A systematic review of local field potential physiomarkers in Parkinson’s disease: from clinical correlations to adaptive deep brain stimulation algorithms

Journal of Neurology, Год журнала: 2022, Номер 270(2), С. 1162 - 1177

Опубликована: Окт. 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.

Язык: Английский

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Single threshold adaptive deep brain stimulation in Parkinson's disease depends on parameter selection, movement state and controllability of subthalamic beta activity

Brain stimulation, Год журнала: 2024, Номер 17(1), С. 125 - 133

Опубликована: Янв. 1, 2024

BackgroundDeep brain stimulation (DBS) is an invasive treatment option for patients with Parkinson's disease. Recently, adaptive DBS (aDBS) systems have been developed, which adjust timing and amplitude in real-time. However, it unknown how changes parameters, movement states the controllability of subthalamic beta activity affect aDBS performance.ObjectiveTo characterize parameter choice, state interactively electrophysiological behavioral response to single threshold aDBS.MethodsWe recorded local field potentials 12 disease receiving acute post-operative state. We investigated two parameters: onset time smoothing real-time power. Electrophysiological patterns motor performance were assessed while at rest during a simple task. further studied impact on by comparing without power modulation continuous stimulation.ResultsOur findings reveal that control extent suppression achievable rest. Behavioral data indicate only specific combinations yield beneficial effect aDBS. During movement, action induced reduces responsivity closed loop algorithm. demonstrate prerequisite effective dependent activity.ConclusionOur results highlight interaction between selection, driving performance. By this means, we identify directions development closed-loop algorithms.

Язык: Английский

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Employing LFP recording to optimize stimulation location and amplitude in chronic DBS for Parkinson’s disease: A proof-of-concept pilot study

Deep Brain Stimulation, Год журнала: 2023, Номер 2, С. 1 - 5

Опубликована: Май 16, 2023

ObjectivesParkinson patients with chronic DBS routinely receive sensing-enabled implantable pulse generators upon battery replacement. Here we aimed to assess whether and/or how local field potential based reprogramming may be of use in this population.MethodsIn four Parkinson on treatment bilateral STN-DBS and implanted the Percept™ PC generator, employed an approach select stimulation contacts amplitudes beta-activity. When applicable, effect parameter adjustments effectiveness DBS-induced side effects was assessed.ResultsIn one out eight electrodes, LFP-guided contact different from clinically determined one. Beta-based therapeutic windows could defined five electrodes. were performed two patients, resulting improved motor fluctuations decreased stimulation-induced respectively.DiscussionLFP-guided has improve decrease selected cases. Prospective controlled research is required clinical usefulness reprogramming.

Язык: Английский

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Local Field Potentials Predict Motor Performance in Deep Brain Stimulation for Parkinson's Disease

Movement Disorders, Год журнала: 2023, Номер 38(12), С. 2185 - 2196

Опубликована: Окт. 12, 2023

Abstract Background Deep brain stimulation ( DBS ) is an effective treatment option for patients with Parkinson's disease PD ). However, clinical programming remains challenging segmented electrodes. Objective Using novel sensing‐enabled neurostimulators, we investigated local field potentials LFPs and their modulation by to assess whether electrophysiological biomarkers may facilitate in chronically implanted patients. Methods Sixteen (31 hemispheres) electrodes the subthalamic nucleus a neurostimulator were included this study. Recordings conducted 3 months after surgery following overnight withdrawal of dopaminergic medication. acquired while was turned OFF during monopolar review both directional ring contacts. Directional beta power stimulation‐induced suppression computed. Motor performance, as assessed pronation‐supination task, electrode placement correlated suppression. Results Better motor performance associated stronger at higher amplitudes. Across contacts, differences extent predicted performance. within individual hemispheres, superior selecting contact best Contacts clinically activated chronic than non‐activated Conclusions Our results suggest that β most contact. In sum, guide systems © 2023 The Authors. Movement Disorders published Wiley Periodicals LLC on behalf International Parkinson Disorder Society.

Язык: Английский

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A comparison of methods to suppress electrocardiographic artifacts in local field potential recordings

Clinical Neurophysiology, Год журнала: 2022, Номер 146, С. 147 - 161

Опубликована: Дек. 2, 2022

Local field potential (LFP) recordings from deep brain stimulation (DBS) electrodes are often contaminated with electrocardiographic (ECG) artifacts that hinder the detection of disease-specific electrical activity.Three ECG suppression methods were evaluated: (1) QRS interpolation Perceive toolbox, (2) template subtraction, and (3) singular value decomposition (SVD). LFPs recorded Medtronic PerceptTM PC system in nine Parkinson's disease patients OFF ("OFF-DBS"; anode disconnected) ON at 0 mA ("ON-DBS mA"; connected). Findings verified simulated ECG-contaminated time series.ECG present 10 out 18 ON-DBS recordings. All drastically reduced artifact-induced beta band (13-35 Hz) power least partly recovered peak burst dynamics. Using external lengthening artifact epoch length improved performance methods. Increasing length, however, elevated risk flattening losing dynamics.The SVD method formed preferred trade-off between cleaning signal loss, as long its parameter settings adequately chosen.ECG enable analysis neural activity signals affected by artifacts.

Язык: Английский

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Adaptive deep brain stimulation for Parkinson’s disease: looking back at the past decade on motor outcomes

Journal of Neurology, Год журнала: 2022, Номер 270(3), С. 1371 - 1387

Опубликована: Дек. 6, 2022

Язык: Английский

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Basal ganglia theta power indexes trait anxiety in people with Parkinson's disease

medRxiv (Cold Spring Harbor Laboratory), Год журнала: 2024, Номер unknown

Опубликована: Июнь 5, 2024

Neuropsychiatric symptoms are common and disabling in Parkinson's disease (PD), with troublesome anxiety occurring one-third of patients. Management PD is challenging, hampered by insufficient insight into underlying mechanisms, lack objective measurements, largely ineffective treatments.In this study, we assessed the intracranial neurophysiological correlates patients treated deep brain stimulation (DBS) laboratory at home. We hypothesized that low-frequency (theta-alpha) activity would be associated anxiety.

Язык: Английский

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Comparison of beta peak detection algorithms for data-driven deep brain stimulation programming strategies in Parkinson’s disease

npj Parkinson s Disease, Год журнала: 2024, Номер 10(1)

Опубликована: Авг. 9, 2024

Abstract Oscillatory activity within the beta frequency range (13–30 Hz) serves as a Parkinson’s disease biomarker for tailoring deep brain stimulation (DBS) treatments. Currently, identifying clinically relevant signals, specifically frequencies of peak amplitudes spectral band, is subjective process. To inform potential strategies objective clinical decision making, we assessed algorithms peaks and devised standardized approach both research applications. Employing novel monopolar referencing strategy, utilized sensing device to measure power across distinct contacts along each DBS electrode implanted in subthalamic nucleus. We then evaluated accuracy ten detection against benchmark established by expert consensus. The most accurate algorithms, all sharing similar underlying algebraic dynamic amplitude thresholding approaches, matched consensus performance reliably predicted parameters during follow-up visits. These findings highlight algorithmic solutions overcome bias identification, presenting viable options standardizing this Such advancements could lead significant improvements efficiency patient-specific therapy parameterization.

Язык: Английский

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Modeling and Optimizing Deep Brain Stimulation to Enhance Gait in Parkinson's Disease: Personalized Treatment with Neurophysiological Insights

medRxiv (Cold Spring Harbor Laboratory), Год журнала: 2024, Номер unknown

Опубликована: Ноя. 1, 2024

Abstract Although high-frequency deep brain stimulation (DBS) is effective at relieving many motor symptoms of Parkinson’s disease (PD), its effects on gait can be variable and unpredictable. This due to 1) a lack standardized robust metrics for assessment in PD patients, 2) the challenges performing thorough evaluation all parameters space that alter gait, 3) understanding impacts neurophysiological signatures walking. In this study, our goal was develop data-driven approach identify optimal, personalized DBS improve patients signature improved gait. Local field potentials from globus pallidus electrocorticography cortex three were recorded using an implanted bidirectional neural stimulator during overground A walking performance index (WPI) developed assess with high reliability. frequency, amplitude, pulse width “clinically-optimized” contact then systemically changed study their underlying dynamics. We Gaussian Process Regressor (GPR) model map relationship between settings WPI. Using model, we identified validated significantly metrics. Linear mixed models employed spectral features associated enhanced performance. demonstrated linked modulation activity specific frequency bands, reduced beta band power pallidum increased alpha pallidal-motor coherence synchronization key moments cycle. Integrating WPI GPR optimize underscores importance developing personalized, interventions improvement PD.

Язык: Английский

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Clinically Implemented Sensing-based Initial Programming of Deep Brain Stimulation for Parkinson’s Disease: A Retrospective Study

Neuromodulation Technology at the Neural Interface, Год журнала: 2024, Номер unknown

Опубликована: Дек. 1, 2024

ObjectivesInitial deep brain stimulation (DBS) programming using a monopolar review is time-consuming, subjective, and burdensome. Incorporating neurophysiology has the potential to expedite, objectify, automatize initial DBS programming. We aimed assess feasibility performance of clinically implemented sensing-based for Parkinson's disease (PD).Materials MethodsWe conducted single-center retrospective study in 15 patients with PD (25 hemispheres) implanted sensing-enabled neurostimulator whom subthalamic nucleus/globus pallidus pars interna was guided by beta power real-time local field recordings, instead review.ResultsThe visit lasted on average 42.2 minutes (SD 18) per hemisphere. During optimization phase, conventional clinical not required any patients. The contact level remained same at final follow-up all hemispheres except three. amplitude 0.8 mA 0.9) higher than initially set after original visit. One year surgery, off-medication International Parkinson Movement Disorder Society Unified Disease Rating Scale (MDS-UPDRS) III total score, tremor subscore, MDS-UPDRS IV, levodopa-equivalent dose improved 47.0% (p < 0.001), 77.7% = 51.1% 0.006), 44.8% 0.011) compared preoperatively this approach.ConclusionsThis shows that feasible rapid, selected effective contacts most patients, including those tremor. Technologic innovations practical developments could improve

Язык: Английский

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