Safety Study of Combination Treatment: Deep Brain Stimulation and Transcranial Magnetic Stimulation
Open Access
- 3 April 2020
- journal article
- research article
- Published by Frontiers Media SA in Frontiers in Human Neuroscience
- Vol. 14, 123
- https://doi.org/10.3389/fnhum.2020.00123
Abstract
Patients with advanced Parkinson's disease (PD) often receive deep brain stimulation (DBS) treatment, in which conductive leads are surgically implanted in the brain. While DBS treats tremor and rigidity, patients often continue to suffer from speech and swallowing impairments. There is preliminary evidence that transcranial magnetic stimulation (TMS) of the cortex may be beneficial for these symptoms. However, the potential electromagnetic interactions of the strong magnetic fields from TMS on the conductive leads is unknown, and the combination therapy has not been approved for use. In this article, we report an experimental study of the safety of combining DBS and TMS. We fabricated an anatomically accurate head and brain phantom with electrical conductivities matching cerebrospinal fluid and averaged conductivity of gray and white matter. Induced current on an implanted DBS probe in the brain phantom was measured. Our results show that TMS will induce current values in the range or higher than typical DBS stimulation current. Thus, the combination of TMS/DBS treatment might cause over-stimulation in the brain when stimulated directly over the DBS lead with 100% TMS current intensity.This publication has 42 references indexed in Scilit:
- Dysphagia in the elderly: management and nutritional considerationsClinical Interventions in Aging, 2012
- Safety of transcranial magnetic stimulation for the newer generation of deep brain stimulatorsParkinsonism & Related Disorders, 2011
- The relationship between quality of life and swallowing in Parkinson's diseaseMovement Disorders, 2009
- Deep Brain Stimulation Devices: A Brief Technical History and ReviewArtificial Organs, 2009
- Parkinson's disease: clinical features and diagnosisJournal of Neurology, Neurosurgery & Psychiatry, 2008
- Role of electrode design on the volume of tissue activated during deep brain stimulationJournal of Neural Engineering, 2005
- Electric field and stimulating influence generated by deep brain stimulation of the subthalamic nucleusClinical Neurophysiology, 2004
- Long term safety and efficacy of unilateral deep brain stimulation of the thalamus for parkinsonian tremorJournal of Neurology, Neurosurgery & Psychiatry, 2001
- The dielectric properties of biological tissues: II. Measurements in the frequency range 10 Hz to 20 GHzPhysics in Medicine & Biology, 1996
- Responses to rapid-rate transcranial magnetic stimulation of the human motor cortexBrain, 1994