Deep brain stimulation for Parkinson's disease: A case for patient empowerment

McAuley, Mark D.

doi:10.1016/j.brs.2023.01.840

Cited by 5 publications

(4 citation statements)

References 6 publications

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“…1B ). 2) Sleep-wake state dependent: Neural activity may selectively entrain at subharmonics of stimulation frequency according to sleep state [ 6 ]. In a system where stimulation and signal processing remain unchanged, for subharmonic entrainment to appear or disappear solely reflects a change in underlying neural circuitry.…”

Section: Physiological Confirmation Stepsmentioning

confidence: 99%

1:2 entrainment is not a device-induced artefact, except when it is

Sermon,

Benjaber,

Duchet

et al. 2024

Brain Stimulation

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Section: Physiological Confirmation Stepsmentioning

confidence: 99%

1:2 entrainment is not a device-induced artefact, except when it is

Sermon,

Benjaber,

Duchet

et al. 2024

Brain Stimulation

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“…The ability to perform multiple sessions of sleep recordings in the MC across normal and parkinsonian states is unique to the NHP preclinical studies and provides preliminary insights into the neural correlates of SWS dysfunction in mild parkinsonism. Future preclinical studies that explore neuromodulation (e.g., both non-invasive as well as DBS 33 ) techniques for suppressing beta oscillations during sleep and characterizing its effect on cortical SWS to further support the notion that suppression of excessive beta oscillations during sleep can profoundly improve sleep quality. Moreover, simultaneous neural recordings across the basal ganglia thalamocortical network and directed connectivity analysis can help decipher the mechanisms by which beta oscillations in the cortex are elevated during SWS in the early stage of parkinsonism 11,21,34 .…”

mentioning

confidence: 91%

Excessive cortical beta oscillations are associated with slow-wave sleep dysfunction in mild parkinsonism

Verma,

Nandakumar,

Acedillo

et al. 2023

Preprint

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Increasing evidence associates slow-wave sleep (SWS) dysfunction with neurodegeneration. Using a within-subject design in the nonhuman primate model of Parkinson’s disease (PD), we found that reduced SWS quantity in mild parkinsonism was accompanied by elevated beta and reduced delta power during SWS in the motor cortex. Our findings support excessive beta oscillations as a mechanism for SWS dysfunction and will inform development of neuromodulation therapies for enhancing SWS in PD.

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“…However, the relatively simple control algorithms of conventional closed-loop DBS limit the ability to capture complex dynamics of neural activity related to disease which can cause interference with normal activity, such as interruption of volitional movement (42) which is further exacerbated by large scale activation from electrical stimulation (43). More complex control methods are advantageous in accounting for brain wide state changes, such as sleep wake cycles (44). We therefore utilized deep RLs ability to develop statistical mappings of systems in response to state perturbations in order to drive cortical activity to desired firing states.…”

Section: Introductionmentioning

confidence: 99%

Spatially specific, closed-loop infrared thalamocortical deep brain stimulation

Coventry,

Lawlor,

Bagnati

et al. 2023

Preprint

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Deep brain stimulation (DBS) is a powerful clinical tool for the treatment of circuitopathy-related neurological and psychiatric diseases and disorders such as Parkinson’s disease and obsessive-compulsive disorder. Electrically-mediated DBS, however, is limited by the spread of stimulus currents into tissue unrelated to disease course and treatment, potentially causing undesirable patient side effects. In this work, we utilize infrared neural stimulation (INS), an optical neuromodulation technique that uses near to mid-infrared light to drive graded excitatory and inhibitory responses in nerves and neurons, to facilitate an optical and spatially constrained DBS paradigm. INS has been shown to provide spatially constrained responses in cortical neurons and, unlike other optical techniques, does not require genetic modification of the neural target. In this study, we show that INS produces graded, biophysically relevant single-unit responses with robust information transfer in thalamocortical circuits. Importantly, we show that cortical spread of activation from thalamic INS produces more spatially constrained response profiles than conventional electrical stimulation. Owing to observed spatial precision of INS, we used deep reinforcement learning for closed-loop control of thalamocortical circuits, creating real-time representations of stimulus-response dynamics while driving cortical neurons to precise firing patterns. Our data suggest that INS can serve as a targeted and dynamic stimulation paradigm for both open and closed-loop DBS.Significance StatementDespite initial clinical successes, electrical deep brain stimulation (DBS) is fraught with off-target current spillover into tissue outside of therapeutic targets, giving rise to patient side effects and the reduction of therapeutic efficacy. In this study, we validate infrared neural stimulation (INS) as a spatially constrained optical DBS paradigm by quantifying dose-response profiles and robust information transfer through INS driven thalamocortical circuits. We show that INS elicits biophysically relevant responses which are spatially constrained compared to conventional electrical stimulation, potentially reducing off-target side effects. Leveraging the spatial specificity of thalamocortical INS, we used deep reinforcement learning to close the loop on thalamocortical INS and showed the ability to drive subject-specific thalamocortical circuits to target response states in real time.

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Deep brain stimulation for Parkinson's disease: A case for patient empowerment

Cited by 5 publications

References 6 publications

1:2 entrainment is not a device-induced artefact, except when it is

1:2 entrainment is not a device-induced artefact, except when it is

Excessive cortical beta oscillations are associated with slow-wave sleep dysfunction in mild parkinsonism

Spatially specific, closed-loop infrared thalamocortical deep brain stimulation

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