Closed-Loop Deep Brain Stimulation for Essential Tremor Based on Thalamic Local Field Potentials.
Closed-Loop Deep Brain Stimulation for Essential Tremor Based on Thalamic Local Field Potentials.
复制标题
DOI：
10.1002/mds.28513
复制
发表时间：
2021-04
期刊：
影响因子：
--
通讯作者：
Tan H
中科院分区：
文献类型：
--
作者：
He S;Baig F;Mostofi A;Pogosyan A;Debarros J;Green AL;Aziz TZ;Pereira E;Brown P;Tan H
高频丘脑刺激是原发性震颤的有效疗法，主要影响随意运动和/或持续姿势。然而，由于震颤的间歇性，连续刺激可能会向大脑输送不必要的电流。我们建议通过使用从植入用于刺激的相同电极记录的局部场电位检测引起震颤的运动状态来闭合丘脑刺激的回路，以便仅在必要时提供刺激。8例原发性震颤患者参加了这项研究。患者特异性支持向量机分类器首先使用患者进行震颤诱发运动时记录的数据进行训练。然后，将训练好的模型应用于真实的时间，以检测这些运动并触发刺激的传递。使用所提出的方法，当存在诱发震颤的运动时，刺激被开启80.37 ± 7.06%的时间。相比之下，当患者处于静息和无震颤状态时，刺激开启的时间为12.71 ± 7.06%。与连续刺激相比，实现了相似量的震颤抑制，同时仅输送连续刺激中使用的能量的36.62 ± 13.49%。结果表明，可以实现基于震颤诱发运动检测的特发性震颤的反应性丘脑刺激，而无需任何外部传感器或额外的皮质电图条。需要进一步的研究来调查解码模型是否在时间上是稳定的，并且可以推广到患者在日常生活中可能参与的各种活动。版权所有© 2021作者。运动障碍由Wiley Periodicals LLC代表国际帕金森和运动障碍协会出版
High‐frequency thalamic stimulation is an effective therapy for essential tremor, which mainly affects voluntary movements and/or sustained postures. However, continuous stimulation may deliver unnecessary current to the brain due to the intermittent nature of the tremor. We proposed to close the loop of thalamic stimulation by detecting tremor‐provoking movement states using local field potentials recorded from the same electrodes implanted for stimulation, so that the stimulation is only delivered when necessary. Eight patients with essential tremor participated in this study. Patient‐specific support vector machine classifiers were first trained using data recorded while the patient performed tremor‐provoking movements. Then, the trained models were applied in real‐time to detect these movements and triggered the delivery of stimulation. Using the proposed method, stimulation was switched on for 80.37 ± 7.06% of the time when tremor‐evoking movements were present. In comparison, the stimulation was switched on for 12.71 ± 7.06% of the time when the patients were at rest and tremor‐free. Compared with continuous stimulation, a similar amount of tremor suppression was achieved while only delivering 36.62 ± 13.49% of the energy used in continuous stimulation. The results suggest that responsive thalamic stimulation for essential tremor based on tremor‐provoking movement detection can be achieved without any requirement for external sensors or additional electrocorticography strips. Further research is required to investigate whether the decoding model is stable across time and generalizable to the variety of activities patients may engage with in everyday life. © 2021 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society
登录
查看更多内容
晚期帕金森病的自适应深脑刺激。
影响因子：
11.2
作者：
Little, Simon;Pogosyan, Alex;Neal, Spencer;Zavala, Baltazar;Zrinzo, Ludvic;Hariz, Marwan;Foltynie, Thomas;Limousin, Patricia;Ashkan, Keyoumars;FitzGerald, James;Green, Alexander L.;Aziz, Tipu Z.;Brown, Peter
通讯作者：
Brown, Peter
影响因子：
4.1
作者：
Pilitsis, Julie G.;Metman, Leo Verhagen;Bakay, Roy A. E.
通讯作者：
Bakay, Roy A. E.
影响因子：
2.9
作者：
Ramirez-Zamora, Adolfo;Giordano, James;Okun, Michael S.
通讯作者：
Okun, Michael S.
影响因子：
14.5
作者：
Hirschmann, Jan;Hartmann, Christian J.;Schnitzler, Alfons
通讯作者：
Schnitzler, Alfons
影响因子：
4
作者：
Houston, Brady;Thompson, Margaret;Chizeck, Howard
通讯作者：
Chizeck, Howard