Phasic Burst Stimulation: A Closed-Loop Approach to Tuning Deep Brain Stimulation Parameters for Parkinson's Disease.
Phasic Burst Stimulation: A Closed-Loop Approach to Tuning Deep Brain Stimulation Parameters for Parkinson's Disease.
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DOI：
10.1371/journal.pcbi.1005011
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发表时间：
2016-07
影响因子：
4.3
通讯作者：
Netoff TI
中科院分区：
文献类型：
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作者：
Holt AB;Wilson D;Shinn M;Moehlis J;Netoff TI
我们提出了一种新的闭环方法来调整深部脑刺激（DBS）治疗帕金森病（PD）。该方法被称为相位爆发刺激（PhaBS），在预测破坏PD中观察到的病理性振荡的相位范围内应用刺激脉冲的爆发。刺激参数基于相位响应曲线（PRC）进行优化，该曲线将从每个患者测量。这种方法是测试在一个计算模型的PD与紧急人口振荡。我们表明，刺激相位可以使用PRC进行优化，并且PhaBS比单一相位刺激脉冲更有效地抑制病理性振荡。PhaBS为DBS提供了一种闭环方法，可以针对每位患者进行优化。脑深部电刺激（DBS）可有效治疗药物难治性帕金森病（PD）患者的运动症状。目前，使用试错过程为每个患者调谐高频刺激（>100 Hz）。基于患者生理学调整刺激参数的系统方法有可能改善患者的生活质量。我们提出了一种新的DBS闭环方法，称为相位爆发刺激，其中刺激脉冲的时间是使用基于患者生理学的算法进行优化。闭环方法有可能提高治疗效果，通过降低功耗延长电池寿命，通过更有选择性的刺激减少负面副作用，并随着运动症状的波动进行调整。
We propose a novel, closed-loop approach to tuning deep brain stimulation (DBS) for Parkinson’s disease (PD). The approach, termed Phasic Burst Stimulation (PhaBS), applies a burst of stimulus pulses over a range of phases predicted to disrupt pathological oscillations seen in PD. Stimulation parameters are optimized based on phase response curves (PRCs), which would be measured from each patient. This approach is tested in a computational model of PD with an emergent population oscillation. We show that the stimulus phase can be optimized using the PRC, and that PhaBS is more effective at suppressing the pathological oscillation than a single phasic stimulus pulse. PhaBS provides a closed-loop approach to DBS that can be optimized for each patient. Deep brain stimulation (DBS) is effective at treating motor symptoms of patients with medication-refractory Parkinson’s disease (PD). Currently, high frequency stimulation (>100 Hz) is tuned for each patient using a trial-and-error process. A systematic approach to tuning stimulation parameters based on patient physiology has the potential to improve patient quality of life. We present a novel closed-loop approach to DBS, termed Phasic Burst Stimulation, where the timing of stimulus pulses is optimized using an algorithm based on patient physiology. A closed-loop approach has the potential to improve therapeutic efficacy, extend battery lifetime by decreasing power consumption, decrease negative side effects by more selectively stimulating, and adjust as motor symptoms fluctuate.