Delivering the Stimulation

For better or worse, manufacturers of neurotechnology devices have a strong dependence on their colleagues in the neurosurgical equipment business, as we discuss in our article on page 1 of this issue. This is particularly true for manufacturers of deep-brain stimulation systems, for several reasons. First, no matter how well designed and well tested the system is, if the implantation procedure is overly cumbersome or traumatic to the patient, the product’s acceptance in the market will suffer.

Also, the complexity of the implantation procedure is bound to impact the overall cost of the system to the patient. No matter how cost effective a neurostimulation device may be, if the cost of the surgery to implant the device is excessive, in the opinion of medical insurers, the product will have a harder time in the market. Cost and complexity of the equipment and training needed for implantation is important to neurosurgeons too. Anything the manufacturer of neurosurgical systems can do to make the process more palatable to surgeons will likely have a positive effect on sales of DBS systems.

Neurostimulation system vendors would be wise to consider neurosurgical equipment manufacturers as more than just component suppliers, however. The design and development of new surgical tools may well stimulate new ideas for improving DBS system components or even new types of stimulation systems altogether. A possible example is Stereotaxis Inc.’s Niobe magnetic navigation system. This product, which relies on external magnetic fields to guide a catheter or stimulation lead to a precise location in the brain, not only offers the potential for an improved implantation procedure, it also conjures up a host of future scenarios for combining magnetic and electrical energy in a way that would make Maxwell proud.

Is it possible, for example, that a passive lead or coil implanted in the brain can be an effective neurostimulation system when combined with externally applied varying magnetic fields?

Is it possible to introduce a microelectrode into the body in a location other than the brain and then migrate it to the brain later?

Is it possible to construct a conducting microelectrode within the cerebral vasculature and then activate it when it is fully formed?
Is it possible to isolate existing fibers or neural centers to be used as externally activated current generators in the brain?

Some of these questions may be off the wall or too far into the future for neurotechnology vendors to contemplate. But the point is that by giving as much thought to the means by which a stimulation system is introduced to the body as is given to the design of the stimulator itself, neurotechnology manufacturers have much to gain.

James Cavuoto
Editor and Publisher