# Dual Lead Thalamic DBR-DBS Interface for Closed Loop Control of Severe Essential Tremor

> **NIH NIH UH3** · UNIVERSITY OF FLORIDA · 2023 · $777,159

## Abstract

Project Abstract
 Essential Tremor (ET) is a progressive disease that leads to significant disability and
markedly diminished quality of life. Deep brain stimulation (DBS) in the ventralis intermedius
(VIM) thalamus has been an effective treatment for ET control, but is associated with
problematic side effects (e.g. dysarthia, imbalance) and may lose efficacy over time in people
with severe ET. The ability to improve tremor control and reduce side effects with multifocal,
current steering DBS techniques will be an important advance to the field. Furthermore, the
ability to concurrently perform Deep Brain Recording (DBR) during DBS is of critical importance
for characterizing both the pathologic neural circuitry of tremor and network mechanisms of DBS.
 We seek to restore optimal tremor control to subjects with refractory ET by replacing a failing
single lead VIM thalamic DBS system with a dual lead (VIM + Ventralis Oralis (VOP)) thalamic
DBS system in patients seeking revision surgery. The dual lead system will not only offer an
effective rescue strategy for patients with severe tremor (open loop) and failure of standard VIM
DBS, but the optional use of a DBR-capable system will also afford us an unprecedented
opportunity to explore closed loop, on-demand, patient-specific tremor control. We propose to
conduct this clinical feasibility study in 10 human subjects. Our specific aims are:
Aim 1: Evaluate the efficacy and safety of dual lead thalamic DBS for treatment of severe
essential tremor that has failed standard VIM DBS;
Aim 2: Identify neurophysiologic markers of action tremor using a dual lead DBS/DBR
system
Aim 3: Develop neural decoding and control strategies for closed loop dual lead
stimulation
 The proposal addresses what are arguably some of the most important limitations of
currently available treatment for severe ET patients. We have assembled a highly experienced
team of investigators and established an exclusive industrial partnership with Medtronic to fulfill
the goals of this project. The proposed plan is driven by solid neuroscience and engineering
principles that may have overarching impact on clinical applications of DBS technology for years
to come.

## Key facts

- **NIH application ID:** 10468601
- **Project number:** 5UH3NS109845-03
- **Recipient organization:** UNIVERSITY OF FLORIDA
- **Principal Investigator:** Kelly D Foote
- **Activity code:** UH3 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2023
- **Award amount:** $777,159
- **Award type:** 5
- **Project period:** 2019-09-30 → 2026-03-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10468601

## Citation

> US National Institutes of Health, RePORTER application 10468601, Dual Lead Thalamic DBR-DBS Interface for Closed Loop Control of Severe Essential Tremor (5UH3NS109845-03). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10468601. Licensed CC0.

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