Subthalamic–Cortical Network Reorganization during Parkinson's Tremor DOI Creative Commons
Peter M. Lauro, Shane Lee, Umer Akbar

et al.

Journal of Neuroscience, Journal Year: 2021, Volume and Issue: 41(47), P. 9844 - 9858

Published: Oct. 26, 2021

Tremor, a common and often primary symptom of Parkinson's disease, has been modeled with distinct onset maintenance dynamics. To identify the neurophysiologic correlates each state, we acquired intraoperative cortical subthalamic nucleus recordings from 10 patients (9 male, 1 female) performing naturalistic visual–motor task. From this task, isolated short epochs tremor sustained tremor. Comparing these epochs, found that was central to onset, as it drove both motor activity output. Once became sustained, control shifted cortex. At same time, changes in directed functional connectivity across sensorimotor cortex further distinguished state. SIGNIFICANCE STATEMENT Tremor is disease (PD). While pathophysiology thought involve basal ganglia cerebello–thalamic–cortical circuits, unknown how structures functionally interact produce In article, analyzed intracranial PD undergoing deep brain stimulation surgery. Using an examined two separate dynamic contexts: when first emerged, sustained. We believe findings reconcile several models tremor, while describing short-timescale dynamics subcortical–cortical interactions during for time. These may describe framework developing proactive responsive neurostimulation specifically treating

Language: Английский

Toward therapeutic electrophysiology: beta-band suppression as a biomarker in chronic local field potential recordings DOI Creative Commons
Lucia K. Feldmann, Roxanne Lofredi, Wolf‐Julian Neumann

et al.

npj Parkinson s Disease, Journal Year: 2022, Volume and Issue: 8(1)

Published: April 19, 2022

Adaptive deep brain stimulation (aDBS) is a promising concept for feedback-based neurostimulation, with the potential of clinical implementation sensing-enabled Percept neurostimulator. We aim to characterize chronic electrophysiological activity during and validate beta-band as biomarker bradykinesia. Subthalamic was recorded stepwise amplitude increase OFF medication in 10 Parkinson's patients rest finger tapping. Offline analysis wavelet-transformed assessment inter-variable relationships linear mixed effects models were implemented. There suppression low-beta increasing intensity (p = 0.002). Low-beta power negatively correlated movement speed predictive velocity improvements < 0.001), beta 0.001). Here, we modulation motor performance. Our investigations support use electrophysiology therapy optimization, providing evidence aDBS.

Language: Английский

Citations

93
Adaptive Deep Brain Stimulation: From Experimental Evidence Toward Practical Implementation DOI Creative Commons
Wolf‐Julian Neumann, Ro’ee Gilron, Simon Little

et al.

Movement Disorders, Journal Year: 2023, Volume and Issue: 38(6), P. 937 - 948

Published: May 6, 2023

Abstract Closed‐loop adaptive deep brain stimulation (aDBS) can deliver individualized therapy at an unprecedented temporal precision for neurological disorders. This has the potential to lead a breakthrough in neurotechnology, but translation clinical practice remains significant challenge. Via bidirectional implantable brain‐computer‐interfaces that have become commercially available, aDBS now sense and selectively modulate pathophysiological circuit activity. Pilot studies investigating different control strategies showed promising results, short experimental study designs not yet supported analyses of patient‐specific factors biomarker therapeutic response dynamics. Notwithstanding clear theoretical advantages patient‐tailored approach, these new possibilities open vast mostly unexplored parameter space, leading practical hurdles implementation development trials. Therefore, thorough understanding neurophysiological neurotechnological aspects related is crucial develop evidence‐based treatment regimens practice. Therapeutic success will depend on integrated feedback signal identification, artifact mitigation, processing, policy adjustment, precise delivery tailored individual patients. The present review introduces reader foundation Parkinson's disease (PD) other network disorders, explains currently available policies, highlights pitfalls difficulties be addressed upcoming years. Finally, it importance interdisciplinary research within across DBS centers, toward patient‐centered approach invasive stimulation. © 2023 Authors. Movement Disorders published by Wiley Periodicals LLC behalf International Parkinson Disorder Society.

Language: Английский

Citations

79
Chronic adaptive deep brain stimulation versus conventional stimulation in Parkinson’s disease: a blinded randomized feasibility trial DOI
Carina R. Oehrn, Stephanie Cernera, Lauren H. Hammer

et al.

Nature Medicine, Journal Year: 2024, Volume and Issue: 30(11), P. 3345 - 3356

Published: Aug. 19, 2024

Language: Английский

Citations

45
N2GNet tracks gait performance from subthalamic neural signals in Parkinson’s disease DOI Creative Commons
Jin Woo Choi, Chuyi Cui, Kevin B. Wilkins

et al.

npj Digital Medicine, Journal Year: 2025, Volume and Issue: 8(1)

Published: Jan. 4, 2025

Abstract Adaptive deep brain stimulation (DBS) provides individualized therapy for people with Parkinson’s disease (PWP) by adjusting the in real-time using neural signals that reflect their motor state. Current algorithms, however, utilize condensed and manually selected features which may result a less robust biased therapy. In this study, we propose Neural-to-Gait Neural network (N2GNet), novel learning-based regression model capable of tracking gait performance from subthalamic nucleus local field potentials (STN LFPs). The LFP data were acquired when eighteen PWP performed stepping place, ground reaction forces measured to track weight shifts representing performance. By exhibiting stronger correlation compared higher-correlation beta power two leads outperforming other evaluated designs, N2GNet effectively leverages comprehensive frequency band, not limited range, solely STN LFPs.

Language: Английский

Citations

2
Subthalamic beta band suppression reflects effective neuromodulation in chronic recordings DOI
Lucia K. Feldmann, Wolf‐Julian Neumann, Patricia Krause

et al.

European Journal of Neurology, Journal Year: 2021, Volume and Issue: 28(7), P. 2372 - 2377

Published: March 6, 2021

Abstract Background and purpose Biomarkers for future adaptive deep brain stimulation still need evaluation in clinical routine. Here, we aimed to assess stimulation‐induced modulation of beta‐band activity symptoms a Parkinson's disease patient during chronic neuronal sensing using novel implantable pulse generator. Methods Subthalamic was recorded OFF ON medication stepwise increase amplitude. Off‐line fast fourier transfom ‐based analysis correlated with motor performance rated from blinded videos. Results The amplitude resulted decreased beta oscillatory improvement bradykinesia. Mean low (13–20 Hz) significantly bradykinesia (ρ = 0.662, p < 0.01). Conclusions Motor is reflected reduced subthalamic disease, supporting as reliable biomarker. PERCEPT neurostimulator enables Our findings pave the way personalized precision‐medicine approach neurostimulation.

Language: Английский

Citations

58
Spectral and spatial distribution of subthalamic beta peak activity in Parkinson's disease patients DOI Creative Commons
Natasha Darcy, Roxanne Lofredi, Bassam Al‐Fatly

et al.

Experimental Neurology, Journal Year: 2022, Volume and Issue: 356, P. 114150 - 114150

Published: June 19, 2022

Current efforts to optimise subthalamic deep brain stimulation in Parkinson's disease patients aim harness local oscillatory activity the beta frequency range (13–35 Hz) as a feedback-signal for demand-based adaptive paradigms. A high prevalence of peak is prerequisite this approach become routine clinical practice. In large dataset postoperative rest recordings from 106 we quantified occurrence and identified determinants spectral peaks alpha, low bands. At least one band occurred 92% 84% hemispheres off medication, irrespective demographic parameters, subtype or motor symptom severity. Distance previously described sweet spot was significantly related both power (rho −0.21, p 0.006), particularly band. Electrophysiological landscapes our cohort's normalised space showed divergent heatmaps alpha but found similar regions We discuss potential ramifications clinicians' programming decisions. summary, report provides robust evidence that can be detected vast majority Parkinsonian nuclei, increasing confidence broad applicability beta-guided stimulation.

Language: Английский

Citations

54
A systematic review of local field potential physiomarkers in Parkinson’s disease: from clinical correlations to adaptive deep brain stimulation algorithms DOI Creative Commons
Bernadette C.M. van Wijk, Rob M.A. de Bie, Martijn Beudel

et al.

Journal of Neurology, Journal Year: 2022, Volume and Issue: 270(2), P. 1162 - 1177

Published: Oct. 8, 2022

Deep brain stimulation (DBS) treatment has proven effective in suppressing symptoms of rigidity, bradykinesia, and tremor Parkinson's disease. Still, patients may suffer from disabling fluctuations motor non-motor symptom severity during the day. Conventional DBS consists continuous but can potentially be further optimised by adapting settings to presence or absence through closed-loop control. This critically relies on use 'physiomarkers' extracted (neuro)physiological signals. Ideal physiomarkers for adaptive (aDBS) are indicative severity, detectable every patient, technically suitable implementation. In last decades, much effort been put into detection local field potential (LFP) their clinical practice. We conducted a research synthesis correlations that have reported between LFP signal features one more specific PD symptoms. Features based spectral beta band (~ 13 30 Hz) explained ~ 17% individual variability bradykinesia rigidity severity. Limitations oscillations as physiomarker discussed, strategies improvement aDBS explored.

Language: Английский

Citations

45
Personalized chronic adaptive deep brain stimulation outperforms conventional stimulation in Parkinson’s disease DOI Creative Commons
Carina R. Oehrn, Stephanie Cernera, Lauren H. Hammer

et al.

medRxiv (Cold Spring Harbor Laboratory), Journal Year: 2023, Volume and Issue: unknown

Published: Aug. 8, 2023

Deep brain stimulation is a widely used therapy for Parkinson's disease (PD) but currently lacks dynamic responsiveness to changing clinical and neural states. Feedback control has the potential improve therapeutic effectiveness, optimal strategy additional benefits of "adaptive" neurostimulation are unclear. We implemented adaptive subthalamic nucleus stimulation, controlled by or cortical signals, in three PD patients (five hemispheres) during normal daily life. identified neurophysiological biomarkers residual motor fluctuations using data-driven analyses field potentials over wide frequency range varying amplitudes. Narrowband gamma oscillations (65-70 Hz) at either site emerged as best signal sensing stimulation. A blinded, randomized trial demonstrated improved symptoms quality life compared clinically optimized standard Our approach highlights promise personalized based on selection signals may be applied other neurological disorders.

Language: Английский

Citations

30
Sensing data and methodology from the Adaptive DBS Algorithm for Personalized Therapy in Parkinson’s Disease (ADAPT-PD) clinical trial DOI Creative Commons
Scott Stanslaski, Rebekah L. S. Summers,

Lisa Tonder

et al.

npj Parkinson s Disease, Journal Year: 2024, Volume and Issue: 10(1)

Published: Sept. 17, 2024

Language: Английский

Citations

11
Could adaptive deep brain stimulation treat freezing of gait in Parkinson’s disease? DOI Creative Commons
Philipp Klocke, M. Loeffler, Simon J.G. Lewis

et al.

Journal of Neurology, Journal Year: 2025, Volume and Issue: 272(4)

Published: March 12, 2025

Abstract Next-generation neurostimulators capable of running closed-loop adaptive deep brain stimulation (aDBS) are about to enter the clinical landscape for treatment Parkinson’s disease. Already promising results using aDBS have been achieved symptoms such as bradykinesia, rigidity and motor fluctuations. However, heterogeneity freezing gait (FoG) with its wide range presentations exacerbation cognitive emotional load make it more difficult predict treat. Currently, a successful strategy ameliorate FoG lacks robust oscillatory biomarker. Furthermore, technical implementation suppressing an upcoming episode in real-time represents significant challenge. This review describes neurophysiological signals underpinning explains how is currently being implemented. we offer discussion addressing both theoretical practical areas that will need be resolved if going able unlock full potential treat FoG.

Language: Английский

Citations

1