Cortical Brain–Computer Interface for Closed-Loop Deep Brain Stimulation

Herron, Jeffrey A.; Thompson, Margaret C.; Brown, Timothy; Chizeck, H.J.; Ojemann, Jeffrey G.; Ko, Andrew L.

doi:10.1109/tnsre.2017.2705661

Cited by 80 publications

(68 citation statements)

References 20 publications

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“…Chronic recordings have been used to prototype several adaptive deep-brain stimulation algorithms using primary motor cortex electrocorticography signals to deliver different levels of stimulation depending on movement state. One paradigm used motor cortex beta to increase stimulation when patients initiated movement (Herron et al, 2017). Adaptive stimulation may allow delivery of fully therapeutic deep-brain stimulation without adverse effects associated with chronic "open-loop" (unvarying) stimulation.…”

Section: Using the Beta Signature In Clinical Medicinementioning

confidence: 99%

Beta Oscillations in Working Memory, Executive Control of Movement and Thought, and Sensorimotor Function

et al. 2019

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Beta oscillations (ϳ13 to 30 Hz) have been observed during many perceptual, cognitive, and motor processes in a plethora of brain recording studies. Although the function of beta oscillations (hereafter "beta" for short) is unlikely to be explained by any single monolithic description, we here discuss several convergent findings. In prefrontal cortex (PFC), increased beta appears at the end of a trial when working memory information needs to be erased. A similar "clear-out" function might apply during the stopping of action and the stopping of long-term memory retrieval (stopping thoughts), where increased prefrontal beta is also observed. A different apparent role for beta in PFC occurs during the delay period of working memory tasks: it might serve to maintain the current contents and/or to prevent interference from distraction. We confront the challenge of relating these observations to the large literature on beta recorded from sensorimotor cortex. Potentially, the clear-out of working memory in PFC has its counterpart in the postmovement clear-out of the motor plan in sensorimotor cortex. However, recent studies support alternative interpretations. In addition, we flag emerging research on different frequencies of beta and the relationship between beta and single-neuron spiking. We also discuss where beta might be generated: basal ganglia, cortex, or both. We end by considering the clinical implications for adaptive deep-brain stimulation.

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Section: Using the Beta Signature In Clinical Medicinementioning

confidence: 99%

Beta Oscillations in Working Memory, Executive Control of Movement and Thought, and Sensorimotor Function

et al. 2019

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“…A closed-loop stimulation strategy first was shown to be effective in a non-human primate model of PD via recording in motor cortex and the globus pallidus (GPi) and stimulating in the GPi [192]. The translational nature of this approach recently has attracted many multidisciplinary research groups bringing neurologists, neurosurgeons, engineers, and neuroscientists together with the aim to improve therapeutic outcome in DBS [49,50,137,181,[193][194][195][196][197][198]. The first studies in human PD patients utilized pathological increases in STN beta activity to trigger stimulation with fixed DBS parameters, where stimulation ceased after sufficient beta signal suppression was achieved [194,[199][200][201].…”

Section: Parkinson's Diseasementioning

confidence: 99%

Toward Electrophysiology-Based Intelligent Adaptive Deep Brain Stimulation for Movement Disorders

et al. 2019

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Deep brain stimulation (DBS) represents one of the major clinical breakthroughs in the age of translational neuroscience. In 1987, Benabid and colleagues demonstrated that high-frequency stimulation can mimic the effects of ablative neurosurgery in Parkinson's disease (PD), while offering two key advantages to previous procedures: adjustability and reversibility. Deep brain stimulation is now an established therapeutic approach that robustly alleviates symptoms in patients with movement disorders, such as Parkinson's disease, essential tremor, and dystonia, who present with inadequate or adverse responses to medication. Currently, stimulation electrodes are implanted in specific target regions of the basal ganglia-thalamic circuit and stimulation pulses are delivered chronically. To achieve optimal therapeutic effect, stimulation frequency, amplitude, and pulse width must be adjusted on a patient-specific basis by a movement disorders specialist. The finding that pathological neural activity can be sampled directly from the target region using the DBS electrode has inspired a novel DBS paradigm: closed-loop adaptive DBS (aDBS). The goal of this strategy is to identify pathological and physiologically normal patterns of neuronal activity that can be used to adapt stimulation parameters to the concurrent therapeutic demand. This review will give detailed insight into potential biomarkers and discuss next-generation strategies, implementing advances in artificial intelligence, to further elevate the therapeutic potential of DBS by capitalizing on its modifiable nature. Development of intelligent aDBS, with an ability to deliver highly personalized treatment regimens and to create symptom-specific therapeutic strategies in real-time, could allow for significant further improvements in the quality of life for movement disorders patients with DBS that ultimately could outperform traditional drug treatment.

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“…Evaluation of the accuracy of the controller showed that stimulation was on for 100% of prompted movement tasks and was on throughout tasks such as spiral drawing or water pouring. 23 This demand-driven paradigm for ET did reveal challenges of an "on-off" approach to closed-loop DBS: individual sensitivity to the rate of amplitude changes must be taken into consideration. Use of a bipolar electrode configuration mitigates paresthesias during initiation of stimulation.…”

Section: Electrocorticographymentioning

confidence: 99%

“…Most of the more mature approaches to closed-loop DBS take this approach, employing either an event-dependent, on/off control, or continuous-time control where stimulation amplitude varies proportionately to the amplitude of the signal. As described above, efficacy of this approach to feedback has been employed with kinematic markers in PD 35 and ET, 22 electrocorticography in ET, 23 and STN LFPs in PD. 32,33 Model-Based Approaches…”

Section: Amplitude Responsementioning

confidence: 99%

Approaches to closed-loop deep brain stimulation for movement disorders

Kuo

White-Dzuro

2018

Neurosurgical Focus

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OBJECTIVEDeep brain stimulation (DBS) is a safe and effective therapy for movement disorders, such as Parkinson’s disease (PD), essential tremor (ET), and dystonia. There is considerable interest in developing “closed-loop” DBS devices capable of modulating stimulation in response to sensor feedback. In this paper, the authors review related literature and present selected approaches to signal sources and approaches to feedback being considered for deployment in closed-loop systems.METHODSA literature search using the keywords “closed-loop DBS” and “adaptive DBS” was performed in the PubMed database. The search was conducted for all articles published up until March 2018. An in-depth review was not performed for publications not written in the English language, nonhuman studies, or topics other than Parkinson’s disease or essential tremor, specifically epilepsy and psychiatric conditions.RESULTSThe search returned 256 articles. A total of 71 articles were primary studies in humans, of which 50 focused on treatment of movement disorders. These articles were reviewed with the aim of providing an overview of the features of closed-loop systems, with particular attention paid to signal sources and biomarkers, general approaches to feedback control, and clinical data when available.CONCLUSIONSClosed-loop DBS seeks to employ biomarkers, derived from sensors such as electromyography, electrocorticography, and local field potentials, to provide real-time, patient-responsive therapy for movement disorders. Most studies appear to focus on the treatment of Parkinson’s disease. Several approaches hold promise, but additional studies are required to determine which approaches are feasible, efficacious, and efficient.

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Cortical Brain–Computer Interface for Closed-Loop Deep Brain Stimulation

Cited by 80 publications

References 20 publications

Beta Oscillations in Working Memory, Executive Control of Movement and Thought, and Sensorimotor Function

Beta Oscillations in Working Memory, Executive Control of Movement and Thought, and Sensorimotor Function

Toward Electrophysiology-Based Intelligent Adaptive Deep Brain Stimulation for Movement Disorders

Approaches to closed-loop deep brain stimulation for movement disorders

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