Adaptive control of Parkinson's state based on a nonlinear computational model with unknown parameters

Design of Closed-Loop Control Schemes Based on the GA-PID and GA-RBF-PID Algorithms for Brain Dynamic Modulation

Neurostimulation can be used to modulate brain dynamics of patients with neuropsychiatric disorders to make abnormal neural oscillations restore to normal. The control schemes proposed on the bases of neural computational models can predict the mechanism of neural oscillations induced by neurostimulation, and then make clinical decisions that are suitable for the patient's condition to ensure better treatment outcomes. The present work proposes two closed-loop control schemes based on the improved incremental proportional integral derivative (PID) algorithms to modulate brain dynamics simulated by Wendling-type coupled neural mass models. The introduction of the genetic algorithm (GA) in traditional incremental PID algorithm aims to overcome the disadvantage that the selection of control parameters depends on the designer's experience, so as to ensure control accuracy. The introduction of the radial basis function (RBF) neural network aims to improve the dynamic performance and stability of the control scheme by adaptively adjusting control parameters. The simulation results show the high accuracy of the closed-loop control schemes based on GA-PID and GA-RBF-PID algorithms for modulation of brain dynamics, and also confirm the superiority of the scheme based on the GA-RBF-PID algorithm in terms of the dynamic performance and stability. This research of making hypotheses and predictions according to model data is expected to improve and perfect the equipment of early intervention and rehabilitation treatment for neuropsychiatric disorders in the biomedical engineering field.

Robust multi-input multi-output adaptive fuzzy terminal sliding mode control of deep brain stimulation in Parkinson's disease: a simulation study

Deep brain stimulation (DBS) has become an effective therapeutic solution for Parkinson’s disease (PD). Adaptive closed-loop DBS can be used to minimize stimulation-induced side effects by automatically determining the stimulation parameters based on the PD dynamics. In this paper, by modeling the interaction between the neurons in populations of the thalamic, the network-level modulation of thalamic is represented in a standard canonical form as a multi-input multi-output (MIMO) nonlinear first-order system with uncertainty and external disturbances. A class of fast and robust MIMO adaptive fuzzy terminal sliding mode control (AFTSMC) has been presented for control of membrane potential of thalamic neuron populations through continuous adaptive DBS current applied to the thalamus. A fuzzy logic system (FLS) is used to estimate the unknown nonlinear dynamics of the model, and the weights of FLS are adjusted online to guarantee the convergence of FLS parameters to optimal values. The simulation results show that the proposed AFTSMC not only significantly produces lower tracking errors in comparison with the classical adaptive fuzzy sliding mode control (AFSMC), but also makes more robust and reliable outputs. The results suggest that the proposed AFTSMC provides a more robust and smooth control input which is highly desirable for hardware design and implementation.

On the Modeling of the Three Types of Non-spiking Neurons of the Caenorhabditis elegans

The nematode Caenorhabditis elegans (C. elegans) is a well-known model organism in neuroscience. The relative simplicity of its nervous system, made up of few hundred neurons, shares some essential features with more sophisticated nervous systems, including the human one. If we are able to fully characterize the nervous system of this organism, we will be one step closer to understanding the mechanisms underlying the behavior of living things. Following a recently conducted electrophysiological survey on different C. elegans neurons, this paper aims at modeling the three non-spiking RIM, AIY and AFD neurons (arbitrarily named with three upper case letters by convention). To date, they represent the three possible forms of non-spiking neuronal responses of the C. elegans. To achieve this objective, we propose a conductance-based neuron model adapted to the electrophysiological features of each neuron. These features are based on current biological research and a series of in-silico experiments which use differential evolution to fit the model to experimental data. From the obtained results, we formulate a series of biological hypotheses regarding currents involved in the neuron dynamics. These models reproduce experimental data with a high degree of accuracy while being biologically consistent with state-of-the-art research.

Multi-disease Deep Brain Stimulation

Current closed-loop deep brain stimulation (DBS) devices can generally tackle one disorder. This paper presents the design and evaluation of a multi-disease closed-loop DBS device that can sense multiple brain biomarkers, detect a disorder, and adaptively deliver electrical stimulation pulses based on the disease state. The device consists of: (i) a neural sensor, (ii) a controller involving a feature extractor, a disease classifier, and a control strategy, and (iii) neural stimulator. The neural sensor records and processes local field potentials and spikes from within the brain using two low-frequency and high-frequency channels. The feature extractor digitally processes the output of the neural sensor, and extracts five potential biomarkers: alpha, beta, slow gamma, high-frequency oscillations, and spikes. The disease classifier identifies the type of the neurological disorder through an analysis of the biomarkers' amplitude features. The control strategy considers the disease state and supplies the stimulation settings to the neural stimulator. Both the disease classifier and control strategy are based on fuzzy algorithms. The neural stimulator generates electrical stimulation pulses according to the control commands, and delivers them to the target area of the brain. The device can generate current stimulation pulses with specific amplitude, frequency, and duration. The fabricated device has the maximum radius of 15 mm. Its total weight including the circuit board, battery and battery holder is 5.1 g. The performance of the integrated device has been evaluated through six bench and in-vitro experiments. The experimental results are presented, analyzed, and discussed. Six bench and in-vitro experiments were conducted using sinusoidal, normal pre-recorded, and diseased neural signals representing normal, epilepsy, depression and PD conditions. The results obtained through these tests indicate the successful neural sensing, classification, control, and neural stimulating performance.

Fractional order controllers increase the robustness of closed-loop deep brain stimulation systems

We studied the effects of using fractional order proportional, integral, and derivative (PID) controllers in a closed-loop mathematical model of deep brain stimulation. The objective of the controller was to dampen oscillations from a neural network model of Parkinson's disease. We varied intrinsic parameters, such as the gain of the controller, and extrinsic variables, such as the excitability of the network. We found that in most cases, fractional order components increased the robustness of the model multi-fold to changes in the gains of the controller. Similarly, the controller could be set to a fixed set of gains and remain stable to a much larger range, than for the classical PID case, of changes in synaptic weights that otherwise would cause oscillatory activity. The increase in robustness is a consequence of the properties of fractional order derivatives that provide an intrinsic memory trace of past activity, which works as a negative feedback system. Fractional order PID controllers could provide a platform to develop stand-alone closed-loop deep brain stimulation systems.

A Basal Ganglia Computational Model to Explain the Paradoxical Sensorial Improvement in the Presence of Huntington's Disease

The basal ganglia (BG) represent a critical center of the nervous system for sensorial discrimination. Although it is known that Huntington's disease (HD) affects this brain area, it still remains unclear how HD patients achieve paradoxical improvement in sensorial discrimination tasks. This paper presents a computational model of the BG including the main nuclei and the typical firing properties of their neurons. The BG model has been embedded within an auditory signal detection task. We have emulated the effect that the altered levels of dopamine and the degree of HD affectation have in information processing at different layers of the BG, and how these aspects shape transient and steady states differently throughout the selection task. By extracting the independent components of the BG activity at different populations, it is evidenced that early and medium stages of HD affectation may enhance transient activity in the striatum and the substantia nigra pars reticulata. These results represent a possible explanation for the paradoxical improvement that HD patients present in discrimination task performance. Thus, this paper provides a novel understanding on how the fast dynamics of the BG network at different layers interact and enable transient states to emerge throughout the successive neuron populations.

N-of-1 Trials for Closed-Loop Deep Brain Stimulation Devices

Closed-loop deep brain stimulation (DBS) devices hold great promise for treating various neurological and psychiatric conditions. Yet while these algorithmic-based devices provide personalized treatment to each patient, they also present uniquely individualized risks of physiological and psychological harms. These experimental devices are typically tested in randomized controlled trials, which may not be the optimum approach to identifying and assessing phenomenological harms they pose to patients. In this article, we contend that an N-of-1 trial design-which is being used ever more frequently to realize the goals of individualized, precision medicine-could provide beneficial phenomenological data about the potential risks of harm to properly inform the use of closed-loop DBS devices. Data from N-of-1 trials may provide patients, as well as their families and other caregivers, with better information on which to base informed choices about pursuing this type of treatment option.

Parkinsonism Differently Affects the Single Neuronal Activity in the Primary and Supplementary Motor Areas in Monkeys: An Investigation in Linear and Nonlinear Domains

The changes in neuronal firing activity in the primary motor cortex (M1) and supplementary motor area (SMA) were compared in monkeys rendered parkinsonian by treatment with 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine. The neuronal dynamic was characterized using mathematical tools defined in different frameworks (rate, oscillations or complex patterns). Then, and for each cortical area, multivariate and discriminate analyses were further performed on these features to identify those important to differentiate between the normal and the pathological neuronal activity. Our results show a different order in the importance of the features to discriminate the pathological state in each cortical area which suggests that the M1 and the SMA exhibit dissimilarities in their neuronal alterations induced by parkinsonism. Our findings highlight the need for multiple mathematical frameworks to best characterize the pathological neuronal activity related to parkinsonism. Future translational studies are warranted to investigate the causal relationships between cortical region-specificities, dominant pathological hallmarks and symptoms.

Leveraging network analysis to support experts in their analyses of subjects with MCI and AD

In this paper, we propose a network analysis-based approach to help experts in their analyses of subjects with mild cognitive impairment (hereafter, MCI) and Alzheimer's disease (hereafter, AD) and to investigate the evolution of these subjects over time. The inputs of our approach are the electroencephalograms (hereafter, EEGs) of the patients to analyze, performed at a certain time and, again, 3 months later. Given an EEG of a subject, our approach constructs a network with nodes that represent the electrodes and edges that denote connections between electrodes. Then, it applies several network-based techniques allowing the investigation of subjects with MCI and AD and the analysis of their evolution over time. (i) A connection coefficient, supporting experts to distinguish patients with MCI from patients with AD; (ii) A conversion coefficient, supporting experts to verify if a subject with MCI is converting to AD; (iii) Some network motifs, i.e., network patterns very frequent in one kind of patient and absent, or very rare, in the other. Patients with AD, just by the very nature of their condition, cannot be forced to stay motionless while undergoing examinations for a long time. EEG is a non-invasive examination that can be easily done on them. Since AD and MCI, if prodromal to AD, are associated with a loss of cortical connections, the adoption of network analysis appears suitable to investigate the effects of the progression of the disease on EEG. This paper confirms the suitability of this idea Graphical Abstract Ability of our proposed model to distinguish a control subject from a patient with MCI and a patient with AD. Blue edges represent strong connections among the corresponding brain areas; red edges denote middle connections, whereas green edges indicate weak connections. In the control subject (at the top), most connections are blue. In the patient with MCI (at the middle), most connections are red and green. In the patient with AD (at the bottom), most connections are either absent or green. .

Parkinson's disease: Cause factors, measurable indicators, and early diagnosis

Parkinson's disease (PD) is a neurodegenerative disease of the central nervous system caused due to the loss of dopaminergic neurons. It is classified under movement disorder as patients with PD present with tremor, rigidity, postural changes, and a decrease in spontaneous movements. Comorbidities including anxiety, depression, fatigue, and sleep disorders are observed prior to the diagnosis of PD. Gene mutations, exposure to toxic substances, and aging are considered as the causative factors of PD even though its genesis is unknown. This paper reviews PD etiologies, progression, and in particular measurable indicators of PD such as neuroimaging and electrophysiology modalities. In addition to gene therapy, neuroprotective, pharmacological, and neural transplantation treatments, researchers are actively aiming at identifying biological markers of PD with the goal of early diagnosis. Neuroimaging modalities used together with advanced machine learning techniques offer a promising path for the early detection and intervention in PD patients.

Short-Term Effects of Binaural Beats on EEG Power, Functional Connectivity, Cognition, Gait and Anxiety in Parkinson’s Disease

We applied rhythmic binaural sound to Parkinson’s Disease (PD) patients to investigate its influence on several symptoms of this disease and on Electrophysiology (Electrocardiography and Electroencephalography (EEG)). We conducted a double-blind, randomized controlled study in which rhythmic binaural beats and control were administered over two randomized and counterbalanced sessions (within-subjects repeated-measures design). Patients ([Formula: see text], age [Formula: see text], stage I–III Hoehn & Yahr scale) participated in two sessions of sound stimulation for 10[Formula: see text]min separated by a minimum of 7 days. Data were collected immediately before and after both stimulations with the following results: (1) a decrease in theta activity, (2) a general decrease in Functional Connectivity (FC), and (3) an improvement in working memory performance. However, no significant changes were identified in the gait performance, heart rate or anxiety level of the patients. With regard to the control stimulation, we did not identify significant changes in the variables analyzed. The use of binaural-rhythm stimulation for PD, as designed in this study, seems to be an effective, portable, inexpensive and noninvasive method to modulate brain activity. This influence on brain activity did not induce changes in anxiety or gait parameters; however, it resulted in a normalization of EEG power (altered in PD), normalization of brain FC (also altered in PD) and working memory improvement (a normalizing effect). In summary, we consider that sound, particularly binaural-rhythmic sound, may be a co-assistant tool in the treatment of PD, however more research is needed to consider the use of this type of stimulation as an effective therapy.

Permutation Jaccard Distance-Based Hierarchical Clustering to Estimate EEG Network Density Modifications in MCI Subjects

In this paper, a novel electroencephalographic (EEG)-based method is introduced for the quantification of brain-electrical connectivity changes over a longitudinal evaluation of mild cognitive impaired (MCI) subjects. In the proposed method, a dissimilarity matrix is constructed by estimating the coupling strength between every pair of EEG signals, Hierarchical clustering is then applied to group the related electrodes according to the dissimilarity estimated on pairs of EEG recordings. Subsequently, the connectivity density of the electrodes network is calculated. The technique was tested over two different coupling strength descriptors: wavelet coherence (WC) and permutation Jaccard distance (PJD), a novel metric of coupling strength between time series introduced in this paper. Twenty-five MCI patients were enrolled within a follow-up program that consisted of two successive evaluations, at time T0 and at time T1, three months later. At T1, four subjects were diagnosed to have converted to Alzheimer's Disease (AD). When applying the PJD-based method, the converted patients exhibited a significantly increased PJD (p < 0.05), i.e., a reduced overall coupling strength, specifically in delta and θ bands and in the overall range (0.5-32 Hz). In addition, in contrast to stable MCI patients, converted patients exhibited a network density reduction in every subband (delta, θ, alpha, and beta). When WC was used as coupling strength descriptor, the method resulted in a less sensitive and specific outcome. The proposed method, mixing nonlinear analysis to a machine learning approach, appears to provide an objective evaluation of the connectivity density modifications associated to the MCI-AD conversion, just processing noninvasive EEG signals.

Nonlinear predictive control for adaptive adjustments of deep brain stimulation parameters in basal ganglia-thalamic network

The efficacy of deep brain stimulation (DBS) for Parkinson's disease (PD) depends in part on the post-operative programming of stimulation parameters. Closed-loop stimulation is one method to realize the frequent adjustment of stimulation parameters. This paper introduced the nonlinear predictive control method into the online adjustment of DBS amplitude and frequency. This approach was tested in a computational model of basal ganglia-thalamic network. The autoregressive Volterra model was used to identify the process model based on physiological data. Simulation results illustrated the efficiency of closed-loop stimulation methods (amplitude adjustment and frequency adjustment) in improving the relay reliability of thalamic neurons compared with the PD state. Besides, compared with the 130Hz constant DBS the closed-loop stimulation methods can significantly reduce the energy consumption. Through the analysis of inter-spike-intervals (ISIs) distribution of basal ganglia neurons, the evoked network activity by the closed-loop frequency adjustment stimulation was closer to the normal state.

Advances in closed-loop deep brain stimulation devices

BACKGROUND

Millions of patients around the world are affected by neurological and psychiatric disorders. Deep brain stimulation (DBS) is a device-based therapy that could have fewer side-effects and higher efficiencies in drug-resistant patients compared to other therapeutic options such as pharmacological approaches. Thus far, several efforts have been made to incorporate a feedback loop into DBS devices to make them operate in a closed-loop manner.

METHODS

This paper presents a comprehensive investigation into the existing research-based and commercial closed-loop DBS devices. It describes a brief history of closed-loop DBS techniques, biomarkers and algorithms used for closing the feedback loop, components of the current research-based and commercial closed-loop DBS devices, and advancements and challenges in this field of research. This review also includes a comparison of the closed-loop DBS devices and provides the future directions of this area of research.

RESULTS

Although we are in the early stages of the closed-loop DBS approach, there have been fruitful efforts in design and development of closed-loop DBS devices. To date, only one commercial closed-loop DBS device has been manufactured. However, this system does not have an intelligent and patient dependent control algorithm. A closed-loop DBS device requires a control algorithm to learn and optimize the stimulation parameters according to the brain clinical state.

CONCLUSIONS

The promising clinical effects of open-loop DBS have been demonstrated, indicating DBS as a pioneer technology and treatment option to serve neurological patients. However, like other commercial devices, DBS needs to be automated and modernized.

La Enfermedad de Parkinson: Etiología, Tratamientos y Factores Preventivos

La enfermedad de Parkinson (EP) es la patología neurodegenerativa motora con mayor incidencia a nivel mundial. Esta afecta a aproximadamente 2-3% de la población mayor a 60 años de edad y sus causas aún no han sido bien determinadas. Actualmente no existe cura para esta patología; sin embargo, es posible contar con diferentes tratamientos que permiten aliviar algunos de sus síntomas y enlentecer su curso. Estos tratamientos tienen como premisa contrarrestar los efectos ocasionados por la pérdida de la función dopaminérgica de la sustancia nigra (SN) sobre estructuras como el núcleo subtálamico (NST) o globo pálido interno (GPi) ya sea por medio de tratamientos farmacológicos, estimulación cerebral profunda (ECP) o con el implante celular. Existen también investigaciones que están dirigiendo su interés al desarrollo de fármacos con potencial terapéutico, que presenten alta especificidad a receptores colinérgicos de nicotina (nAChRs) y antagonistas de receptores de adenosina, específicamente del subtipo A2A. Estos últimos, juegan un papel importante en el control de liberación dopaminérgica y en los procesos de neuroprotección. En esta revisión se pretende ofrecer una panorámica actual sobre algunos de los factores de riesgo asociados a EP, algunos de los tratamientos actuales más utilizados y acerca del rol de sustancias potencialmente útiles en la prevención de esta enfermedad.

Modulation of Parkinsonian State With Uncertain Disturbance Based on Sliding Mode Control

Parkinson's disease (PD) is a degenerative disorder of central nervous system that endangers the olds' health seriously. The motor symptoms of PD can be attributed to the distorted relay reliability of thalamus to cortical sensorimotor input that results from the increase of inhibitory input from internal segment of the globus pallidum (GPi). Based on this, we construct the GPi-thalamocortical computational model to generate the normal and pathological firing patterns by varying GPi spike train input. A kind of closed-loop deep brain stimulation (DBS) strategy is proposed here. Our control objective is to make the controlled membrane potential of the thalamic neuron return to the normal firing pattern. The control input that directly acts on the thalamus is the DBS waveform, which is adjusted in real time according to the feedback signal. Aimed at a certain system without the change of object parameters or stochastic disturbance, the input-output feedback linearization method is able to eliminate the error between the system output and the desired output. When uncertain elements taken into consideration in the system, the simulation results indicate that sliding mode control scheme provides better effectiveness and higher robustness.

Closed-Loop Modulation of the Pathological Disorders of the Basal Ganglia Network

A generalized predictive closed-loop control strategy to improve the basal ganglia activity patterns in Parkinson's disease (PD) is explored in this paper. Based on system identification, an input-output model is established to reveal the relationship between external stimulation and neuronal responses. The model contributes to the implementation of the generalized predictive control (GPC) algorithm that generates the optimal stimulation waveform to modulate the activities of neuronal nuclei. By analyzing the roles of two critical control parameters within the GPC law, optimal closed-loop control that has the capability of restoring the normal relay reliability of the thalamus with the least stimulation energy expenditure can be achieved. In comparison with open-loop deep brain stimulation and traditional static control schemes, the generalized predictive closed-loop control strategy can optimize the stimulation waveform without requiring any particular knowledge of the physiological properties of the system. This type of closed-loop control strategy generates an adaptive stimulation waveform with low energy expenditure with the potential to improve the treatments for PD.

Superlinear Summation of Information in Premotor Neuron Pairs

Whether premotor/motor neurons encode information in terms of spiking frequency or by their relative time of firing, which may display synchronization, is still undetermined. To address this issue, we used an information theory approach to analyze neuronal responses recorded in the premotor (area F5) and primary motor (area F1) cortices of macaque monkeys under four different conditions of visual feedback during hand grasping. To evaluate the sensitivity of spike timing correlation between single neurons, we investigated the stimulus dependent synchronization in our population of pairs. We first investigated the degree of correlation of trial-to-trial fluctuations in response strength between neighboring neurons for each condition, and second estimated the stimulus dependent synchronization by means of an information theoretical approach. We compared the information conveyed by pairs of simultaneously recorded neurons with the sum of information provided by the respective individual cells. The information transmission across pairs of cells in the primary motor cortex seems largely independent, whereas information transmission across pairs of premotor neurons is summed superlinearly. The brain could take advantage of both the accuracy provided by the independency of F1 and the synergy allowed by the superlinear information population coding in F5, distinguishing thus the generalizing role of F5.

Computer-Aided Diagnosis of Parkinson's Disease Using Enhanced Probabilistic Neural Network

Early and accurate diagnosis of Parkinson's disease (PD) remains challenging. Neuropathological studies using brain bank specimens have estimated that a large percentages of clinical diagnoses of PD may be incorrect especially in the early stages. In this paper, a comprehensive computer model is presented for the diagnosis of PD based on motor, non-motor, and neuroimaging features using the recently-developed enhanced probabilistic neural network (EPNN). The model is tested for differentiating PD patients from those with scans without evidence of dopaminergic deficit (SWEDDs) using the Parkinson's Progression Markers Initiative (PPMI) database, an observational, multi-center study designed to identify PD biomarkers for diagnosis and disease progression. The results are compared to four other commonly-used machine learning algorithms: the probabilistic neural network (PNN), support vector machine (SVM), k-nearest neighbors (k-NN) algorithm, and classification tree (CT). The EPNN had the highest classification accuracy at 92.5% followed by the PNN (91.6%), k-NN (90.8%) and CT (90.2%). The EPNN exhibited an accuracy of 98.6% when classifying healthy control (HC) versus PD, higher than any previous studies.