Machine learning for adaptive deep brain stimulation in Parkinson’s disease: closing the loop

Journal of Neurology, Год журнала: 2023, Номер 270(11), С. 5313 - 5326

Опубликована: Авг. 2, 2023

Abstract Parkinson’s disease (PD) is the second most common neurodegenerative bearing a severe social and economic impact. So far, there no known modifying therapy current available treatments are symptom oriented. Deep Brain Stimulation (DBS) established as an effective treatment for PD, however systems lag behind today’s technological potential. Adaptive DBS, where stimulation parameters depend on patient’s physiological state, emerges important step towards “smart” strategy that enables adaptive personalized therapy. This new facilitated by currently neurotechnologies allowing simultaneous monitoring of multiple signals, providing relevant information. Advanced computational models analytical methods tool to explore richness data identify signal properties close loop in DBS. To tackle this challenge, machine learning (ML) applied DBS have gained popularity due their ability make good predictions presence variables subtle patterns. ML based approaches being explored at different fronts such identification electrophysiological biomarkers development control systems, leading relief. In review, we how can help overcome challenges closed-loop particularly its role search electrophysiology biomarkers. Promising results demonstrate potential supporting generation with better management delivery, resulting more efficient patient-tailored treatments.

Язык: Английский

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Adverse and compensatory neurophysiological slowing in Parkinson’s disease

Progress in Neurobiology, Год журнала: 2023, Номер 231, С. 102538 - 102538

Опубликована: Окт. 11, 2023

Patients with Parkinson's disease (PD) exhibit multifaceted changes in neurophysiological brain activity, hypothesized to represent a global cortical slowing effect. Using task-free magnetoencephalography and extensive clinical assessments, we found that PD is differentially associated motor non-motor symptoms along sagittal gradient over the anatomy. In superior parietal regions, reflects an adverse effect scales cognitive impairments, while across inferior frontal cortex, compatible compensatory role. This adverse-to-compensatory sensitive individual profiles, such as drug regimens laterality of symptoms; it also aligned topography neurotransmitter transporter systems relevant PD. We conclude patients signals both deleterious protective mechanisms disease, from posterior anterior regions respectively, functional relevance symptoms.

Язык: Английский

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Electrophysiological approaches to informing therapeutic interventions with deep brain stimulation

npj Parkinson s Disease, Год журнала: 2025, Номер 11(1)

Опубликована: Янв. 20, 2025

Abstract Neuromodulation therapy comprises a range of non-destructive and adjustable methods for modulating neural activity using electrical stimulations, chemical agents, or mechanical interventions. Here, we discuss how electrophysiological brain recording imaging at multiple scales, from cells to large-scale networks, contribute defining the target location stimulation parameters neuromodulation, with an emphasis on deep (DBS).

Язык: Английский

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Spectral Topography of the Subthalamic Nucleus to Inform Next‐Generation Deep Brain Stimulation

Movement Disorders, Год журнала: 2023, Номер 38(5), С. 818 - 830

Опубликована: Март 28, 2023

Abstract Background The landscape of neurophysiological symptoms and behavioral biomarkers in basal ganglia signals for movement disorders is expanding. clinical translation sensing‐based deep brain stimulation (DBS) also requires a thorough understanding the anatomical organization spectral within subthalamic nucleus (STN). Objectives aims were to systematically investigate topography, including wide range sub‐bands STN local field potentials (LFP) Parkinson's disease (PD) patients, evaluate its predictive performance response DBS. Methods STN‐LFPs recorded from 70 PD patients (130 hemispheres) awake at rest using multicontact DBS electrodes. A comprehensive spatial characterization, hot spot localization focality estimation, was performed multiple (delta, theta, alpha, low‐beta, high‐beta, low‐gamma, high‐gamma, fast‐gamma (FG) as well low‐ fast high‐frequency oscillations [HFO]) compared rigidity biomarker map established used predict Results shows heterogeneous topographic distribution different biomarkers, with strongest segregation inferior‐superior axis. Relative superiorly localized beta spot, HFOs (FG, slow HFO) up 2 mm more inferiorly. Beta are spatially spread other sub‐bands. Both proximity contacts distance higher‐frequency spots best Conclusions properties target structure can additionally be informative implementation next‐generation © 2023 Authors. Movement Disorders published by Wiley Periodicals LLC on behalf International Parkinson Disorder Society.

Язык: Английский

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Towards biomarker-based optimization of deep brain stimulation in Parkinson’s disease patients

Frontiers in Neuroscience, Год журнала: 2023, Номер 16

Опубликована: Янв. 11, 2023

Subthalamic deep brain stimulation (DBS) is an established therapy to treat Parkinson's disease (PD). To maximize therapeutic outcome, optimal DBS settings must be carefully selected for each patient. Unfortunately, this not always achieved because of: (1) increased technological complexity of devices, (2) time restraints, or lack expertise, and (3) delayed response some symptoms. Biomarkers accurately predict the most effective patient could streamline process improve outcomes.To investigate use evoked potentials (EPs) clinical outcomes in PD patients with DBS.In ten (12 hemispheres), a monopolar review was performed by systematically stimulating on contact measuring window. Standard imaging data were collected. EEG-based EPs then recorded at 10 Hz 50 s DBS-contact. Linear mixed models used assess how well both image-derived information predicted data.Evoked potential peaks 3 ms (P3) (P10) observed nine eleven hemispheres, respectively. Clinical using either P3 P10. A separate model showed that also similar accuracy. Combining one yielded highest predictive value.Evoked can responses. further improves prediction. Future refinement approach may programming, thereby improving outcomes.ClinicalTrials.gov, identifier NCT04658641.

Язык: Английский

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Association of subthalamic beta frequency sub-bands to symptom severity in patients with Parkinson's disease: A systematic review

Parkinsonism & Related Disorders, Год журнала: 2023, Номер 110, С. 105364 - 105364

Опубликована: Март 20, 2023

Язык: Английский

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Machine learning explains response variability of deep brain stimulation on Parkinson’s disease quality of life

npj Digital Medicine, Год журнала: 2024, Номер 7(1)

Опубликована: Окт. 2, 2024

Abstract Improving health-related quality of life (QoL) is crucial for managing Parkinson’s disease. However, QoL outcomes after deep brain stimulation (DBS) the subthalamic nucleus (STN) vary considerably. Current approaches lack integration demographic, patient-reported, neuroimaging, and neurophysiological data to understand this variability. This study used explainable machine learning analyze multimodal factors affecting changes, measured by Disease Questionnaire (PDQ-39) in 63 patients, quantified each variable’s contribution. Results showed that preoperative PDQ-39 scores upper beta band activity (>20 Hz) left STN were key predictors changes. Lower initial burden predicted worsening, while improvement was associated with higher activity. Additionally, electrode positions along superior-inferior axis, especially relative z = −7 coordinate standard space, influenced outcomes, improved worsened above below marker. emphasizes a tailored, data-informed approach optimize DBS treatment improve patient QoL.

Язык: Английский

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Subthalamic high-beta oscillation informs the outcome of deep brain stimulation in patients with Parkinson's disease

Frontiers in Human Neuroscience, Год журнала: 2022, Номер 16

Опубликована: Сен. 8, 2022

Background The therapeutic effect of deep brain stimulation (DBS) the subthalamic nucleus (STN) for Parkinson's disease (PD) is related to modulation pathological neural activities, particularly synchronization in β band (13–35 Hz). However, whether local activity STN region can directly predict outcome remains unclear. Objective We tested hypothesis that low- (13–20 Hz) and/or high- (20–35 activities recorded from DBS efficacy. Methods Local field potentials (LFPs) were 26 patients undergoing surgery area. Recordings made after implantation electrode prior its connection a stimulator. maximum normalized powers theta (4–7 Hz), alpha (7–13 and low-γ (40–55 subbands postoperatively LFP correlated with stimulation-induced improvement contralateral tremor or bradykinesia–rigidity. distance between contact selected subband power was Following identification potential predictors by significant correlations, multiple regression analysis performed evaluate their on outcome. Results positively bradykinesia–rigidity ( r s = 0.549, p < 0.0001). negatively −0.452, 0.001). No correlation observed power. both analysis, explaining 37.4% variance altogether. Tremor not significantly any frequency. Conclusion High- oscillations, but lead inform PD. oscillations help refine targeting selection therapy.

Язык: Английский

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Eltoprazine modulated gamma oscillations on ameliorating L‐dopa‐induced dyskinesia in rats

CNS Neuroscience & Therapeutics, Год журнала: 2023, Номер 29(10), С. 2998 - 3013

Опубликована: Апрель 30, 2023

Parkinson's disease (PD) is a pervasive neurodegenerative disease, and levodopa (L-dopa) its preferred treatment. The pathophysiological mechanism of levodopa-induced dyskinesia (LID), the most common complication long-term L-dopa administration, remains obscure. Accumulated evidence suggests that dopaminergic as well non-dopaminergic systems contribute to LID development. As 5-hydroxytryptamine 1A/1B receptor agonist, eltoprazine ameliorates dyskinesia, although little known about electrophysiological mechanism. aim this study was investigate cumulative effects chronic administration potential eltoprazine's amelioration at level in rats.Neural analysis techniques were conducted on acquired local field (LFP) data from primary motor cortex (M1) dorsolateral striatum (DLS) during different pathological states obtain information power spectrum density, theta-gamma phase-amplitude coupling (PAC), functional connectivity. Behavior tests AIMs scoring performed verify PD model establishment evaluate severity.We detected exaggerated gamma activities dyskinetic state, with features impacts distinct regions. Gamma oscillations M1 narrowband manner, whereas DLS had broadband appearance. Striatal PAC state contributed oscillation, aperiodic-corrected cortical beta correlated robustly M1. M1-DLS coherence phase-locking values (PLVs) band enhanced following administration. Eltoprazine intervention reduced oscillations, DLS, PLVs alleviate dyskinesia.Excessive oscillation compelling clinical indicator dyskinesia. detection connectivity gamma-band can be used guide optimize deep brain stimulation parameters. has application for

Язык: Английский

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Review of directional leads, stimulation patterns and programming strategies for deep brain stimulation

Cognitive Neurodynamics, Год журнала: 2025, Номер 19(1)

Опубликована: Янв. 23, 2025

Язык: Английский

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