Cargando…
Controlling Parkinson's Disease With Adaptive Deep Brain Stimulation
Adaptive deep brain stimulation (aDBS) has the potential to improve the treatment of Parkinson's disease by optimizing stimulation in real time according to fluctuating disease and medication state. In the present realization of adaptive DBS we record and stimulate from the DBS electrodes impla...
Autores principales: | , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MyJove Corporation
2014
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4217393/ https://www.ncbi.nlm.nih.gov/pubmed/25077449 http://dx.doi.org/10.3791/51403 |
_version_ | 1782342394778222592 |
---|---|
author | Little, Simon Pogosyan, Alek Neal, Spencer Zrinzo, Ludvic Hariz, Marwan Foltynie, Thomas Limousin, Patricia Brown, Peter |
author_facet | Little, Simon Pogosyan, Alek Neal, Spencer Zrinzo, Ludvic Hariz, Marwan Foltynie, Thomas Limousin, Patricia Brown, Peter |
author_sort | Little, Simon |
collection | PubMed |
description | Adaptive deep brain stimulation (aDBS) has the potential to improve the treatment of Parkinson's disease by optimizing stimulation in real time according to fluctuating disease and medication state. In the present realization of adaptive DBS we record and stimulate from the DBS electrodes implanted in the subthalamic nucleus of patients with Parkinson's disease in the early post-operative period. Local field potentials are analogue filtered between 3 and 47 Hz before being passed to a data acquisition unit where they are digitally filtered again around the patient specific beta peak, rectified and smoothed to give an online reading of the beta amplitude. A threshold for beta amplitude is set heuristically, which, if crossed, passes a trigger signal to the stimulator. The stimulator then ramps up stimulation to a pre-determined clinically effective voltage over 250 msec and continues to stimulate until the beta amplitude again falls down below threshold. Stimulation continues in this manner with brief episodes of ramped DBS during periods of heightened beta power. Clinical efficacy is assessed after a minimum period of stabilization (5 min) through the unblinded and blinded video assessment of motor function using a selection of scores from the Unified Parkinson's Rating Scale (UPDRS). Recent work has demonstrated a reduction in power consumption with aDBS as well as an improvement in clinical scores compared to conventional DBS. Chronic aDBS could now be trialed in Parkinsonism. |
format | Online Article Text |
id | pubmed-4217393 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2014 |
publisher | MyJove Corporation |
record_format | MEDLINE/PubMed |
spelling | pubmed-42173932014-11-13 Controlling Parkinson's Disease With Adaptive Deep Brain Stimulation Little, Simon Pogosyan, Alek Neal, Spencer Zrinzo, Ludvic Hariz, Marwan Foltynie, Thomas Limousin, Patricia Brown, Peter J Vis Exp Medicine Adaptive deep brain stimulation (aDBS) has the potential to improve the treatment of Parkinson's disease by optimizing stimulation in real time according to fluctuating disease and medication state. In the present realization of adaptive DBS we record and stimulate from the DBS electrodes implanted in the subthalamic nucleus of patients with Parkinson's disease in the early post-operative period. Local field potentials are analogue filtered between 3 and 47 Hz before being passed to a data acquisition unit where they are digitally filtered again around the patient specific beta peak, rectified and smoothed to give an online reading of the beta amplitude. A threshold for beta amplitude is set heuristically, which, if crossed, passes a trigger signal to the stimulator. The stimulator then ramps up stimulation to a pre-determined clinically effective voltage over 250 msec and continues to stimulate until the beta amplitude again falls down below threshold. Stimulation continues in this manner with brief episodes of ramped DBS during periods of heightened beta power. Clinical efficacy is assessed after a minimum period of stabilization (5 min) through the unblinded and blinded video assessment of motor function using a selection of scores from the Unified Parkinson's Rating Scale (UPDRS). Recent work has demonstrated a reduction in power consumption with aDBS as well as an improvement in clinical scores compared to conventional DBS. Chronic aDBS could now be trialed in Parkinsonism. MyJove Corporation 2014-07-16 /pmc/articles/PMC4217393/ /pubmed/25077449 http://dx.doi.org/10.3791/51403 Text en Copyright © 2014, Journal of Visualized Experiments http://creativecommons.org/licenses/by/3.0/us/ This is an open-access article distributed under the terms of the Creative Commons Attribution 3.0 License. To view a copy of this license, visithttp://creativecommons.org/licenses/by/3.0/us/ |
spellingShingle | Medicine Little, Simon Pogosyan, Alek Neal, Spencer Zrinzo, Ludvic Hariz, Marwan Foltynie, Thomas Limousin, Patricia Brown, Peter Controlling Parkinson's Disease With Adaptive Deep Brain Stimulation |
title | Controlling Parkinson's Disease With Adaptive Deep Brain Stimulation |
title_full | Controlling Parkinson's Disease With Adaptive Deep Brain Stimulation |
title_fullStr | Controlling Parkinson's Disease With Adaptive Deep Brain Stimulation |
title_full_unstemmed | Controlling Parkinson's Disease With Adaptive Deep Brain Stimulation |
title_short | Controlling Parkinson's Disease With Adaptive Deep Brain Stimulation |
title_sort | controlling parkinson's disease with adaptive deep brain stimulation |
topic | Medicine |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4217393/ https://www.ncbi.nlm.nih.gov/pubmed/25077449 http://dx.doi.org/10.3791/51403 |
work_keys_str_mv | AT littlesimon controllingparkinsonsdiseasewithadaptivedeepbrainstimulation AT pogosyanalek controllingparkinsonsdiseasewithadaptivedeepbrainstimulation AT nealspencer controllingparkinsonsdiseasewithadaptivedeepbrainstimulation AT zrinzoludvic controllingparkinsonsdiseasewithadaptivedeepbrainstimulation AT harizmarwan controllingparkinsonsdiseasewithadaptivedeepbrainstimulation AT foltyniethomas controllingparkinsonsdiseasewithadaptivedeepbrainstimulation AT limousinpatricia controllingparkinsonsdiseasewithadaptivedeepbrainstimulation AT brownpeter controllingparkinsonsdiseasewithadaptivedeepbrainstimulation |