Toronto, ON M5S 1A4
Temporal Pattern of Stimulation as a New Dimension of Therapeutic Innovation
Warren M. Grill, Professor of Biomedical Engineering, Duke University
IBBME Research Theme
Neural, Sensory Systems & Rehabilitation
Electrical stimulation for treatment of neurological disorders, diseases, or injuries has relied on controlling the effects of stimulation through selection of stimulation amplitude, pulse duration, and pulse repetition frequency.
I introduce a new parameter dimension—the temporal pattern of stimulation—and demonstrate how model-based design of temporal patterns of stimulation increases the efficacy and energy efficiency of neural stimulation therapies.
Our finding that the effects of deep brain stimulation (DBS) were dependent on the temporal pattern of stimulation [Dorval et al. 2010], in addition to the frequency of stimulation, inspired the design of novel temporal patterns of DBS. Patterns were developed that treat the symptoms of PD more effectively than conventional regularly patterned DBS [Brocker et al. 2013a] or enable equivalent treatment of symptoms but with a substantial reduction in the required energy [Brocker 2013b]. This latter innovation is an important consideration for the size, recharge frequency, and battery life of implanted pulse generators.
This concept was then extended to develop novel temporal patterns of epidural spinal cord stimulation for the treatment of chronic pain.
Collectively, the results demonstrate the utility of a new dimension of neural stimulation parameters—the timing between stimulation pulses—to increase the efficacy and efficiency of neural stimulation therapies.
Collaborators on our work on deep brain stimulation include David Brocker, Chuck Dorval, Brandon Swan, and Dennis Turner at Duke University, Robert Gross at Emory University, and Stephen Tatter at Wake Forest Baptist Medical Center, and this work is supported by NIH grant R37 NS040894. Collaborators on our work on spinal cord stimulation include Tianhe Zhang, Nate Crosby, and Leonel Medina at Duke, and John Janik at Stryker Inc, and this work is supported by grants from Stryker Inc.
Warren M. Grill is Professor of Biomedical Engineering at Duke University, with secondary appointments in Electrical and Computer Engineering, Neurobiology, and Surgery. Dr. Grill received the B.S. degree in biomedical engineering in 1989 from Boston University and the Ph.D. in biomedical engineering in 1995 from Case Western Reserve University, Cleveland, OH.
Professor Grill teaches courses on circuits and instrumentation, bioelectricity, and on the fundamentals and applications of electrical stimulation. In 2008 he received the Capers & Marion McDonald Award for Excellence in Teaching and Research at Duke University, in 2013 was awarded Outstanding Postdoc Mentor at Duke University, and in 2014 received the University Scholar/Teacher of the Year Award at Duke.
His research interests are in neural engineering and neuromodulation and include design and testing of electrodes and stimulation techniques, the electrical properties of tissues and cells, and computational neuroscience with applications to restoration of bladder function, treatment of movement disorders with deep brain stimulation, and electrical stimulation for treatment of pain. He has published over 160 peer reviewed journal articles and has been awarded 29 US patents.
He is Co-Founder, Director, and Chief Scientific Officer of NDI Medical, a medical device incubator, Director and Chief Scientific Advisor at SPR Therapeutics, which has developed a novel therapy for treating pain, and Co-Founder, Director, and Chief Scientific Officer of DBI, which is commercializing a novel approach to brain stimulation for neurological disorders. In addition, he provides technical consulting to both small and large neurological device companies.
Dr. Grill serves as a Consultant to the Neurological Devices Panel of the FDA Medical Devices Advisory Committee, a member of the Department of Veterans Affairs Secretary’s Advisory Committee on Prosthetics and Special-Disabilities Program, and on the editorial boards of Brain Stimulation and Journal of Neural Engineering. He was elected as a Fellow of the American Institute of Medical and Biological Engineering in 2007, elected as a Fellow of the Biomedical Engineering Society in 2011, and was awarded a Javits Neuroscience Investigator Award by NIH-NINDS in 2015.