Diurnal modulation of subthalamic beta oscillatory power in Parkinson’s disease patients during deep brain stimulation

npj Parkinson s Disease, Год журнала: 2022, Номер 8(1)

Опубликована: Июль 8, 2022

Beta-band activity in the subthalamic local field potential (LFP) is correlated with Parkinson's disease (PD) symptom severity and therapeutic target of deep brain stimulation (DBS). While beta fluctuations PD patients are well characterized on shorter timescales, it not known how evolves around diurnal cycle, outside a clinical setting. Here, we obtained chronic recordings (34 ± 13 days) power implanted Percept DBS device during high-frequency analysed their properties as sensitivity to artifacts. Time day explained 41 9% variance (p < 0.001 all patients), increased reduced at night. Certain movements affected LFP quality, which may have contributed patterns some patients. Future algorithms benefit from taking such artifactual into account.

Язык: Английский

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Pathological pallidal beta activity in Parkinson’s disease is sustained during sleep and associated with sleep disturbance

Nature Communications, Год журнала: 2023, Номер 14(1)

Опубликована: Сен. 5, 2023

Parkinson's disease (PD) is associated with excessive beta activity in the basal ganglia. Brain sensing implants aim to leverage this biomarker for demand-dependent adaptive stimulation. Sleep disturbance among most common non-motor symptoms PD, but its relationship unknown. To investigate clinical potential of as a sleep quality we recorded pallidal local field potentials during polysomnography PD patients off dopaminergic medication and compared results dystonia patients. exhibited sustained elevated across wakefulness, rapid eye movement (REM), non-REM sleep, which was correlated disturbance. Simulation stimulation revealed that sleep-related changes remain unaccounted by current algorithms, negative outcomes overall life

Язык: Английский

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Multi-night cortico-basal recordings reveal mechanisms of NREM slow-wave suppression and spontaneous awakenings in Parkinson’s disease

Nature Communications, Год журнала: 2024, Номер 15(1)

Опубликована: Фев. 27, 2024

Abstract Sleep disturbance is a prevalent and disabling comorbidity in Parkinson’s disease (PD). We performed multi-night (n = 57) at-home intracranial recordings from electrocorticography subcortical electrodes using sensing-enabled Deep Brain Stimulation (DBS), paired with portable polysomnography four PD participants one cervical dystonia (clinical trial: NCT03582891). Cortico-basal activity delta increased beta decreased during NREM (N2 + N3) versus wakefulness PD. DBS caused further elevation cortical decrease alpha low-beta compared to OFF state. Our primary outcome demonstrated an inverse interaction between slow-wave NREM. secondary revealed increases prior spontaneous awakenings classified vs. high accuracy both traditional (30 s: 92.6 ± 1.7%) rapid (5 88.3 2.1%) data epochs of signals. findings elucidate sleep neurophysiology impacts on informing adaptive for dysfunction.

Язык: Английский

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Proceedings of the 10th annual deep brain stimulation think tank: Advances in cutting edge technologies, artificial intelligence, neuromodulation, neuroethics, interventional psychiatry, and women in neuromodulation

Frontiers in Human Neuroscience, Год журнала: 2023, Номер 16

Опубликована: Янв. 27, 2023

The deep brain stimulation (DBS) Think Tank X was held on August 17–19, 2022 in Orlando FL. session organizers and moderators were all women with the theme neuromodulation . Dr. Helen Mayberg from Mt. Sinai, NY keynote speaker. She discussed milestones her experiences developing depression DBS. DBS founded 2012 provides an open platform where clinicians, engineers researchers (from industry academia) can freely discuss current emerging technologies as well logistical ethical issues facing field. consensus among speakers that has continued to expand scope however several indications have reached “trough of disillusionment.” for considered “re-emerging” approaching a slope enlightenment. will soon re-enter clinical trials. group estimated globally more than 244,000 devices been implanted neurological neuropsychiatric disorders. This year’s meeting focused advances following areas: Europe, Asia, Australia; cutting-edge technologies, closed loop DBS, tele-health, neuroethics, lesion therapy, interventional psychiatry, adaptive

Язык: Английский

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At home adaptive dual target deep brain stimulation in Parkinson’s disease with proportional control

Brain, Год журнала: 2023, Номер 147(3), С. 911 - 922

Опубликована: Дек. 20, 2023

Abstract Continuous deep brain stimulation (cDBS) of the subthalamic nucleus (STN) or globus pallidus is an effective treatment for motor symptoms Parkinson’s disease. The relative benefit one region over other great interest but cannot usually be compared in same patient. Simultaneous DBS both regions may synergistically increase therapeutic benefit. limited by a lack responsiveness to dynamic, fluctuating intrinsic Adaptive (aDBS) adjusts response biomarkers improve efficacy, side effects, and efficiency. We combined bilateral STN (dual target DBS) prospective within-participant, clinical trial six patients with disease (n = 6, 55–65 years, n 2 females). Dual cDBS was tested symptom control annually measured rating scales, on time without dyskinesia, medication reduction. Random amplitude experiments probed system dynamics estimate parameters aDBS. then implemented proportional-plus-integral aDBS using novel distributed (off-implant) architecture. In home setting, we collected tremor dyskinesia scores as well individualized β amplitudes. reduced Unified Disease Rating Scale (UPDRS) greater degree than either alone (P &lt; 0.05, linear mixed model) cohort. β-oscillations correlated speed hand grasp movements five participants Pearson correlation). provided insight into temporal windowing avoid artefacts demonstrated correlation between amplitude. Proportional plus integral average power, while preserving UPDRS III clinic 0.28, Wilcoxon signed rank), during blinded testing at 3, P &gt; ranked sum). power reductions were slight significant. offer improvement alone. When proportional aDBS, reduced, increased dual DBS.

Язык: Английский

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Printed Silk Microelectrode Arrays for Electrophysiological Recording and Controlled Drug Delivery

Advanced Healthcare Materials, Год журнала: 2023, Номер 12(17)

Опубликована: Фев. 24, 2023

The use of soft and flexible bioelectronic interfaces can enhance the quality for recording cells' electrical activity by ensuring a continuous intimate contact with smooth, curving surfaces found in physiological environment. This work develops microelectrode arrays (MEAs) made silk fibroin (SF) films that also serve as drug delivery system. Inkjet printing is used tool to deposit substrate, conductive electrode, insulator, well drug-delivery nanocomposite film. approach highly versatile, shown fabrication carbon microelectrodes, sandwiched between substrate insulator. technique permits development thin-film devices be employed vitro extracellular recordings HL-1 cell action potentials. tuning SF applying an stimulus produce permeable layer on-demand systems demonstrated. multifunctional MEA developed here pave way screening time-resolved localized chemical stimuli.

Язык: Английский

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NeuroDots: From Single-Target to Brain-Network Modulation: Why and What Is Needed?

Neuromodulation Technology at the Neural Interface, Год журнала: 2024, Номер 27(4), С. 711 - 729

Опубликована: Апрель 16, 2024

Current techniques in brain stimulation are still largely based on a phrenologic approach that single target can treat disorder. Nevertheless, meta-analyses of implants indicate an overall success rate 50% improvement patients, irrespective the brain-related Thus, there is large margin for improvement. The goal this manuscript to 1) develop general theoretical framework functioning amenable surgical neuromodulation, and 2) describe engineering requirements next generation implantable stimulators follow from theoretic model.

Язык: Английский

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Circadian attributes of neurological and psychiatric disorders as basis for their medication chronotherapy

Advanced Drug Delivery Reviews, Год журнала: 2025, Номер unknown, С. 115576 - 115576

Опубликована: Апрель 1, 2025

Язык: Английский

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Unraveling the complexities of programming neural adaptive deep brain stimulation in Parkinson’s disease

Frontiers in Human Neuroscience, Год журнала: 2023, Номер 17

Опубликована: Ноя. 28, 2023

Over the past three decades, deep brain stimulation (DBS) for Parkinson’s disease (PD) has been applied in a continuous open loop fashion, unresponsive to changes given patient’s state or symptoms over course of day. Advances recent neurostimulator technology enable possibility closed adaptive DBS (aDBS) PD as treatment option near future which adjusts demand-based manner. Although aDBS offers great clinical potential motor symptoms, it also brings with need better understanding how implement order maximize its benefits. In this perspective, we outline considerations programing several key parameters based on our experience across aDBS-capable research neurostimulators. At core, hinges successful identification relevant biomarkers that can be measured reliably real-time working cohesion control policy governs adaption. However, auxiliary such window is allowed adapt, well rate changes, just impactful performance and vary depending patient. A standardize protocol programming will crucial ensuring effective application practice.

Язык: Английский

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Multi-night naturalistic cortico-basal recordings reveal mechanisms of NREM slow wave suppression and spontaneous awakenings in Parkinson’s disease

bioRxiv (Cold Spring Harbor Laboratory), Год журнала: 2023, Номер unknown

Опубликована: Июнь 26, 2023

ABSTRACT Background Sleep disturbance is a prevalent and highly disabling comorbidity in individuals with Parkinson’s disease (PD) that leads to worsening of daytime symptoms, accelerated progression reduced quality life. Objectives We aimed investigate changes sleep neurophysiology PD particularly during non-rapid eye movement (NREM) sleep, both the presence absence deep brain stimulation (DBS). Methods Multi-night (n=58) intracranial recordings were performed at-home, from chronic electrocorticography subcortical electrodes, sensing-enabled DBS pulse generators, paired portable polysomnography. Four people one person cervical dystonia evaluated determine neural structures, signals connections modulated NREM prior spontaneous awakenings. Recordings ON OFF conventional dopaminergic replacement medications. Results demonstrate an increase cortico-basal slow wave activity delta (1-4 Hz) decrease beta (13-31 (N2 N3) versus wakefulness PD. Cortical-subcortical coherence was also found be higher range lower wakefulness. resulted further elevation cortical alpha (8-13 low (13-15 power compared state. During we observed strong inverse interaction between increases Conclusions Chronic, multi-night reveal opposing stage specific modulations connectivity NREM, effects are enhanced DBS. Within specifically, strongly inversely correlated predict find therapy appears improve partially through direct modulation oscillations. Our findings help elucidate contributory mechanism responsible for disturbances highlight potential biomarkers future precision neuromodulation therapies targeting

Язык: Английский

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