Perspectives of Implementation of Closed-Loop Deep Brain Stimulation: From Neurological to Psychiatric Disorders

Groppa, Sergiu; Gonzalez-Escamilla, Gabriel; Tinkhauser, Gerd; Baqapuri, Halim Ibrahim; Sajonz, Bastian; Wiest, Christoph; Pereira, Joana; Herz, Damian M.; Dold, Matthias R.; Bange, Manuel; Ciolac, Dumitru; Almeida, Viviane; Neuber, John; Mirzac, Daniela; Martín-Rodríguez, Juan Francisco; Dresel, Christian; Muthuraman, Muthuraman; Adarmes Gomez, Astrid D.; Navas, Marta; Temiz, Gizem; Gunduz, Aysegul; Rotaru, Lilia; Winter, Yaroslav; Schuurman, Rick; Contarino, Maria F.; Glaser, Martin; Tangermann, Michael; Leentjens, Albert F.G.; Mir, Pablo; Torres Diaz, Cristina V.; Karachi, Carine; Linden, David E.J.; Tan, Huiling; Coenen, Volker A.; ,

doi:10.1159/000535114

Cited by 4 publications

(1 citation statement)

References 108 publications

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“…CL-DBS paves in our view the way for adaptive personalised DBS protocols. Future studies should address however the perspectives of CL technology and its opportunities and potential pitfalls for clinical use (Bouthour et al 2019;Groppa et al 2023).…”

Section: Deep Brain Stimulation (Dbs)mentioning

confidence: 99%

Advanced therapies in Parkinson’s disease: an individualized approach to their indication

Schröter,

Sajonz,

Jost

et al. 2024

J Neural Transm

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Device aided therapies (DAT) comprising the intrajejunal administration of levodopa/carbidopa intestinal gel (LCIG) and levodopa/carbidopa/entacapone intestinal gel (LECIG), the continuous subcutaneous application of foslevodopa/foscarbidopa or apomorphine infusion (CSAI) and deep brain stimulation (DBS) are used to treat Parkinson’s disease with insufficient symptom alleviation under intensified pharmacotherapy. These DAT significantly differ in their efficacy profiles, indication, invasiveness, contraindications, and potential side effects. Usually, the evaluation of all these procedures is conducted simultaneously at the same point in time. However, as disease progression and symptom burden is extremely heterogeneous, clinical experience shows that patients reach the individual milestones for a certain therapy at different points in their disease course. Therefore, advocating for an individualized therapy evaluation for each DAT, requiring an ongoing evaluation. This necessitates that, during each consultation, the current symptomatology should be analyzed, and the potential suitability for a DAT be assessed. This work represents a critical interdisciplinary appraisal of these therapies in terms of their individual profiles and compares these DAT regarding contraindications, periprocedural considerations as well as their efficacy regarding motor- and non-motor deficits, supporting a personalized approach.

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Section: Deep Brain Stimulation (Dbs)mentioning

confidence: 99%

Advanced therapies in Parkinson’s disease: an individualized approach to their indication

Schröter,

Sajonz,

Jost

et al. 2024

J Neural Transm

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Low‐Frequency Deep Brain Stimulation in Non‐Rapid Eye Movement Sleep Modifies Memory Retention in Parkinson's Disease

Herz,

Blech,

Winter

et al. 2024

Movement Disorders

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Background and ObjectiveMemory impairment is a frequent and debilitating symptom in neurodegenerative disorders. The objective of this study was to provide proof‐of‐principle that deep brain stimulation during sleep can modify memory consolidation in people with Parkinson's disease depending on the stimulation frequency that is applied.MethodsTwenty‐four patients with Parkinson's disease who were treated with deep brain stimulation of the subthalamic nucleus were included in this single‐blind pilot study. Six patients had to be excluded because of insomnia on the night of testing. Patients were randomized (1:1 ratio) to receiving either low frequency deep brain stimulation (4 Hz) or clinically used high frequency deep brain stimulation (130 Hz) during early non‐rapid eye movement (NREM) sleep. The main outcome measure was overnight memory retention as measured by a validated declarative memory task.ResultsPatients receiving low frequency deep brain stimulation during early NREM sleep (n = 9, 4 females, mean age 61.1 ± 4.3 years) showed improved overnight memory retention (z = 2.549, P = 0.011). Patients receiving clinically used high frequency deep brain stimulation (n = 9, 2 females, mean age 62.2 ± 7.1) did not show any improvement (z = 1.023, P = 0.306) leading to a significant difference between groups (z = 2.214, P = 0.027). Stronger improvement in memory function was correlated with increased cortical low frequency activity after low frequency deep brain stimulation as measured by electroencephalography (ρ = 0.711, P = 0.037).ConclusionThese results provide proof‐of‐principle that memory can be modulated by frequency‐specific deep brain stimulation during sleep. © 2024 The Author(s). Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.

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A Comprehensive Overview of the Current Status and Advancements in Various Treatment Strategies against Epilepsy

Waris,

Siraj,

Khan

et al. 2024

ACS Pharmacol. Transl. Sci.

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Epilepsy affects more than 70 million individuals of all ages worldwide and remains one of the most severe chronic noncommunicable neurological diseases globally. Several neurotransmitters, membrane protein channels, receptors, enzymes, and, more recently noted, various pathways, such as inflammatory and mTORC complexes, play significant roles in the initiation and propagation of seizures. Over the past two decades, significant developments have been made in the diagnosis and treatment of epilepsy. Various pharmacological drugs with diverse mechanisms of action and other treatment options have been developed to control seizures and treat epilepsy. These options include surgical treatment, nanomedicine, gene therapy, natural products, nervous stimulation, a ketogenic diet, gut microbiota, etc., which are in various developmental stages. Despite a plethora of drugs and other treatment options, one-third of affected individuals are resistant to current medications, while the majority of approved drugs have severe side effects, and significant changes can occur, such as pharmacoresistance, effects on cognition, long-term problems, drug interactions, risks of poor adherence, specific effects for certain medications, and psychological complications. Therefore, the development of new drugs and other treatment options that have no or minimal adverse effects is needed to combat this deadly disease. In this Review, we comprehensively summarize and explain all of the treatment options that have been approved or are in developmental stages for epilepsy as well as their status in clinical trials and advancements.

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Perspectives of Implementation of Closed-Loop Deep Brain Stimulation: From Neurological to Psychiatric Disorders

Cited by 4 publications

References 108 publications

Advanced therapies in Parkinson’s disease: an individualized approach to their indication

Advanced therapies in Parkinson’s disease: an individualized approach to their indication

Low‐Frequency Deep Brain Stimulation in Non‐Rapid Eye Movement Sleep Modifies Memory Retention in Parkinson's Disease

A Comprehensive Overview of the Current Status and Advancements in Various Treatment Strategies against Epilepsy

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