Responsive neurostimulation device is a

medical device A medical device is any device intended to be used for medical purposes. Significant potential for hazards are inherent when using a device for medical purposes and thus medical devices must be proved safe and effective with reasonable assura ...

that senses changes in a person's body and uses

neurostimulation Neurostimulation is the purposeful modulation of the nervous system's activity using invasive (e.g. microelectrodes) or non-invasive means (e.g. transcranial magnetic stimulation or transcranial electric stimulation, tES, such as tDCS or trans ...

to respond in the treatment of disease. The

FDA The United States Food and Drug Administration (FDA or US FDA) is a federal agency of the Department of Health and Human Services. The FDA is responsible for protecting and promoting public health through the control and supervision of food ...

has approved devices for use in the United States in the treatment of

epileptic seizures An epileptic seizure, informally known as a seizure, is a period of symptoms due to abnormally excessive or synchronous neuronal activity in the brain. Outward effects vary from uncontrolled shaking movements involving much of the body with los ...

and

chronic pain Chronic pain is classified as pain that lasts longer than three to six months. In medicine, the distinction between acute and chronic pain is sometimes determined by the amount of time since onset. Two commonly used markers are pain that continue ...

conditions. Devices are being studied for use in the treatment of

essential tremor Essential tremor (ET), also called benign tremor, familial tremor, and idiopathic tremor, is a medical condition characterized by involuntary rhythmic contractions and relaxations ( oscillations or twitching movements) of certain muscle groups in ...

Parkinson's disease Parkinson's disease (PD), or simply Parkinson's, is a long-term degenerative disorder of the central nervous system that mainly affects the motor system. The symptoms usually emerge slowly, and as the disease worsens, non-motor symptoms becom ...

Tourette's syndrome Tourette syndrome or Tourette's syndrome (abbreviated as TS or Tourette's) is a common neurodevelopmental disorder that begins in childhood or adolescence. It is characterized by multiple movement (motor) tics and at least one vocal (phonic) ...

, depression,

obesity Obesity is a medical condition, sometimes considered a disease, in which excess body fat has accumulated to such an extent that it may negatively affect health. People are classified as obese when their body mass index (BMI)—a person's ...

, and

post-traumatic stress disorder Post-traumatic stress disorder (PTSD) is a mental and behavioral disorder that can develop because of exposure to a traumatic event, such as sexual assault, warfare, traffic collisions, child abuse, domestic violence, or other threats o ...

Medical Uses

Epilepsy

The use of neurostimulation to treat epileptic seizures is only recommended in those who have failed multiple medications for the treatment of their seizures. The NeuroPace RNS system was approved for use by the FDA in 2013 and is the only medical device for epilepsy that uses responsive neurostimulation. The device is surgically implanted into the patient's head with electrical leads placed near the site in the

brain A brain is an organ that serves as the center of the nervous system in all vertebrate and most invertebrate animals. It is located in the head, usually close to the sensory organs for senses such as vision. It is the most complex organ in a ve ...

that is believed to be the origin of the patient's seizures. These leads record electrical activity in the brain and deliver electrical stimulation when a seizure is detected. The device keeps a record of abnormal electrical activity that is reviewed by a

neurologist Neurology (from el, νεῦρον (neûron), "string, nerve" and the suffix -logia, "study of") is the branch of medicine dealing with the diagnosis and treatment of all categories of conditions and disease involving the brain, the spinal c ...

to improve the detection and treatment of seizures. The patient is able to record when they are having symptoms with the device to see if their symptoms are correlating with seizures. The use of responsive stimulation has found to be effective for seizure reduction. Some patient's are able to achieve complete seizure freedom with responsive and non-responsive neurostimulation.

Chronic Pain

Neurostimulation for chronic pain is primarily through the use of

spinal cord stimulator A spinal cord stimulator (SCS) or dorsal column stimulator (DCS) is a type of implantable neuromodulation device (sometimes called a "pain pacemaker") that is used to send electrical signals to select areas of the spinal cord (dorsal columns) for ...

s. These devices deliver electrical stimulation to different areas of the spine based on where they are implanted. Since 2012, Medtronic has produced spinal cord stimulators with

accelerometer An accelerometer is a tool that measures proper acceleration. Proper acceleration is the acceleration (the rate of change of velocity) of a body in its own instantaneous rest frame; this is different from coordinate acceleration, which is acc ...

s that can predict the patient's position. The device can be programmed to give additional electrical stimulation if the patient is thought to be in a more painful position.

Research

Reponsive neurostimulation is an active area of research with multiple clinical trials underway. Continuous, or ''non-responsive'', neurostimulation has been FDA approved since 2002 with the introduction of deep brain stimulators for Parkinson's disease. As medical technology has improved, so has our understanding of neural networks and their role in human disease. Adding sensing capabilities to these devices has provided new targets to stimulate and feedback into how to more effectively stimulate the brain. At this time, there are clinical trials for reponsive neurostimulation devices in the treatment of