Insights and opportunities for deep brain stimulation as a brain circuit intervention

Trends in Neurosciences, Год журнала: 2023, Номер 46(6), С. 472 - 487

Опубликована: Апрель 25, 2023

Deep brain stimulation (DBS) is an effective treatment and has provided unique insights into the dynamic circuit architecture of disorders. This Review illustrates our current understanding pathophysiology movement disorders their underlying circuits that are modulated with DBS. It proposes principles pathological network synchronization patterns like beta activity (13–35 Hz) in Parkinson's disease. We describe alterations from microscale including local synaptic via modulation mesoscale hypersynchronization to changes whole-brain macroscale connectivity. Finally, outlook on advances for clinical innovations next-generation neurotechnology provided: preoperative connectomic targeting feedback controlled closed-loop adaptive DBS as individualized network-specific interventions.

Язык: Английский

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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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Neuroscience fundamentals relevant to neuromodulation: Neurobiology of deep brain stimulation in Parkinson's disease

Neurotherapeutics, Год журнала: 2024, Номер 21(3), С. e00348 - e00348

Опубликована: Апрель 1, 2024

Deep Brain Stimulation (DBS) has become a pivotal therapeutic approach for Parkinson's Disease (PD) and various neuropsychiatric conditions, impacting over 200,000 patients. Despite its widespread application, the intricate mechanisms behind DBS remain subject of ongoing investigation. This article provides an overview current knowledge surrounding local, circuit, neurobiochemical effects DBS, focusing on subthalamic nucleus (STN) as key target in PD management.The local once thought to mimic reversible lesion, now reveal more nuanced interplay with myelinated axons, neurotransmitter release, microenvironment. Circuit illuminate modulation oscillatory activities within basal ganglia emphasize communication between STN primary motor cortex. Neurobiochemical effects, encompassing changes dopamine levels epigenetic modifications, add further complexity landscape.Finally, context understanding PD, highlights controversial question whether exerts disease-modifying PD. While preclinical evidence suggests neuroprotective potential, clinical trials such EARLYSTIM face challenges assessing long-term disease modification due enrollment timing methodology limitations. The discussion underscores need robust biomarkers large-scale prospective conclusively determine DBS's potential therapy

Язык: Английский

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Proceedings of the 11th Annual Deep Brain Stimulation Think Tank: pushing the forefront of neuromodulation with functional network mapping, biomarkers for adaptive DBS, bioethical dilemmas, AI-guided neuromodulation, and translational advancements

Frontiers in Human Neuroscience, Год журнала: 2024, Номер 18

Опубликована: Фев. 21, 2024

The Deep Brain Stimulation (DBS) Think Tank XI was held on August 9–11, 2023 in Gainesville, Florida with the theme of “Pushing Forefront Neuromodulation”. keynote speaker Dr. Nico Dosenbach from Washington University St. Louis, Missouri. He presented his research recently published Nature inn a collaboration Evan Gordon to identify and characterize somato-cognitive action network (SCAN), which has redefined motor homunculus led new hypotheses about integrative networks underpinning therapeutic 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. group estimated that globally more than 263,000 devices have been implanted for neurological neuropsychiatric disorders. This year's meeting focused advances following areas: cutting-edge translational neuromodulation, physiology, neuromodulation Europe Asia, neuroethical dilemmas, artificial intelligence computational modeling, time scales mood disorders, future devices.

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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Neuronal and synaptic adaptations underlying the benefits of deep brain stimulation for Parkinson's disease

Translational Neurodegeneration, Год журнала: 2023, Номер 12(1)

Опубликована: Ноя. 30, 2023

Abstract Deep brain stimulation (DBS) is a well-established and effective treatment for patients with advanced Parkinson's disease (PD), yet its underlying mechanisms remain enigmatic. Optogenetics, primarily conducted in animal models, provides unique approach that allows cell type- projection-specific modulation mirrors the frequency-dependent stimulus effects of DBS. Opto-DBS research models plays pivotal role unraveling neuronal synaptic adaptations contribute to efficacy DBS PD treatment. DBS-induced responses rely on complex interplay between distributions presynaptic inputs, depression, intrinsic excitability postsynaptic neurons. This orchestration leads conversion firing patterns, enabling both antidromic orthodromic neural circuits. Understanding these vital decoding position- programming-dependent Furthermore, patterned emerging as promising strategy yielding long-lasting therapeutic benefits. Research may pave way development more enduring precise patterns. Advanced technologies, such adaptive or directional electrodes, can also be integrated circuit-specific neuromodulation. These insights hold potential greatly improve effectiveness advance new levels.

Язык: Английский

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How to entrain a selected neuronal rhythm but not others: open-loop dithered brain stimulation for selective entrainment

Journal of Neural Engineering, Год журнала: 2023, Номер 20(2), С. 026003 - 026003

Опубликована: Март 7, 2023

Abstract Objective. While brain stimulation therapies such as deep for Parkinson’s disease (PD) can be effective, they have yet to reach their full potential across neurological disorders. Entraining neuronal rhythms using rhythmic has been suggested a new therapeutic mechanism restore neurotypical behaviour in conditions chronic pain, depression, and Alzheimer’s disease. However, theoretical experimental evidence indicate that also entrain at sub- super-harmonics, far from the frequency. Crucially, these counterintuitive effects could harmful patients, example by triggering debilitating involuntary movements PD. We therefore seek principled approach selectively promote close frequency, while avoiding preventing entrainment super-harmonics. Approach. Our open-loop selective entrainment, dithered stimulation, consists adding white noise period. Main results. theoretically establish ability of given rhythm, verify its efficacy simulations uncoupled neural oscillators, networks coupled oscillators. Furthermore, we show implemented neurostimulators with limited capabilities toggling within finite set frequencies. Significance. Likely implementable variety existing devices, dithering-based enable therapies, well neuroscientific research exploiting modulate higher-order entrainment.

Язык: Английский

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Dissecting deep brain stimulation evoked neural activity in the basal ganglia

Neurotherapeutics, Год журнала: 2024, Номер 21(3), С. e00356 - e00356

Опубликована: Апрель 1, 2024

Deep brain stimulation (DBS) is an established therapeutic tool for the treatment of Parkinson's disease (PD). The mechanisms DBS PD are likely rooted in modulation subthalamo-pallidal network. However, it can be difficult to electrophysiologically interrogate that network human patients. recent identification large amplitude evoked potential (EP) oscillations from subthalamic nucleus (STN) or globus pallidus internus (GPi) providing new scientific opportunities expand understanding basal ganglia activity. In turn, goal this review provide a summary DBS-induced EPs and attempt explain various components EP waveforms their origins. Our analyses suggest antidromic activation externus (GPe) key driver these oscillatory EPs, independent location (i.e. STN GPi). This suggests potentially more important role GPe than typically assumed. And practical perspective, poised become clinically useful electrophysiological biomarker signals verification target engagement.

Язык: Английский

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Is the Subthalamic Nucleus Sleeping Under Nitrous Oxide–Ketamine General Anesthesia?

European Journal of Neuroscience, Год журнала: 2025, Номер 61(5)

Опубликована: Март 1, 2025

Nitrous oxide is a common gaseous anesthetic used in wide range of medical procedures due to its desirable combination and analgesic properties. Deep brain stimulation surgery, well-established treatment for movement disorders like Parkinson's disease, often requires precise microelectrode recordings the awake brain's electrical signals optimal results. However, influence anesthetics on these remains critical consideration. This study investigated how nitrous general anesthesia supplemented by ketamine affects electrophysiology subthalamic nucleus compared low-dose sedation during deep targeting disease patients. Spectral analysis electrophysiological characteristics statistical dimensions were performed retrospective data from three centers. Our findings revealed that nitrous-ketamine allows identification, despite slight decrease overall activity level. Nevertheless, showed significantly lower beta frequency power inside groups. At group level, many trajectories, delineation subdomains can be achieved detection changes delta oscillations. Notably, no differences found between These suggest it possible recognize entrance exit with high confidence under oxide-ketamine anesthesia. motor subregion more difficult delineate than or awake, which may affect outcome.

Язык: Английский

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Paired Deep Brain Stimuli Elicit Short‐Term Facilitation in Globus Pallidus Interna and Subthalamic Nucleus

Movement Disorders, Год журнала: 2025, Номер unknown

Опубликована: Апрель 28, 2025

Abstract Background Deep brain stimulation (DBS) elicits oscillatory local field potentials in patients with Parkinson's disease (PD) and other movement disorders. Greater knowledge about the fast dynamics of these neural responses could shed light on circuit pathophysiology inform novel approaches to neuromodulation therapies. Objectives To compare short‐term neuroplasticity globus pallidus interna (GPi) subthalamic nucleus (STN), canonical functional targets for PD dystonia. Methods During surgery DBS lead implantation, we delivered pairs stimuli across various interstimulus intervals amplitudes recorded DBS‐evoked from unused contacts lead. After stimulus artifact removal, contrasted magnitude timing by paired pulse interval target. Additionally, compared versus resting at same recording site. Results In 14 undergoing STN 9 GPi DBS, evoked exhibited greater than those GPi. However, was larger STN. Otherwise, both sites similar hastening refractoriness, onset latencies, frequencies measured first two peaks. Conclusions Single pulses elicit oscillations display time neuroplasticity. These findings therapeutic innovation future systems that utilize sensing technologies. © 2025 The Author(s). Movement Disorders published Wiley Periodicals LLC behalf International Parkinson Disorder Society.

Язык: Английский

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