1
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Wu Y, Hu K, Liu S. Computational models advance deep brain stimulation for Parkinson's disease. NETWORK (BRISTOL, ENGLAND) 2024:1-32. [PMID: 38923890 DOI: 10.1080/0954898x.2024.2361799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 05/25/2024] [Indexed: 06/28/2024]
Abstract
Deep brain stimulation(DBS) has become an effective intervention for advanced Parkinson's disease(PD), but the exact mechanism of DBS is still unclear. In this review, we discuss the history of DBS, the anatomy and internal architecture of the basal ganglia (BG), the abnormal pathological changes of the BG in PD, and how computational models can help understand and advance DBS. We also describe two types of models: mathematical theoretical models and clinical predictive models. Mathematical theoretical models simulate neurons or neural networks of BG to shed light on the mechanistic principle underlying DBS, while clinical predictive models focus more on patients' outcomes, helping to adapt treatment plans for each patient and advance novel electrode designs. Finally, we provide insights and an outlook on future technologies.
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Affiliation(s)
- Yongtong Wu
- School of Mathematics, South China University of Technology, Guangzhou, Guangdong, China
| | - Kejia Hu
- Department of Neurosurgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Center for Functional Neurosurgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Shenquan Liu
- School of Mathematics, South China University of Technology, Guangzhou, Guangdong, China
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2
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Balamur R, Eren GO, Kaleli HN, Karatum O, Kaya L, Hasanreisoglu M, Nizamoglu S. A Retina-Inspired Optoelectronic Synapse Using Quantum Dots for Neuromorphic Photostimulation of Neurons. ADVANCED SCIENCE (WEINHEIM, BADEN-WURTTEMBERG, GERMANY) 2024; 11:e2401753. [PMID: 38447181 PMCID: PMC11095222 DOI: 10.1002/advs.202401753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/19/2024] [Indexed: 03/08/2024]
Abstract
Neuromorphic electronics, inspired by the functions of neurons, have the potential to enable biomimetic communication with cells. Such systems require operation in aqueous environments, generation of sufficient levels of ionic currents for neurostimulation, and plasticity. However, their implementation requires a combination of separate devices, such as sensors, organic synaptic transistors, and stimulation electrodes. Here, a compact neuromorphic synapse that combines photodetection, memory, and neurostimulation functionalities all-in-one is presented. The artificial photoreception is facilitated by a photovoltaic device based on cell-interfacing InP/ZnS quantum dots, which induces photo-faradaic charge-transfer mediated plasticity. The device sends excitatory post-synaptic currents exhibiting paired-pulse facilitation and post-tetanic potentiation to the hippocampal neurons via the biohybrid synapse. The electrophysiological recordings indicate modulation of the probability of action potential firing due to biomimetic temporal summation of excitatory post-synaptic currents. The results pave the way for the development of novel bioinspired neuroprosthetics and soft robotics and highlight the potential of quantum dots for achieving versatile neuromorphic functionality in aqueous environments.
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Affiliation(s)
- Ridvan Balamur
- Department of Electrical and Electronics EngineeringKoç UniversityIstanbul34450Türkiye
| | - Guncem Ozgun Eren
- Department of Biomedical Science and EngineeringKoç UniversityIstanbul34450Türkiye
| | - Humeyra Nur Kaleli
- Research Center for Translational MedicineKoç UniversityIstanbul34450Türkiye
| | - Onuralp Karatum
- Department of Electrical and Electronics EngineeringKoç UniversityIstanbul34450Türkiye
| | - Lokman Kaya
- Department of Electrical and Electronics EngineeringKoç UniversityIstanbul34450Türkiye
| | - Murat Hasanreisoglu
- Research Center for Translational MedicineKoç UniversityIstanbul34450Türkiye
| | - Sedat Nizamoglu
- Department of Electrical and Electronics EngineeringKoç UniversityIstanbul34450Türkiye
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3
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Balamur R, Eren GO, Kaleli HN, Karatum O, Kaya L, Hasanreisoglu M, Nizamoglu S. A Retina-Inspired Optoelectronic Synapse Using Quantum Dots for Neuromorphic Photostimulation of Neurons. ADVANCED SCIENCE (WEINHEIM, BADEN-WURTTEMBERG, GERMANY) 2024; 11:e2306097. [PMID: 38514908 PMCID: PMC11132067 DOI: 10.1002/advs.202306097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 01/08/2024] [Indexed: 03/23/2024]
Abstract
Neuromorphic electronics, inspired by the functions of neurons, have the potential to enable biomimetic communication with cells. Such systems require operation in aqueous environments, generation of sufficient levels of ionic currents for neurostimulation, and plasticity. However, their implementation requires a combination of separate devices, such as sensors, organic synaptic transistors, and stimulation electrodes. Here, a compact neuromorphic synapse that combines photodetection, memory, and neurostimulation functionalities all-in-one is presented. The artificial photoreception is facilitated by a photovoltaic device based on cell-interfacing InP/ZnS quantum dots, which induces photo-faradaic charge-transfer mediated plasticity. The device sends excitatory post-synaptic currents exhibiting paired-pulse facilitation and post-tetanic potentiation to the hippocampal neurons via the biohybrid synapse. The electrophysiological recordings indicate modulation of the probability of action potential firing due to biomimetic temporal summation of excitatory post-synaptic currents. These results pave the way for the development of novel bioinspired neuroprosthetics and soft robotics, and highlight the potential of quantum dots for achieving versatile neuromorphic functionality in aqueous environments.
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Affiliation(s)
- Ridvan Balamur
- Department of Electrical and Electronics EngineeringKoç UniversityIstanbul34450Türkiye
| | - Guncem Ozgun Eren
- Department of Biomedical Science and EngineeringKoç UniversityIstanbul34450Türkiye
| | - Humeyra Nur Kaleli
- Research Center for Translational MedicineKoç UniversityIstanbul34450Türkiye
| | - Onuralp Karatum
- Department of Electrical and Electronics EngineeringKoç UniversityIstanbul34450Türkiye
| | - Lokman Kaya
- Department of Electrical and Electronics EngineeringKoç UniversityIstanbul34450Türkiye
| | - Murat Hasanreisoglu
- Research Center for Translational MedicineKoç UniversityIstanbul34450Türkiye
| | - Sedat Nizamoglu
- Department of Electrical and Electronics EngineeringKoç UniversityIstanbul34450Türkiye
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4
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Guo W, He Y, Zhang W, Sun Y, Wang J, Liu S, Ming D. A novel non-invasive brain stimulation technique: "Temporally interfering electrical stimulation". Front Neurosci 2023; 17:1092539. [PMID: 36777641 PMCID: PMC9912300 DOI: 10.3389/fnins.2023.1092539] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Accepted: 01/17/2023] [Indexed: 01/30/2023] Open
Abstract
For decades, neuromodulation technology has demonstrated tremendous potential in the treatment of neuropsychiatric disorders. However, challenges such as being less intrusive, more concentrated, using less energy, and better public acceptance, must be considered. Several novel and optimized methods are thus urgently desiderated to overcome these barriers. In specific, temporally interfering (TI) electrical stimulation was pioneered in 2017, which used a low-frequency envelope waveform, generated by the superposition of two high-frequency sinusoidal currents of slightly different frequency, to stimulate specific targets inside the brain. TI electrical stimulation holds the advantages of both spatial targeting and non-invasive character. The ability to activate deep pathogenic targets without surgery is intriguing, and it is expected to be employed to treat some neurological or psychiatric disorders. Recently, efforts have been undertaken to investigate the stimulation qualities and translation application of TI electrical stimulation via computational modeling and animal experiments. This review detailed the most recent scientific developments in the field of TI electrical stimulation, with the goal of serving as a reference for future research.
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Affiliation(s)
- Wanting Guo
- Academy of Medical Engineering and Translational Medicine, Tianjin University, Tianjin, China
| | - Yuchen He
- Academy of Medical Engineering and Translational Medicine, Tianjin University, Tianjin, China
| | - Wenquan Zhang
- Academy of Medical Engineering and Translational Medicine, Tianjin University, Tianjin, China
| | - Yiwei Sun
- Academy of Medical Engineering and Translational Medicine, Tianjin University, Tianjin, China
| | - Junling Wang
- Academy of Medical Engineering and Translational Medicine, Tianjin University, Tianjin, China
| | - Shuang Liu
- Academy of Medical Engineering and Translational Medicine, Tianjin University, Tianjin, China,*Correspondence: Shuang Liu,
| | - Dong Ming
- Academy of Medical Engineering and Translational Medicine, Tianjin University, Tianjin, China,Department of Biomedical Engineering, College of Precision Instruments and Optoelectronics Engineering, Tianjin University, Tianjin, China,Tianjin International Joint Research Center for Neural Engineering, Tianjin, China,Dong Ming,
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5
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Cabrera LY, Gilbert MMC, Achtyes ED, McCright AM, Bluhm R. Jumping through the hoops: Barriers and other ethical concerns regarding the use of psychiatric electroceutical interventions. Psychiatry Res 2022; 313:114612. [PMID: 35584563 PMCID: PMC10516532 DOI: 10.1016/j.psychres.2022.114612] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Revised: 04/14/2022] [Accepted: 04/16/2022] [Indexed: 11/19/2022]
Abstract
Stakeholders' perceptions of barriers to and other ethical concerns about using psychiatric electroceutical interventions (PEIs), interventions that use electrical or magnetic stimuli to treat psychiatric conditions like treatment-resistant depression (TRD), may influence the uptake of these interventions. This study examined such perceptions among psychiatrists, patients with depression, and members of the public. We conducted semi-structured qualitative interviews with 16 members of each group to examine their views on practical barriers and ethical concerns. We used qualitative content analysis to identify relevant themes, and compared findings across stakeholder groups. Access limitations to the interventions, including cost and availability of the interventions, cut across all PEIs-including those that are still experimental, and were raised by all groups. Most participants across all groups raised concerns about informed consent, in terms of receiving adequate, appropriate, and understandable information. Our results suggest that these three stakeholder groups perceive similar structural and attitudinal barriers to, and have similar ethical concerns about, using PEIs for TRD. These results identify key issues that must be addressed for the full potential of PEIs to be realized. Future research with larger samples will help to better understand how to address these barriers to treatment for individuals with TRD.
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Affiliation(s)
- Laura Y Cabrera
- Center for Neural Engineering, Department of Science and Mechanics and Rock Ethics Institute, Pennsylvania State University, University Park, W-316 Millennium Science Complex, PA 16802, United States.
| | - Maryssa M C Gilbert
- College of Human Medicine, Michigan State University, East Lansing, MI, United States
| | - Eric D Achtyes
- Division of Psychiatry & Behavioral Medicine, College of Human Medicine, Michigan State University, Grand Rapids, MI, United States; Pine Rest Christian Mental Health Services, Grand Rapids, MI, United States
| | - Aaron M McCright
- Department of Sociology, College of Social Science, Michigan State University, East Lansing, MI, United States
| | - Robyn Bluhm
- Department of Philosophy, College of Arts and Letters, and Lyman Briggs College, Michigan State University, East Lansing, MI, United States
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6
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Zhang Q, Zhao B, Neumann WJ, Xie H, Shi L, Zhu G, Yin Z, Qin G, Bai Y, Meng F, Yang A, Jiang Y, Zhang J. Low-frequency oscillations link frontal and parietal cortex with subthalamic nucleus in conflicts. Neuroimage 2022; 258:119389. [PMID: 35714885 DOI: 10.1016/j.neuroimage.2022.119389] [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: 01/26/2022] [Revised: 05/04/2022] [Accepted: 06/13/2022] [Indexed: 11/18/2022] Open
Abstract
Low-frequency oscillations (LFOs, 28 Hz) in the subthalamic nucleus(STN) are known to reflect cognitive conflict. However, it is unclear if LFOs mediate communication and functional interactions among regions implicated in conflict processing, such as the motor cortex (M1), premotor cortex (PMC), and superior parietal lobule (SPL). To investigate the potential contribution of LFOs to cognitive conflict mediation, we recorded M1, PMC, and SPL activities by right subdural electrocorticography (ECoG) simultaneously with bilateral STN local field potentials (LFPs) by deep brain stimulation electrodes in 13 patients with Parkinson's disease who performed the arrow version of the Eriksen flanker task. Elevated cue-related LFO activity was observed across patients during task trials, with the earliest onset in PMC and SPL. At cue onset, LFO power exhibited a significantly greater increase or a trend of a greater increase in the PMC, M1, and STN, and less increase in the SPL during high-conflict (incongruent) trials than in low-conflict (congruent) trials. The local LFO power increases in PMC, SPL, and right STN were correlated with response time, supporting the notion that these structures are critical hubs for cognitive conflict processing. This power increase was accompanied by increased functional connectivity between the PMC and right STN, which was correlated with response time across subjects. Finally, ipsilateral PMC-STN Granger causality was enhanced during high-conflict trials, with direction from STN to PMC. Our study indicates that LFOs link the frontal and parietal cortex with STN during conflicts, and the ipsilateral PMC-STN connection is specifically involved in this cognitive conflict processing.
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Affiliation(s)
- Quan Zhang
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, The South Fourth Ring Road, West Road, Fengtai District & No. 119, Beijing 100070, China
| | - Baotian Zhao
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, The South Fourth Ring Road, West Road, Fengtai District & No. 119, Beijing 100070, China
| | - Wolf-Julian Neumann
- Movement Disorder and Neuromodulation Unit, Department of Neurology, Charite´, Universita¨Tsmedizin Berlin, Charite´ Campus Mitte, Berlin 10117, Germany
| | - Hutao Xie
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, The South Fourth Ring Road, West Road, Fengtai District & No. 119, Beijing 100070, China
| | - Lin Shi
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, The South Fourth Ring Road, West Road, Fengtai District & No. 119, Beijing 100070, China
| | - Guanyu Zhu
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, The South Fourth Ring Road, West Road, Fengtai District & No. 119, Beijing 100070, China
| | - Zixiao Yin
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, The South Fourth Ring Road, West Road, Fengtai District & No. 119, Beijing 100070, China
| | - Guofan Qin
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, The South Fourth Ring Road, West Road, Fengtai District & No. 119, Beijing 100070, China
| | - Yutong Bai
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, The South Fourth Ring Road, West Road, Fengtai District & No. 119, Beijing 100070, China
| | - Fangang Meng
- Department of Functional Neurosurgery, Beijing Neurosurgical Institute, Capital Medical University, The South Fourth Ring Road, West Road, Fengtai District & No. 119, Beijing 100070, China
| | - Anchao Yang
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, The South Fourth Ring Road, West Road, Fengtai District & No. 119, Beijing 100070, China
| | - Yin Jiang
- Department of Functional Neurosurgery, Beijing Neurosurgical Institute, Capital Medical University, The South Fourth Ring Road, West Road, Fengtai District & No. 119, Beijing 100070, China.
| | - Jianguo Zhang
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, The South Fourth Ring Road, West Road, Fengtai District & No. 119, Beijing 100070, China; Department of Functional Neurosurgery, Beijing Neurosurgical Institute, Capital Medical University, The South Fourth Ring Road, West Road, Fengtai District & No. 119, Beijing 100070, China; Beijing Key Laboratory of Neurostimulation, Beijing, 100070, China.
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7
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Ahsan F, Chi T, Cho R, Sheth SA, Goodman W, Aazhang B. EMvelop stimulation: minimally invasive deep brain stimulation using temporally interfering electromagnetic waves. J Neural Eng 2022; 19. [PMID: 35700717 DOI: 10.1088/1741-2552/ac7894] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2022] [Accepted: 06/14/2022] [Indexed: 11/12/2022]
Abstract
OBJECTIVE Recently, the temporal interference stimulation (TIS) technique for focal noninvasive deep brain stimulation (DBS) was reported. However, subsequent computational modeling studies on the human brain have shown that while TIS achieves higher focality of electric fields than state-of-the-art methods, further work is needed to improve the stimulation strength. Here, we investigate the idea of EMvelop stimulation, a minimally invasive DBS setup using temporally interfering gigahertz (GHz) electromagnetic (EM) waves. At GHz frequencies, we can create antenna arrays at the scale of a few centimeters or less that can be endocranially implanted to enable longitudinal stimulation and circumvent signal attenuation due to the scalp and skull. Furthermore, owing to the small wavelength of GHz EM waves, we can optimize both amplitudes and phases of the EM waves to achieve high intensity and focal stimulation at targeted regions within the safety limit for exposure to EM waves. APPROACH We develop a simulation framework investigating the propagation of GHz EM waves generated by line current antenna elements and the corresponding heat generated in the brain tissue. We propose two optimization flows to identify antenna current amplitudes and phases for either maximal intensity or maximal focality transmission of the interfering electric fields with EM waves safety constraint. MAIN RESULTS A representative result of our study is that with two endocranially implanted arrays of size 4.2 cm × 4.7 cm each, we can achieve an intensity of 12 V/m with a focality of 3.6 cm at a target deep in the brain tissue. SIGNIFICANCE In this proof-of-principle study, we show that the idea of EMvelop stimulation merits further investigation as it can be a minimally invasive way of stimulating deep brain targets and offers benefits not shared by prior methodologies of electrical or magnetic stimulation.
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Affiliation(s)
- Fatima Ahsan
- Electrical and computer engineering, Rice University, 6100 Main Street, Houston, Texas, 77005, UNITED STATES
| | - Taiyun Chi
- Department of Electrical and Computer Engineering and Neuroengineering Initiative, Rice University, 6100 Main Street, Houston, Texas, 77005-1892, UNITED STATES
| | - Raymond Cho
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, 1 Baylor Plaza, Houston, TX 77030, Houston, Texas, 77030-3411, UNITED STATES
| | - Sameer A Sheth
- Neurosurgery, Baylor College of Medicine, Baylor College of Medicine, Neurosurgery Houston, TX, USA, Houston, Texas, 77030, UNITED STATES
| | - Wayne Goodman
- Psychiatry, Baylor College of Medicine, Baylor College of Medicine, Psychiatry Houston, TX, USA, Houston, Texas, 77030, UNITED STATES
| | - Behnaam Aazhang
- Department of Electrical and Computer Engineering, Rice University, George R. Brown School of Engineering, 6100 Main Street, Houston, TX 77005, USA, Houston, 77005, UNITED STATES
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8
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Stevens I, Gilbert F. International Regulatory Standards for the Qualitative Measurement of Deep Brain Stimulation in Clinical Research. J Empir Res Hum Res Ethics 2022; 17:228-241. [DOI: 10.1177/15562646221094922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Deep brain stimulation (DBS) has progressed to become a promising treatment modality for neurologic and psychiatric disorders like epilepsy and major depressive disorder due to its growing personalization. Despite evidence pointing to the benefits of DBS if tested on these personalized qualitative metrics, rather than randomized-control trial quantitative standards, the evaluation of these novel devices appears to be based on the latter. This study surveyed the presence of this trend in the national regulatory guidelines of the prominent DBS researching countries. It was found that two governing bodies, in the European Union and Australia, acknowledged the option for qualitative measures. These findings support further development of national regulatory guidelines, so the neuroscientific community developing these neurotechnologies can better understand the impact their treatments have on patients.
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Affiliation(s)
- I. Stevens
- School of Humanities, University of Tasmania, Hobart, Tasmania, Australia
| | - F. Gilbert
- School of Humanities, University of Tasmania, Hobart, Tasmania, Australia
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9
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Kochanski RB, Slavin KV. The future perspectives of psychiatric neurosurgery. PROGRESS IN BRAIN RESEARCH 2022; 270:211-228. [PMID: 35396029 DOI: 10.1016/bs.pbr.2022.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
The future of psychiatric neurosurgery can be viewed from two separate perspectives: the immediate future and the distant future. Both show promise, but the treatment strategy for mental diseases and the technology utilized during these separate periods will likely differ dramatically. It can be expected that the initial advancements will be built upon progress of neuroimaging and stereotactic targeting while surgical technology becomes adapted to patient-specific symptomatology and structural/functional imaging parameters. This individualized approach has already begun to show significant promise when applied to deep brain stimulation for treatment-resistant depression and obsessive-compulsive disorder. If effectiveness of these strategies is confirmed by well designed, double-blind, placebo-controlled clinical studies, further technological advances will continue into the distant future, and will likely involve precise neuromodulation at the cellular level, perhaps using wireless technology with or without closed-loop design. This approach, being theoretically less invasive and carrying less risk, may ultimately propel psychiatric neurosurgery to the forefront in the treatment algorithm of mental illness. Despite prominent development of non-invasive therapeutic options, such as stereotactic radiosurgery or transcranial magnetic resonance-guided focused ultrasound, chances are there will still be a need in surgical management of patients with most intractable psychiatric conditions.
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Affiliation(s)
- Ryan B Kochanski
- Neurosurgery, Methodist Healthcare System, San Antonio, TX, United States
| | - Konstantin V Slavin
- Department of Neurosurgery, University of Illinois at Chicago, Chicago, IL, United States; Neurology Service, Jesse Brown Veterans Administration Medical Center, Chicago, IL, United States.
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10
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Lorusso ND, Mohan UR, Jacobs J. Jose Delgado: A controversial trailblazer in neuromodulation. Artif Organs 2022; 46:531-540. [PMID: 35199350 DOI: 10.1111/aor.14200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 12/29/2021] [Accepted: 01/14/2022] [Indexed: 11/27/2022]
Abstract
Dr. Jose Delgado performed audacious demonstrations utilizing brain stimulation to instantly change behavior in animals. These feats spark ethical debates to this day. However, behind his controversial career is an important legacy of neurological discoveries and technological innovation. Delgado pioneered techniques in causally manipulating brain patterns and behavior with electrical stimulation and developed innovative, closed-loop neural devices. His inventive devices and techniques were ahead of his time and remain relevant to the field of neuromodulation today.
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Affiliation(s)
| | - Uma R Mohan
- Department of Biomedical Engineering, Columbia University, New York, USA
| | - Joshua Jacobs
- Department of Biomedical Engineering, Columbia University, New York, USA.,Department of Neurological Surgery, Columbia University, New York, USA
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11
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Ma R, Xia X, Zhang W, Lu Z, Wu Q, Cui J, Song H, Fan C, Chen X, Zha R, Wei J, Ji GJ, Wang X, Qiu B, Zhang X. High Gamma and Beta Temporal Interference Stimulation in the Human Motor Cortex Improves Motor Functions. Front Neurosci 2022; 15:800436. [PMID: 35046771 PMCID: PMC8761631 DOI: 10.3389/fnins.2021.800436] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2021] [Accepted: 11/29/2021] [Indexed: 12/14/2022] Open
Abstract
Background: Temporal interference (TI) stimulation is a new technique of non-invasive brain stimulation. Envelope-modulated waveforms with two high-frequency carriers can activate neurons in target brain regions without stimulating the overlying cortex, which has been validated in mouse brains. However, whether TI stimulation can work on the human brain has not been elucidated. Objective: To assess the effectiveness of the envelope-modulated waveform of TI stimulation on the human primary motor cortex (M1). Methods: Participants attended three sessions of 30-min TI stimulation during a random reaction time task (RRTT) or a serial reaction time task (SRTT). Motor cortex excitability was measured before and after TI stimulation. Results: In the RRTT experiment, only 70 Hz TI stimulation had a promoting effect on the reaction time (RT) performance and excitability of the motor cortex compared to sham stimulation. Meanwhile, compared with the sham condition, only 20 Hz TI stimulation significantly facilitated motor learning in the SRTT experiment, which was significantly positively correlated with the increase in motor evoked potential. Conclusion: These results indicate that the envelope-modulated waveform of TI stimulation has a significant promoting effect on human motor functions, experimentally suggesting the effectiveness of TI stimulation in humans for the first time and paving the way for further explorations.
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Affiliation(s)
- Ru Ma
- Hefei National Laboratory for Physical Sciences at the Microscale, Division of Life Science and Medicine, Department of Radiology, The First Affiliated Hospital of USTC, School of Life Science, University of Science and Technology of China, Hefei, China
| | - Xinzhao Xia
- Centers for Biomedical Engineering, School of Information Science and Technology, University of Science and Technology of China, Hefei, China
| | - Wei Zhang
- Hefei National Laboratory for Physical Sciences at the Microscale, Division of Life Science and Medicine, Department of Radiology, The First Affiliated Hospital of USTC, School of Life Science, University of Science and Technology of China, Hefei, China
| | - Zhuo Lu
- Centers for Biomedical Engineering, School of Information Science and Technology, University of Science and Technology of China, Hefei, China
| | - Qianying Wu
- Hefei National Laboratory for Physical Sciences at the Microscale, Division of Life Science and Medicine, Department of Radiology, The First Affiliated Hospital of USTC, School of Life Science, University of Science and Technology of China, Hefei, China.,Division of the Humanities and Social Sciences, California Institute of Technology, Pasadena, CA, United States
| | - Jiangtian Cui
- Centers for Biomedical Engineering, School of Information Science and Technology, University of Science and Technology of China, Hefei, China.,School of Optometry and Vision Sciences, Cardiff University, Cardiff, United Kingdom
| | - Hongwen Song
- Hefei National Laboratory for Physical Sciences at the Microscale, Division of Life Science and Medicine, Department of Radiology, The First Affiliated Hospital of USTC, School of Life Science, University of Science and Technology of China, Hefei, China
| | - Chuan Fan
- Centers for Biomedical Engineering, School of Information Science and Technology, University of Science and Technology of China, Hefei, China
| | - Xueli Chen
- Hefei National Laboratory for Physical Sciences at the Microscale, Division of Life Science and Medicine, Department of Radiology, The First Affiliated Hospital of USTC, School of Life Science, University of Science and Technology of China, Hefei, China
| | - Rujing Zha
- Hefei National Laboratory for Physical Sciences at the Microscale, Division of Life Science and Medicine, Department of Radiology, The First Affiliated Hospital of USTC, School of Life Science, University of Science and Technology of China, Hefei, China
| | - Junjie Wei
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Gong-Jun Ji
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Xiaoxiao Wang
- Centers for Biomedical Engineering, School of Information Science and Technology, University of Science and Technology of China, Hefei, China
| | - Bensheng Qiu
- Centers for Biomedical Engineering, School of Information Science and Technology, University of Science and Technology of China, Hefei, China
| | - Xiaochu Zhang
- Hefei National Laboratory for Physical Sciences at the Microscale, Division of Life Science and Medicine, Department of Radiology, The First Affiliated Hospital of USTC, School of Life Science, University of Science and Technology of China, Hefei, China.,Centers for Biomedical Engineering, School of Information Science and Technology, University of Science and Technology of China, Hefei, China.,Department of Psychology, School of Humanities and Social Science, University of Science and Technology of China, Hefei, China.,Biomedical Sciences and Health Laboratory of Anhui Province, University of Science and Technology of China, Hefei, China
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12
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Berggren M, Głowacki ED, Simon DT, Stavrinidou E, Tybrandt K. In Vivo Organic Bioelectronics for Neuromodulation. Chem Rev 2022; 122:4826-4846. [PMID: 35050623 PMCID: PMC8874920 DOI: 10.1021/acs.chemrev.1c00390] [Citation(s) in RCA: 39] [Impact Index Per Article: 19.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
![]()
The nervous system
poses a grand challenge for integration with
modern electronics and the subsequent advances in neurobiology, neuroprosthetics,
and therapy which would become possible upon such integration. Due
to its extreme complexity, multifaceted signaling pathways, and ∼1
kHz operating frequency, modern complementary metal oxide semiconductor
(CMOS) based electronics appear to be the only technology platform
at hand for such integration. However, conventional CMOS-based electronics
rely exclusively on electronic signaling and therefore require an
additional technology platform to translate electronic signals into
the language of neurobiology. Organic electronics are just such a
technology platform, capable of converting electronic addressing into
a variety of signals matching the endogenous signaling of the nervous
system while simultaneously possessing favorable material similarities
with nervous tissue. In this review, we introduce a variety of organic
material platforms and signaling modalities specifically designed
for this role as “translator”, focusing especially on
recent implementation in in vivo neuromodulation.
We hope that this review serves both as an informational resource
and as an encouragement and challenge to the field.
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Affiliation(s)
- Magnus Berggren
- Laboratory of Organic Electronics, Department of Science and Technology, Linköping University, 601 74 Norrköping, Sweden
| | - Eric D Głowacki
- Laboratory of Organic Electronics, Department of Science and Technology, Linköping University, 601 74 Norrköping, Sweden.,Bioelectronics Materials and Devices, Central European Institute of Technology, Brno University of Technology, Purkyňova 656/123, 612 00 Brno, Czech Republic
| | - Daniel T Simon
- Laboratory of Organic Electronics, Department of Science and Technology, Linköping University, 601 74 Norrköping, Sweden
| | - Eleni Stavrinidou
- Laboratory of Organic Electronics, Department of Science and Technology, Linköping University, 601 74 Norrköping, Sweden
| | - Klas Tybrandt
- Laboratory of Organic Electronics, Department of Science and Technology, Linköping University, 601 74 Norrköping, Sweden
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13
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Pozzi NG, Isaias IU. Adaptive deep brain stimulation: Retuning Parkinson's disease. HANDBOOK OF CLINICAL NEUROLOGY 2022; 184:273-284. [PMID: 35034741 DOI: 10.1016/b978-0-12-819410-2.00015-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
A brain-machine interface represents a promising therapeutic avenue for the treatment of many neurologic conditions. Deep brain stimulation (DBS) is an invasive, neuro-modulatory tool that can improve different neurologic disorders by delivering electric stimulation to selected brain areas. DBS is particularly successful in advanced Parkinson's disease (PD), where it allows sustained improvement of motor symptoms. However, this approach is still poorly standardized, with variable clinical outcomes. To achieve an optimal therapeutic effect, novel adaptive DBS (aDBS) systems are being developed. These devices operate by adapting stimulation parameters in response to an input signal that can represent symptoms, motor activity, or other behavioral features. Emerging evidence suggests greater efficacy with fewer adverse effects during aDBS compared with conventional DBS. We address this topic by discussing the basics principles of aDBS, reviewing current evidence, and tackling the many challenges posed by aDBS for PD.
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Affiliation(s)
- Nicoló G Pozzi
- Department of Neurology, University Hospital Würzburg and Julius Maximilian University Würzburg, Würzburg, Germany
| | - Ioannis U Isaias
- Department of Neurology, University Hospital Würzburg and Julius Maximilian University Würzburg, Würzburg, Germany.
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14
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Accelerating Input-Output Model Estimation with Parallel Computing for Testing Hippocampal Memory Prostheses in Human. J Neurosci Methods 2022; 370:109492. [DOI: 10.1016/j.jneumeth.2022.109492] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 01/21/2022] [Accepted: 01/27/2022] [Indexed: 11/16/2022]
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15
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Amoozegar S, Pooyan M, Roghani M. Identification of effective features of LFP signal for making closed-loop deep brain stimulation in parkinsonian rats. Med Biol Eng Comput 2021; 60:135-149. [PMID: 34775553 DOI: 10.1007/s11517-021-02470-3] [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: 05/11/2021] [Accepted: 11/06/2021] [Indexed: 02/01/2023]
Abstract
Traditional deep brain stimulation (DBS) is one of the acceptable methods to relieve the clinical symptoms of Parkinson's disease in its advanced stages. Today, the use of closed-loop DBS to increase stimulation efficiency and patient satisfaction is one of the most important issues under investigation. The present study was aimed to find local field potential (LFP) features of parkinsonian rats, which can determine the timing of stimulation with high accuracy. The LFP signals from rats were recorded in three groups of parkinsonian rat models receiving stimulation (stimulation), without getting stimulation (off-stimulation), and sham-controlled group. The frequency domain and chaotic features of signals were extracted for classifying three classes by support vector machine (SVM) and neural networks. The best combination of features was selected using the genetic algorithm (GA). Finally, the effective features were introduced to determine the on/off stimulation time, and the optimal stimulation parameters were identified. It was found that a combination of frequency domain and chaotic features with an accuracy of about 99% was able to determine the time the DBS must switch on. In about 80.67% of the 1861 different stimulation parameters, the brain was able to maintain its state for about 3 min after stimulation discontinuation.
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Affiliation(s)
- Sana Amoozegar
- Department of Biomedical Engineering, Faculty of Engineering, Shahed University, Tehran, Iran
| | - Mohammad Pooyan
- Department of Biomedical Engineering, Faculty of Engineering, Shahed University, Tehran, Iran.
| | - Mehrdad Roghani
- Neurophysiology Research Center, Shahed University, Tehran, Iran
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16
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Sand D, Arkadir D, Abu Snineh M, Marmor O, Israel Z, Bergman H, Hassin-Baer S, Israeli-Korn S, Peremen Z, Geva AB, Eitan R. Deep Brain Stimulation Can Differentiate Subregions of the Human Subthalamic Nucleus Area by EEG Biomarkers. Front Syst Neurosci 2021; 15:747681. [PMID: 34744647 PMCID: PMC8565520 DOI: 10.3389/fnsys.2021.747681] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Accepted: 09/16/2021] [Indexed: 01/10/2023] Open
Abstract
Introduction: Precise lead localization is crucial for an optimal clinical outcome of subthalamic nucleus (STN) deep brain stimulation (DBS) treatment in patients with Parkinson's disease (PD). Currently, anatomical measures, as well as invasive intraoperative electrophysiological recordings, are used to locate DBS electrodes. The objective of this study was to find an alternative electrophysiology tool for STN DBS lead localization. Methods: Sixty-one postoperative electrophysiology recording sessions were obtained from 17 DBS-treated patients with PD. An intraoperative physiological method automatically detected STN borders and subregions. Postoperative EEG cortical activity was measured, while STN low frequency stimulation (LFS) was applied to different areas inside and outside the STN. Machine learning models were used to differentiate stimulation locations, based on EEG analysis of engineered features. Results: A machine learning algorithm identified the top 25 evoked response potentials (ERPs), engineered features that can differentiate inside and outside STN stimulation locations as well as within STN stimulation locations. Evoked responses in the medial and ipsilateral fronto-central areas were found to be most significant for predicting the location of STN stimulation. Two-class linear support vector machine (SVM) predicted the inside (dorso-lateral region, DLR, and ventro-medial region, VMR) vs. outside [zona incerta, ZI, STN stimulation classification with an accuracy of 0.98 and 0.82 for ZI vs. VMR and ZI vs. DLR, respectively, and an accuracy of 0.77 for the within STN (DLR vs. VMR)]. Multiclass linear SVM predicted all areas with an accuracy of 0.82 for the outside and within STN stimulation locations (ZI vs. DLR vs. VMR). Conclusions: Electroencephalogram biomarkers can use low-frequency STN stimulation to localize STN DBS electrodes to ZI, DLR, and VMR STN subregions. These models can be used for both intraoperative electrode localization and postoperative stimulation programming sessions, and have a potential to improve STN DBS clinical outcomes.
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Affiliation(s)
- Daniel Sand
- Department of Medical Neurobiology (Physiology), Institute of Medical Research Israel-Canada, Hebrew University of Jerusalem, Jerusalem, Israel.,Edmond and Lily Safra Center for Brain Research, Hebrew University of Jerusalem, Jerusalem, Israel.,Elminda Ltd., Herzliya, Israel
| | - David Arkadir
- Department of Neurology, Hadassah Medical Center and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Muneer Abu Snineh
- Department of Neurology, Hadassah Medical Center and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Odeya Marmor
- Department of Medical Neurobiology (Physiology), Institute of Medical Research Israel-Canada, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Zvi Israel
- Brain Division, Hadassah Medical Organization and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel.,Functional Neurosurgery Unit, Hadassah Medical Organization and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Hagai Bergman
- Department of Medical Neurobiology (Physiology), Institute of Medical Research Israel-Canada, Hebrew University of Jerusalem, Jerusalem, Israel.,Edmond and Lily Safra Center for Brain Research, Hebrew University of Jerusalem, Jerusalem, Israel.,Functional Neurosurgery Unit, Hadassah Medical Organization and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Sharon Hassin-Baer
- Department of Neurology, Movement Disorders Institute, Sheba Medical Center and Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Simon Israeli-Korn
- Department of Neurology, Movement Disorders Institute, Sheba Medical Center and Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | | | - Amir B Geva
- Department of Electrical and Computer Engineering, Ben Gurion University, Beer-Sheva, Israel
| | - Renana Eitan
- Department of Medical Neurobiology (Physiology), Institute of Medical Research Israel-Canada, Hebrew University of Jerusalem, Jerusalem, Israel.,Brain Division, Hadassah Medical Organization and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel.,Neuropsychiatry Unit, Jerusalem Mental Health Center and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel.,Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States
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17
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Herrera-Melendez AL, Bajbouj M, Aust S. Application of Transcranial Direct Current Stimulation in Psychiatry. Neuropsychobiology 2021; 79:372-383. [PMID: 31340213 DOI: 10.1159/000501227] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2018] [Accepted: 05/28/2019] [Indexed: 11/19/2022]
Abstract
Transcranial direct current stimulation (tDCS) is a neuromodulation technique, which noninvasively alters cortical excitability via weak polarizing currents between two electrodes placed on the scalp. Since it is comparably easy to handle, cheap to use and relatively well tolerated, tDCS has gained increasing interest in recent years. Based on well-known behavioral effects, a number of clinical studies have been performed in populations including patients with major depressive disorder followed by schizophrenia and substance use disorders, in sum with heterogeneous results with respect to efficacy. Nevertheless, the potential of tDCS must not be underestimated since it could be further improved by systematically investigating the various stimulation parameters to eventually increase clinical efficacy. The present article briefly explains the underlying physiology of tDCS, summarizes typical stimulation protocols and then reviews clinical efficacy for various psychiatric disorders as well as prevalent adverse effects. Future developments include combined and more complex interactions of tDCS with pharmacological or psychotherapeutic interventions. In particular, using computational models to individualize stimulation protocols, considering state dependency and applying closed-loop technologies will pave the way for tDCS-based personalized interventions as well as the development of home treatment settings promoting the role of tDCS as an effective treatment option for patients with mental health problems.
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Affiliation(s)
- Ana-Lucia Herrera-Melendez
- Department of Psychiatry, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany,
| | - Malek Bajbouj
- Department of Psychiatry, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
| | - Sabine Aust
- Department of Psychiatry, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
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18
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Vedam-Mai V, Deisseroth K, Giordano J, Lazaro-Munoz G, Chiong W, Suthana N, Langevin JP, Gill J, Goodman W, Provenza NR, Halpern CH, Shivacharan RS, Cunningham TN, Sheth SA, Pouratian N, Scangos KW, Mayberg HS, Horn A, Johnson KA, Butson CR, Gilron R, de Hemptinne C, Wilt R, Yaroshinsky M, Little S, Starr P, Worrell G, Shirvalkar P, Chang E, Volkmann J, Muthuraman M, Groppa S, Kühn AA, Li L, Johnson M, Otto KJ, Raike R, Goetz S, Wu C, Silburn P, Cheeran B, Pathak YJ, Malekmohammadi M, Gunduz A, Wong JK, Cernera S, Wagle Shukla A, Ramirez-Zamora A, Deeb W, Patterson A, Foote KD, Okun MS. Proceedings of the Eighth Annual Deep Brain Stimulation Think Tank: Advances in Optogenetics, Ethical Issues Affecting DBS Research, Neuromodulatory Approaches for Depression, Adaptive Neurostimulation, and Emerging DBS Technologies. Front Hum Neurosci 2021; 15:644593. [PMID: 33953663 PMCID: PMC8092047 DOI: 10.3389/fnhum.2021.644593] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Accepted: 03/10/2021] [Indexed: 12/20/2022] Open
Abstract
We estimate that 208,000 deep brain stimulation (DBS) devices have been implanted to address neurological and neuropsychiatric disorders worldwide. DBS Think Tank presenters pooled data and determined that DBS expanded in its scope and has been applied to multiple brain disorders in an effort to modulate neural circuitry. The DBS Think Tank was founded in 2012 providing a space where clinicians, engineers, researchers from industry and academia discuss current and emerging DBS technologies and logistical and ethical issues facing the field. The emphasis is on cutting edge research and collaboration aimed to advance the DBS field. The Eighth Annual DBS Think Tank was held virtually on September 1 and 2, 2020 (Zoom Video Communications) due to restrictions related to the COVID-19 pandemic. The meeting focused on advances in: (1) optogenetics as a tool for comprehending neurobiology of diseases and on optogenetically-inspired DBS, (2) cutting edge of emerging DBS technologies, (3) ethical issues affecting DBS research and access to care, (4) neuromodulatory approaches for depression, (5) advancing novel hardware, software and imaging methodologies, (6) use of neurophysiological signals in adaptive neurostimulation, and (7) use of more advanced technologies to improve DBS clinical outcomes. There were 178 attendees who participated in a DBS Think Tank survey, which revealed the expansion of DBS into several indications such as obesity, post-traumatic stress disorder, addiction and Alzheimer’s disease. This proceedings summarizes the advances discussed at the Eighth Annual DBS Think Tank.
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Affiliation(s)
- Vinata Vedam-Mai
- Norman Fixel Institute for Neurological Diseases and the Program for Movement Disorders and Neurorestoration, Department of Neurology, University of Florida, Gainesville, FL, United States
| | - Karl Deisseroth
- Department of Bioengineering, Stanford University, Stanford, CA, United States.,Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, United States
| | - James Giordano
- Department of Neurology and Neuroethics Studies Program, Georgetown University Medical Center, Washington, DC, United States
| | - Gabriel Lazaro-Munoz
- Center for Medical Ethics and Health Policy, Baylor College of Medicine, Houston, TX, United States
| | - Winston Chiong
- Weill Institute for Neurosciences, Memory and Aging Center, University of California, San Francisco, San Francisco, CA, United States
| | - Nanthia Suthana
- Department of Neurosurgery, David Geffen School of Medicine and Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, United States.,Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, United States.,Department of Psychology, University of California, Los Angeles, Los Angeles, CA, United States.,Department of Bioengineering, University of California, Los Angeles, Los Angeles, CA, United States
| | - Jean-Philippe Langevin
- Department of Neurosurgery, David Geffen School of Medicine and Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, United States.,Neurosurgery Service, Department of Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, CA, United States
| | - Jay Gill
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, United States
| | - Wayne Goodman
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, United States
| | - Nicole R Provenza
- School of Engineering, Brown University, Providence, RI, United States
| | - Casey H Halpern
- Department of Neurosurgery, Stanford University Medical Center, Stanford, CA, United States
| | - Rajat S Shivacharan
- Department of Neurosurgery, Stanford University Medical Center, Stanford, CA, United States
| | - Tricia N Cunningham
- Department of Neurosurgery, Stanford University Medical Center, Stanford, CA, United States
| | - Sameer A Sheth
- Department of Neurological Surgery, Baylor College of Medicine, Houston, TX, United States
| | - Nader Pouratian
- Department of Neurosurgery, David Geffen School of Medicine and Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, United States
| | - Katherine W Scangos
- Department of Psychiatry, University of California, San Francisco, San Francisco, CA, United States
| | - Helen S Mayberg
- Department of Neurology and Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Andreas Horn
- Movement Disorders & Neuromodulation Unit, Department for Neurology, Charité - University Medicine Berlin, Berlin, Germany
| | - Kara A Johnson
- Department of Biomedical Engineering, University of Utah, Salt Lake City, UT, United States.,Scientific Computing and Imaging Institute, University of Utah, Salt Lake City, UT, United States
| | - Christopher R Butson
- Department of Biomedical Engineering, University of Utah, Salt Lake City, UT, United States.,Scientific Computing and Imaging Institute, University of Utah, Salt Lake City, UT, United States
| | - Ro'ee Gilron
- Department of Neurological Surgery, Kavli Institute for Fundamental Neuroscience, University of California, San Francisco, San Francisco, CA, United States
| | - Coralie de Hemptinne
- Norman Fixel Institute for Neurological Diseases and the Program for Movement Disorders and Neurorestoration, Department of Neurology, University of Florida, Gainesville, FL, United States.,Department of Neurological Surgery, Kavli Institute for Fundamental Neuroscience, University of California, San Francisco, San Francisco, CA, United States
| | - Robert Wilt
- Department of Neurological Surgery, Kavli Institute for Fundamental Neuroscience, University of California, San Francisco, San Francisco, CA, United States
| | - Maria Yaroshinsky
- Department of Neurological Surgery, Kavli Institute for Fundamental Neuroscience, University of California, San Francisco, San Francisco, CA, United States
| | - Simon Little
- Department of Neurological Surgery, Kavli Institute for Fundamental Neuroscience, University of California, San Francisco, San Francisco, CA, United States
| | - Philip Starr
- Department of Neurological Surgery, Kavli Institute for Fundamental Neuroscience, University of California, San Francisco, San Francisco, CA, United States
| | - Greg Worrell
- Department of Neurology, Mayo Clinic, Rochester, MN, United States
| | - Prasad Shirvalkar
- Department of Neurological Surgery, Kavli Institute for Fundamental Neuroscience, University of California, San Francisco, San Francisco, CA, United States.,Department of Anesthesiology (Pain Management) and Neurology, University of California, San Francisco, San Francisco, CA, United States
| | - Edward Chang
- Department of Neurological Surgery, Kavli Institute for Fundamental Neuroscience, University of California, San Francisco, San Francisco, CA, United States
| | - Jens Volkmann
- Neurologischen Klinik Universitätsklinikum Würzburg, Würzburg, Germany
| | - Muthuraman Muthuraman
- Section of Movement Disorders and Neurostimulation, Biomedical Statistics and Multimodal Signal Processing Unit, Department of Neurology, Focus Program Translational Neuroscience, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Sergiu Groppa
- Section of Movement Disorders and Neurostimulation, Biomedical Statistics and Multimodal Signal Processing Unit, Department of Neurology, Focus Program Translational Neuroscience, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Andrea A Kühn
- Department of Neurology, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Luming Li
- National Engineering Laboratory for Neuromodulation, School of Aerospace Engineering, Tsinghua University, Beijing, China
| | - Matthew Johnson
- Department of Biomedical Engineering, University of Minnesota, Minneapolis, MN, United States
| | - Kevin J Otto
- J. Crayton Pruitt Family Department of Biomedical Engineering, University of Florida, Gainesville, FL, United States
| | - Robert Raike
- Restorative Therapies Group Implantables, Research and Core Technology, Medtronic, Minneapolis, MN, United States
| | - Steve Goetz
- Restorative Therapies Group Implantables, Research and Core Technology, Medtronic, Minneapolis, MN, United States
| | - Chengyuan Wu
- Department of Neurological Surgery, Thomas Jefferson University Hospitals, Philadelphia, PA, United States
| | - Peter Silburn
- Asia Pacific Centre for Neuromodulation, Queensland Brain Institute, The University of Queensland, Brisbane, QLD, Australia
| | - Binith Cheeran
- Neuromodulation Division, Abbott, Plano, TX, United States
| | - Yagna J Pathak
- Neuromodulation Division, Abbott, Plano, TX, United States
| | | | - Aysegul Gunduz
- Norman Fixel Institute for Neurological Diseases and the Program for Movement Disorders and Neurorestoration, Department of Neurology, University of Florida, Gainesville, FL, United States.,J. Crayton Pruitt Family Department of Biomedical Engineering, University of Florida, Gainesville, FL, United States
| | - Joshua K Wong
- Norman Fixel Institute for Neurological Diseases and the Program for Movement Disorders and Neurorestoration, Department of Neurology, University of Florida, Gainesville, FL, United States
| | - Stephanie Cernera
- Norman Fixel Institute for Neurological Diseases and the Program for Movement Disorders and Neurorestoration, Department of Neurology, University of Florida, Gainesville, FL, United States.,J. Crayton Pruitt Family Department of Biomedical Engineering, University of Florida, Gainesville, FL, United States
| | - Aparna Wagle Shukla
- Norman Fixel Institute for Neurological Diseases and the Program for Movement Disorders and Neurorestoration, Department of Neurology, University of Florida, Gainesville, FL, United States
| | - Adolfo Ramirez-Zamora
- Norman Fixel Institute for Neurological Diseases and the Program for Movement Disorders and Neurorestoration, Department of Neurology, University of Florida, Gainesville, FL, United States
| | - Wissam Deeb
- Department of Neurology, University of Massachusetts, Worchester, MA, United States
| | - Addie Patterson
- Norman Fixel Institute for Neurological Diseases and the Program for Movement Disorders and Neurorestoration, Department of Neurology, University of Florida, Gainesville, FL, United States
| | - Kelly D Foote
- Norman Fixel Institute for Neurological Diseases and the Program for Movement Disorders and Neurorestoration, Department of Neurology, University of Florida, Gainesville, FL, United States
| | - Michael S Okun
- Norman Fixel Institute for Neurological Diseases and the Program for Movement Disorders and Neurorestoration, Department of Neurology, University of Florida, Gainesville, FL, United States
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19
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Cabrera LY, Nowak GR, McCright AM, Achtyes E, Bluhm R. A qualitative study of key stakeholders' perceived risks and benefits of psychiatric electroceutical interventions. HEALTH, RISK & SOCIETY 2021; 23:217-235. [PMID: 35574212 PMCID: PMC9103575 DOI: 10.1080/13698575.2021.1979194] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
Amid a renewed interest in alternatives to psychotherapy and medication to treat depression, there is limited data as to how different stakeholders perceive of the risks and benefits of psychiatric electroceutical interventions (PEIs), including electroconvulsive therapy (ECT) and deep brain stimulation (DBS). To address this gap, we conducted 48 semi-structured interviews, including 16 psychiatrists, 16 persons diagnosed with depression, and 16 members of the general public. To provide a basis of comparison, we asked participants to also compare each modality to front-line therapies for depression and to neurosurgical procedures used for non-psychiatric conditions. Across all stakeholder groups, perceived memory loss was the most frequently mentioned potential risk with ECT. The most discussed benefits across all stakeholder groups were efficacy and quick response. Psychiatrists most often referenced effectiveness when discussing ECT, while patients and the public did so when discussing DBS. Taken as a whole, these data highlight stakeholders' contrasting perspectives on the risks and benefits of electroceuticals.
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Affiliation(s)
- Laura Y Cabrera
- Center for Neural Engineering, Department of Engineering Science and Mechanics, Pennsylvania State University, University Park, PA, United States
- Rock Ethics Institute, Pennsylvania State University, University Park, PA, United States
| | - Gerald R Nowak
- Department of Sociology, Michigan State University, East Lansing, MI, United States
| | - Aaron M McCright
- Department of Sociology, Michigan State University, East Lansing, MI, United States
| | - Eric Achtyes
- Division of Psychiatry and Behavioral Medicine, Michigan State University, East Grand Rapids, MI, United States
- Pine Rest Christian Mental Health Services, Grand Rapids, MI, United States
| | - Robyn Bluhm
- Lyman Briggs College and Department of Philosophy, Michigan State University, East Lansing, MI, United States
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20
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Burns MR, Chiu SY, Patel B, Mitropanopoulos SG, Wong JK, Ramirez-Zamora A. Advances and Future Directions of Neuromodulation in Neurologic Disorders. Neurol Clin 2020; 39:71-85. [PMID: 33223090 DOI: 10.1016/j.ncl.2020.09.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
"Deep brain stimulation is a safe and effective therapy for the management of a variety of neurologic conditions with Food and Drug Administration or humanitarian exception approval for Parkinson disease, dystonia, tremor, and obsessive-compulsive disorder. Advances in neurophysiology, neuroimaging, and technology have driven increasing interest in the potential benefits of neurostimulation in other neuropsychiatric conditions including dementia, depression, pain, Tourette syndrome, and epilepsy, among others. New anatomic or combined targets are being investigated in these conditions to improve symptoms refractory to medications or standard stimulation."
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Affiliation(s)
- Matthew R Burns
- The Fixel Institute for Neurological Diseases, Department of Neurology, The University of Florida, 3009 Williston Road, Gainesville, FL 32608, USA
| | - Shannon Y Chiu
- The Fixel Institute for Neurological Diseases, Department of Neurology, The University of Florida, 3009 Williston Road, Gainesville, FL 32608, USA
| | - Bhavana Patel
- The Fixel Institute for Neurological Diseases, Department of Neurology, The University of Florida, 3009 Williston Road, Gainesville, FL 32608, USA
| | - Sotiris G Mitropanopoulos
- The Fixel Institute for Neurological Diseases, Department of Neurology, The University of Florida, 3009 Williston Road, Gainesville, FL 32608, USA
| | - Joshua K Wong
- The Fixel Institute for Neurological Diseases, Department of Neurology, The University of Florida, 3009 Williston Road, Gainesville, FL 32608, USA
| | - Adolfo Ramirez-Zamora
- The Fixel Institute for Neurological Diseases, Department of Neurology, The University of Florida, 3009 Williston Road, Gainesville, FL 32608, USA.
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21
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Srivastava P, Nozari E, Kim JZ, Ju H, Zhou D, Becker C, Pasqualetti F, Pappas GJ, Bassett DS. Models of communication and control for brain networks: distinctions, convergence, and future outlook. Netw Neurosci 2020; 4:1122-1159. [PMID: 33195951 PMCID: PMC7655113 DOI: 10.1162/netn_a_00158] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Accepted: 07/21/2020] [Indexed: 12/13/2022] Open
Abstract
Recent advances in computational models of signal propagation and routing in the human brain have underscored the critical role of white-matter structure. A complementary approach has utilized the framework of network control theory to better understand how white matter constrains the manner in which a region or set of regions can direct or control the activity of other regions. Despite the potential for both of these approaches to enhance our understanding of the role of network structure in brain function, little work has sought to understand the relations between them. Here, we seek to explicitly bridge computational models of communication and principles of network control in a conceptual review of the current literature. By drawing comparisons between communication and control models in terms of the level of abstraction, the dynamical complexity, the dependence on network attributes, and the interplay of multiple spatiotemporal scales, we highlight the convergence of and distinctions between the two frameworks. Based on the understanding of the intertwined nature of communication and control in human brain networks, this work provides an integrative perspective for the field and outlines exciting directions for future work.
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Affiliation(s)
- Pragya Srivastava
- Department of Bioengineering, University of Pennsylvania, Philadelphia, PA USA
| | - Erfan Nozari
- Department of Electrical & Systems Engineering, University of Pennsylvania, Philadelphia, PA USA
| | - Jason Z. Kim
- Department of Bioengineering, University of Pennsylvania, Philadelphia, PA USA
| | - Harang Ju
- Neuroscience Graduate Group, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA USA
| | - Dale Zhou
- Neuroscience Graduate Group, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA USA
| | - Cassiano Becker
- Department of Bioengineering, University of Pennsylvania, Philadelphia, PA USA
| | - Fabio Pasqualetti
- Department of Mechanical Engineering, University of California, Riverside, CA USA
| | - George J. Pappas
- Department of Electrical & Systems Engineering, University of Pennsylvania, Philadelphia, PA USA
| | - Danielle S. Bassett
- Department of Bioengineering, University of Pennsylvania, Philadelphia, PA USA
- Department of Electrical & Systems Engineering, University of Pennsylvania, Philadelphia, PA USA
- Department of Physics & Astronomy, University of Pennsylvania, Philadelphia, PA USA
- Department of Neurology, University of Pennsylvania, Philadelphia, PA USA
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA USA
- Santa Fe Institute, Santa Fe, NM USA
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Scholten K, Larson CE, Xu H, Song D, Meng E. A 512-Channel Multi-Layer Polymer-Based Neural Probe Array. JOURNAL OF MICROELECTROMECHANICAL SYSTEMS : A JOINT IEEE AND ASME PUBLICATION ON MICROSTRUCTURES, MICROACTUATORS, MICROSENSORS, AND MICROSYSTEMS 2020; 29:1054-1058. [PMID: 33746477 PMCID: PMC7978043 DOI: 10.1109/jmems.2020.2999550] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
We present for the first time the design, fabrication, and preliminary bench-top characterization of a high-density, polymer-based penetrating microelectrode array, developed for chronic, large-scale recording in the cortices and hippocampi of behaving rats. We present two architectures for these targeted brain regions, both featuring 512 Pt recording electrodes patterned front-and-back on micromachined eight-shank arrays of thin-film Parylene C. These devices represent an order of magnitude improvement in both number and density of recording electrodes compared with prior work on polymer-based microelectrode arrays. We present enabling advances in polymer micro-machining related to lithographic resolution and a new method for back-side patterning of electrodes. In vitro electrochemical data verifies suitable electrode function and surface properties. Finally, we describe next steps toward the implementation of these arrays in chronic, large-scale recording studies in free-moving animal models.
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Affiliation(s)
- Kee Scholten
- Department of Biomedical Engineering, Viterbi School of Engineering, University of Southern California, Los Angeles, CA 90089 USA
| | - Christopher E Larson
- Department of Biomedical Engineering, Viterbi School of Engineering, University of Southern California, Los Angeles, CA 90089 USA
| | - Huijing Xu
- Department of Biomedical Engineering, Viterbi School of Engineering, University of Southern California, Los Angeles, CA 90089 USA
| | - Dong Song
- Department of Biomedical Engineering, Viterbi School of Engineering, University of Southern California, Los Angeles, CA 90089 USA
| | - Ellis Meng
- Department of Biomedical Engineering, Viterbi School of Engineering, University of Southern California, Los Angeles, CA 90089 USA
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23
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Dalrymple AN, Huynh M, Nayagam BA, Lee CD, Weiland GR, Petrossians A, J J, Iii W, Fallon JB, Shepherd RK. Electrochemical and biological characterization of thin-film platinum-iridium alloy electrode coatings: a chronic in vivo study. J Neural Eng 2020; 17:036012. [PMID: 32408281 DOI: 10.1088/1741-2552/ab933d] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
OBJECTIVE To evaluate the electrochemical properties, biological response, and surface characterization of an electrodeposited Platinum-Iridium (Pt-Ir) electrode coating on cochlear implants subjected to chronic stimulation in vivo. APPROACH Electrochemical impedance spectroscopy (EIS), charge storage capacity (CSC), charge injection limit (CIL), and voltage transient (VT) impedance were measured bench-top before and after implant and in vivo. Coated Pt-Ir and uncoated Pt electrode arrays were implanted into cochlea of normal hearing rats and stimulated for ∼4 h d, 5 d week-1 for 5 weeks at levels within the normal clinical range. Neural function was monitored using electrically-evoked auditory brainstem responses. After explant, the electrode surfaces were assessed, and cochleae examined histologically. MAIN RESULTS When measured on bench-top before and after stimulation, Pt-Ir coated electrodes had significantly lower VT impedance (p < 0.001) and significantly higher CSC (p < 0.001) and CIL (p < 0.001) compared to uncoated Pt electrodes. In vivo, the CSC and CIL of Pt-Ir were significantly higher than Pt throughout the implantation period (p= 0.047 and p< 0.001, respectively); however, the VT impedance (p= 0.3) was not. There was no difference in foreign body response between material cohorts, although cochleae implanted with coated electrodes contained small deposits of Pt-Ir. There was no evidence of increased neural loss or loss of neural function in either group. Surface examination revealed no Pt corrosion on any electrodes. SIGNIFICANCE Electrodeposited Pt-Ir electrodes demonstrated significant improvements in electrochemical performance on the bench-top and in vivo compared to uncoated Pt. Neural function and tissue response to Pt-Ir electrodes were not different from uncoated Pt, despite small deposits of Pt-Ir in the tissue capsule. Electrodeposited Pt-Ir coatings offer promise as an improved electrode coating for active neural prostheses.
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24
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Dalrymple AN, Robles UA, Huynh M, Nayagam BA, Green RA, Poole-Warren LA, Fallon JB, Shepherd RK. Electrochemical and biological performance of chronically stimulated conductive hydrogel electrodes. J Neural Eng 2020; 17:026018. [DOI: 10.1088/1741-2552/ab7cfc] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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25
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Ramirez-Zamora A, Giordano J, Gunduz A, Alcantara J, Cagle JN, Cernera S, Difuntorum P, Eisinger RS, Gomez J, Long S, Parks B, Wong JK, Chiu S, Patel B, Grill WM, Walker HC, Little SJ, Gilron R, Tinkhauser G, Thevathasan W, Sinclair NC, Lozano AM, Foltynie T, Fasano A, Sheth SA, Scangos K, Sanger TD, Miller J, Brumback AC, Rajasethupathy P, McIntyre C, Schlachter L, Suthana N, Kubu C, Sankary LR, Herrera-Ferrá K, Goetz S, Cheeran B, Steinke GK, Hess C, Almeida L, Deeb W, Foote KD, Okun MS. Proceedings of the Seventh Annual Deep Brain Stimulation Think Tank: Advances in Neurophysiology, Adaptive DBS, Virtual Reality, Neuroethics and Technology. Front Hum Neurosci 2020; 14:54. [PMID: 32292333 PMCID: PMC7134196 DOI: 10.3389/fnhum.2020.00054] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Accepted: 02/05/2020] [Indexed: 12/12/2022] Open
Abstract
The Seventh Annual Deep Brain Stimulation (DBS) Think Tank held on September 8th of 2019 addressed the most current: (1) use and utility of complex neurophysiological signals for development of adaptive neurostimulation to improve clinical outcomes; (2) Advancements in recent neuromodulation techniques to treat neuropsychiatric disorders; (3) New developments in optogenetics and DBS; (4) The use of augmented Virtual reality (VR) and neuromodulation; (5) commercially available technologies; and (6) ethical issues arising in and from research and use of DBS. These advances serve as both "markers of progress" and challenges and opportunities for ongoing address, engagement, and deliberation as we move to improve the functional capabilities and translational value of DBS. It is in this light that these proceedings are presented to inform the field and initiate ongoing discourse. As consistent with the intent, and spirit of this, and prior DBS Think Tanks, the overarching goal is to continue to develop multidisciplinary collaborations to rapidly advance the field and ultimately improve patient outcomes.
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Affiliation(s)
- Adolfo Ramirez-Zamora
- Department of Neurology, Norman Fixel Institute for Neurological Diseases, Program for Movement Disorders and Neurorestoration, University of Florida, Gainesville, FL, United States
| | - James Giordano
- Departments of Neurology and Biochemistry, and Neuroethics Studies Program—Pellegrino Center for Clinical Bioethics, Georgetown University Medical Center, Washington, DC, United States
| | - Aysegul Gunduz
- J. Crayton Pruitt Family Department of Biomedical Engineering, Center for Movement Disorders and Neurorestoration, University of Florida, Gainesville, FL, United States
- Department of Neurosurgery, Center for Movement Disorders and Neurorestoration, University of Florida, Gainesville, FL, United States
| | - Jose Alcantara
- J. Crayton Pruitt Family Department of Biomedical Engineering, Center for Movement Disorders and Neurorestoration, University of Florida, Gainesville, FL, United States
- Department of Neurosurgery, Center for Movement Disorders and Neurorestoration, University of Florida, Gainesville, FL, United States
| | - Jackson N. Cagle
- J. Crayton Pruitt Family Department of Biomedical Engineering, Center for Movement Disorders and Neurorestoration, University of Florida, Gainesville, FL, United States
- Department of Neurosurgery, Center for Movement Disorders and Neurorestoration, University of Florida, Gainesville, FL, United States
| | - Stephanie Cernera
- J. Crayton Pruitt Family Department of Biomedical Engineering, Center for Movement Disorders and Neurorestoration, University of Florida, Gainesville, FL, United States
- Department of Neurosurgery, Center for Movement Disorders and Neurorestoration, University of Florida, Gainesville, FL, United States
| | - Parker Difuntorum
- J. Crayton Pruitt Family Department of Biomedical Engineering, Center for Movement Disorders and Neurorestoration, University of Florida, Gainesville, FL, United States
- Department of Neurosurgery, Center for Movement Disorders and Neurorestoration, University of Florida, Gainesville, FL, United States
| | - Robert S. Eisinger
- J. Crayton Pruitt Family Department of Biomedical Engineering, Center for Movement Disorders and Neurorestoration, University of Florida, Gainesville, FL, United States
- Department of Neurosurgery, Center for Movement Disorders and Neurorestoration, University of Florida, Gainesville, FL, United States
| | - Julieth Gomez
- J. Crayton Pruitt Family Department of Biomedical Engineering, Center for Movement Disorders and Neurorestoration, University of Florida, Gainesville, FL, United States
- Department of Neurosurgery, Center for Movement Disorders and Neurorestoration, University of Florida, Gainesville, FL, United States
| | - Sarah Long
- J. Crayton Pruitt Family Department of Biomedical Engineering, Center for Movement Disorders and Neurorestoration, University of Florida, Gainesville, FL, United States
- Department of Neurosurgery, Center for Movement Disorders and Neurorestoration, University of Florida, Gainesville, FL, United States
| | - Brandon Parks
- J. Crayton Pruitt Family Department of Biomedical Engineering, Center for Movement Disorders and Neurorestoration, University of Florida, Gainesville, FL, United States
- Department of Neurosurgery, Center for Movement Disorders and Neurorestoration, University of Florida, Gainesville, FL, United States
| | - Joshua K. Wong
- Department of Neurology, Norman Fixel Institute for Neurological Diseases, Program for Movement Disorders and Neurorestoration, University of Florida, Gainesville, FL, United States
| | - Shannon Chiu
- Department of Neurology, Norman Fixel Institute for Neurological Diseases, Program for Movement Disorders and Neurorestoration, University of Florida, Gainesville, FL, United States
| | - Bhavana Patel
- Department of Neurology, Norman Fixel Institute for Neurological Diseases, Program for Movement Disorders and Neurorestoration, University of Florida, Gainesville, FL, United States
| | - Warren M. Grill
- Department of Biomedical Engineering, Duke University, Durham, NC, United States
| | - Harrison C. Walker
- Department of Neurology, University of Alabama at Birmingham, Birmingham, AL, United States
- Department of Biomedical Engineering, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Simon J. Little
- Department of Neurology, University of California, San Francisco, San Francisco, CA, United States
| | - Ro’ee Gilron
- Graduate Program in Neuroscience, Department of Neurological Surgery, Kavli Institute for Fundamental Neuroscience, University of California, San Francisco, San Francisco, CA, United States
| | - Gerd Tinkhauser
- Department of Neurology, Bern University Hospital and the University of Bern, Bern, Switzerland
- Medical Research Council Brain Network Dynamics Unit, University of Oxford, Oxford, United Kingdom
| | - Wesley Thevathasan
- Department of Neurology, The Royal Melbourne and Austin Hospitals, University of Melbourne, Melbourne, VIC, Australia
- Medical Bionics Department, University of Melbourne, East Melbourne, VIC, Australia
- Bionics Institute, East Melbourne, VIC, Australia
| | - Nicholas C. Sinclair
- Medical Bionics Department, University of Melbourne, East Melbourne, VIC, Australia
- Bionics Institute, East Melbourne, VIC, Australia
| | - Andres M. Lozano
- Department of Surgery, Division of Neurosurgery, University of Toronto, Toronto, ON, Canada
| | - Thomas Foltynie
- Institute of Neurology, University College London, London, United Kingdom
| | - Alfonso Fasano
- Edmond J. Safra Program in Parkinson’s Disease, Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital, UHN, Toronto, ON, Canada
- Division of Neurology, University of Toronto, Krembil Brain Institute, Center for Advancing Neurotechnological Innovation to Application (CRANIA), Toronto, ON, Canada
| | - Sameer A. Sheth
- Department of Neurological Surgery, Baylor College of Medicine, Houston, TX, United States
| | - Katherine Scangos
- Department of Psychiatry, University of California, San Francisco, San Francisco, CA, United States
| | - Terence D. Sanger
- Department of Biomedical Engineering, Neurology, Biokinesiology, University of Southern California, Los Angeles, CA, United States
| | - Jonathan Miller
- Case Western Reserve University School of Medicine, University Hospitals Cleveland Medical Center, Cleveland, OH, United States
| | - Audrey C. Brumback
- Departments of Neurology and Pediatrics at Dell Medical School and the Center for Learning and Memory, University of Texas at Austin, Austin, TX, United States
| | - Priya Rajasethupathy
- Laboratory for Neural Dynamics and Cognition, Rockefeller University, New York, NY, United States
- Department of Bioengineering, Stanford University, Stanford, CA, United States
| | - Cameron McIntyre
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH, United States
| | - Leslie Schlachter
- Department of Neurosurgery, Mount Sinai Health System, New York, NY, United States
| | - Nanthia Suthana
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA, United States
| | - Cynthia Kubu
- Department of Neurology, Cleveland Clinic, Cleveland, OH, United States
| | - Lauren R. Sankary
- Center for Bioethics, Cleveland Clinic, Cleveland, OH, United States
| | | | - Steven Goetz
- Medtronic Neuromodulation, Minneapolis, MN, United States
| | - Binith Cheeran
- Neuromodulation Division, Abbott, Plano, TX, United States
| | - G. Karl Steinke
- Boston Scientific Neuromodulation, Valencia, CA, United States
| | - Christopher Hess
- Department of Neurology, Norman Fixel Institute for Neurological Diseases, Program for Movement Disorders and Neurorestoration, University of Florida, Gainesville, FL, United States
| | - Leonardo Almeida
- Department of Neurology, Norman Fixel Institute for Neurological Diseases, Program for Movement Disorders and Neurorestoration, University of Florida, Gainesville, FL, United States
| | - Wissam Deeb
- Department of Neurology, Norman Fixel Institute for Neurological Diseases, Program for Movement Disorders and Neurorestoration, University of Florida, Gainesville, FL, United States
| | - Kelly D. Foote
- Department of Neurosurgery, Norman Fixel Institute for Neurological Diseases, Center for Movement Disorders and Neurorestoration, University of Florida, Gainesville, FL, United States
| | - Michael S. Okun
- Department of Neurology, Norman Fixel Institute for Neurological Diseases, Program for Movement Disorders and Neurorestoration, University of Florida, Gainesville, FL, United States
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Liu ZS, Cui YH, Sun D, Lu Q, Jiang YW, Jiang L, Wang JQ, Luo R, Fang F, Zhou SZ, Wang Y, Cai FC, Lin Q, Xiong L, Zheng Y, Qin J. Current Status, Diagnosis, and Treatment Recommendation for Tic Disorders in China. Front Psychiatry 2020; 11:774. [PMID: 32903695 PMCID: PMC7438753 DOI: 10.3389/fpsyt.2020.00774] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/29/2020] [Accepted: 07/21/2020] [Indexed: 12/19/2022] Open
Abstract
Tic disorders (TD) are a group neuropsychiatric disorders with childhood onset characterized by tics, i.e. repetitive, sudden, and involuntary movements or vocalizations; and Tourette syndrome (TS) is the most severe form of TD. Their clinical manifestations are diverse; and are often associated with various psychopathological and/or behavioral comorbidities, including attention deficit hyperactivity disorder (ADHD), obsessive-compulsive disorder (OCD), anxiety, depression, and sleep disorders. Individual severity and response to treatment are highly variable, and there are some refractory cases, which are less responsive to conventional TD treatment. TD/TS are also common in the Chinese pediatric population. To help improve the understanding of TD for pediatricians and other health professionals, and to improve its diagnosis and treatment in China, the Chinese Child Neurology Society (CCNS) has developed an Expert Consensus on Diagnosis and Treatment of TD in China, which is based on our clinical experience and the availability therapeutic avenues. It is focused on clinical diagnosis and evaluation of TD and its comorbidities, psychological and educational intervention, nonpharmacological therapy, pharmacological treatment, including traditional Chinese medicine and acupuncture, as well as prognosis in children with TD in China. A summary of the current status of TD and up-to-date diagnosis and treatment recommendations for TD in China is presented here.
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Affiliation(s)
- Zhi-Sheng Liu
- Department of Neurology, Wuhan Children's Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yong-Hua Cui
- Department of Neurology and Psychiatry, Beijing Children's Hospital, Capital Medical University, Beijing, China
| | - Dan Sun
- Department of Neurology, Wuhan Children's Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Qing Lu
- Department of Neurology, Wuhan Children's Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yu-Wu Jiang
- Department of Pediatrics, Peking University First Hospital, Beijing, China
| | - Li Jiang
- Department of Neurology, Children's Hospital of Chongqing Medical University, Chongqing, China
| | - Jia-Qin Wang
- Department of Pediatrics, Third Affiliated Hospital of Xinxiang Medical College, Xinxiang, China
| | - Rong Luo
- Department of Pediatrics, Huaxi Second Hospital of Sichuan University, Chengdu, China
| | - Fang Fang
- Department of Neurology and Psychiatry, Beijing Children's Hospital, Capital Medical University, Beijing, China
| | - Shui-Zhen Zhou
- Department of Neurology, Pediatric Hospital Affiliated to Fudan University, Shanghai, China
| | - Yi Wang
- Department of Neurology, Pediatric Hospital Affiliated to Fudan University, Shanghai, China
| | - Fang-Cheng Cai
- Department of Neurology, Children's Hospital of Chongqing Medical University, Chongqing, China
| | - Qing Lin
- Department of Pediatrics, Peking University First Hospital, Beijing, China
| | - Lan Xiong
- Montreal Neurological Institute and Hospital, McGill University, Montreal, QC, Canada
| | - Yi Zheng
- Department of Pediatrics, Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Jiong Qin
- Department of Pediatrics, Peking University People's Hospital, Beijing, China
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27
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Local Field Potentials and ECoG. Stereotact Funct Neurosurg 2020. [DOI: 10.1007/978-3-030-34906-6_9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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28
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Sedrak M, Sabelman E, Pezeshkian P, Duncan J, Bernstein I, Bruce D, Tse V, Khandhar S, Call E, Heit G, Alaminos-Bouza A. Biplanar X-Ray Methods for Stereotactic Intraoperative Localization in Deep Brain Stimulation Surgery. Oper Neurosurg (Hagerstown) 2019; 19:302-312. [PMID: 31858143 DOI: 10.1093/ons/opz397] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Accepted: 10/28/2019] [Indexed: 11/14/2022] Open
Abstract
Abstract
BACKGROUND
Efficacy in deep brain stimulation (DBS) is dependent on precise positioning of electrodes within the brain. Intraoperative fluoroscopy, computed tomography (CT), or magnetic resonance imaging are used for stereotactic intraoperative localization (StIL), but the utility of biplanar X-ray has not been evaluated in detail.
OBJECTIVE
To determine if analysis of orthogonal biplanar X-rays using graphical analysis (GA), ray tracing (RT), and/or perspective projection (PP) can be utilized for StIL.
METHODS
A review of electrode tip positions comparing postoperative CT to X-ray methods was performed for DBS operations containing orthogonal biplanar X-ray with referential spheres and pins.
RESULTS
Euclidean (Re) errors for final DBS electrode position on intraoperative X-rays vs postoperative CT using GA, RT, and PP methods averaged 1.58 mm (±0.75), 0.74 mm (±0.45), and 1.07 mm (±0.64), respectively (n = 56). GA was more accurate with a ventriculogram. RT and PP predicted positions that correlated with third ventricular structures on ventriculogram cases. RT was the most stable but required knowledge of the geometric setup. PP was more flexible than RT but required well-distributed reference points. A single case using the O-arm demonstrated Re errors of 0.43 mm and 0.28 mm for RT and PP, respectively. In addition, these techniques could also be used to calculate directional electrode rotation.
CONCLUSION
GA, RT, and PP can be employed for precise StIL during DBS using orthogonal biplanar X-ray. These methods may be generalized to other stereotactic procedures or instances of biplanar imaging such as angiograms, radiosurgery, or injection therapeutics.
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Affiliation(s)
- Mark Sedrak
- Department of Neurosurgery, Kaiser Permanente, Redwood City, California
- Stanford University, Stanford, California
| | - Eric Sabelman
- Department of Neurosurgery, Kaiser Permanente, Redwood City, California
| | | | - John Duncan
- Department of Neurosurgery, Kaiser Permanente, Redwood City, California
| | - Ivan Bernstein
- Department of Neurosurgery, Kaiser Permanente, Redwood City, California
| | - Diana Bruce
- Department of Neurosurgery, Kaiser Permanente, Redwood City, California
| | - Victor Tse
- Department of Neurosurgery, Kaiser Permanente, Redwood City, California
| | - Suketu Khandhar
- Kaiser Permanente Sacramento Medical Center and Medical Offices, Sacramento, California
| | - Elena Call
- Department of Neurosurgery, Kaiser Permanente, Redwood City, California
| | - Gary Heit
- Department of Neurosurgery, Kaiser Permanente, Redwood City, California
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29
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Ereifej ES, Shell CE, Schofield JS, Charkhkar H, Cuberovic I, Dorval AD, Graczyk EL, Kozai TDY, Otto KJ, Tyler DJ, Welle CG, Widge AS, Zariffa J, Moritz CT, Bourbeau DJ, Marasco PD. Neural engineering: the process, applications, and its role in the future of medicine. J Neural Eng 2019; 16:063002. [PMID: 31557730 DOI: 10.1088/1741-2552/ab4869] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
OBJECTIVE Recent advances in neural engineering have restored mobility to people with paralysis, relieved symptoms of movement disorders, reduced chronic pain, restored the sense of hearing, and provided sensory perception to individuals with sensory deficits. APPROACH This progress was enabled by the team-based, interdisciplinary approaches used by neural engineers. Neural engineers have advanced clinical frontiers by leveraging tools and discoveries in quantitative and biological sciences and through collaborations between engineering, science, and medicine. The movement toward bioelectronic medicines, where neuromodulation aims to supplement or replace pharmaceuticals to treat chronic medical conditions such as high blood pressure, diabetes and psychiatric disorders is a prime example of a new frontier made possible by neural engineering. Although one of the major goals in neural engineering is to develop technology for clinical applications, this technology may also offer unique opportunities to gain insight into how biological systems operate. MAIN RESULTS Despite significant technological progress, a number of ethical and strategic questions remain unexplored. Addressing these questions will accelerate technology development to address unmet needs. The future of these devices extends far beyond treatment of neurological impairments, including potential human augmentation applications. Our task, as neural engineers, is to push technology forward at the intersection of disciplines, while responsibly considering the readiness to transition this technology outside of the laboratory to consumer products. SIGNIFICANCE This article aims to highlight the current state of the neural engineering field, its links with other engineering and science disciplines, and the challenges and opportunities ahead. The goal of this article is to foster new ideas for innovative applications in neurotechnology.
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Affiliation(s)
- Evon S Ereifej
- Veteran Affairs Ann Arbor Healthcare System, Ann Arbor, MI, United States of America. Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, United States of America. Department of Neurology, University of Michigan, Ann Arbor, MI, United States of America. Advanced Platform Technology Center, Louis Stokes Cleveland VA Medical Center, Cleveland, OH, United States of America
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Khobragade N, Tuninetti D, Graupe D. On the need for adaptive learning in on-demand Deep Brain Stimulation for Movement Disorders. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2019; 2018:2190-2193. [PMID: 30440839 DOI: 10.1109/embc.2018.8512664] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
The results presented in this paper indicate that future on-demand Deep Brain Stimulation (DBS) systems for chronic use in patients with movement disorders should continuously and adaptively "learn" in order to maintain high symptom control efficacy. In this work, two machine learning algorithms-Decision Tree and LArge Memory STorage And Retrieval (LAMSTAR) neural network, both with surface Electromyography and accelerometry as control signals-are used to predict onset of tremor after DBS has been switched off in two patients, one suffering from Parkinson's disease and the other from essential tremor. The novelty of this work is that training and testing are done by using different data recorded during sessions at least one week apart. The question is whether the applied algorithms are robust to long-term operation (as patient's control signal may change over time due to disease progression, displacement of the wearable sensor, etc.). Various metrics are used to compare the performance of the proposed approach to those available in the literature, where training and testing are done on data from the same recording session. It is shown that a 100% sensitivity is achieved for training and testing over the same session; however, the sensitivity reduces when tested over a different session. The ratio of predicted stimulation-off time to observed stimulation-off time value is also found to be lower when training and testing on data from separate sessions. These results point to the need of adaptive learning in on-demand DBS systems.
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31
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Patel SR, Lieber CM. Precision electronic medicine in the brain. Nat Biotechnol 2019; 37:1007-1012. [PMID: 31477925 PMCID: PMC6741780 DOI: 10.1038/s41587-019-0234-8] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2018] [Accepted: 07/23/2019] [Indexed: 02/06/2023]
Abstract
Periodically throughout history developments from adjacent fields of science and technology reach a tipping point where together they produce unparalleled advances, such as the Allen Brain Atlas and the Human Genome Project. Today, research focused at the interface between the nervous system and electronics is not only leading to advances in fundamental neuroscience, but also unlocking the potential of implants capable of cellular-level therapeutic targeting. Ultimately, these personalized electronic therapies will provide new treatment modalities for neurodegenerative and neuropsychiatric illness; powerful control of prosthetics for restorative function in degenerative diseases, trauma and amputation; and even augmentation of human cognition. Overall, we believe that emerging advances in tissue-like electronics will enable minimally invasive devices capable of establishing a stable long-term cellular neural interface and providing long-term treatment for chronic neurological conditions.
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Affiliation(s)
- Shaun R Patel
- McCance Center for Brain Health, Genetics and Aging Research Unit, Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
| | - Charles M Lieber
- Department of Chemistry and Chemical Biology, Center for Brain Science, and John A. Paulson School of Engineering and Applied Sciences, Harvard University, Cambridge, MA, USA.
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Provenza NR, Paulk AC, Peled N, Restrepo MI, Cash SS, Dougherty DD, Eskandar EN, Borton DA, Widge AS. Decoding task engagement from distributed network electrophysiology in humans. J Neural Eng 2019; 16:056015. [PMID: 31419211 PMCID: PMC6765221 DOI: 10.1088/1741-2552/ab2c58] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
OBJECTIVE Here, our objective was to develop a binary decoder to detect task engagement in humans during two distinct, conflict-based behavioral tasks. Effortful, goal-directed decision-making requires the coordinated action of multiple cognitive processes, including attention, working memory and action selection. That type of mental effort is often dysfunctional in mental disorders, e.g. when a patient attempts to overcome a depression or anxiety-driven habit but feels unable. If the onset of engagement in this type of focused mental activity could be reliably detected, decisional function might be augmented, e.g. through neurostimulation. However, there are no known algorithms for detecting task engagement with rapid time resolution. APPROACH We defined a new network measure, fixed canonical correlation (FCCA), specifically suited for neural decoding applications. We extracted FCCA features from local field potential recordings in human volunteers to give a temporally continuous estimate of mental effort, defined by engagement in experimental conflict tasks. MAIN RESULTS Using a small number of features per participant, we accurately decoded and distinguished task engagement from other mental activities. Further, the decoder distinguished between engagement in two different conflict-based tasks within seconds of their onset. SIGNIFICANCE These results demonstrate that network-level brain activity can detect specific types of mental efforts. This could form the basis of a responsive intervention strategy for decision-making deficits.
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Affiliation(s)
- Nicole R Provenza
- Brown University School of Engineering, Providence, RI, United States of America
- Charles Stark Draper Laboratory, Cambridge, MA, United States of America
| | - Angelique C Paulk
- Massachusetts General Hospital Neurosurgery Research, Boston, MA, United States of America
- Massachusetts General Hospital Neurology, Boston, MA, United States of America
| | - Noam Peled
- MGH/HST Martinos Center for Biomedical Imaging, Charlestown, MA, United States of America
| | - Maria I Restrepo
- Center for Computation and Visualization, Brown University, Providence, RI 02912, United States of America
| | - Sydney S Cash
- Massachusetts General Hospital Neurology, Boston, MA, United States of America
| | - Darin D Dougherty
- Massachusetts General Hospital Psychiatry, Boston, MA, United States of America
| | - Emad N Eskandar
- Massachusetts General Hospital Neurosurgery Research, Boston, MA, United States of America
- Present affiliation: Chair, Department of Neurological Surgery, Montefiore Medical Center, New York, NY, United States of America
| | - David A Borton
- Brown University School of Engineering, Providence, RI, United States of America
- Carney Institute for Brain Science, Providence, RI, United States of America
- Department of Veterans Affairs, Providence Medical Center, Center for Neurorestoration and Neurotechnology, Providence, RI, United States of America
| | - Alik S Widge
- Massachusetts General Hospital Psychiatry, Boston, MA, United States of America
- Present affiliation: Department of Psychiatry, University of Minnesota, Minneapolis, MN, United States of America
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Lee MB, Kramer DR, Peng T, Barbaro MF, Liu CY, Kellis S, Lee B. Clinical neuroprosthetics: Today and tomorrow. J Clin Neurosci 2019; 68:13-19. [PMID: 31375306 DOI: 10.1016/j.jocn.2019.07.056] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2019] [Revised: 06/27/2019] [Accepted: 07/16/2019] [Indexed: 12/19/2022]
Abstract
Implantable neurostimulation devices provide a direct therapeutic link to the nervous system and can be considered brain-computer interfaces (BCI). Under this definition, BCI are not simply science fiction, they are part of existing neurosurgical practice. Clinical BCI are standard of care for historically difficult to treat neurological disorders. These systems target the central and peripheral nervous system and include Vagus Nerve Stimulation, Responsive Neurostimulation, and Deep Brain Stimulation. Recent advances in clinical BCI have focused on creating "closed-loop" systems. These systems rely on biomarker feedback and promise individualized therapy with optimal stimulation delivery and minimal side effects. Success of clinical BCI has paralleled research efforts to create BCI that restore upper extremity motor and sensory function to patients. Efforts to develop closed loop motor/sensory BCI is linked to the successes of today's clinical BCI.
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Affiliation(s)
- Morgan B Lee
- Department of Neurological Surgery, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA, USA; USC Neurorestoration Center, Keck School of Medicine of USC, Los Angeles, CA, USA.
| | - Daniel R Kramer
- Department of Neurological Surgery, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA, USA; USC Neurorestoration Center, Keck School of Medicine of USC, Los Angeles, CA, USA
| | - Terrance Peng
- Department of Neurological Surgery, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA, USA; USC Neurorestoration Center, Keck School of Medicine of USC, Los Angeles, CA, USA
| | - Michael F Barbaro
- Department of Neurological Surgery, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA, USA; USC Neurorestoration Center, Keck School of Medicine of USC, Los Angeles, CA, USA
| | - Charles Y Liu
- Department of Neurological Surgery, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA, USA; USC Neurorestoration Center, Keck School of Medicine of USC, Los Angeles, CA, USA; Department of Biology and Biological Engineering, California Institute of Technology, Pasadena, CA, USA
| | - Spencer Kellis
- Department of Neurological Surgery, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA, USA; USC Neurorestoration Center, Keck School of Medicine of USC, Los Angeles, CA, USA; T&C Chen Brain Machine Interface Center, California Institute of Technology, Pasadena, CA, USA; Department of Biology and Biological Engineering, California Institute of Technology, Pasadena, CA, USA
| | - Brian Lee
- Department of Neurological Surgery, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA, USA; USC Neurorestoration Center, Keck School of Medicine of USC, Los Angeles, CA, USA; Department of Biology and Biological Engineering, California Institute of Technology, Pasadena, CA, USA
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Widge AS, Miller EK. Targeting Cognition and Networks Through Neural Oscillations: Next-Generation Clinical Brain Stimulation. JAMA Psychiatry 2019; 76:671-672. [PMID: 31116372 PMCID: PMC7067567 DOI: 10.1001/jamapsychiatry.2019.0740] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Affiliation(s)
- Alik S. Widge
- Department of Psychiatry, University of Minnesota, Minneapolis
| | - Earl K. Miller
- The Picower Institute for Learning and Memory, Department of Brain and Cognitive Sciences, Massachusetts Institute of Technology, Cambridge
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Abstract
Neural recording electrode technologies have contributed considerably to neuroscience by enabling the extracellular detection of low-frequency local field potential oscillations and high-frequency action potentials of single units. Nevertheless, several long-standing limitations exist, including low multiplexity, deleterious chronic immune responses and long-term recording instability. Driven by initiatives encouraging the generation of novel neurotechnologies and the maturation of technologies to fabricate high-density electronics, novel electrode technologies are emerging. Here, we provide an overview of recently developed neural recording electrode technologies with high spatial integration, long-term stability and multiple functionalities. We describe how these emergent neurotechnologies can approach the ultimate goal of illuminating chronic brain activity with minimal disruption of the neural environment, thereby providing unprecedented opportunities for neuroscience research in the future.
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Affiliation(s)
- Guosong Hong
- Department of Chemistry and Chemical Biology, Harvard University, Cambridge, MA, USA
- Department of Materials Science and Engineering, Stanford University, Stanford, CA, USA
- Wu Tsai Neurosciences Institute, Stanford University, Stanford, CA, USA
| | - Charles M Lieber
- Department of Chemistry and Chemical Biology, Harvard University, Cambridge, MA, USA.
- Center for Brain Science, Harvard University, Cambridge, MA, USA.
- John A. Paulson School of Engineering and Applied Sciences, Harvard University, Cambridge, MA, USA.
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Deep brain stimulation of the internal capsule enhances human cognitive control and prefrontal cortex function. Nat Commun 2019; 10:1536. [PMID: 30948727 PMCID: PMC6449385 DOI: 10.1038/s41467-019-09557-4] [Citation(s) in RCA: 76] [Impact Index Per Article: 15.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2018] [Accepted: 03/19/2019] [Indexed: 01/11/2023] Open
Abstract
Deep brain stimulation (DBS) is a circuit-oriented treatment for mental disorders. Unfortunately, even well-conducted psychiatric DBS clinical trials have yielded inconsistent symptom relief, in part because DBS’ mechanism(s) of action are unclear. One clue to those mechanisms may lie in the efficacy of ventral internal capsule/ventral striatum (VCVS) DBS in both major depression (MDD) and obsessive-compulsive disorder (OCD). MDD and OCD both involve deficits in cognitive control. Cognitive control depends on prefrontal cortex (PFC) regions that project into the VCVS. Here, we show that VCVS DBS’ effect is explained in part by enhancement of PFC-driven cognitive control. DBS improves human subjects’ performance on a cognitive control task and increases theta (5–8Hz) oscillations in both medial and lateral PFC. The theta increase predicts subjects’ clinical outcomes. Our results suggest a possible mechanistic approach to DBS therapy, based on tuning stimulation to optimize these neurophysiologic phenomena. Deep brain stimulation (DBS) is a promising treatment for psychiatric disorders, but its mechanism in relieving symptoms is unclear. Here, the authors show that DBS of ventral internal capsule/ventral striatum (VCVS) may act by enhancing prefrontal cortex oscillations that in turn enhance cognitive control.
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Abstract
PURPOSE OF REVIEW To review recent advances in therapeutics for motor and nonmotor symptoms of Parkinson's disease. RECENT FINDINGS Neuroprotection remains a large area of investigation with preliminary safety data on alpha synuclein immunotherapy and glucagon-like peptide-1 agonists. Novel Monoamine Oxidase B and Caetchol-O-methyltransferase-inhibitors for motor fluctuations have shown benefit and are recently approved for clinical use. Long-acting amantadine has also been approved to reduce dyskinesia. Alternative delivery strategies (sublingual, inhaled) dopaminergics may prove useful for rapid reversal of Parkinson's disease motor symptoms. Advanced therapies (surgery and infusional therapies) continue to be useful in subgroups of patients for motor complications with improved safety and also benefit on some nonmotor symptoms, including neuropsychiatric issues. Specific therapeutics for cognition, swallowing, sleep, and mood disorders had moderate to limited benefits. Exercise-based therapy appears beneficial at all stages of Parkinson's disease. SUMMARY The motor symptoms of Parkinson's disease can be reasonably treated and managed. However, therapies to slow or prevent disease progression remain a focus of research. Despite increased studies, treating nonmotor symptoms remains a challenge and an ongoing priority.
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Connectivity and Dynamics Underlying Synaptic Control of the Subthalamic Nucleus. J Neurosci 2019; 39:2470-2481. [PMID: 30700533 DOI: 10.1523/jneurosci.1642-18.2019] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2018] [Revised: 12/29/2018] [Accepted: 01/24/2019] [Indexed: 12/16/2022] Open
Abstract
Adaptive motor control critically depends on the interconnected nuclei of the basal ganglia in the CNS. A pivotal element of the basal ganglia is the subthalamic nucleus (STN), which serves as a therapeutic target for deep brain stimulation (DBS) in movement disorders, such as Parkinson's disease. The functional connectivity of the STN at the microcircuit level, however, still requires rigorous investigation. Here we combine multiple simultaneous whole-cell recordings with extracellular stimulation and post hoc neuroanatomical analysis to investigate intrinsic and afferent connectivity and synaptic properties of the STN in acute brain slices obtained from rats of both sexes. Our data reveal an absence of intrinsic connectivity and an afferent innervation with low divergence, suggesting that STN neurons operate as independent processing elements driven by upstream structures. Hence, synchrony in the STN, a hallmark of motor processing, exclusively depends on the interactions and dynamics of GABAergic and glutamatergic afferents. Importantly, these inputs are subject to differential short-term depression when stimulated at high, DBS-like frequencies, shifting the balance of excitation and inhibition toward inhibition. Thus, we present a mechanism for fast yet transient decoupling of the STN from synchronizing afferent control. Together, our study provides new insights into the microcircuit organization of the STN by identifying its neurons as parallel processing units and thus sets new constraints for future computational models of the basal ganglia. The observed differential short-term plasticity of afferent inputs further offers a basis to better understand and optimize DBS algorithms.SIGNIFICANCE STATEMENT The subthalamic nucleus (STN) is a pivotal element of the basal ganglia and serves as target for deep brain stimulation, but information on the functional connectivity of its neurons is limited. To investigate the STN microcircuitry, we combined multiple simultaneous patch-clamp recordings and neuroanatomical analysis. Our results provide new insights into the synaptic organization of the STN identifying its neurons as parallel processing units and thus set new constraints for future computational models of the basal ganglia. We further find that synaptic dynamics of afferent inputs result in a rapid yet transient decoupling of the STN when stimulated at high frequencies. These results offer a better understanding of deep brain stimulation mechanisms, promoting the development of optimized algorithms.
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Eisinger RS, Cernera S, Gittis A, Gunduz A, Okun MS. A review of basal ganglia circuits and physiology: Application to deep brain stimulation. Parkinsonism Relat Disord 2019; 59:9-20. [PMID: 30658883 DOI: 10.1016/j.parkreldis.2019.01.009] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Revised: 01/07/2019] [Accepted: 01/09/2019] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Drawing on the seminal work of DeLong, Albin, and Young, we have now entered an era of basal ganglia neuromodulation. Understanding, re-evaluating, and leveraging the lessons learned from neuromodulation will be crucial to facilitate an increased and improved application of neuromodulation in human disease. METHODS We will focus on deep brain stimulation (DBS) - the most common form of basal ganglia neuromodulation - however, similar principles can apply to other neuromodulation modalities. We start with a brief review of DBS for Parkinson's disease, essential tremor, dystonia, and Tourette syndrome. We then review hallmark studies on basal ganglia circuits and electrophysiology resulting from decades of experience in neuromodulation. The organization and content of this paper follow Dr. Okun's Lecture from the 2018 Parkinsonism and Related Disorders World Congress. RESULTS Information gained from neuromodulation has led to an expansion of the basal ganglia rate model, an enhanced understanding of nuclei dynamics, an emerging focus on pathological oscillations, a revision of the tripartite division of the basal ganglia, and a redirected focus toward individualized symptom-specific stimulation. Though there have been many limitations of the basal ganglia "box model," the construct provided the necessary foundation to advance the field. We now understand that information in the basal ganglia is encoded through complex neural responses that can be reliably measured and used to infer disease states for clinical translation. CONCLUSIONS Our deepened understanding of basal ganglia physiology will drive new neuromodulation strategies such as adaptive DBS or cell-specific neuromodulation through the use of optogenetics.
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Affiliation(s)
- Robert S Eisinger
- Department of Neuroscience, University of Florida, Gainesville, FL, USA
| | - Stephanie Cernera
- Department of Biomedical Engineering, University of Florida, Gainesville, FL, USA.
| | - Aryn Gittis
- Biological Sciences and Center for Neural Basis of Cognition, Carnegie Mellon University, Pittsburgh, PA, USA
| | - Aysegul Gunduz
- Department of Neuroscience, University of Florida, Gainesville, FL, USA; Department of Biomedical Engineering, University of Florida, Gainesville, FL, USA; Department of Neurology, Fixel Center for Neurological Diseases, University of Florida, Gainesville, FL, USA
| | - Michael S Okun
- Department of Neuroscience, University of Florida, Gainesville, FL, USA; Department of Neurology, Fixel Center for Neurological Diseases, University of Florida, Gainesville, FL, USA
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40
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Casagrande SCB, Cury RG, Alho EJL, Fonoff ET. Deep brain stimulation in Tourette's syndrome: evidence to date. Neuropsychiatr Dis Treat 2019; 15:1061-1075. [PMID: 31114210 PMCID: PMC6497003 DOI: 10.2147/ndt.s139368] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
Tourette's syndrome (TS) is a neurodevelopmental disorder that comprises vocal and motor tics associated with a high frequency of psychiatric comorbidities, which has an important impact on quality of life. The onset is mainly in childhood and the symptoms can either fade away or require pharmacological therapies associated with cognitive-behavior therapies. In rare cases, patients experience severe and disabling symptoms refractory to conventional treatments. In these cases, deep brain stimulation (DBS) can be considered as an interesting and effective option for symptomatic control. DBS has been studied in numerous trials as a therapy for movement disorders, and currently positive data supports that DBS is partially effective in reducing the motor and non-motor symptoms of TS. The average response, mostly from case series and prospective cohorts and only a few controlled studies, is around 40% improvement on tic severity scales. The ventromedial thalamus has been the preferred target, but more recently the globus pallidus internus has also gained some notoriety. The mechanism by which DBS is effective on tics and other symptoms in TS is not yet understood. As refractory TS is not common, even reference centers have difficulties in performing large controlled trials. However, studies that reproduce the current results in larger and multicenter randomized controlled trials to improve our knowledge so as to support the best target and stimulation settings are still lacking. This article will discuss the selection of the candidates, DBS targets and mechanisms on TS, and clinical evidence to date reviewing current literature about the use of DBS in the treatment of TS.
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Affiliation(s)
- Sara C B Casagrande
- Department of Neurology, School of Medicine, Movement Disorders Center, University of São Paulo, São Paulo, Brazil
| | - Rubens G Cury
- Department of Neurology, School of Medicine, Movement Disorders Center, University of São Paulo, São Paulo, Brazil
| | - Eduardo J L Alho
- Department of Neurology, School of Medicine, University of São Paulo, São Paulo, Brazil,
| | - Erich Talamoni Fonoff
- Department of Neurology, School of Medicine, University of São Paulo, São Paulo, Brazil,
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Grossman N, Okun MS, Boyden ES. Translating Temporal Interference Brain Stimulation to Treat Neurological and Psychiatric Conditions. JAMA Neurol 2018; 75:1307-1308. [DOI: 10.1001/jamaneurol.2018.2760] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Nir Grossman
- Division of Brain Sciences, Imperial College London, London, United Kingdom
- United Kingdom Dementia Research Institute, Imperial College London, London, United Kingdom
| | - Michael S. Okun
- Department of Neurology, Fixel Center for Neurological Diseases, Program in Movement Disorders and Neurorestoration, University of Florida, Gainesville
| | - Edward S. Boyden
- Media Lab, Massachusetts Institute of Technology, Cambridge
- McGovern Institute for Brain Research, Massachusetts Institute of Technology, Cambridge
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Zuk P, Torgerson L, Sierra-Mercado D, Lázaro-Muñoz G. Neuroethics of Neuromodulation: An Update. CURRENT OPINION IN BIOMEDICAL ENGINEERING 2018; 8:45-50. [PMID: 30687802 DOI: 10.1016/j.cobme.2018.10.003] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
This article reviews neuroethics issues that arise with the development, translation, and use of technologies for neuromodulation. Three electronic databases (PubMed, Embase, and PhilPapers) were searched for relevant articles published between 1/1/16 - 6/26/18. We focus on pressing ethical issues related to the use of deep brain stimulation (DBS), adaptive DBS (aDBS), transcranial magnetic stimulation (TMS), transcranial direct current stimulation (tDCS), and associated technologies. The neuroethics issues we address include privacy, continued access to devices, device removal, do-it-yourself neurostimulation, neuroenhancement, media coverage, changes in personal identity and agency, informed consent, and neuromodulation in minors. This review should be of assistance to a variety of stakeholders, including neurotechnology developers, as they make important decisions that will drive these neurotechnologies.
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Affiliation(s)
- Peter Zuk
- Center for Medical Ethics and Health Policy, Baylor College of Medicine, Houston, Texas, USA.,Department of Philosophy, Rice University, Houston, Texas, USA
| | - Laura Torgerson
- Center for Medical Ethics and Health Policy, Baylor College of Medicine, Houston, Texas, USA
| | - Demetrio Sierra-Mercado
- Department of Anatomy & Neurobiology, University of Puerto Rico School of Medicine, San Juan, Puerto Rico
| | - Gabriel Lázaro-Muñoz
- Center for Medical Ethics and Health Policy, Baylor College of Medicine, Houston, Texas, USA
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Witjas-Slucki T. Surgical treatments for tremors. Rev Neurol (Paris) 2018; 174:615-620. [PMID: 30224158 DOI: 10.1016/j.neurol.2018.07.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2018] [Revised: 07/20/2018] [Accepted: 07/24/2018] [Indexed: 10/28/2022]
Abstract
Stereotactic surgery is an increasingly popular option for disabling tremors whenever it is insufficiently improved by drug treatment. Surgical approaches are expanding. Thalamic deep brain stimulation is one of the most efficacious treatments. Its recent technological advances with adaptive stimulation and new electrodes configuration will allow a more physiological stimulation. However, a reappraisal of less invasive, new lesioning procedures is underway. Gamma Knife thalamotomy and magnetic resonance-guided focused ultrasounds encounter very few contraindications. Recent studies reported their efficacy on tremor control and safety profile. Besides the ventralis intermedius nucleus of the thalamus, alternative targets are also emerging. The effectiveness of surgical therapies on essential tremor and Parkinson's disease tremor is well established. For more uncommon tremors, preliminary studies are encouraging. All these surgical therapies can be proposed as treatment option for medically refractory tremors.
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Affiliation(s)
- T Witjas-Slucki
- Service de neurologie et pathologie du mouvement, UMR 7289 CNRS Aix-Marseille université, institut de neurosciences de la Timone, CHU Timone, Marseille, boulevard, Jean-Moulin, 13005 Marseille, France.
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Moraud EM, Tinkhauser G, Agrawal M, Brown P, Bogacz R. Predicting beta bursts from local field potentials to improve closed-loop DBS paradigms in Parkinson's patients. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2018; 2018:3766-3796. [PMID: 30441186 PMCID: PMC6277014 DOI: 10.1109/embc.2018.8513348] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Motor symptoms in Parkinson's disease (PD) correlate with an excess in synchrony in the beta frequency band (13-30Hz) of local field potentials recorded from basal ganglia circuits. Recent results have suggested that this abnormal activity arises as a result of changes in specific dynamical features of the underlying neural signatures. In particular, patterns of activity in the beta band have been shown to be structured in bursts of longer durations and higher amplitudes in untreated patients with PD. Closed-loop deep brain stimulation (DBS) paradigms that specifically target these pathological bursts of activity hold promises to help trim, and thus normalize, their abnormal behavior in real-time. Here, we developed classification algorithms that predict pathological beta bursts based on ongoing changes in LFP frequency dynamics. We then compared simulations of prediction-based DBS profiles with existing 'adaptive DBS' alternatives. We show that model-driven stimulation profiles are more precise in restricting the delivery of stimulation to bursts that are considered pathological, while preserving physiological ones. The overall stimulation time required is also diminished, thus supporting longer battery life. These results represent a conceptual and algorithmic framework for the development of more precise DBS strategies that are selectively tailored to the electrophysiological profile of each patient.
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