An investigation into closed-loop treatment of neurological disorders based on sensing mitochondrial dysfunction.
An investigation into closed-loop treatment of neurological disorders based on sensing mitochondrial dysfunction.
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DOI：
10.1186/s12984-018-0349-z
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发表时间：
2018-02-13
影响因子：
5.1
通讯作者：
Berk M
中科院分区：
文献类型：
--
作者：
Adams SD;Kouzani AZ;Tye SJ;Bennet KE;Berk M
基于动态反馈的闭环医疗设备为治疗异质神经病症提供了许多优点。闭环设备集成了一定程度的神经生物学反馈，允许进行实时调整，其总体目标是提高治疗效果并最大限度地降低不良事件的风险。一个尚未被广泛探索作为闭环疗法中的潜在反馈组分的靶点是线粒体功能。几种神经退行性和精神疾病，包括帕金森氏病、重度抑郁症和双相情感障碍，都与线粒体呼吸链的紊乱有关。本文探讨了监测这种线粒体功能作为闭环神经调节治疗反馈方法的潜力。开发了闭环治疗的通用模型，以描述设计用于基于线粒体对刺激的响应来控制神经功能的任何系统的高级功能，从而简化比较和未来的荟萃分析。该模型由传感器、信号处理器、控制器和执行器四部分组成。这些组件中的每一个都进行了描述，并对每个组件的几种潜在技术进行了研究。虽然其中一些候选技术已经相当成熟，但仍然存在技术差距。闭环医疗设备领域正在迅速发展，虽然人们对这一领域很感兴趣，但由于存在一些技术障碍，尚未实现广泛采用。然而，这项技术提供的显著治疗益处意味着这将是未来几年研究的一个活跃领域。
Dynamic feedback based closed-loop medical devices offer a number of advantages for treatment of heterogeneous neurological conditions. Closed-loop devices integrate a level of neurobiological feedback, which allows for real-time adjustments to be made with the overarching aim of improving treatment efficacy and minimizing risks for adverse events. One target which has not been extensively explored as a potential feedback component in closed-loop therapies is mitochondrial function. Several neurodegenerative and psychiatric disorders including Parkinson’s disease, Major Depressive disorder and Bipolar disorder have been linked to perturbations in the mitochondrial respiratory chain. This paper investigates the potential to monitor this mitochondrial function as a method of feedback for closed-loop neuromodulation treatments. A generic model of the closed-loop treatment is developed to describe the high-level functions of any system designed to control neural function based on mitochondrial response to stimulation, simplifying comparison and future meta-analysis. This model has four key functional components including: a sensor, signal manipulator, controller and effector. Each of these components are described and several potential technologies for each are investigated. While some of these candidate technologies are quite mature, there are still technological gaps remaining. The field of closed-loop medical devices is rapidly evolving, and whilst there is a lot of interest in this area, widespread adoption has not yet been achieved due to several remaining technological hurdles. However, the significant therapeutic benefits offered by this technology mean that this will be an active area for research for years to come.
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