Evoked potentials generated by deep brain stimulation for Parkinson's disease.

Evoked potentials generated by deep brain stimulation for Parkinson's disease.
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DOI:
10.1016/j.brs.2022.07.048
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发表时间:
2022-09
期刊:
影响因子:
7.7
通讯作者:
Grill, Warren M.
Grill, Warren M.
中科院分区:
医学1区
文献类型:
--
作者:
Dale, Jahrane;Schmidt, Stephen L.;Mitchell, Kyle;Turner, Dennis A.;Grill, Warren M.

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本文就脑深部刺激(DBS)产生的脑诱发电位(EPs)的一般特征、机制、技术记录因素及临床应用作一综述。对DBS脉冲作出反应的诱发电位发生在毫秒级的时间尺度上,既可以在刺激部位局部发现,也可以远程在大脑皮层发现。DBS诱发电位产生于逆行和顺行传导通路反应的复杂整合,为理解症状治疗的机制和回路提供了有价值的信息。此外,这些信号可能为改善DBS的预后和功能提供生物标志物。例如,诱发电位可以用作DBS编程或自适应DBS的控制信号。尽管它们有希望,但在我们对诱发电位产生的机制以及如何测量这些信号并将其应用于临床环境的理解方面仍存在严重差距。在没有刺激伪影干扰的情况下以足够的分辨率记录高瞬变信号的技术挑战是更好地理解DBS诱发的EPs的障碍。我们描述了当前诱发电位的科学图景,以促进和激励进一步的研究。
The goal of this review is to describe the general features, mechanisms, technical recording factors, and clinical applications of brain evoked potentials (EPs) generated by deep brain stimulation (DBS) for Parkinson’s disease (PD). Evoked potentials in response to DBS pulses occur on the timescale of milliseconds and are found both locally at the site of stimulation and remotely in the cortex. DBS evoked potentials arise from a complex integration of antidromic and orthodromic conduction pathway responses, and provide information valuable for understanding the mechanisms and circuits involved in symptom treatment. Furthermore, these signals may provide biomarkers for improving DBS outcomes and function. For example, evoked potentials may have utility as control signals for DBS programming or adaptive DBS. Despite their promise there are still critical gaps in our understanding of the mechanisms by which evoked potentials arise and how these signals may be measured and applied in the clinical setting. Technical challenges of recording a highly transient signal at sufficient resolution without the interference of stimulation artifact present a barrier to understanding better DBS-induced EPs. We describe the current scientific landscape of evoked potentials to facilitate and stimulate further investigation.
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