Personalized medicine in deep brain stimulation through utilization of neural oscillations

The presence of abnormal neural oscillations within the cortico-basal ganglia-thalamo-cortical (CBGTC) network has emerged as one of the current principal theories to explain the pathophysiology of movement disorders. In theory, these oscillations can be used as biomarkers and thereby serve as a feedback signal to control the delivery of deep brain stimulation (DBS). This new form of DBS, dependent on different characteristics of pathological oscillations, is called adaptive DBS (aDBS), and it has already been applied in patients with Parkinson’s disease. In this review, the authors summarize the scientific research to date on pathological oscillations in dystonia and address potential biomarkers that might be used as a feedback signal for controlling aDBS in patients with dystonia.

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Case Report: Chronic Adaptive Deep Brain Stimulation Personalizing Therapy Based on Parkinsonian State

Frontiers in Human Neuroscience ◽

10.3389/fnhum.2021.702961 ◽

2021 ◽

Vol 15 ◽

Author(s):

Asuka Nakajima ◽

Yasushi Shimo ◽

Atsuhito Fuse ◽

Joji Tokugawa ◽

Makoto Hishii ◽

...

Keyword(s):

Deep Brain Stimulation ◽

Brain Stimulation ◽

Field Potential ◽

Neural Oscillations ◽

Target Structure ◽

New Device ◽

Stimulation Method ◽

Local Field Potential Lfp ◽

Beta Oscillation ◽

Deep Brain

We describe the case of a 51-year-old man with Parkinson's disease (PD) presenting with motor fluctuations, who received bilateral subthalamic deep brain stimulation (DBS) with an adaptive DBS (aDBS) device, Percept™ PC (Medtronic, Inc. , Minneapolis, MN). This device can deliver electrical stimulations based on fluctuations of neural oscillations of the local field potential (LFP) at the target structure. We observed that the LFP fluctuations were less evident inside the hospital than outside, while the stimulation successfully adapted to beta oscillation fluctuations during the aDBS phase without any stimulation-induced side effects. Thus, this new device facilitates condition-dependent stimulation; this new stimulation method is feasible and provides new insights into the pathophysiological mechanisms of PD.

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Devices, Drugs, and Difference: Deep Brain Stimulation and the Advent of Personalized Medicine

Handbook of Neuroethics ◽

10.1007/978-94-007-4707-4_33 ◽

2014 ◽

pp. 607-620 ◽

Cited By ~ 1

Author(s):

Joseph J. Fins

Keyword(s):

Deep Brain Stimulation ◽

Personalized Medicine ◽

Brain Stimulation ◽

Deep Brain

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Deep brain stimulation modulates neural oscillations of subthalamic nucleus and globus pallidus interna in Tourette’s syndrome

Brain Stimulation ◽

10.1016/j.brs.2018.12.788 ◽

2019 ◽

Vol 12 (2) ◽

pp. 542

Author(s):

X. Geng ◽

G. Zhu ◽

R. Zhang ◽

J. Zhang ◽

S. Wang

Keyword(s):

Deep Brain Stimulation ◽

Globus Pallidus ◽

Subthalamic Nucleus ◽

Brain Stimulation ◽

Tourette's Syndrome ◽

Neural Oscillations ◽

Tourette’S Syndrome ◽

Deep Brain

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Phase-Dependent Deep Brain Stimulation: A Review

Brain Sciences ◽

10.3390/brainsci11040414 ◽

2021 ◽

Vol 11 (4) ◽

pp. 414

Author(s):

Lekshmy Sudha Kumari ◽

Abbas Z. Kouzani

Keyword(s):

Deep Brain Stimulation ◽

Brain Stimulation ◽

Closed Loop ◽

Field Potential ◽

Neural Oscillations ◽

Oscillation Phase ◽

Frequency Bands ◽

Brain Functions ◽

The Brain ◽

Deep Brain

Neural oscillations are repetitive patterns of neural activity in the central nervous systems. Oscillations of the neurons in different frequency bands are evident in electroencephalograms and local field potential measurements. These oscillations are understood to be one of the key mechanisms for carrying out normal functioning of the brain. Abnormality in any of these frequency bands of oscillations can lead to impairments in different cognitive and memory functions leading to different pathological conditions of the nervous system. However, the exact role of these neural oscillations in establishing various brain functions and the brain pathologies are still under investigation. Closed loop deep brain stimulation paradigms with neural oscillations as biomarkers could be used as a mechanism to understand the function of these oscillations. For making use of the neural oscillations as biomarkers to manipulate the frequency band of the oscillation, phase of the oscillation, and stimulation signal are of importance. This paper reviews recent trends in deep brain stimulation systems and their non-invasive counterparts, in the use of phase specific stimulation to manipulate individual neural oscillations. In particular, the paper reviews the methods adopted in different brain stimulation systems and devices for stimulating at a definite phase to further optimize closed loop brain stimulation strategies.

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