Supporting clinical decision making during deep brain stimulation surgery by means of a stochastic dynamical model

Abstract

The suggested comprehensive method exhibits remarkable performance in automatically determining both the acceptable MER trajectories and the optimal stimulation sites, thereby having the potential to accelerate precise target finalization during DBS surgery for PD.

Modeling sequence and quasi-uniform assumption in computational neurostimulation

“…Developing computational neurostimulation models requires the right balance of detailed multiscale model with appropriate reductionism (Douglas et al, 2015;Frohlich et al, 2015;Holt and Netoff, 2014;Karamintziou et al, 2014;Mina et al, 2013;Modolo et al, 2011;Shukla et al, 2014). This review attempts to present the modeling process as tractable, even when dealing with unknowns, including serializing modeling steps and applying the quasi-uniform assumption where relevant.…”

Design of a novel closed-loop deep brain stimulation system for Parkinson's disease and obsessive-compulsive disorder

“…Informed consent was provided by each patient. Stereotactic surgery and patients" clinical characteristics have been described in detail elsewhere [13]. A commercially available MER system (Leadpoint TM Neural Activity Monitoring System, Medtronic Inc., Minneapolis, MN) was used intraoperatively for data acquisition.…”

“…For signals recorded at sites lying within the intraoperatively confirmed borders of the STN, we proceed to the assessment of three-scale neuronal activity using Matlab (Mathworks, Natick, MA): (a) spiking activity of one or just a few large isolated cells quantified through the spike detection process, (b) sub-noise level spiking activity of the surrounding neural population extracted based on the background unit activity extraction process, and (c) activity of large neural populations quantified through the LFPs [13].…”

“…1), in light of evidence that disruption of neural synchronization in this nucleus may be related to the therapeutic mechanism of action of stimulation [10,11]. The system operates according to an online real-time algorithm that integrates a sensitive biomarker approach, the 0-1 test for chaos [12], and an improved modification of a stochastic dynamical phase model [13]. Principally, the 0-1 test for chaos is a binary test for definitely distinguishing chaotic from regular dynamics in deterministic dynamical systems, and may therefore be superior to the "dubious" LFP beta power as a neurophysiological biomarker of the pathological state.…”

“…Herein, we validate the outcome of this test as a control parameter in the proposed closed-loop DBS scheme and its potential to support "on-demand" stimulation. In case of a null outcome, optimal stimulation patterns may be determined on grounds of the stochastic phase model [13] and an appropriately designed cost function for minimum energy desynchronization of the pathologic neuronal activity. Preliminary results are obtained on the basis of microelectrode recordings (MERs) acquired during 8 and 2 DBS surgical interventions for PD and OCD, respectively [13,14].…”