neurological disorders.

FERMONT, CA: Latest advancements in plastics and medical tools are allowing scientists and doctors to team up and develop bioresorbable electronics that can be implanted in the brain and dissolve when they are not needed. This medical device will help doctors to measure temperature and pressure in the brain. As these sensors or devices can dissolve, they minimize the need for additional surgeries. It is extremely challenging to diagnose disorders of the brain chemically. There is hence, a great demand in designing and optimizing tools for detection of chemical biomarkers implicated in neurological disorders to enhance diagnosis and treatment. Devices that are capable of tracking brain chemicals, neurotransmitters, in particular, need to be biocompatible, perform with the high spatiotemporal resolution, and ensure high selectivity and sensitivity. 

Neurostimulators are very effective in stopping tremors in patients with multiple neuropathies. However, what makes it especially challenging for neurostimulators to do so is that the electrical impulses that cause tremors and seizures are often very tiny, making it hard to detect them. Also very delicate is the magnitude of electrical impulse required to avoid these symptoms, making it hard to balance the two. Doctors often need years to make the small adjustments necessary to optimize the treatment for neurostimulation.

Recent developments in electrochemical techniques address these criteria; the resulting systems show excellent promise for in vivo identification of neurotransmitters. A new neurostimulator technology (WAND- wireless artifact-free neuromodulation device) has the capability to simultaneously listen to and boost electrical current in the brain, possibly providing fine-tuned treatments to patients with illnesses such as epilepsy or seizures and Parkinson's. WAND operates as a "brain pacemaker," monitoring the electrical activity of the brain and providing electrical stimulation if abnormalities are detected.

WAND is both wireless and autonomous, which means that once it learns to acknowledge the signs of tremor or seizure, the stimulation parameters can be adjusted by itself to avoid unwanted movements. And because it is closed-loop—meaning it can simultaneously boost and record—these parameters can be adjusted in real-time. Deep brain stimulators currently either prevent recording while providing electrical stimulation or record the stimulation at another portion of the brain from where it is applied. To offer closed-loop stimulation-based therapies, which is a major objective for providers treating Parkinson's and epilepsy as well as a range of neurological illnesses, it is essential to simultaneously conduct both neural recordings and stimulation, which no single commercial device presently performs. It is highly expensive and can take years to find the correct treatment for a patient. High cost and duration reductions can potentially lead to significantly improved results and accessibility.

As outlined, the rapid advances in neurostimulation techniques provide the needed instruments for treating patients with many neurological and mental illnesses that are debilitating. Clinically, the proven invasive electrical stimulation systems are used to cause dysfunctional neural circuitry therapeutic neuromodulation. Although we are on an accelerated route towards an adaptable and accurate neuromodulation treatment, there is still much to be achieved. This involves advances such as electrode design to allow long-term sensing and stimulation of high precision as well as computing methods to obtain and evaluate significant feedback signals in actual time to adapt stimulation parameters appropriately. More importantly, a more comprehensive understanding of the neurostimulation therapeutic mechanisms for various neurological disorders is required, enabling the discovery of biomarker feedback signals that inform the closed-loop system effectively.