Multi-objective data-driven optimization for improving deep brain stimulation in Parkinson's disease.
Multi-objective data-driven optimization for improving deep brain stimulation in Parkinson's disease.
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DOI：
10.1088/1741-2552/abf8ca
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发表时间：
2021-05-05
影响因子：
4
通讯作者：
中科院分区：
文献类型：
--
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Deep brain stimulation (DBS) is an effective treatment for Parkinson’s disease (PD) but its success depends on a time-consuming process of trial-and-error to identify the optimal stimulation settings for each individual patient. Data-driven optimization algorithms have been proposed to efficiently find the stimulation setting that maximizes a quantitative biomarker of symptom relief. However, these algorithms cannot efficiently take into account stimulation settings that may control symptoms but also cause side effects. Here we demonstrate how multi-objective data-driven optimization can be used to find the optimal trade-off between maximizing symptom relief and minimizing side effects. Cortical and motor evoked potential data collected from PD patients during intraoperative stimulation of the subthalamic nucleus were used to construct a framework for designing and prototyping data-driven multi-objective optimization algorithms. Using this framework, we explored how these techniques can be applied clinically, and characterized the design features critical for solving this optimization problem. Our two optimization objectives were to maximize cortical evoked potentials, a putative biomarker of therapeutic benefit, and to minimize motor potentials, a biomarker of motor side effects. Using this in silico design framework, we demonstrated how the optimal trade-off between two objectives can substantially reduce the stimulation parameter space by 61 ± 19%. The best algorithm for identifying the optimal trade-off between the two objectives was a Bayesian optimization approach with an area under the receiver operating characteristic curve of up to 0.94 ± 0.02, which was possible with the use of a surrogate model and a well-tuned acquisition function to efficiently select which stimulation settings to sample. These findings show that multi-objective optimization is a promising approach for identifying the optimal trade-off between symptom relief and side effects in DBS. Moreover, these approaches can be readily extended to newly discovered biomarkers, adapted to DBS for disorders beyond PD, and can scale with the development of more complex DBS devices.
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影响因子：
17.1
作者：
Brocker DT;Swan BD;So RQ;Turner DA;Gross RE;Grill WM
通讯作者：
Grill WM
影响因子：
8.6
作者：
Krack, P;Fraix, V;Pollak, P
通讯作者：
Pollak, P
影响因子：
14.5
作者：
Costa, Joao;Valls-Sole, Josep;Tolosa, Eduardo
通讯作者：
Tolosa, Eduardo
影响因子：
7.7
作者：
Howell B;Isbaine F;Willie JT;Opri E;Gross RE;De Hemptinne C;Starr PA;McIntyre CC;Miocinovic S
通讯作者：
Miocinovic S
影响因子：
7.7
作者：
Johnson LA;Nebeck SD;Muralidharan A;Johnson MD;Baker KB;Vitek JL
通讯作者：
Vitek JL