Neurophysiological Biomarkers to Optimize Deep Brain Stimulation in Movement Disorders

Sirica, Daniel; Hewitt, Angela; Tarolli, Christopher G.; Weber, Miriam; Zimmerman, Carol; Santiago, Aida; Wensel, A.; Mink, Jonathan W.; Lizárraga, Karlo J.

doi:10.2217/nmt-2021-0002

Cited by 19 publications

(12 citation statements)

References 103 publications

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“…Additional Percept TM PC studies confirm the presence of LFP signals of interest in other approved DBS indications, including generalized dystonia, ET and epilepsy (Fasano et al, 2021;Goyal et al, 2021). Further, the emerging implications from these studies and others in progress strongly suggest a role for LFP signals in supporting the objective guidance of DBS therapy programming and titration (Fasano et al, 2021;Sirica et al, 2021). Moreover, several ongoing industry-sponsored trials are evaluating the safety and effectiveness of LFP-beta controlled aDBS in PD.…”

Section: A Role For Local Field Potentials Signals In Supporting the ...mentioning

confidence: 82%

Proceedings of the Ninth Annual Deep Brain Stimulation Think Tank: Advances in Cutting Edge Technologies, Artificial Intelligence, Neuromodulation, Neuroethics, Pain, Interventional Psychiatry, Epilepsy, and Traumatic Brain Injury

Wong

Deuschl

Wolke

et al. 2022

Front. Hum. Neurosci.

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DBS Think Tank IX was held on August 25–27, 2021 in Orlando FL with US based participants largely in person and overseas participants joining by video conferencing technology. The DBS Think Tank was founded in 2012 and provides an open platform where clinicians, engineers and researchers (from industry and academia) can freely discuss current and emerging deep brain stimulation (DBS) technologies as well as the logistical and ethical issues facing the field. The consensus among the DBS Think Tank IX speakers was that DBS expanded in its scope and has been applied to multiple brain disorders in an effort to modulate neural circuitry. After collectively sharing our experiences, it was estimated that globally more than 230,000 DBS devices have been implanted for neurological and neuropsychiatric disorders. As such, this year’s meeting was focused on advances in the following areas: neuromodulation in Europe, Asia and Australia; cutting-edge technologies, neuroethics, interventional psychiatry, adaptive DBS, neuromodulation for pain, network neuromodulation for epilepsy and neuromodulation for traumatic brain injury.

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Section: A Role For Local Field Potentials Signals In Supporting the ...mentioning

confidence: 82%

Proceedings of the Ninth Annual Deep Brain Stimulation Think Tank: Advances in Cutting Edge Technologies, Artificial Intelligence, Neuromodulation, Neuroethics, Pain, Interventional Psychiatry, Epilepsy, and Traumatic Brain Injury

Wong

Deuschl

Wolke

et al. 2022

Front. Hum. Neurosci.

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“…Delivering bilateral STN-DBS in a lateralized or alternating fashion might prevent stimulation-induced axial dysfunction in these patients. Recent and future advances in DBS, including directional and adaptive stimulation based on electrophysiological and imaging data, 37,40 could facilitate implementation of this approach.…”

Section: Discussionmentioning

confidence: 99%

Lateralized Subthalamic Stimulation for Axial Dysfunction in Parkinson's Disease: A Randomized Trial

et al. 2022

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Background Patients with Parkinson's disease might develop treatment‐resistant axial dysfunction after bilateral subthalamic stimulation. Objectives To study whether lateralized stimulation (unilateral 50% amplitude reduction) for ≥21 days results in ≥0.13 m/s faster gait velocity in the dopaminergic ON state in these patients, and its effects on motor and axial function, quantitative gait and speech measures, quality of life, and selected cognitive tasks. Methods Randomized, double‐blinded, double‐crossover trial. Results In 22 participants (51–79 years old, 15 women), there were no significant changes in gait velocity, quality of life, cognitive, and speech measures. Reducing left‐sided amplitude resulted in a 2.5‐point improvement in axial motor Movement Disorder Society Unified Parkinson's Disease Rating Scale (MDS‐UPDRS) (P = 0.005, uncorrected) and a 1.9‐point improvement in the Freezing of Gait Questionnaire (P = 0.024, uncorrected). Conclusions Lateralized subthalamic stimulation does not result in meaningful improvement in gait velocity in patients with Parkinson's disease who develop treatment‐resistant axial dysfunction after bilateral subthalamic stimulation. Left subthalamic overstimulation may contribute to axial deterioration in these patients. © 2022 International Parkinson and Movement Disorder Society

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“…MER has been implemented to optimize the target location for the implantation of DBS electrodes 36, 37 , as well as the stimulation parameters (frequency, amplitude, pulse width) 38, 39 . The neuronal firing rate – including both single-unit and mean firing rate – is an important quantifying standard regarding using MER to identify the proper DBS setting and anatomical site 16, 36, 39, 40 . Following the investigation and localization with MER, macroelectrode is then often implanted to deliver long-time DBS therapy 37, 41 .…”

Section: Methodsmentioning

confidence: 99%

Modelling Instantaneous Firing Rate of DBS Target Neuronal Ensembles in Basal Ganglia and Thalamus

Tian

Murphy

Steiner

et al. 2022

Preprint

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Parkinson's disease (PD) is the second most common neurodegenerative disorder symptom, and is closely related to the dysfunction of the basal ganglia-thalamocortical network. Deep Brain Stimulation (DBS) is an effective treatment for suppressing PD motor symptoms; however, the underlying mechanisms of DBS remain elusive. A recent study demonstrated that different substructures of the basal ganglia and thalamus respond differently to various frequencies of DBS. Despite the capability of existing models in qualitatively interpreting experimental data, there are very few unified computational models that quantitatively capture the dynamics of the neuronal activity of varying stimulated substructures - including subthalamic nucleus (STN), substantia nigra pars reticulate (SNr) and ventralis intermedius (Vim) - across different DBS frequencies. Here, we developed a novel mathematical model to represent the firing rate of nuclei receiving DBS (microstimulation), including STN, SNr and Vim - across different DBS frequencies. In our model, the DBS pulses are filtered through a synapse model and a transfer function to formulate the firing rate variability. To consistently fit the model in varying frequencies of DBS, we developed a novel parameter optimization method based on the concatenated data from all DBS frequencies. Our model accurately reproduces the firing rates observed and calculated from both experimental and synthetic data. The optimal model parameters are consistent across different DBS frequencies, and this consistency conforms to the relatively static synaptic structures in short durations of DBS. Our model can be potentially implemented in navigating the DBS parameter space and improves DBS clinical effects.

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Neurophysiological Biomarkers to Optimize Deep Brain Stimulation in Movement Disorders

Cited by 19 publications

References 103 publications

Proceedings of the Ninth Annual Deep Brain Stimulation Think Tank: Advances in Cutting Edge Technologies, Artificial Intelligence, Neuromodulation, Neuroethics, Pain, Interventional Psychiatry, Epilepsy, and Traumatic Brain Injury

Proceedings of the Ninth Annual Deep Brain Stimulation Think Tank: Advances in Cutting Edge Technologies, Artificial Intelligence, Neuromodulation, Neuroethics, Pain, Interventional Psychiatry, Epilepsy, and Traumatic Brain Injury

Lateralized Subthalamic Stimulation for Axial Dysfunction in Parkinson's Disease: A Randomized Trial

Modelling Instantaneous Firing Rate of DBS Target Neuronal Ensembles in Basal Ganglia and Thalamus

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