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Chao-Chia Lu D, Boulay C, Chan ADC, Sachs AJ. A Systematic Review of Neurophysiology-Based Localization Techniques Used in Deep Brain Stimulation Surgery of the Subthalamic Nucleus. Neuromodulation 2024; 27:409-421. [PMID: 37462595 DOI: 10.1016/j.neurom.2023.02.081] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2022] [Revised: 01/13/2023] [Accepted: 02/09/2023] [Indexed: 04/05/2024]
Abstract
OBJECTIVE This systematic review is conducted to identify, compare, and analyze neurophysiological feature selection, extraction, and classification to provide a comprehensive reference on neurophysiology-based subthalamic nucleus (STN) localization. MATERIALS AND METHODS The review was carried out using the methods and guidelines of the Kitchenham systematic review and provides an in-depth analysis on methods proposed on STN localization discussed in the literature between 2000 and 2021. Three research questions were formulated, and 115 publications were identified to answer the questions. RESULTS The three research questions formulated are answered using the literature found on the respective topics. This review discussed the technologies used in past research, and the performance of the state-of-the-art techniques is also reviewed. CONCLUSION This systematic review provides a comprehensive reference on neurophysiology-based STN localization by reviewing the research questions other new researchers may also have.
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Affiliation(s)
| | | | | | - Adam J Sachs
- The Ottawa Hospital Research Institute, Ottawa, ON, Canada
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2
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Mirzai N, Polet K, Morisot A, Hesse S, Pesce A, Louchart de la Chapelle S, Iakimova G. Can the Ability to Recognize Facial Emotions in Individuals With Neurodegenerative Disease be Improved? A Systematic Review and Meta-analysis. Cogn Behav Neurol 2023; 36:202-218. [PMID: 37410880 PMCID: PMC10683976 DOI: 10.1097/wnn.0000000000000348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Accepted: 03/30/2023] [Indexed: 07/08/2023]
Abstract
BACKGROUND Facial emotion recognition (FER) is commonly impaired in individuals with neurodegenerative disease (NDD). This impairment has been linked to an increase in behavioral disorders and caregiver burden. OBJECTIVE To identify interventions targeting the improvement of FER ability in individuals with NDD and investigate the magnitude of the efficacy of the interventions. We also wanted to explore the duration of the effects of the intervention and their possible impacts on behavioral and psychological symptoms of dementia and caregiver burden. METHOD We included 15 studies with 604 individuals who had been diagnosed with NDD. The identified interventions were categorized into three types of approach (cognitive, neurostimulation, and pharmacological) as well as a combined approach (neurostimulation with pharmacological). RESULTS The three types of approaches pooled together had a significant large effect size for FER ability improvement (standard mean difference: 1.21, 95% CI = 0.11, 2.31, z = 2.15, P = 0.03). The improvement lasted post intervention, in tandem with a decrease in behavioral disorders and caregiver burden. CONCLUSION A combination of different approaches for FER ability improvement may be beneficial for individuals with NDD and their caregivers.
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Affiliation(s)
- Naz Mirzai
- Clinical Research Unit–Memory Clinic, Princess Grace Hospital, Monaco
- Cote d’Azur University, Laboratory of Clinical, Cognitive and Social Anthropology and Psychology, Nice, France
| | - Kévin Polet
- Clinical Research Unit–Memory Clinic, Princess Grace Hospital, Monaco
| | - Adeline Morisot
- Clinical Research Unit–Memory Clinic, Princess Grace Hospital, Monaco
- Public Health Department, Cote d’Azur University, University Hospital Center of Nice, Nice, France
| | - Solange Hesse
- Clinical Research Unit–Memory Clinic, Princess Grace Hospital, Monaco
| | - Alain Pesce
- Bibliographic Research Association for Neurosciences, Nice, France
| | | | - Galina Iakimova
- Cote d’Azur University, Laboratory of Clinical, Cognitive and Social Anthropology and Psychology, Nice, France
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3
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Effects of Contralateral Deep Brain Stimulation and Levodopa on Subthalamic Nucleus Oscillatory Activity and Phase-Amplitude Coupling. Neuromodulation 2023; 26:310-319. [PMID: 36513587 DOI: 10.1016/j.neurom.2022.11.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 10/14/2022] [Accepted: 11/07/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND The modulatory effects of medication and deep brain stimulation (DBS) on subthalamic nucleus (STN) neural activity in Parkinson's disease have been widely studied. However, effects on the contralateral side to the stimulated STN, in particular, changes in local field potential (LFP) oscillatory activity and phase-amplitude coupling (PAC), have not yet been reported. OBJECTIVE The aim of this study was to examine changes in STN LFP activity across a range of frequency bands and STN PAC for different combinations of DBS and medication on/off on the side contralateral to the applied stimulation. MATERIALS AND METHODS We examined STN LFPs that were recorded using externalized leads from eight parkinsonian patients during unilateral DBS from the side contralateral to the stimulation. LFP spectral power in alpha (5 to ∼13 Hz), low beta (13 to ∼20 Hz), high beta (20-30 Hz), and high gamma plus high-frequency oscillation (high gamma+HFO) (100-400 Hz) bands were estimated for different combinations of medication and unilateral stimulation (off/on). PAC between beta and high gamma+HFO in the STN LFPs was also investigated. The effect of the condition was examined using linear mixed models. RESULTS PAC in the STN LFP was reduced by DBS when compared to the baseline condition (no medication and stimulation). Medication had no significant effect on PAC. Alpha power decreased with DBS, both alone and when combined with medication. Beta power decreased with DBS, medication, and DBS and medication combined. High gamma+HFO power increased during the application of contralateral DBS and was unaltered by medication. CONCLUSIONS The results provide new insights into the effects of DBS and levodopa on STN LFP PAC and oscillatory activity on the side contralateral to stimulation. These may have important implications in understanding mechanisms underlying motor improvements with DBS, including changes on both contralateral and ipsilateral sides, while suggesting a possible role for contralateral sensing during unilateral DBS.
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4
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Guidetti M, Arlotti M, Bocci T, Bianchi AM, Parazzini M, Ferrucci R, Priori A. Electric Fields Induced in the Brain by Transcranial Electric Stimulation: A Review of In Vivo Recordings. Biomedicines 2022; 10:biomedicines10102333. [PMID: 36289595 PMCID: PMC9598743 DOI: 10.3390/biomedicines10102333] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Revised: 09/10/2022] [Accepted: 09/14/2022] [Indexed: 01/12/2023] Open
Abstract
Transcranial electrical stimulation (tES) techniques, such as direct current stimulation (tDCS) and transcranial alternating current stimulation (tACS), cause neurophysiological and behavioral modifications as responses to the electric field are induced in the brain. Estimations of such electric fields are based mainly on computational studies, and in vivo measurements have been used to expand the current knowledge. Here, we review the current tDCS- and tACS-induced electric fields estimations as they are recorded in humans and non-human primates using intracerebral electrodes. Direct currents and alternating currents were applied with heterogeneous protocols, and the recording procedures were characterized by a tentative methodology. However, for the clinical stimulation protocols, an injected current seems to reach the brain, even at deep structures. The stimulation parameters (e.g., intensity, frequency and phase), the electrodes’ positions and personal anatomy determine whether the intensities might be high enough to affect both neuronal and non-neuronal cell activity, also deep brain structures.
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Affiliation(s)
- Matteo Guidetti
- Aldo Ravelli Research Center for Neurotechnology and Experimental Neurotherapeutics, Department of Health Sciences, University of Milan, Via Antonio di Rudinì 8, 20142 Milan, Italy
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, Piazza Leonardo da Vinci 32, 20133 Milan, Italy
| | | | - Tommaso Bocci
- Aldo Ravelli Research Center for Neurotechnology and Experimental Neurotherapeutics, Department of Health Sciences, University of Milan, Via Antonio di Rudinì 8, 20142 Milan, Italy
- III Neurology Clinic, ASST-Santi Paolo e Carlo University Hospital, 20142 Milan, Italy
| | - Anna Maria Bianchi
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, Piazza Leonardo da Vinci 32, 20133 Milan, Italy
| | - Marta Parazzini
- Istituto di Elettronica e di Ingegneria dell’Informazione e delle Telecomunicazioni (IEIIT), Consiglio Nazionale delle Ricerche (CNR), 20133 Milan, Italy
| | - Roberta Ferrucci
- Aldo Ravelli Research Center for Neurotechnology and Experimental Neurotherapeutics, Department of Health Sciences, University of Milan, Via Antonio di Rudinì 8, 20142 Milan, Italy
- III Neurology Clinic, ASST-Santi Paolo e Carlo University Hospital, 20142 Milan, Italy
| | - Alberto Priori
- Aldo Ravelli Research Center for Neurotechnology and Experimental Neurotherapeutics, Department of Health Sciences, University of Milan, Via Antonio di Rudinì 8, 20142 Milan, Italy
- III Neurology Clinic, ASST-Santi Paolo e Carlo University Hospital, 20142 Milan, Italy
- Correspondence:
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5
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Nwogo RO, Kammermeier S, Singh A. Abnormal neural oscillations during gait and dual-task in Parkinson’s disease. Front Syst Neurosci 2022; 16:995375. [PMID: 36185822 PMCID: PMC9522469 DOI: 10.3389/fnsys.2022.995375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Accepted: 08/23/2022] [Indexed: 12/03/2022] Open
Abstract
Gait dysfunctions are debilitating motor symptoms of Parkinson’s disease (PD) and may result in frequent falling with health complications. The contribution of the motor-cognitive network to gait disturbance can be studied more thoroughly by challenging motor-cognitive dual-task gait performances. Gait is a complex motor task that requires an appropriate contribution from motor and cognitive networks, reflected in frequency modulations among several cortical and subcortical networks. Electrophysiological recordings by scalp electroencephalography and implanted deep brain stimulation (DBS) electrodes have unveiled modulations of specific oscillatory patterns in the cortical-subcortical circuits in PD. In this review, we summarize oscillatory contributions of the cortical, basal ganglia, mesencephalic locomotor, and cerebellar regions during gait and dual-task activities in PD. We detail the involvement of the cognitive network in dual-task settings and compare how abnormal oscillations in the specific frequency bands in the cortical and subcortical regions correlate with gait deficits in PD, particularly freezing of gait (FOG). We suggest that altered neural oscillations in different frequencies can cause derangements in broader brain networks, so neuromodulation and pharmacological therapies should be considered to normalize those network oscillations to improve challenged gait and dual-task motor functions in PD. Specifically, the theta and beta bands in premotor cortical areas, subthalamic nucleus, as well as alpha band activity in the brainstem prepontine nucleus, modulate under clinically effective levodopa and DBS therapies, improving gait and dual-task performance in PD with FOG, compared to PD without FOG and age-matched healthy control groups.
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Affiliation(s)
- Rachel O. Nwogo
- Division of Basic Biomedical Sciences, Sanford School of Medicine, University of South Dakota, Vermillion, SD, United States
| | | | - Arun Singh
- Division of Basic Biomedical Sciences, Sanford School of Medicine, University of South Dakota, Vermillion, SD, United States
- *Correspondence: Arun Singh,
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6
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Lee LHN, Huang CS, Wang RW, Lai HJ, Chung CC, Yang YC, Kuo CC. Deep brain stimulation rectifies the noisy cortex and irresponsive subthalamus to improve parkinsonian locomotor activities. NPJ Parkinsons Dis 2022; 8:77. [PMID: 35725730 PMCID: PMC9209473 DOI: 10.1038/s41531-022-00343-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Accepted: 05/31/2022] [Indexed: 11/10/2022] Open
Abstract
The success of deep brain stimulation (DBS) therapy indicates that Parkinson's disease is a brain rhythm disorder. However, the manifestations of the erroneous rhythms corrected by DBS remain to be established. We found that augmentation of α rhythms and α coherence between the motor cortex (MC) and the subthalamic nucleus (STN) is characteristically prokinetic and is decreased in parkinsonian rats. In multi-unit recordings, movement is normally associated with increased changes in spatiotemporal activities rather than overall spike rates in MC. In parkinsonian rats, MC shows higher spike rates at rest but less spatiotemporal activity changes upon movement, and STN burst discharges are more prevalent, longer lasting, and less responsive to MC inputs. DBS at STN rectifies the foregoing pathological MC-STN oscillations and consequently locomotor deficits, yet overstimulation may cause behavioral restlessness. These results indicate that delicate electrophysiological considerations at both cortical and subcortical levels should be exercised for optimal DBS therapy.
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Affiliation(s)
- Lan-Hsin Nancy Lee
- Department of Physiology, National Taiwan University College of Medicine, Taipei, Taiwan.,Department of Neurology, Fu Jen Catholic University Hospital, New Taipei, Taiwan.,Department of Neurology, National Taiwan University Hospital, Taipei, Taiwan
| | - Chen-Syuan Huang
- Graduate Institute of Biomedical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Ren-Wei Wang
- Department of Physiology, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Hsing-Jung Lai
- Department of Physiology, National Taiwan University College of Medicine, Taipei, Taiwan.,Department of Neurology, National Taiwan University Hospital, Taipei, Taiwan.,National Taiwan University Hospital, Jin-Shan Branch, New Taipei, Taiwan
| | - Chih-Ching Chung
- Department of Biomedical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Ya-Chin Yang
- Graduate Institute of Biomedical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan. .,Department of Biomedical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan. .,Neuroscience Research Center, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, Taiwan. .,Department of Psychiatry, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, Taiwan.
| | - Chung-Chin Kuo
- Department of Physiology, National Taiwan University College of Medicine, Taipei, Taiwan. .,Department of Neurology, National Taiwan University Hospital, Taipei, Taiwan.
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7
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Arlotti M, Colombo M, Bonfanti A, Mandat T, Lanotte MM, Pirola E, Borellini L, Rampini P, Eleopra R, Rinaldo S, Romito L, Janssen MLF, Priori A, Marceglia S. A New Implantable Closed-Loop Clinical Neural Interface: First Application in Parkinson's Disease. Front Neurosci 2021; 15:763235. [PMID: 34949982 PMCID: PMC8689059 DOI: 10.3389/fnins.2021.763235] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Accepted: 11/04/2021] [Indexed: 11/13/2022] Open
Abstract
Deep brain stimulation (DBS) is used for the treatment of movement disorders, including Parkinson’s disease, dystonia, and essential tremor, and has shown clinical benefits in other brain disorders. A natural path for the improvement of this technique is to continuously observe the stimulation effects on patient symptoms and neurophysiological markers. This requires the evolution of conventional deep brain stimulators to bidirectional interfaces, able to record, process, store, and wirelessly communicate neural signals in a robust and reliable fashion. Here, we present the architecture, design, and first use of an implantable stimulation and sensing interface (AlphaDBSR System) characterized by artifact-free recording and distributed data management protocols. Its application in three patients with Parkinson’s disease (clinical trial n. NCT04681534) is shown as a proof of functioning of a clinically viable implanted brain-computer interface (BCI) for adaptive DBS. Reliable artifact free-recordings, and chronic long-term data and neural signal management are in place.
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Affiliation(s)
| | | | - Andrea Bonfanti
- Newronika SpA, Milan, Italy.,Dipartimento di Elettronica, Informazione e Bioingegneria, Politecnico di Milano, Milan, Italy
| | - Tomasz Mandat
- Narodowy Instytut Onkologii im. Marii Skłodowskiej-Curie, Warsaw, Poland
| | - Michele Maria Lanotte
- Department of Neuroscience, University of Torino, Torino, Italy.,AOU Città della Salute e della Scienza, Molinette Hospital, Turin, Italy
| | - Elena Pirola
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Linda Borellini
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Paolo Rampini
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Roberto Eleopra
- Movement Disorders Unit, Department of Clinical Neurosciences, Fondazione IRCCS Istituto Neurologico C. Besta, Milan, Italy
| | - Sara Rinaldo
- Movement Disorders Unit, Department of Clinical Neurosciences, Fondazione IRCCS Istituto Neurologico C. Besta, Milan, Italy
| | - Luigi Romito
- Movement Disorders Unit, Department of Clinical Neurosciences, Fondazione IRCCS Istituto Neurologico C. Besta, Milan, Italy
| | - Marcus L F Janssen
- Department of Neurology and Clinical Neurophysiology, Maastricht University Medical Center, Maastricht, Netherlands.,Faculty of Health, Medicine and Life Sciences, School for Mental Health and Neuroscience, Maastricht University, Maastricht, Netherlands
| | - Alberto Priori
- Department of Health Sciences, Aldo Ravelli Research Center for Neurotechnology and Experimental Neurotherapeutics, University of Milan, Milan, Italy
| | - Sara Marceglia
- Dipartimento di Ingegneria e Architettura, Università degli Studi di Trieste, Trieste, Italy
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8
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Lee LHN, Huang CS, Chuang HH, Lai HJ, Yang CK, Yang YC, Kuo CC. An electrophysiological perspective on Parkinson's disease: symptomatic pathogenesis and therapeutic approaches. J Biomed Sci 2021; 28:85. [PMID: 34886870 PMCID: PMC8656091 DOI: 10.1186/s12929-021-00781-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Accepted: 11/29/2021] [Indexed: 12/16/2022] Open
Abstract
Parkinson's disease (PD), or paralysis agitans, is a common neurodegenerative disease characterized by dopaminergic deprivation in the basal ganglia because of neuronal loss in the substantia nigra pars compacta. Clinically, PD apparently involves both hypokinetic (e.g. akinetic rigidity) and hyperkinetic (e.g. tremor/propulsion) symptoms. The symptomatic pathogenesis, however, has remained elusive. The recent success of deep brain stimulation (DBS) therapy applied to the subthalamic nucleus (STN) or the globus pallidus pars internus indicates that there are essential electrophysiological abnormalities in PD. Consistently, dopamine-deprived STN shows excessive burst discharges. This proves to be a central pathophysiological element causally linked to the locomotor deficits in PD, as maneuvers (such as DBS of different polarities) decreasing and increasing STN burst discharges would decrease and increase the locomotor deficits, respectively. STN bursts are not so autonomous but show a "relay" feature, requiring glutamatergic synaptic inputs from the motor cortex (MC) to develop. In PD, there is an increase in overall MC activities and the corticosubthalamic input is enhanced and contributory to excessive burst discharges in STN. The increase in MC activities may be relevant to the enhanced beta power in local field potentials (LFP) as well as the deranged motor programming at the cortical level in PD. Moreover, MC could not only drive erroneous STN bursts, but also be driven by STN discharges at specific LFP frequencies (~ 4 to 6 Hz) to produce coherent tremulous muscle contractions. In essence, PD may be viewed as a disorder with deranged rhythms in the cortico-subcortical re-entrant loops, manifestly including STN, the major component of the oscillating core, and MC, the origin of the final common descending motor pathways. The configurations of the deranged rhythms may play a determinant role in the symptomatic pathogenesis of PD, and provide insight into the mechanism underlying normal motor control. Therapeutic brain stimulation for PD and relevant disorders should be adaptively exercised with in-depth pathophysiological considerations for each individual patient, and aim at a final normalization of cortical discharge patterns for the best ameliorating effect on the locomotor and even non-motor symptoms.
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Affiliation(s)
- Lan-Hsin Nancy Lee
- Department of Physiology, National Taiwan University College of Medicine, 1 Jen-Ai Road, 1st Section, Taipei, 100, Taiwan.,Department of Neurology, Fu Jen Catholic University Hospital, New Taipei, Taiwan.,Department of Neurology, National Taiwan University Hospital, Taipei, Taiwan
| | - Chen-Syuan Huang
- Graduate Institute of Biomedical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Hsiang-Hao Chuang
- Graduate Institute of Biomedical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Hsing-Jung Lai
- Department of Physiology, National Taiwan University College of Medicine, 1 Jen-Ai Road, 1st Section, Taipei, 100, Taiwan.,Department of Neurology, National Taiwan University Hospital, Taipei, Taiwan.,National Taiwan University Hospital, Jin-Shan Branch, New Taipei, Taiwan
| | - Cheng-Kai Yang
- Department of Biomedical Sciences, College of Medicine, Chang Gung University, 259 Wen-Hwa 1st Road, Kwei-Shan, Taoyuan, 333, Taiwan
| | - Ya-Chin Yang
- Graduate Institute of Biomedical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan. .,Department of Biomedical Sciences, College of Medicine, Chang Gung University, 259 Wen-Hwa 1st Road, Kwei-Shan, Taoyuan, 333, Taiwan. .,Neuroscience Research Center, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, Taiwan.
| | - Chung-Chin Kuo
- Department of Physiology, National Taiwan University College of Medicine, 1 Jen-Ai Road, 1st Section, Taipei, 100, Taiwan. .,Department of Neurology, National Taiwan University Hospital, Taipei, Taiwan.
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9
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Ahmadipour M, Barkhordari-Yazdi M, Seydnejad SR. Subspace-based predictive control of Parkinson's disease: A model-based study. Neural Netw 2021; 142:680-689. [PMID: 34403908 DOI: 10.1016/j.neunet.2021.07.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Revised: 06/19/2021] [Accepted: 07/21/2021] [Indexed: 10/20/2022]
Abstract
Deep brain stimulation (DBS) of the Basal Ganglia (BG) is an effective treatment to suppress the symptoms of Parkinson's disease (PD). Using a closed-loop scheme in DBS can not only improve its therapeutic effects but it can also reduce its energy consumption and possible side effects. In this paper, a predictive closed loop control strategy is employed to suppress the PD in real-time. A linear multi-input multi-output (MIMO) state-delayed system is considered as a simplified model of the BG neuronal network relating the stimulation signals as inputs to the beta power of local field potentials as PD biomarkers. The effect of time delay in different areas of the BG is incorporated into this model and a real-time subspace-based identification is implemented to continuously model the state of the BG neuronal network and drive the predictive control strategy. Simulation results show that the proposed MIMO subspace based predictive controller can suppress PD symptoms more effectively and with less power consumption compared to the conventional open-loop DBS and a recently proposed single-input single-output closed loop controller.
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Affiliation(s)
- Mahboubeh Ahmadipour
- Department of Electrical Engineering, Faculty of Engineering, Shahid Bahonar University of Kerman, Kerman, Iran.
| | - Mojtaba Barkhordari-Yazdi
- Department of Electrical Engineering, Faculty of Engineering, Shahid Bahonar University of Kerman, Kerman, Iran.
| | - Saeid R Seydnejad
- Department of Electrical Engineering, Faculty of Engineering, Shahid Bahonar University of Kerman, Kerman, Iran.
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10
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Marceglia S, Prenassi M, Galbiati TF, Porta M, Zekaj E, Priori A, Servello D. Thalamic Local Field Potentials Are Related to Long-Term DBS Effects in Tourette Syndrome. Front Neurol 2021; 12:578324. [PMID: 33658970 PMCID: PMC7917178 DOI: 10.3389/fneur.2021.578324] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Accepted: 01/07/2021] [Indexed: 12/13/2022] Open
Abstract
Background: Local field potential (LFP) recordings helped to clarify the pathophysiology of Tourette syndrome (TS) and to define new strategies for deep brain stimulation (DBS) treatment for refractory TS, based on the delivery of stimulation in accordance with changes in the electrical activity of the DBS target area. However, there is little evidence on the relationship between LFP pattern and DBS outcomes in TS. Objective: To investigate the relationship between LFP oscillations and DBS effects on tics and on obsessive compulsive behavior (OCB) comorbidities. Methods: We retrospectively analyzed clinical data and LFP recordings from 17 patients treated with DBS of the centromedian-parafascicular/ventralis oralis (CM-Pf/VO) complex, and followed for more several years after DBS in the treating center. In these patients, LFPs were recorded either in the acute setting (3–5 days after DBS electrode implant) or in the chronic setting (during impulse generator replacement surgery). LFP oscillations were correlated with the Yale Global Tic Severity Scale (YGTSS) and the Yale–Brown Obsessive–Compulsive Scale (Y-BOCS) collected at baseline (before DBS surgery), 1 year after DBS, and at the last follow-up available. Results: We found that, at baseline, in the acute setting, the power of the oscillations included in the 5–15-Hz band, previously identified as TS biomarker, is correlated with the pathophysiology of tics, being significantly correlated with total YGTSS before DBS (Spearman's ρ = 0.701, p = 0.011). The power in the 5–15-Hz band was also correlated with the improvement in Y-BOCS after 1 year of DBS (Spearman's ρ = −0.587, p = 0.045), thus suggesting a relationship with the DBS effects on OCB comorbidities. Conclusions: Our observations confirm that the low-frequency (5–15-Hz) band is a significant biomarker of TS, being related to the severity of tics and, also to the long-term response on OCBs. This represents a step toward both the understanding of the mechanisms underlying DBS effects in TS and the development of adaptive DBS strategies.
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Affiliation(s)
- Sara Marceglia
- Dipartimento di Ingegneria e Architettura, Università degli Studi di Trieste, Trieste, Italy.,Unità Operativa Neurofisiopatologia, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Ca'Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Marco Prenassi
- Dipartimento di Ingegneria e Architettura, Università degli Studi di Trieste, Trieste, Italy.,Unità Operativa Neurofisiopatologia, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Ca'Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Tommaso F Galbiati
- Functional Neurosurgery Unit, Istituto di Ricovero e Cura a Carattere Scientifico Galeazzi Hospital, Milan, Italy
| | - Mauro Porta
- Functional Neurosurgery Unit, Istituto di Ricovero e Cura a Carattere Scientifico Galeazzi Hospital, Milan, Italy
| | - Edvin Zekaj
- Functional Neurosurgery Unit, Istituto di Ricovero e Cura a Carattere Scientifico Galeazzi Hospital, Milan, Italy.,"Aldo Ravelli" Research Center for Neurotechnology and Experimental Brain Therapeutics, University of Milan Medical School, Milan, Italy
| | - Alberto Priori
- "Aldo Ravelli" Research Center for Neurotechnology and Experimental Brain Therapeutics, University of Milan Medical School, Milan, Italy
| | - Domenico Servello
- Functional Neurosurgery Unit, Istituto di Ricovero e Cura a Carattere Scientifico Galeazzi Hospital, Milan, Italy
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11
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Wu YH, Ou-Yang YH, Chen CC, Lee CY, Wu CY, Ker MD. Miniaturized Intracerebral Potential Recorder for Long-Term Local Field Potential of Deep Brain Signals. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2020; 2020:5188-5191. [PMID: 33019154 DOI: 10.1109/embc44109.2020.9175384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
A miniaturized intracerebral potential recorder for long-term local field potential (LFP) of deep brain signals is proposed. LFP can be recorded by deep brain electrodes. The abnormal beta-band oscillation of LFP in subthalamic nucleus and internal globus pallidus in patients with Parkinson's disease (PD) are associated with the severity of the symptoms. The LFP signal from patients who have been implanted with deep brain electrode can be monitored by our system for at least 24 hours in real time. Graphical user interface has also been developed for use by medical personnel. Imitation experiments and in vivo experiments were performed to successfully verify that our system can measure LFP signals. With 24-hour intracerebral signals, researchers can analyze what is happened in the brain in daily life. In the future, more effective PD treatment can be developed, such as intelligent closed-loop deep brain stimulation.
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12
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Whalen TC, Willard AM, Rubin JE, Gittis AH. Delta oscillations are a robust biomarker of dopamine depletion severity and motor dysfunction in awake mice. J Neurophysiol 2020; 124:312-329. [PMID: 32579421 PMCID: PMC7500379 DOI: 10.1152/jn.00158.2020] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Revised: 06/15/2020] [Accepted: 06/17/2020] [Indexed: 12/14/2022] Open
Abstract
Delta oscillations (0.5-4 Hz) are a robust feature of basal ganglia pathophysiology in patients with Parkinson's disease (PD) in relationship to tremor, but their relationship to other parkinsonian symptoms has not been investigated. While delta oscillations have been observed in mouse models of PD, they have only been investigated in anesthetized animals, suggesting that the oscillations may be an anesthesia artifact and limiting the ability to relate them to motor symptoms. Here, we establish a novel approach to detect spike oscillations embedded in noise to provide the first study of delta oscillations in awake, dopamine-depleted mice. We find that approximately half of neurons in the substantia nigra pars reticulata (SNr) exhibit delta oscillations in dopamine depletion and that these oscillations are a strong indicator of dopamine loss and akinesia, outperforming measures such as changes in firing rate, irregularity, bursting, and synchrony. These oscillations are typically weakened, but not ablated, during movement. We further establish that these oscillations are caused by the loss of D2-receptor activation and do not originate from motor cortex, contrary to previous findings in anesthetized animals. Instead, SNr oscillations precede those in M1 at a 100- to 300-ms lag, and these neurons' relationship to M1 oscillations can be used as the basis for a novel classification of SNr into two subpopulations. These results give insight into how dopamine loss leads to motor dysfunction and suggest a reappraisal of delta oscillations as a marker of akinetic symptoms in PD.NEW & NOTEWORTHY This work introduces a novel method to detect spike oscillations amidst neural noise. Using this method, we demonstrate that delta oscillations in the basal ganglia are a defining feature of awake, dopamine-depleted mice and are strongly correlated with dopamine loss and parkinsonian motor symptoms. These oscillations arise from a loss of D2-receptor activation and do not require motor cortex. Similar oscillations in human patients may be an underappreciated marker and target for Parkinson's disease (PD) treatment.
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Affiliation(s)
- Timothy C Whalen
- Center for the Neural Basis of Cognition, Carnegie Mellon University, Pittsburgh, Pennsylvania
- Neuroscience Institute and Department of Biological Sciences, Carnegie Mellon University, Pittsburgh, Pennsylvania
| | - Amanda M Willard
- Center for the Neural Basis of Cognition, Carnegie Mellon University, Pittsburgh, Pennsylvania
- Neuroscience Institute and Department of Biological Sciences, Carnegie Mellon University, Pittsburgh, Pennsylvania
- Department of Biology and Geosciences, Clarion University, Clarion, Pennsylvania
| | - Jonathan E Rubin
- Center for the Neural Basis of Cognition, Carnegie Mellon University, Pittsburgh, Pennsylvania
- Department of Mathematics, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Aryn H Gittis
- Center for the Neural Basis of Cognition, Carnegie Mellon University, Pittsburgh, Pennsylvania
- Neuroscience Institute and Department of Biological Sciences, Carnegie Mellon University, Pittsburgh, Pennsylvania
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13
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Effects of Subthalamic Nucleus Deep Brain Stimulation on Facial Emotion Recognition in Parkinson's Disease: A Critical Literature Review. Behav Neurol 2020; 2020:4329297. [PMID: 32724481 PMCID: PMC7382738 DOI: 10.1155/2020/4329297] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Accepted: 06/12/2020] [Indexed: 01/04/2023] Open
Abstract
Deep brain stimulation (DBS) of the subthalamic nucleus (STN) is an effective therapy for Parkinson's disease (PD). Nevertheless, DBS has been associated with certain nonmotor, neuropsychiatric effects such as worsening of emotion recognition from facial expressions. In order to investigate facial emotion recognition (FER) after STN DBS, we conducted a literature search of the electronic databases MEDLINE and Web of science. In this review, we analyze studies assessing FER after STN DBS in PD patients and summarize the current knowledge of the effects of STN DBS on FER. The majority of studies, which had clinical and methodological heterogeneity, showed that FER is worsening after STN DBS in PD patients, particularly for negative emotions (sadness, fear, anger, and tendency for disgust). FER worsening after STN DBS can be attributed to the functional role of the STN in limbic circuits and the interference of STN stimulation with neural networks involved in FER, including the connections of the STN with the limbic part of the basal ganglia and pre- and frontal areas. These outcomes improve our understanding of the role of the STN in the integration of motor, cognitive, and emotional aspects of behaviour in the growing field of affective neuroscience. Further studies using standardized neuropsychological measures of FER assessment and including larger cohorts are needed, in order to draw definite conclusions about the effect of STN DBS on emotional recognition and its impact on patients' quality of life.
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Hasegawa H, Fischer P, Tan H, Pogosyan A, Samuel M, Brown P, Ashkan K. The Effect of Unilateral Subthalamic Nucleus Deep Brain Stimulation on Contralateral Subthalamic Nucleus Local Field Potentials. Neuromodulation 2020; 23:509-514. [PMID: 32281215 DOI: 10.1111/ner.13155] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2019] [Revised: 03/05/2020] [Accepted: 03/10/2020] [Indexed: 11/27/2022]
Abstract
OBJECTIVES Unilateral subthalamic nucleus (STN) deep brain stimulation (DBS) for Parkinson's disease (PD) improves ipsilateral symptoms, but how this occurs is not well understood. We investigated whether unilateral STN DBS suppresses contralateral STN beta activity in the local field potential (LFP), since previous research has shown that activity in the beta band can correlate with the severity of contralateral clinical symptoms and is modulated by DBS. MATERIALS AND METHODS We recorded STN LFPs from 14 patients who underwent bilateral STN DBS for PD. Following a baseline recording, unilateral STN stimulation was delivered at therapeutic parameters while LFPs were recorded from the contralateral (unstimulated) STN. RESULTS Unilateral STN DBS suppressed contralateral beta power (p = 0.039, relative suppression = -5.7% ± [SD] 16% when averaging across the highest beta peak channels; p = 0.033, relative suppression = -5.2% ± 13% when averaging across all channels). Unilateral STN DBS produced a 17% ipsilateral (p = 0.016) and 29% contralateral (p = 0.002) improvement in upper limb hemi-body bradykinesia-rigidity (UPDRS-III, items 3.3-3.6). The ipsilateral clinical improvement and the change in contralateral beta power were not significantly correlated. CONCLUSIONS Unilateral STN DBS suppresses contralateral STN beta LFP. This indicates that unilateral STN DBS modulates bilateral basal ganglia networks. It remains unclear whether this mechanism accounts for the ipsilateral motor improvements.
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Affiliation(s)
- Harutomo Hasegawa
- Department of Neurosurgery, King's College Hospital, London, UK.,Department of Neurology, King's College Hospital, London, UK
| | - Petra Fischer
- Medical Research Council Brain Network Dynamics Unit at the University of Oxford, Oxford, UK.,Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, University of Oxford, Oxford, UK
| | - Huiling Tan
- Medical Research Council Brain Network Dynamics Unit at the University of Oxford, Oxford, UK.,Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, University of Oxford, Oxford, UK
| | - Alek Pogosyan
- Medical Research Council Brain Network Dynamics Unit at the University of Oxford, Oxford, UK.,Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, University of Oxford, Oxford, UK
| | - Michael Samuel
- Department of Neurosurgery, King's College Hospital, London, UK.,Department of Neurology, King's College Hospital, London, UK
| | - Peter Brown
- Medical Research Council Brain Network Dynamics Unit at the University of Oxford, Oxford, UK.,Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, University of Oxford, Oxford, UK
| | - Keyoumars Ashkan
- Department of Neurosurgery, King's College Hospital, London, UK.,Department of Neurology, King's College Hospital, London, UK
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15
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Abstract
We review the motor cortical and basal ganglia involvement in two important movement disorders: Parkinson's disease (PD) and dystonia. Single and paired pulse transcranial magnetic stimulation studies showed altered excitability and cortical circuits in PD with decreased silent period, short interval intracortical inhibition, intracortical facilitation, long afferent inhibition, interhemispheric inhibition, and cerebellar inhibition, and increased long interval intracortical inhibition and short interval intracortical facilitation. In dystonia, there is decreased silent period, short interval intracortical inhibition, long afferent inhibition, interhemispheric inhibition, and increased intracortical facilitation. Plasticity induction protocols revealed deficient plasticity in PD and normal and exaggerated plasticity in dystonia. In the basal ganglia, there is increased β (14-30Hz) rhythm in PD and characteristic 5-18Hz band synchronization in dystonia. These motor cortical circuits, cortical plasticity, and oscillation profiles of the basal ganglia are altered with medications and deep brain stimulation treatment. There is considerable variability in these measures related to interindividual variations, different disease characteristics, and methodological considerations. Nevertheless, these pathophysiologic studies have expanded our knowledge of cortical excitability, plasticity, and oscillations in PD and dystonia, improved our understanding of disease pathophysiology, and helped to develop new treatments for these conditions.
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Affiliation(s)
- Kaviraja Udupa
- Department of Neurophysiology, National Institute of Mental Health and Neuro Sciences, Bangalore, India
| | - Robert Chen
- Division of Neurology, Department of Medicine, University of Toronto, Toronto, ON, Canada.
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16
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Zhao D, Sun Q, Cheng S, He M, Chen X, Hou X. Extraction of Parkinson’s Disease-Related Features from Local Field Potentials for Adaptive Deep Brain Stimulation. NEUROPHYSIOLOGY+ 2018. [DOI: 10.1007/s11062-018-9717-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
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17
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Kolb R, Abosch A, Felsen G, Thompson JA. Use of intraoperative local field potential spectral analysis to differentiate basal ganglia structures in Parkinson's disease patients. Physiol Rep 2017; 5:e13322. [PMID: 28642341 PMCID: PMC5492209 DOI: 10.14814/phy2.13322] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2017] [Accepted: 05/24/2017] [Indexed: 01/06/2023] Open
Abstract
Identification of brain structures traversed during implantation of deep brain-stimulating (DBS) electrodes into the subthalamic nucleus (STN-DBS) for the treatment of Parkinson's disease (PD) frequently relies on subjective correspondence between kinesthetic response and multiunit activity. However, recent work suggests that local field potentials (LFP) could be used as a more robust signal to objectively differentiate subcortical structures. The goal of this study was to analyze the spectral properties of LFP collected during STN-DBS in order to objectively identify commonly traversed brain regions and improve our understanding of aberrant oscillations in the PD-related pathophysiological cortico-basal ganglia network. In 21 PD patients, LFP were collected and analyzed during STN-DBS implantation surgery. Spectral power for delta-, theta-, alpha-, low-beta-, and high-beta-frequency bands was assessed at multiple depths throughout the subcortical structures traversed on the trajectory to the ventral border of STN. Similar to previous findings, beta-band oscillations had an increased magnitude within the borders of the motor-related area of STN, however, across several subjects, we also observed increased high-beta magnitude within the borders of thalamus. Comparing across all patients using relative power, we observed a gradual increase in the magnitude of both low- and high-beta-frequency bands as the electrode descended from striatum to STN. These results were also compared with frequency bands below beta, and similar trends were observed. Our results suggest that LFP signals recorded during the implantation of a DBS electrode evince distinct oscillatory signatures that distinguish subcortical structures.
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Affiliation(s)
- Rachel Kolb
- Department of Bioengineering, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Aviva Abosch
- Department of Neurosurgery, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Gidon Felsen
- Department of Physiology and Biophysics, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - John A Thompson
- Department of Neurosurgery, University of Colorado School of Medicine, Aurora, Colorado, USA
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18
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Risk of Infection After Local Field Potential Recording from Externalized Deep Brain Stimulation Leads in Parkinson's Disease. World Neurosurg 2017; 97:64-69. [DOI: 10.1016/j.wneu.2016.09.069] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2016] [Revised: 09/14/2016] [Accepted: 09/16/2016] [Indexed: 11/22/2022]
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19
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Qian X, Chen Y, Feng Y, Ma B, Hao H, Li L. A Method for Removal of Deep Brain Stimulation Artifact From Local Field Potentials. IEEE Trans Neural Syst Rehabil Eng 2016; 25:2217-2226. [PMID: 28113981 DOI: 10.1109/tnsre.2016.2613412] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
This paper presents a signal processing method for the electrophysiology simultaneously recorded during deep brain stimulation (DBS) as a research tool. Regarding the local field potential (LFP) signals recorded during stimulation, a novel method was proposed for removal of stimulation artifacts caused by the much stronger stimulating pulse compared to typical LFP. This artifact suppression method was tested and evaluated in an in vitro situation. The results indicate that the stimulation artifacts are well suppressed by this method. Secondly, this method was tested in vivo in Parkinson's disease (PD) patients. It was used to process the LFP signals recorded intraoperatively from PD patients to preliminarily explore the quantitative dependencies of beta band synchronization variations in the subthalamic nucleus (STNs) on the applied DBS parameters, including stimulation voltage, frequency and pulse width. The results confirm that DBS therapy can suppress excessive beta frequency activity and that the degree of attenuation increases with increasing DBS voltage within a range of 1-3 V and increasing DBS frequency within a range of 60-120 Hz. The proposed artifact suppression method provides technical support for exploring the direct effect of electrical stimulation on the brain activities.
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20
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Arlotti M, Rosa M, Marceglia S, Barbieri S, Priori A. The adaptive deep brain stimulation challenge. Parkinsonism Relat Disord 2016; 28:12-7. [PMID: 27079257 DOI: 10.1016/j.parkreldis.2016.03.020] [Citation(s) in RCA: 56] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2015] [Revised: 03/25/2016] [Accepted: 03/28/2016] [Indexed: 01/17/2023]
Abstract
Sub-optimal clinical outcomes of conventional deep brain stimulation (cDBS) in treating Parkinson's Disease (PD) have boosted the development of new solutions to improve DBS therapy. Adaptive DBS (aDBS), consisting of closed-loop, real-time changing of stimulation parameters according to the patient's clinical state, promises to achieve this goal and is attracting increasing interest in overcoming all of the challenges posed by its development and adoption. In the design, implementation, and application of aDBS, the choice of the control variable and of the control algorithm represents the core challenge. The proposed approaches, in fact, differ in the choice of the control variable and control policy, in the system design and its technological limits, in the patient's target symptom, and in the surgical procedure needed. Here, we review the current proposals for aDBS systems, focusing on the choice of the control variable and its advantages and drawbacks, thus providing a general overview of the possible pathways for the clinical translation of aDBS with its benefits, limitations and unsolved issues.
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Affiliation(s)
- Mattia Arlotti
- Clinical Center for Neurostimulation, Neurotechnology, and Movement Disorders, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy; Department of Electronics, Computer Science and Systems, University of Bologna, Cesena, Italy
| | - Manuela Rosa
- Clinical Center for Neurostimulation, Neurotechnology, and Movement Disorders, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Sara Marceglia
- Clinical Center for Neurostimulation, Neurotechnology, and Movement Disorders, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy; Department of Engineering and Architecture, University of Trieste, Trieste, Italy
| | - Sergio Barbieri
- Clinical Center for Neurostimulation, Neurotechnology, and Movement Disorders, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy; Unità di Neurofisiopatologia, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico di Milano, Milan, Italy
| | - Alberto Priori
- Department of Health Sciences, University of Milan, Fondazione IRCCS Ca'Granda, Milan, Italy.
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21
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Arlotti M, Rossi L, Rosa M, Marceglia S, Priori A. An external portable device for adaptive deep brain stimulation (aDBS) clinical research in advanced Parkinson's Disease. Med Eng Phys 2016; 38:498-505. [PMID: 27029510 DOI: 10.1016/j.medengphy.2016.02.007] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2015] [Revised: 12/14/2015] [Accepted: 02/22/2016] [Indexed: 11/18/2022]
Abstract
Compared to conventional deep brain stimulation (DBS) for patients with Parkinson's Disease (PD), the newer approach of adaptive DBS (aDBS), regulating stimulation on the basis of the patient's clinical state, promises to achieve better clinical outcomes, avoid adverse-effects and save time for tuning parameters. A remaining challenge before aDBS comes into practical use is to prove its feasibility and its effectiveness in larger groups of patients and in more ecological conditions. We developed an external portable aDBS system prototype designed for clinical testing in freely-moving PD patients with externalized DBS electrodes. From a single-channel bipolar artifact-free recording, it analyses local field potentials (LFPs), during ongoing DBS for tuning stimulation parameters, independent from the specific feedback algorithm implemented. We validated the aDBS system in vitro, by testing both its sensing and closed-loop stimulation capabilities, and then tested it in vivo, focusing on the sensing capabilities. By applying the aDBS system prototype in a patient with PD, we provided evidence that it can track levodopa and DBS-induced LFP spectral power changes among different patient's clinical states. Our system, intended for testing LFP-based feedback strategies for aDBS, should help understanding how and whether aDBS therapy works in PD and indicating future technical and clinical advances.
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Affiliation(s)
- Mattia Arlotti
- Clinical Center for Neurostimulation, Neurotechnology, and Movement Disorders, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy; Department of Electronics, Computer Science and Systems, University of Bologna, Cesena, Italy.
| | | | - Manuela Rosa
- Clinical Center for Neurostimulation, Neurotechnology, and Movement Disorders, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
| | - Sara Marceglia
- Clinical Center for Neurostimulation, Neurotechnology, and Movement Disorders, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy; Department of Engineering and Architecture, University of Trieste, Trieste, Italy.
| | - Alberto Priori
- Clinical Center for Neurostimulation, Neurotechnology, and Movement Disorders, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy; Department of Health Sciences, University of Milan, Ospedale San Paolo, Milan, Italy.
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22
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Oswal A, Beudel M, Zrinzo L, Limousin P, Hariz M, Foltynie T, Litvak V, Brown P. Deep brain stimulation modulates synchrony within spatially and spectrally distinct resting state networks in Parkinson's disease. Brain 2016; 139:1482-96. [PMID: 27017189 PMCID: PMC4845255 DOI: 10.1093/brain/aww048] [Citation(s) in RCA: 171] [Impact Index Per Article: 21.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2015] [Accepted: 01/25/2016] [Indexed: 11/13/2022] Open
Abstract
Chronic dopamine depletion in Parkinson's disease leads to progressive motor and cognitive impairment, which is associated with the emergence of characteristic patterns of synchronous oscillatory activity within cortico-basal-ganglia circuits. Deep brain stimulation of the subthalamic nucleus is an effective treatment for Parkinson's disease, but its influence on synchronous activity in cortico-basal-ganglia loops remains to be fully characterized. Here, we demonstrate that deep brain stimulation selectively suppresses certain spatially and spectrally segregated resting state subthalamic nucleus-cortical networks. To this end we used a validated and novel approach for performing simultaneous recordings of the subthalamic nucleus and cortex using magnetoencephalography (during concurrent subthalamic nucleus deep brain stimulation). Our results highlight that clinically effective subthalamic nucleus deep brain stimulation suppresses synchrony locally within the subthalamic nucleus in the low beta oscillatory range and furthermore that the degree of this suppression correlates with clinical motor improvement. Moreover, deep brain stimulation relatively selectively suppressed synchronization of activity between the subthalamic nucleus and mesial premotor regions, including the supplementary motor areas. These mesial premotor regions were predominantly coupled to the subthalamic nucleus in the high beta frequency range, but the degree of deep brain stimulation-associated suppression in their coupling to the subthalamic nucleus was not found to correlate with motor improvement. Beta band coupling between the subthalamic nucleus and lateral motor areas was not influenced by deep brain stimulation. Motor cortical coupling with subthalamic nucleus predominantly involved driving of the subthalamic nucleus, with those drives in the higher beta frequency band having much shorter net delays to subthalamic nucleus than those in the lower beta band. These observations raise the possibility that cortical connectivity with the subthalamic nucleus in the high and low beta bands may reflect coupling mediated predominantly by the hyperdirect and indirect pathways to subthalamic nucleus, respectively, and that subthalamic nucleus deep brain stimulation predominantly suppresses the former. Yet only the change in strength of local subthalamic nucleus oscillations correlates with the degree of improvement during deep brain stimulation, compatible with the current view that a strengthened hyperdirect pathway is a prerequisite for locally generated beta activity but that it is the severity of the latter that may determine or index motor impairment.
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Affiliation(s)
- Ashwini Oswal
- Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, Oxford, UK Medical Research Council Brain Network Dynamics Unit, University of Oxford, UK Wellcome Trust Centre for Neuroimaging, UCL Institute of Neurology, 12 Queen Square, London, UK
| | - Martijn Beudel
- Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, Oxford, UK Unit of Functional Neurosurgery, Sobell Department of Motor Neuroscience and Movement Disorders, UCL Institute of Neurology, Queen Square, London, UK University Medical Centre Groningen, Department of Neurology, University of Groningen, The Netherlands
| | - Ludvic Zrinzo
- Unit of Functional Neurosurgery, Sobell Department of Motor Neuroscience and Movement Disorders, UCL Institute of Neurology, Queen Square, London, UK
| | - Patricia Limousin
- Unit of Functional Neurosurgery, Sobell Department of Motor Neuroscience and Movement Disorders, UCL Institute of Neurology, Queen Square, London, UK
| | - Marwan Hariz
- Unit of Functional Neurosurgery, Sobell Department of Motor Neuroscience and Movement Disorders, UCL Institute of Neurology, Queen Square, London, UK
| | - Tom Foltynie
- Unit of Functional Neurosurgery, Sobell Department of Motor Neuroscience and Movement Disorders, UCL Institute of Neurology, Queen Square, London, UK
| | - Vladimir Litvak
- Wellcome Trust Centre for Neuroimaging, UCL Institute of Neurology, 12 Queen Square, London, UK
| | - Peter Brown
- Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, Oxford, UK Medical Research Council Brain Network Dynamics Unit, University of Oxford, UK
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Yu Y, Feng Z, Cao J, Guo Z, Wang Z, Hu N, Wei X. Modulation of local field potentials by high-frequency stimulation of afferent axons in the hippocampal CA1 region. J Integr Neurosci 2016; 15:1-17. [DOI: 10.1142/s0219635216500011] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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24
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Oswal A, Jha A, Neal S, Reid A, Bradbury D, Aston P, Limousin P, Foltynie T, Zrinzo L, Brown P, Litvak V. Analysis of simultaneous MEG and intracranial LFP recordings during Deep Brain Stimulation: a protocol and experimental validation. J Neurosci Methods 2015; 261:29-46. [PMID: 26698227 PMCID: PMC4758829 DOI: 10.1016/j.jneumeth.2015.11.029] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2015] [Accepted: 11/30/2015] [Indexed: 11/17/2022]
Abstract
Setup for MEG and intracranial recordings during Deep Brain Stimulation is described. Phantom experiment showed correct recovery of oscillatory sources despite artefacts. The method is applied to real data from a patient with Parkinson's Disease. Cortico-subthalamic coherence profiles on and off stimulation were comparable.
Background Deep Brain Stimulation (DBS) is an effective treatment for several neurological and psychiatric disorders. In order to gain insights into the therapeutic mechanisms of DBS and to advance future therapies a better understanding of the effects of DBS on large-scale brain networks is required. New method In this paper, we describe an experimental protocol and analysis pipeline for simultaneously performing DBS and intracranial local field potential (LFP) recordings at a target brain region during concurrent magnetoencephalography (MEG) measurement. Firstly we describe a phantom setup that allowed us to precisely characterise the MEG artefacts that occurred during DBS at clinical settings. Results Using the phantom recordings we demonstrate that with MEG beamforming it is possible to recover oscillatory activity synchronised to a reference channel, despite the presence of high amplitude artefacts evoked by DBS. Finally, we highlight the applicability of these methods by illustrating in a single patient with Parkinson's disease (PD), that changes in cortical-subthalamic nucleus coupling can be induced by DBS. Comparison with existing approaches To our knowledge this paper provides the first technical description of a recording and analysis pipeline for combining simultaneous cortical recordings using MEG, with intracranial LFP recordings of a target brain nucleus during DBS.
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Affiliation(s)
- Ashwini Oswal
- Wellcome Trust Centre for Neuroimaging, 12 Queen Square, London, UK; Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, Oxford, UK
| | - Ashwani Jha
- Sobell Department of Motor Neuroscience and Movement Disorders, Institute of Neurology, Queen Square, London, UK
| | - Spencer Neal
- Sobell Department of Motor Neuroscience and Movement Disorders, Institute of Neurology, Queen Square, London, UK
| | - Alphonso Reid
- Wellcome Trust Centre for Neuroimaging, 12 Queen Square, London, UK
| | - David Bradbury
- Wellcome Trust Centre for Neuroimaging, 12 Queen Square, London, UK
| | - Peter Aston
- Wellcome Trust Centre for Neuroimaging, 12 Queen Square, London, UK
| | - Patricia Limousin
- Sobell Department of Motor Neuroscience and Movement Disorders, Institute of Neurology, Queen Square, London, UK
| | - Tom Foltynie
- Sobell Department of Motor Neuroscience and Movement Disorders, Institute of Neurology, Queen Square, London, UK
| | - Ludvic Zrinzo
- Sobell Department of Motor Neuroscience and Movement Disorders, Institute of Neurology, Queen Square, London, UK
| | - Peter Brown
- Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, Oxford, UK
| | - Vladimir Litvak
- Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, Oxford, UK.
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25
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Udupa K, Chen R. The mechanisms of action of deep brain stimulation and ideas for the future development. Prog Neurobiol 2015; 133:27-49. [DOI: 10.1016/j.pneurobio.2015.08.001] [Citation(s) in RCA: 100] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2015] [Revised: 08/04/2015] [Accepted: 08/15/2015] [Indexed: 12/19/2022]
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26
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Therapeutic deep brain stimulation reduces cortical phase-amplitude coupling in Parkinson's disease. Nat Neurosci 2015; 18:779-86. [PMID: 25867121 PMCID: PMC4414895 DOI: 10.1038/nn.3997] [Citation(s) in RCA: 425] [Impact Index Per Article: 47.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2014] [Accepted: 03/12/2015] [Indexed: 12/15/2022]
Abstract
Deep brain stimulation (DBS) is increasingly applied for the treatment of brain disorders, but its mechanism of action remains unknown. Here we evaluate the effect of basal ganglia DBS on cortical function using invasive cortical recordings in Parkinson's disease (PD) patients undergoing DBS implantation surgery. In the primary motor cortex of PD patients, neuronal population spiking is excessively synchronized to the phase of network oscillations. This manifests in brain surface recordings as exaggerated coupling between the phase of the beta rhythm and the amplitude of broadband activity. We show that acute therapeutic DBS reversibly reduces phase-amplitude interactions over a similar time course as that of the reduction in parkinsonian motor signs. We propose that DBS of the basal ganglia improves cortical function by alleviating excessive beta phase locking of motor cortex neurons.
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27
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Bour LJ, Lourens MAJ, Verhagen R, de Bie RMA, van den Munckhof P, Schuurman PR, Contarino MF. Directional Recording of Subthalamic Spectral Power Densities in Parkinson's Disease and the Effect of Steering Deep Brain Stimulation. Brain Stimul 2015; 8:730-41. [PMID: 25753176 DOI: 10.1016/j.brs.2015.02.002] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2014] [Revised: 02/03/2015] [Accepted: 02/06/2015] [Indexed: 10/24/2022] Open
Abstract
BACKGROUND A new 32-contacts deep brain stimulation (DBS) lead, capable of directionally steering stimulation, was tested intraoperatively. OBJECTIVE The aim of this pilot study was to perform recordings from the multidirectional contacts and to investigate the effect of directional current steering on the local field potentials (LFPs). METHODS In eight patients with Parkinson's disease, after standard microelectrode recording and clinical testing, the new lead was temporarily implanted. The 32-channel LFP recordings were measured simultaneously at different depths and directions before and after directional stimulation. RESULTS The spatial distribution of LFPs power spectral densities across the contact array at baseline marked the borders of the subthalamic nucleus (STN) with a significant increase in beta power and with a mean accuracy of approximately 0.6 mm in four patients.The power in the 18.5-30 Hz frequency band varied across different directions in all patients. In the three cases that showed improvement of rigidity, this was higher when current was steered toward the direction with the highest LFP power in the beta band. Subthalamic LFPs in six patients showed a differential frequency-dependent suppression/enhancement of the oscillatory activity in the 10-45 Hz frequency band after four different 'steering' modes as compared to ring mode, suggesting a higher specificity. CONCLUSIONS Through a new 32-contact DBS lead it is possible to record simultaneous subthalamic LFPs at different depths and directions, providing confirmation of adequate lead placement and multidirectional spatial-temporal information potentially related to pathological subthalamic electrical activity and to the effect of stimulation. Although further research is needed, this may improve the efficiency of steering stimulation.
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Affiliation(s)
- L J Bour
- Department of Neurology and Clinical Neurophysiology, Academic Medical Center, University of Amsterdam, the Netherlands.
| | - M A J Lourens
- Department of Neurology and Clinical Neurophysiology, Academic Medical Center, University of Amsterdam, the Netherlands
| | - R Verhagen
- Department of Neurology and Clinical Neurophysiology, Academic Medical Center, University of Amsterdam, the Netherlands
| | - R M A de Bie
- Department of Neurology and Clinical Neurophysiology, Academic Medical Center, University of Amsterdam, the Netherlands
| | - P van den Munckhof
- Department of Neurosurgery, Academic Medical Center, University of Amsterdam, the Netherlands
| | - P R Schuurman
- Department of Neurosurgery, Academic Medical Center, University of Amsterdam, the Netherlands
| | - M F Contarino
- Department of Neurology and Clinical Neurophysiology, Academic Medical Center, University of Amsterdam, the Netherlands; Department of Neurology, Haga Teaching Hospital, the Hague, the Netherlands.
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Barow E, Neumann WJ, Brücke C, Huebl J, Horn A, Brown P, Krauss JK, Schneider GH, Kühn AA. Deep brain stimulation suppresses pallidal low frequency activity in patients with phasic dystonic movements. ACTA ACUST UNITED AC 2014; 137:3012-3024. [PMID: 25212852 DOI: 10.1093/brain/awu258] [Citation(s) in RCA: 149] [Impact Index Per Article: 14.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Deep brain stimulation of the globus pallidus internus alleviates involuntary movements in patients with dystonia. However, the mechanism is still not entirely understood. One hypothesis is that deep brain stimulation suppresses abnormally enhanced synchronized oscillatory activity within the motor cortico-basal ganglia network. Here, we explore deep brain stimulation-induced modulation of pathological low frequency (4-12 Hz) pallidal activity that has been described in local field potential recordings in patients with dystonia. Therefore, local field potentials were recorded from 16 hemispheres in 12 patients undergoing deep brain stimulation for severe dystonia using a specially designed amplifier allowing simultaneous high frequency stimulation at therapeutic parameter settings and local field potential recordings. For coherence analysis electroencephalographic activity (EEG) over motor areas and electromyographic activity (EMG) from affected neck muscles were recorded before and immediately after cessation of high frequency stimulation. High frequency stimulation led to a significant reduction of mean power in the 4-12 Hz band by 24.8 ± 7.0% in patients with predominantly phasic dystonia. A significant decrease of coherence between cortical EEG and pallidal local field potential activity in the 4-12 Hz range was revealed for the time period of 30 s after switching off high frequency stimulation. Coherence between EMG activity and pallidal activity was mainly found in patients with phasic dystonic movements where it was suppressed after high frequency stimulation. Our findings suggest that high frequency stimulation may suppress pathologically enhanced low frequency activity in patients with phasic dystonia. These dystonic features are the quickest to respond to high frequency stimulation and may thus directly relate to modulation of pathological basal ganglia activity, whereas improvement in tonic features may depend on long-term plastic changes within the motor network.
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Affiliation(s)
- Ewgenia Barow
- Department of Neurology, Campus Virchow Klinikum, Charité-University Medicine Berlin, Berlin, Germany
| | - Wolf-Julian Neumann
- Department of Neurology, Campus Virchow Klinikum, Charité-University Medicine Berlin, Berlin, Germany
| | - Christof Brücke
- Department of Neurology, Campus Virchow Klinikum, Charité-University Medicine Berlin, Berlin, Germany
| | - Julius Huebl
- Department of Neurology, Campus Virchow Klinikum, Charité-University Medicine Berlin, Berlin, Germany
| | - Andreas Horn
- Department of Neurology, Campus Virchow Klinikum, Charité-University Medicine Berlin, Berlin, Germany
| | - Peter Brown
- Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | - Joachim K Krauss
- Department of Neurosurgery, Medical University Hannover, MHH, Hannover, Germany
| | - Gerd-Helge Schneider
- Department of Neurosurgery, Campus Virchow Klinikum, Charité-University Medicine Berlin, Berlin, Germany
| | - Andrea A Kühn
- Department of Neurology, Campus Virchow Klinikum, Charité-University Medicine Berlin, Berlin, Germany
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Beuter A, Lefaucheur JP, Modolo J. Closed-loop cortical neuromodulation in Parkinson's disease: An alternative to deep brain stimulation? Clin Neurophysiol 2014; 125:874-85. [PMID: 24555921 DOI: 10.1016/j.clinph.2014.01.006] [Citation(s) in RCA: 74] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2013] [Revised: 01/12/2014] [Accepted: 01/14/2014] [Indexed: 02/04/2023]
Abstract
Deep brain stimulation (DBS) is usually performed to treat advanced Parkinson's disease (PD) patients with electrodes permanently implanted in basal ganglia while the stimulator delivers electrical impulses continuously and independently of any feedback (open-loop stimulation). Conversely, in closed-loop stimulation, electrical stimulation is delivered as a function of neuronal activities recorded and analyzed online. There is an emerging development of closed-loop DBS in the treatment of PD and a growing discussion about proposing cortical stimulation rather than DBS for this purpose. Why does it make sense to "close the loop" to treat parkinsonian symptoms? Could closed-loop stimulation applied to the cortex become a valuable therapeutic strategy for PD? Can mathematical modeling contribute to the development of this technique? We review the various evidences in favor of the use of closed-loop cortical stimulation for the treatment of advanced PD, as an emerging technique which might offer substantial clinical benefits for PD patients.
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Affiliation(s)
- Anne Beuter
- Institut Polytechnique de Bordeaux, Talence, France.
| | - Jean-Pascal Lefaucheur
- Université Paris Est Créteil, Faculté de Médecine, EA 4391, Créteil, France; Assistance Publique - Hôpitaux de Paris, Hôpital Henri Mondor, Service de Physiologie - Explorations Fonctionnelles, Créteil, France.
| | - Julien Modolo
- Lawson Health Research Institute, Human Threshold Research Group, London, ON, Canada; Western University, Departments of Medical Biophysics and Medical Imaging, London, ON, Canada
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Marceglia S, Fumagalli M, Priori A. What neurophysiological recordings tell us about cognitive and behavioral functions of the human subthalamic nucleus. Expert Rev Neurother 2014; 11:139-49. [DOI: 10.1586/ern.10.184] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Carron R, Chaillet A, Filipchuk A, Pasillas-Lépine W, Hammond C. Closing the loop of deep brain stimulation. Front Syst Neurosci 2013; 7:112. [PMID: 24391555 PMCID: PMC3868949 DOI: 10.3389/fnsys.2013.00112] [Citation(s) in RCA: 68] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2013] [Accepted: 11/28/2013] [Indexed: 01/20/2023] Open
Abstract
High-frequency deep brain stimulation is used to treat a wide range of brain disorders, like Parkinson's disease. The stimulated networks usually share common electrophysiological signatures, including hyperactivity and/or dysrhythmia. From a clinical perspective, HFS is expected to alleviate clinical signs without generating adverse effects. Here, we consider whether the classical open-loop HFS fulfills these criteria and outline current experimental or theoretical research on the different types of closed-loop DBS that could provide better clinical outcomes. In the first part of the review, the two routes followed by HFS-evoked axonal spikes are explored. In one direction, orthodromic spikes functionally de-afferent the stimulated nucleus from its downstream target networks. In the opposite direction, antidromic spikes prevent this nucleus from being influenced by its afferent networks. As a result, the pathological synchronized activity no longer propagates from the cortical networks to the stimulated nucleus. The overall result can be described as a reversible functional de-afferentation of the stimulated nucleus from its upstream and downstream nuclei. In the second part of the review, the latest advances in closed-loop DBS are considered. Some of the proposed approaches are based on mathematical models, which emphasize different aspects of the parkinsonian basal ganglia: excessive synchronization, abnormal firing-rate rhythms, and a deficient thalamo-cortical relay. The stimulation strategies are classified depending on the control-theory techniques on which they are based: adaptive and on-demand stimulation schemes, delayed and multi-site approaches, stimulations based on proportional and/or derivative control actions, optimal control strategies. Some of these strategies have been validated experimentally, but there is still a large reservoir of theoretical work that may point to ways of improving practical treatment.
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Affiliation(s)
- Romain Carron
- Aix Marseille Université UMR 901 Marseille, France ; Institut national de la Recherche Médicale et de la Santé Inserm, INMED UMR 901 Marseille, France ; APHM, Hopital de la Timone, Service de Neurochirurgie Fonctionnelle et Stereotaxique Marseille, France
| | - Antoine Chaillet
- Laboratoire des Signaux et Systèmes(L2S), CNRS UMR 8506 Gif-sur-Yvette, France ; Université Paris Sud 11, UMR 8506, Supélec Gif-sur-Yvette, France
| | - Anton Filipchuk
- Aix Marseille Université UMR 901 Marseille, France ; Institut national de la Recherche Médicale et de la Santé Inserm, INMED UMR 901 Marseille, France
| | - William Pasillas-Lépine
- Laboratoire des Signaux et Systèmes(L2S), CNRS UMR 8506 Gif-sur-Yvette, France ; Centre national de la recherche scientifique Paris, France
| | - Constance Hammond
- Aix Marseille Université UMR 901 Marseille, France ; Institut national de la Recherche Médicale et de la Santé Inserm, INMED UMR 901 Marseille, France
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Priori A, Foffani G, Rossi L, Marceglia S. Adaptive deep brain stimulation (aDBS) controlled by local field potential oscillations. Exp Neurol 2013; 245:77-86. [DOI: 10.1016/j.expneurol.2012.09.013] [Citation(s) in RCA: 177] [Impact Index Per Article: 16.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2012] [Revised: 07/27/2012] [Accepted: 09/20/2012] [Indexed: 10/27/2022]
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Lempka SF, McIntyre CC. Theoretical analysis of the local field potential in deep brain stimulation applications. PLoS One 2013; 8:e59839. [PMID: 23555799 PMCID: PMC3610913 DOI: 10.1371/journal.pone.0059839] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2012] [Accepted: 02/20/2013] [Indexed: 11/19/2022] Open
Abstract
Deep brain stimulation (DBS) is a common therapy for treating movement disorders, such as Parkinson's disease (PD), and provides a unique opportunity to study the neural activity of various subcortical structures in human patients. Local field potential (LFP) recordings are often performed with either intraoperative microelectrodes or DBS leads and reflect oscillatory activity within nuclei of the basal ganglia. These LFP recordings have numerous clinical implications and might someday be used to optimize DBS outcomes in closed-loop systems. However, the origin of the recorded LFP is poorly understood. Therefore, the goal of this study was to theoretically analyze LFP recordings within the context of clinical DBS applications. This goal was achieved with a detailed recording model of beta oscillations (∼20 Hz) in the subthalamic nucleus. The recording model consisted of finite element models of intraoperative microelectrodes and DBS macroelectrodes implanted in the brain along with multi-compartment cable models of STN projection neurons. Model analysis permitted systematic investigation into a number of variables that can affect the composition of the recorded LFP (e.g. electrode size, electrode impedance, recording configuration, and filtering effects of the brain, electrode-electrolyte interface, and recording electronics). The results of the study suggest that the spatial reach of the LFP can extend several millimeters. Model analysis also showed that variables such as electrode geometry and recording configuration can have a significant effect on LFP amplitude and spatial reach, while the effects of other variables, such as electrode impedance, are often negligible. The results of this study provide insight into the origin of the LFP and identify variables that need to be considered when analyzing LFP recordings in clinical DBS applications.
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Affiliation(s)
- Scott F. Lempka
- Department of Biomedical Engineering, Cleveland Clinic Foundation, Cleveland, Ohio, United States of America
| | - Cameron C. McIntyre
- Department of Biomedical Engineering, Cleveland Clinic Foundation, Cleveland, Ohio, United States of America
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Afshar P, Khambhati A, Stanslaski S, Carlson D, Jensen R, Linde D, Dani S, Lazarewicz M, Cong P, Giftakis J, Stypulkowski P, Denison T. A translational platform for prototyping closed-loop neuromodulation systems. Front Neural Circuits 2013; 6:117. [PMID: 23346048 PMCID: PMC3551193 DOI: 10.3389/fncir.2012.00117] [Citation(s) in RCA: 92] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2012] [Accepted: 12/18/2012] [Indexed: 11/13/2022] Open
Abstract
While modulating neural activity through stimulation is an effective treatment for neurological diseases such as Parkinson's disease and essential tremor, an opportunity for improving neuromodulation therapy remains in automatically adjusting therapy to continuously optimize patient outcomes. Practical issues associated with achieving this include the paucity of human data related to disease states, poorly validated estimators of patient state, and unknown dynamic mappings of optimal stimulation parameters based on estimated states. To overcome these challenges, we present an investigational platform including: an implanted sensing and stimulation device to collect data and run automated closed-loop algorithms; an external tool to prototype classifier and control-policy algorithms; and real-time telemetry to update the implanted device firmware and monitor its state. The prototyping system was demonstrated in a chronic large animal model studying hippocampal dynamics. We used the platform to find biomarkers of the observed states and transfer functions of different stimulation amplitudes. Data showed that moderate levels of stimulation suppress hippocampal beta activity, while high levels of stimulation produce seizure-like after-discharge activity. The biomarker and transfer function observations were mapped into classifier and control-policy algorithms, which were downloaded to the implanted device to continuously titrate stimulation amplitude for the desired network effect. The platform is designed to be a flexible prototyping tool and could be used to develop improved mechanistic models and automated closed-loop systems for a variety of neurological disorders.
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35
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Deep brain electrophysiological recordings provide clues to the pathophysiology of Tourette syndrome. Neurosci Biobehav Rev 2013; 37:1063-8. [PMID: 23333267 DOI: 10.1016/j.neubiorev.2013.01.011] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2012] [Revised: 12/13/2012] [Accepted: 01/03/2013] [Indexed: 01/12/2023]
Abstract
Although ample evidence suggests that high-frequency deep brain stimulation (DBS) is an effective therapy in patients with Tourette syndrome (TS), its pathophysiology and the neurophysiological mechanisms underlying these benefits remain unclear. The DBS targets mainly used to date in TS are located within the basal ganglia-thalamo-cortical circuit compromised in this syndrome: the medial and ventral thalamic nuclei, which are way stations within the circuit, the globus pallidus and the nucleus accumbens. Neuronal activity can be electrophysiologically recorded from deep brain structures during DBS surgery (intraoperative microrecordings) or within few days after DBS electrode implantation (local field potentials, LFPs). Recordings from the thalamus in patients with TS showed that the power in low-frequency oscillations (2-15 Hz) was higher than power in high frequency oscillations (<45 Hz) and that activity in gamma band (25-45 Hz) increases when patients' clinical status improved. Effective thalamic DBS for tic reduction seems to increase high frequency band oscillations (25-45 Hz). The same oscillatory pattern persists after DBS for 1 year, therefore showing that in TS DBS does not induce persistent neuroplastic changes in the neural activity in the stimulated structures. Neurophysiological recordings from deep brain structures suggest that tics originate not from the cortex but from neuronal dysfunction in deep brain structures such as the thalamus and globus pallidus. In conclusion, DBS can induce its beneficial effects in TS by modulating specific neural rhythms in the cortico-basal ganglia thalamic network. DBS could reduce tics related increased low-frequency activity by shifting the basal ganglia-thalamic oscillation power to higher frequencies.
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36
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Hohlefeld FU, Huebl J, Huchzermeyer C, Schneider GH, Schönecker T, Kühn AA, Curio G, Nikulin VV. Long-range temporal correlations in the subthalamic nucleus of patients with Parkinson's disease. Eur J Neurosci 2013; 36:2812-21. [PMID: 22985199 DOI: 10.1111/j.1460-9568.2012.08198.x] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Neuronal activity in the subthalamic nucleus (STN) of patients with Parkinson's disease (PD) is characterised by excessive neuronal synchronization, particularly in the beta frequency range. However, less is known about the temporal dynamics of neuronal oscillations in PD. In this respect long-range temporal correlations (LRTC) are of special interest as they quantify the neuronal dynamics on different timescales and have been shown to be relevant for optimal information processing in the brain. While the presence of LRTC has been demonstrated in cortical data, their existence in deep brain structures remains an open question. We investigated (i) whether LRTC are present in local field potentials (LFP) recorded bilaterally from the STN at wakeful rest in ten patients with PD after overnight withdrawal of levodopa (OFF) and (ii) whether LRTC can be modulated by levodopa treatment (ON). Detrended fluctuation analysis was utilised in order to quantify the temporal dynamics in the amplitude fluctuations of LFP oscillations. We demonstrated for the first time the presence of LRTC (extending up to 50 s) in the STN. Importantly, the ON state was characterised by significantly stronger LRTC than the OFF state, both in beta (13-35 Hz) and high-frequency (> 200 Hz) oscillations. The existence of LRTC in subcortical structures such as STN provides further evidence for their ubiquitous nature in the brain. The weaker LRTC in the OFF state might indicate limited information processing in the dopamine-depleted basal ganglia. The present results implicate LRTC as a potential biomarker of pathological neuronal processes in PD.
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Affiliation(s)
- F U Hohlefeld
- Neurophysics Group, Department of Neurology, Charité- Universitätsmedizin Berlin, Campus Benjamin Franklin, Berlin, Germany
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Richter U, Halje P, Petersson P. Mechanisms underlying cortical resonant states: implications for levodopa-induced dyskinesia. Rev Neurosci 2013; 24:415-29. [DOI: 10.1515/revneuro-2013-0018] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2013] [Accepted: 07/04/2013] [Indexed: 12/31/2022]
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Yousif N, Borisyuk R, Pavese N, Nandi D, Bain P. Spatiotemporal visualization of deep brain stimulation-induced effects in the subthalamic nucleus. Eur J Neurosci 2012; 36:2252-9. [PMID: 22805069 DOI: 10.1111/j.1460-9568.2012.08086.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Deep brain stimulation (DBS) is a successful surgical therapy used to treat the disabling symptoms of movement disorders such as Parkinson's disease. It involves the chronic stimulation of disorder-specific nuclei. However, the mechanisms that lead to clinical improvements remain unclear. Consequently, this slows the optimization of present-day DBS therapy and hinders its future development and application. We used a computational model to calculate the distribution of electric potential induced by DBS and study the effect of stimulation on the spiking activity of a subthalamic nucleus (STN) projection neuron. We previously showed that such a model can reveal detailed spatial effects of stimulation in the vicinity of the electrode. However, this multi-compartmental STN neuron model can fire in either a burst or tonic mode and, in this study, we hypothesized that the firing mode of the cell will have a major impact on the DBS-induced effects. Our simulations showed that the bursting model exhibits behaviour observed in studies of high-frequency stimulation of STN neurons, such as the presence of a silent period at stimulation offset and frequency-dependent stimulation effects. We validated the model by simulating the clinical parameter settings used for a Parkinsonian patient and showed, in a patient-specific anatomical model, that the region of affected tissue is consistent with clinical observations of the optimal DBS site. Our results demonstrated a method of quantitatively assessing neuronal changes induced by DBS, to maximize therapeutic benefit and minimize unwanted side effects.
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Affiliation(s)
- Nada Yousif
- Centre for Neuroscience, Imperial College London, Charing Cross Hospital, London, UK.
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Somatomotor mu rhythm amplitude correlates with rigidity during deep brain stimulation in Parkinsonian patients. Clin Neurophysiol 2012; 123:2010-7. [DOI: 10.1016/j.clinph.2012.03.004] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2011] [Revised: 03/04/2012] [Accepted: 03/08/2012] [Indexed: 11/20/2022]
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40
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Subthalamic local field potentials after seven-year deep brain stimulation in Parkinson's disease. Exp Neurol 2012; 237:312-7. [DOI: 10.1016/j.expneurol.2012.06.012] [Citation(s) in RCA: 74] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2012] [Revised: 06/11/2012] [Accepted: 06/16/2012] [Indexed: 11/21/2022]
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Stein E, Bar-Gad I. β oscillations in the cortico-basal ganglia loop during parkinsonism. Exp Neurol 2012; 245:52-9. [PMID: 22921537 DOI: 10.1016/j.expneurol.2012.07.023] [Citation(s) in RCA: 134] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2012] [Revised: 07/02/2012] [Accepted: 07/14/2012] [Indexed: 10/28/2022]
Abstract
In the normal brain beta band oscillatory activity has been associated with retaining of ongoing motor activities. In Parkinson's disease, enhanced beta band oscillatory activity is displayed across the cortico-basal ganglia pathway and is one of the prominent neurophysiological phenomena associated with the disorder. Intraoperative and postoperative recordings of neural activity in patients undergoing stereotactic neurosurgery combined with studies in animal models of parkinsonism have led to the accumulation of complementary data regarding these oscillations. In this review we address some of the key issues facing researchers in the field. These issues encompass existing agreements as well as open debates in modern studies of beta band oscillations, including their defining characteristics, links to clinical symptoms and the functional properties of their formation and effects on behavior. We address these questions by comparing and contrasting the results of neurophysiological observations in human patients, MPTP primate model and 6-OHDA rat model with conceptual and computational models of the normal and parkinsonian basal ganglia. Defining a unifying scheme of beta band oscillations and their relation to neurophysiological, functional and clinical phenomena will enable future targeting of these oscillations for both diagnosis and treatment of Parkinson's disease.
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Affiliation(s)
- Edward Stein
- Gonda Multidisciplinary Brain Research Center, Bar Ilan University, Ramat Gan, Israel
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Little S, Brown P. What brain signals are suitable for feedback control of deep brain stimulation in Parkinson's disease? Ann N Y Acad Sci 2012; 1265:9-24. [PMID: 22830645 PMCID: PMC3495297 DOI: 10.1111/j.1749-6632.2012.06650.x] [Citation(s) in RCA: 172] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
Abstract
Feedback control of deep brain stimulation (DBS) in Parkinson's disease has great potential to improve efficacy, reduce side effects, and decrease the cost of treatment. In this, the timing and intensity of stimulation are titrated according to biomarkers that capture current clinical state. Stimulation may be at standard high frequency or intelligently patterned to directly modify specific pathological rhythms. The search for and validation of appropriate feedback signals are therefore crucial. Signals recorded from the DBS electrode currently appear to be the most promising source of feedback. In particular, beta-frequency band oscillations in the local field potential recorded at the stimulation target may capture variation in bradykinesia and rigidity across patients, but this remains to be confirmed within patients. Biomarkers that reliably reflect other impairments, such as tremor, also need to be established. Finally, whether brain signals are causally important needs to be established before stimulation can be specifically patterned rather than delivered at empirically defined high frequency.
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Affiliation(s)
- Simon Little
- Nuffield Departments of Clinical Neurosciences, University of Oxford, United Kingdom
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Eusebio A, Cagnan H, Brown P. Does suppression of oscillatory synchronisation mediate some of the therapeutic effects of DBS in patients with Parkinson's disease? Front Integr Neurosci 2012; 6:47. [PMID: 22787444 PMCID: PMC3392592 DOI: 10.3389/fnint.2012.00047] [Citation(s) in RCA: 69] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2012] [Accepted: 06/25/2012] [Indexed: 12/21/2022] Open
Abstract
There is growing evidence for exaggerated oscillatory neuronal synchronisation in patients with Parkinson's disease (PD). In particular, oscillations at around 20 Hz, in the so-called beta frequency band, relate to the cardinal symptoms of bradykinesia and rigidity. Deep brain stimulation (DBS) of the subthalamic nucleus (STN) can significantly improve these motor impairments. Recent evidence has demonstrated reduction of beta oscillations concurrent with alleviation of PD motor symptoms, raising the possibility that suppression of aberrant activity may mediate the effects of DBS. Here we review the evidence supporting suppression of pathological oscillations during stimulation and discuss how this might underlie the efficacy of DBS. We also consider how beta activity may provide a feedback signal suitable for next generation closed-loop and intelligent stimulators.
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Affiliation(s)
- Alexandre Eusebio
- Department of Neurology and Movement Disorders, Assistance Publique - Hôpitaux de Marseille, Timone University HospitalMarseille, France
- Institut de Neurosciences de la Timone – UMR 7289, Aix Marseille Université – CNRSMarseille, France
| | - Hayriye Cagnan
- Department of Clinical Neurology, John Radcliffe HospitalOxford, UK
| | - Peter Brown
- Department of Clinical Neurology, John Radcliffe HospitalOxford, UK
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Stanslaski S, Afshar P, Cong P, Giftakis J, Stypulkowski P, Carlson D, Linde D, Ullestad D, Avestruz AT, Denison T. Design and Validation of a Fully Implantable, Chronic, Closed-Loop Neuromodulation Device With Concurrent Sensing and Stimulation. IEEE Trans Neural Syst Rehabil Eng 2012; 20:410-21. [DOI: 10.1109/tnsre.2012.2183617] [Citation(s) in RCA: 237] [Impact Index Per Article: 19.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Whitmer D, de Solages C, Hill B, Yu H, Henderson JM, Bronte-Stewart H. High frequency deep brain stimulation attenuates subthalamic and cortical rhythms in Parkinson's disease. Front Hum Neurosci 2012; 6:155. [PMID: 22675296 PMCID: PMC3366347 DOI: 10.3389/fnhum.2012.00155] [Citation(s) in RCA: 180] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2011] [Accepted: 05/16/2012] [Indexed: 12/31/2022] Open
Abstract
Parkinson's disease (PD) is marked by excessive synchronous activity in the beta (8–35 Hz) band throughout the cortico-basal ganglia network. The optimal location of high frequency deep brain stimulation (HF DBS) within the subthalamic nucleus (STN) region and the location of maximal beta hypersynchrony are currently matters of debate. Additionally, the effect of STN HF DBS on neural synchrony in functionally connected regions of motor cortex is unknown and is of great interest. Scalp EEG studies demonstrated that stimulation of the STN can activate motor cortex antidromically, but the spatial specificity of this effect has not been examined. The present study examined the effect of STN HF DBS on neural synchrony within the cortico-basal ganglia network in patients with PD. We measured local field potentials dorsal to and within the STN of PD patients, and additionally in the motor cortex in a subset of these patients. We used diffusion tensor imaging (DTI) to guide the placement of subdural cortical surface electrodes over the DTI-identified origin of the hyperdirect pathway (HDP) between motor cortex and the STN. The results demonstrated that local beta power was attenuated during HF DBS both dorsal to and within the STN. The degree of attenuation was monotonic with increased DBS voltages in both locations, but this voltage-dependent effect was greater in the central STN than dorsal to the STN (p < 0.05). Cortical signals over the estimated origin of the HDP also demonstrated attenuation of beta hypersynchrony during DBS dorsal to or within STN, whereas signals from non-specific regions of motor cortex were not attenuated. The spatially-specific suppression of beta synchrony in the motor cortex support the hypothesis that DBS may treat Parkinsonism by reducing excessive synchrony in the functionally connected sensorimotor network.
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Affiliation(s)
- Diane Whitmer
- Department of Neurology and Neurological Sciences, Stanford University, Stanford CA, USA
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Kent AR, Grill WM. Recording evoked potentials during deep brain stimulation: development and validation of instrumentation to suppress the stimulus artefact. J Neural Eng 2012; 9:036004. [PMID: 22510375 DOI: 10.1088/1741-2560/9/3/036004] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
The clinical efficacy of deep brain stimulation (DBS) for the treatment of movement disorders depends on the identification of appropriate stimulation parameters. Since the mechanisms of action of DBS remain unclear, programming sessions can be time consuming, costly and result in sub-optimal outcomes. Measurement of electrically evoked compound action potentials (ECAPs) during DBS, generated by activated neurons in the vicinity of the stimulating electrode, could offer insight into the type and spatial extent of neural element activation and provide a potential feedback signal for the rational selection of stimulation parameters and closed-loop DBS. However, recording ECAPs presents a significant technical challenge due to the large stimulus artefact, which can saturate recording amplifiers and distort short latency ECAP signals. We developed DBS-ECAP recording instrumentation combining commercial amplifiers and circuit elements in a serial configuration to reduce the stimulus artefact and enable high fidelity recording. We used an electrical circuit equivalent model of the instrumentation to understand better the sources of the stimulus artefact and the mechanisms of artefact reduction by the circuit elements. In vitro testing validated the capability of the instrumentation to suppress the stimulus artefact and increase gain by a factor of 1000 to 5000 compared to a conventional biopotential amplifier. The distortion of mock ECAP (mECAP) signals was measured across stimulation parameters, and the instrumentation enabled high fidelity recording of mECAPs with latencies of only 0.5 ms for DBS pulse widths of 50 to 100 µs/phase. Subsequently, the instrumentation was used to record in vivo ECAPs, without contamination by the stimulus artefact, during thalamic DBS in an anesthetized cat. The characteristics of the physiological ECAP were dependent on stimulation parameters. The novel instrumentation enables high fidelity ECAP recording and advances the potential use of the ECAP as a feedback signal for the tuning of DBS parameters.
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Affiliation(s)
- A R Kent
- Department of Biomedical Engineering, Duke University, Durham, NC 27710, USA
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Rosa M, Giannicola G, Marceglia S, Fumagalli M, Barbieri S, Priori A. Neurophysiology of Deep Brain Stimulation. EMERGING HORIZONS IN NEUROMODULATION - NEW FRONTIERS IN BRAIN AND SPINE STIMULATION 2012. [DOI: 10.1016/b978-0-12-404706-8.00004-8] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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Alam M, Heissler HE, Schwabe K, Krauss JK. Deep brain stimulation of the pedunculopontine tegmental nucleus modulates neuronal hyperactivity and enhanced beta oscillatory activity of the subthalamic nucleus in the rat 6-hydroxydopamine model. Exp Neurol 2011; 233:233-42. [PMID: 22036687 DOI: 10.1016/j.expneurol.2011.10.006] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2011] [Revised: 09/28/2011] [Accepted: 10/09/2011] [Indexed: 01/03/2023]
Abstract
Deep brain stimulation (DBS) of the pedunculopontine nucleus (PPN) area has been introduced as a novel surgical therapy for dopamine refractory gait problems, freezing and postural instability in the late stage of Parkinson's disease (PD). Lesions of the pedunculopontine tegmental (PPTg) nucleus, the equivalent of the PPN in rodents, were shown to reduce the elevated discharge rate of the subthalamic nucleus (STN) in the 6-hydroxydopamine (6-OHDA) rat model of PD. In order to further elucidate the modulatory effect of the PPTg on the STN we examined the effect of 25 Hz low frequency PPTg stimulation on neuronal single unit activity and oscillatory local field potentials (LFPs) of the STN, and on the electrocorticogram (ECoG) of the primary motor cortex region in rats with unilateral 6-OHDA induced nigrostriatal lesions. Stimulation of the PPTg reduced the enhanced firing rate in the STN, without affecting the firing pattern or approximate entropy (ApEn). It also reduced the activity in the beta band (15-30 Hz) of the STN, which is elevated in 6-OHDA lesioned rats, without affecting beta activity in the motor cortex. We showed a modulatory effect of PPTg stimulation on altered neuronal STN activity in the PD 6-OHDA rat model, indicating that PPTg DBS may alter activity of the basal ganglia circuitry at least partially. It remains unclear, however, how these changes are exactly mediated and whether they are relevant with regard to the descending PPTg projections in the lower brainstem.
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Affiliation(s)
- Mesbah Alam
- Department of Neurosurgery, Hannover Medical School, Hannover, Germany.
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Fumagalli M, Giannicola G, Rosa M, Marceglia S, Lucchiari C, Mrakic-Sposta S, Servello D, Pacchetti C, Porta M, Sassi M, Zangaglia R, Franzini A, Albanese A, Romito L, Piacentini S, Zago S, Pravettoni G, Barbieri S, Priori A. Conflict-dependent dynamic of subthalamic nucleus oscillations during moral decisions. Soc Neurosci 2011; 6:243-56. [DOI: 10.1080/17470919.2010.515148] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Rouse AG, Stanslaski SR, Cong P, Jensen RM, Afshar P, Ullestad D, Gupta R, Molnar GF, Moran DW, Denison TJ. A chronic generalized bi-directional brain-machine interface. J Neural Eng 2011; 8:036018. [PMID: 21543839 DOI: 10.1088/1741-2560/8/3/036018] [Citation(s) in RCA: 130] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
A bi-directional neural interface (NI) system was designed and prototyped by incorporating a novel neural recording and processing subsystem into a commercial neural stimulator architecture. The NI system prototype leverages the system infrastructure from an existing neurostimulator to ensure reliable operation in a chronic implantation environment. In addition to providing predicate therapy capabilities, the device adds key elements to facilitate chronic research, such as four channels of electrocortigram/local field potential amplification and spectral analysis, a three-axis accelerometer, algorithm processing, event-based data logging, and wireless telemetry for data uploads and algorithm/configuration updates. The custom-integrated micropower sensor and interface circuits facilitate extended operation in a power-limited device. The prototype underwent significant verification testing to ensure reliability, and meets the requirements for a class CF instrument per IEC-60601 protocols. The ability of the device system to process and aid in classifying brain states was preclinically validated using an in vivo non-human primate model for brain control of a computer cursor (i.e. brain-machine interface or BMI). The primate BMI model was chosen for its ability to quantitatively measure signal decoding performance from brain activity that is similar in both amplitude and spectral content to other biomarkers used to detect disease states (e.g. Parkinson's disease). A key goal of this research prototype is to help broaden the clinical scope and acceptance of NI techniques, particularly real-time brain state detection. These techniques have the potential to be generalized beyond motor prosthesis, and are being explored for unmet needs in other neurological conditions such as movement disorders, stroke and epilepsy.
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Affiliation(s)
- A G Rouse
- Department of Biomedical Engineering, Washington University, St Louis, MO, USA
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