Past, Present, and Future of Deep Brain Stimulation: Hardware, Software, Imaging, Physiology and Novel Approaches

Frey, Jessica; Cagle, Jackson N.; Johnson, Kara A.; Wong, Joshua K.; Hilliard, Justin D.; Butson, Christopher R.; Okun, Michael S.; Hemptinne, Coralie de

doi:10.3389/fneur.2022.825178

Cited by 62 publications

(30 citation statements)

References 216 publications

(278 reference statements)

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“…Subjects who met the “UK PD Society Brain Bank Clinical Diagnostic Criteria” for the diagnosis of PD who had DBS surgery at least 3 months prior to enrollment, were included in the study. Directional leads (Vercise Cartesia ® , Boston Scientific Corporation, Marlborough, MA, USA) ( Frey et al, 2022 ) were bilaterally implanted in the STN. These leads have eight DBS-contacts arranged in a 1-3-3-1 configuration, corresponding to four levels with the middle two levels segmented into three horizontal current steering directions (distal-to-proximal contact numbering of left lead: C1-C8; numbering of right lead: C9-C16, where “C” stands for “Contact”).…”

Section: Methodsmentioning

confidence: 99%

Towards biomarker-based optimization of deep brain stimulation in Parkinson’s disease patients

et al. 2023

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BackgroundSubthalamic deep brain stimulation (DBS) is an established therapy to treat Parkinson’s disease (PD). To maximize therapeutic outcome, optimal DBS settings must be carefully selected for each patient. Unfortunately, this is not always achieved because of: (1) increased technological complexity of DBS devices, (2) time restraints, or lack of expertise, and (3) delayed therapeutic response of some symptoms. Biomarkers to accurately predict the most effective stimulation settings for each patient could streamline this process and improve DBS outcomes.ObjectiveTo investigate the use of evoked potentials (EPs) to predict clinical outcomes in PD patients with DBS.MethodsIn ten patients (12 hemispheres), a monopolar review was performed by systematically stimulating on each DBS contact and measuring the therapeutic window. Standard imaging data were collected. EEG-based EPs were then recorded in response to stimulation at 10 Hz for 50 s on each DBS-contact. Linear mixed models were used to assess how well both EPs and image-derived information predicted the clinical data.ResultsEvoked potential peaks at 3 ms (P3) and at 10 ms (P10) were observed in nine and eleven hemispheres, respectively. Clinical data were well predicted using either P3 or P10. A separate model showed that the image-derived information also predicted clinical data with similar accuracy. Combining both EPs and image-derived information in one model yielded the highest predictive value.ConclusionEvoked potentials can accurately predict clinical DBS responses. Combining EPs with imaging data further improves this prediction. Future refinement of this approach may streamline DBS programming, thereby improving therapeutic outcomes.Clinical trial registrationClinicalTrials.gov, identifier NCT04658641.

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Section: Methodsmentioning

confidence: 99%

Towards biomarker-based optimization of deep brain stimulation in Parkinson’s disease patients

et al. 2023

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“…It has been found effective in conditions such as Parkinson's disease, depression, and Alzheimer's disease (AD). In DBS, the conventional lead is composed of 4 electrode ring contacts that are 1.5 mm in length arranged on a diameter of 1.27-1.36 mm cylindrical shaft [41]. Its usage as BCI dated back to 2004 by Loukas et al [6], in which the voluntary hand-movement onset can be detected at 95% accuracy using signals recorded from the subthalamic nucleus (STN) of patients with Parkinson's disease (PD).…”

Section: Depth Electrodesmentioning

confidence: 99%

A Review of Motor Brain-Computer Interfaces using Intracranial Electroencephalography based on Surface Electrodes and Depth Electrodes

Wang¹,

metcalfe²,

He³

et al. 2023

Preprint

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<p>Brain-computer interfaces (BCIs) provide a communication interface between the brain and external devices and have the potential to restore communication and control in patients with neurological injury or disease. For the invasive BCIs, most studies recruited participants from hospitals requiring invasive device implantation. Three widely used clinical invasive devices that have the potential for BCIs applications include surface electrodes used in electrocorticography (ECoG) and depth electrodes used in Stereo-electroencephalography (SEEG) and deep brain stimulation (DBS). This review focused on BCIs research using surface (ECoG) and depth electrodes (including SEEG, and DBS electrodes) for movement decoding on human subjects. Unlike previous reviews, the findings presented here are from the perspective of the decoding target or task. In detail, five tasks will be considered, consisting of the decoding of kinematic, kinetic, identification of actual or imagery movement of limbs, dexterous hand decoding, and movement intention decoding. The reviewed literature demonstrated a distributed motor-related network that spanned multiple brain regions. Comparison between surface and depth studies demonstrated that richer information can be obtained using surface electrodes. In decoding, deep learning exhibited superior performance using raw signals than traditional algorithms. However, despite the promising achievement made by the open-loop BCIs, closed-loop BCIs with sensory feedback are still in their early stage, and the chronic implantation of both ECoG surface and depth electrodes has not been thoroughly evaluated.</p>

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“…In variable frequency stimulation, there are cycles of at least ten seconds of high (>130Hz) and low (60-80hz) frequencies on a single contact. Initial studies yielded positive results with better motor outcomes and significant improvement of FOG, but larger trials are lacking 54 . Burst-cycling stimulation, in which regular frequency stimulation is administered in intermittent bursts, appears to be more energy efficient with similar clinical outcomes 55 .…”

Section: Novel Stimulation Patternsmentioning

confidence: 99%

Deep brain stimulation in Parkinson’s disease: state of the art and future perspectives

França

Carra

Diniz

et al. 2022

Arq. Neuro-Psiquiatr.

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For more than 30 years, Deep Brain Stimulation (DBS) has been a therapeutic option for Parkinson’s disease (PD) treatment. However, this therapy is still underutilized mainly due to misinformation regarding risks and clinical outcomes. DBS can ameliorate several motor and non-motor symptoms, improving patients’ quality of life. Furthermore, most of the improvement after DBS is long-lasting and present even in advanced PD. Adequate patient selection, precise electric leads placement, and correct DBS programming are paramount for good surgical outcomes. Nonetheless, DBS still has many limitations: axial symptoms and signs, such as speech, balance and gait, do not improve to the same extent as appendicular symptoms and can even be worsened as a direct or indirect consequence of surgery and stimulation. In addition, there are still unanswered questions regarding patient’s selection, surgical planning and programming techniques, such as the role of surgicogenomics, more precise imaging-based lead placement, new brain targets, advanced programming strategies and hardware features. The net effect of these innovations should not only be to refine the beneficial effect we currently observe on selected symptoms and signs but also to improve treatment resistant facets of PD, such as axial and non-motor features. In this review, we discuss the current state of the art regarding DBS selection, implant, and programming, and explore new advances in the DBS field.

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Past, Present, and Future of Deep Brain Stimulation: Hardware, Software, Imaging, Physiology and Novel Approaches

Cited by 62 publications

References 216 publications

Towards biomarker-based optimization of deep brain stimulation in Parkinson’s disease patients

Towards biomarker-based optimization of deep brain stimulation in Parkinson’s disease patients

A Review of Motor Brain-Computer Interfaces using Intracranial Electroencephalography based on Surface Electrodes and Depth Electrodes

Deep brain stimulation in Parkinson’s disease: state of the art and future perspectives

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