Could adaptive deep brain stimulation treat freezing of gait in Parkinson’s disease?

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

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Subthalamic Activity Is Associated With Proactive Inhibition in Parkinson's Disease Patients

European Journal of Neuroscience, Journal Year: 2025, Volume and Issue: 61(5)

Published: March 1, 2025

ABSTRACT The subthalamic nucleus (STN) is a key element of the indirect pathway basal ganglia (BG) and an effective target for improving motor symptoms in Parkinson's disease (PD) using deep brain stimulation (DBS). While dopamine neuron loss PD results net shift towards increased inhibitory output from BG, precise mechanisms by which STN contributes to diminished movement remain unclear due complexity multiplicity processes underlying response inhibition. We used modified Go/NoGo task varying uncertainty about Go or NoGo responses determine how changes inhibition are related local field potentials measured 19 patients operated STN‐DBS. When engaged task, low‐frequency band (LFB, 2–7 Hz; including theta band, 4–7 Hz) power was significantly treatment. LFB when there requirement executing withholding compared certain. Increases individual trials were also associated with faster reaction times. By contrast, beta (12–30 exhibited inverted profile: It decreased treatment, certainty slower Our suggest that activity during voluntary behaviour may complement enhance information obtained should be considered as possible biomarker regulation uncertain contexts.

Language: Английский

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Basal ganglia components have distinct computational roles in decision-making dynamics under conflict and uncertainty

PLoS Biology, Journal Year: 2025, Volume and Issue: 23(1), P. e3002978 - e3002978

Published: Jan. 23, 2025

The basal ganglia (BG) play a key role in decision-making, preventing impulsive actions some contexts while facilitating fast adaptations others. specific contributions of different BG structures to this nuanced behavior remain unclear, particularly under varying situations noisy and conflicting information that necessitate ongoing adjustments the balance between speed accuracy. Theoretical accounts suggest dynamic regulation amount evidence required commit decision (a “decision boundary”) may be necessary meet these competing demands. Through application novel computational modeling tools tandem with direct neural recordings from human areas, we find dynamics theta band manifest as variations collapsing boundary function conflict uncertainty. We collected intracranial patients diagnosed either Parkinson’s disease (PD) ( n = 14) or dystonia 3) subthalamic nucleus (STN), globus pallidus internus (GPi), externus (GPe) during their performance perceptual discrimination task which independently manipulated uncertainty conflict. To formally characterize whether components influenced dynamics, leveraged modified diffusion models (DDMs). Behavioral choices response time distributions were best characterized by DDM collapsed over time, but where onset shape collapse varied Moreover, modulated differentially across conditions. In STN, activity was related prolonged (indexed slower therefore more deliberate choices) high situations. Conversely, rapid declines GPe low conditions rapidly boundaries expedited choices, additional complementary bound Finally, GPi effects uniform conditions, increases associated prolongation collapses. Together, findings provide understanding how our brain thwarts nonetheless enabling behavioral adaptation amidst information.

Language: Английский

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Local Field Potential Biomarkers of Non‐Motor Symptoms in Parkinson's Disease: Insights From the Subthalamic Nucleus in Deep Brain Stimulation

European Journal of Neuroscience, Journal Year: 2025, Volume and Issue: 61(5)

Published: March 1, 2025

Non-motor symptoms can severely affect the quality of life Parkinson's disease-afflicted patients, with most common ones being pain, sleep impairments, and neuropsychiatric manifestations. In advanced cases, complex fluctuations motor non-motor occur despite optimal medication. Research on deep brain stimulation subthalamic nucleus suggests that it may provide benefits for treating in addition to improving symptoms. With recent advancements technology, simultaneous recording local field potentials delivery therapeutic is possible. This opens new possibilities better understanding pathophysiology disease identifying potential electrophysiological biomarkers accurately represent these Specifically, this review aims highlight nucleus. The main findings indicate activities beta frequency band are associated nociception impairments such as insomnia rapid eye movement behavior disorders. Additionally, theta alpha bands seem reflect neurocognitive manifestations, including depression impulse control A could improve clinical management disease. They hold promise adjusting parameters open-loop settings might eventually be applied closed-loop systems, though their true impact remains uncertain.

Language: Английский

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Managing impulse control and related behavioral disorders in Parkinson’s disease: where we are in 2025?

Expert Review of Neurotherapeutics, Journal Year: 2025, Volume and Issue: unknown

Published: March 28, 2025

Introduction Impulse control and related behavioral disorders (ICBDs) commonly complicate Parkinson's disease (PD) course. The ICBDs spectrum encompasses two groups of conditions, with distinct pathophysiology: proper 'impulse (ICDs)' (e.g. gambling) the 'ICDs (ICDs-RD)' punding). Behavioral disturbances are associated dopamine replacement therapies. significantly affect quality life patients caregivers, making their management essential for reducing overall burden PD.

Language: Английский

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