# Algorithms for programming DBS systems for Essential Tremor

> **NIH NIH R01** · UNIVERSITY OF MINNESOTA · 2021 · $542,822

## Abstract

PROJECT SUMMARY AND ABSTRACT
Essential tremor (ET) is the most common movement disorder in the United States, affecting 4% of all adults
over the age of 40. For individuals whose motor symptoms are refractory to medication and significantly impair
their daily living, deep brain stimulation (DBS) is considered to be the only bilateral therapeutic option. Despite
recent advances in DBS technology, a significant portion of ET patients with DBS implants will receive
inadequate tremor control because of poorly placed DBS leads, while others will lose efficacy of the therapy
after 1-2 years due in part to inflexible neurostimulator programming options. There is a strong and growing
clinical need for implantable DBS lead designs and programming algorithms that can enable clinicians to better
sculpt electric fields within the brain, especially in cases where stimulation through a poorly placed DBS lead
results in low-threshold side-effects. Our proposed study will integrate high-field magnetic resonance imaging,
histological neurotracing of fiber pathways, computational modeling of DBS, and single-cell electrophysiology
methods to further develop and experimentally-validate a novel semi-automated machine learning algorithm
that facilitates hypothesis-driven determination of subject-specific neurostimulator settings through directional
DBS leads. Specifically, we will: 1) identify the neural pathways involved in the reduction of action and postural
tremor using directional DBS leads and a novel particle swarm optimization algorithm based on subject-specific
anatomy; 2) quantify how tremor-related information is modulated on the single-cell, population, and network
levels by therapeutic DBS in a preclinical large-animal model of harmline-induced tremor; and 3) investigate
how therapeutic windows (i.e. the threshold difference between postural and action tremor abolishment and
side effect emergence) change over time with human DBS therapy targeting one or more pathways within the
cerebello-thalamoc-cortical network. Together, this project will (a) experimentally evaluate and translate a
novel DBS programming algorithm to human ET patients, (b) provide a much more detailed map of the neural
pathways underlying the therapeutic effects of DBS (on postural and action tremor) and side effects of DBS (on
dysarthria, paresthesia, ataxia), (c) rigorously investigate how DBS for treating tremor works mechanistically at
the single cell and network levels within the brain, and (d) probe the neural pathways involved in the worsening
of tremor symptoms for ET patients over time.

## Key facts

- **NIH application ID:** 10246791
- **Project number:** 5R01NS081118-07
- **Recipient organization:** UNIVERSITY OF MINNESOTA
- **Principal Investigator:** NOAM HAREL
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $542,822
- **Award type:** 5
- **Project period:** 2012-09-30 → 2024-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10246791

## Citation

> US National Institutes of Health, RePORTER application 10246791, Algorithms for programming DBS systems for Essential Tremor (5R01NS081118-07). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10246791. Licensed CC0.

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