A neurochemical closed-loop controller for deep brain stimulation: toward individualized smart neuromodulation therapies.
A neurochemical closed-loop controller for deep brain stimulation: toward individualized smart neuromodulation therapies.
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DOI：
10.3389/fnins.2014.00169
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发表时间：
2014
影响因子：
4.3
通讯作者：
Lujan JL
中科院分区：
文献类型：
--
作者：
Grahn PJ;Mallory GW;Khurram OU;Berry BM;Hachmann JT;Bieber AJ;Bennet KE;Min HK;Chang SY;Lee KH;Lujan JL
目前优化脑深部电刺激（DBS）治疗的策略涉及多次术后访视。在每次访视期间，调整刺激参数，直至达到预期的治疗效果并将不良反应降至最低。然而，这些治疗参数的功效可能会随着时间的推移而下降，至少部分原因是疾病进展、宿主环境与电极之间的相互作用以及电极导线迁移。因此，开发能够响应不断变化的神经化学环境的闭环控制系统，为个体患者定制DBS治疗，对于提高DBS的治疗效果至关重要。在动物和人类中使用电生理学和成像技术获得的证据表明，DBS通过调节神经网络活动起作用。最近，动物研究表明，刺激诱发的神经递质释放的变化，反映了正常的生理与DBS的治疗效益。因此，为了充分了解DBS的神经生理学并优化其疗效，可能有必要超越传统的电生理学分析，并表征治疗性和非治疗性刺激的神经化学效应。通过结合电化学监测和数学建模技术，我们可以用确定性方法取代临床编程中使用的试错过程，从而帮助获得最佳和稳定的神经化学特征。在这篇手稿中，我们总结了目前的理解电生理和电化学处理控制的神经调节治疗。此外，我们描述了一种原理证明闭环控制器，其特征在于DBS诱发的多巴胺变化，以调整DBS啮齿动物模型中的刺激参数。本文描述的工作代表了实现用于治疗神经和精神疾病的“智能”神经假体系统的初始步骤。
Current strategies for optimizing deep brain stimulation (DBS) therapy involve multiple postoperative visits. During each visit, stimulation parameters are adjusted until desired therapeutic effects are achieved and adverse effects are minimized. However, the efficacy of these therapeutic parameters may decline with time due at least in part to disease progression, interactions between the host environment and the electrode, and lead migration. As such, development of closed-loop control systems that can respond to changing neurochemical environments, tailoring DBS therapy to individual patients, is paramount for improving the therapeutic efficacy of DBS. Evidence obtained using electrophysiology and imaging techniques in both animals and humans suggests that DBS works by modulating neural network activity. Recently, animal studies have shown that stimulation-evoked changes in neurotransmitter release that mirror normal physiology are associated with the therapeutic benefits of DBS. Therefore, to fully understand the neurophysiology of DBS and optimize its efficacy, it may be necessary to look beyond conventional electrophysiological analyses and characterize the neurochemical effects of therapeutic and non-therapeutic stimulation. By combining electrochemical monitoring and mathematical modeling techniques, we can potentially replace the trial-and-error process used in clinical programming with deterministic approaches that help attain optimal and stable neurochemical profiles. In this manuscript, we summarize the current understanding of electrophysiological and electrochemical processing for control of neuromodulation therapies. Additionally, we describe a proof-of-principle closed-loop controller that characterizes DBS-evoked dopamine changes to adjust stimulation parameters in a rodent model of DBS. The work described herein represents the initial steps toward achieving a “smart” neuroprosthetic system for treatment of neurologic and psychiatric disorders.
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影响因子：
--
作者：
Bronstein JM;Tagliati M;Alterman RL;Lozano AM;Volkmann J;Stefani A;Horak FB;Okun MS;Foote KD;Krack P;Pahwa R;Henderson JM;Hariz MI;Bakay RA;Rezai A;Marks WJ Jr;Moro E;Vitek JL;Weaver FM;Gross RE;DeLong MR
通讯作者：
DeLong MR
细胞外田地和电流的起源-EEG，ECOG，LFP和尖峰。
DOI：
10.1038/nrn3241
发表时间：
2012-05-18
期刊：
Nature reviews. Neuroscience
影响因子：
--
作者：
Buzsáki G;Anastassiou CA;Koch C
通讯作者：
Koch C
影响因子：
4.1
作者：
Bledsoe JM;Kimble CJ;Covey DP;Blaha CD;Agnesi F;Mohseni P;Whitlock S;Johnson DM;Horne A;Bennet KE;Lee KH;Garris PA
通讯作者：
Garris PA
影响因子：
4.1
作者：
Chang, Su-Youne;Kimble, Christopher J.;Lee, Kendall H.
通讯作者：
Lee, Kendall H.
影响因子：
8.9
作者：
Chang, Su-Youne;Kim, Inyong;Lee, Kendall H.
通讯作者：
Lee, Kendall H.