Towards adaptive deep brain stimulation: clinical and technical notes on a novel commercial device for chronic brain sensing
Towards adaptive deep brain stimulation: clinical and technical notes on a novel commercial device for chronic brain sensing
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DOI：
10.1088/1741-2552/ac1d5b
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发表时间：
2021-08-01
影响因子：
4
通讯作者：
Contarino, M. Fiorella
中科院分区：
文献类型：
--
作者：
Thenaisie, Yohann;Palmisano, Chiara;Contarino, M. Fiorella
目标。脑深部刺激(DBS)的技术进步对提高治疗效果和电池寿命至关重要。我们报告了第一批商用设备之一的潜力和缺陷，该设备能够记录植入的DBS导联的大脑局部场电位(LFP)，并在刺激期间进行。其目的是为临床医生提供关于如何在日常实践和研究目的中最大限度地发挥这种新型设备的能力的有根据的提示。接近。我们收集了在我们的中心接受Percept(TM)PC的前20名患者的临床和神经生理学数据(14名帕金森病(PD)患者，5名肌张力障碍患者，1名慢性疼痛患者)。我们还在盐水浴中进行了测试，以验证录音质量。主要结果。Percept PC无线实时可靠地记录了植入部位的LFP。我们记录了在有和没有刺激的情况下，帕金森病和肌张力障碍(β和β振荡)最有前景的临床有用生物标志物。此外，我们还提供了一个开源代码，以方便数据的导出和分析。该系统的关键方面目前涉及联系人选择、伪影检测、数据丢失以及与其他设备的同步。意义重大。新技术将很快允许闭环神经调节疗法，能够基于实时症状特定和任务相关的输入信号来适应刺激。然而，需要考虑技术方面的问题，以确保可靠的录音。越来越多的DBS专家的关键使用将提醒新用户当前观察到的缺点，并告知如何克服这些缺点。
Objective. Technical advances in deep brain stimulation (DBS) are crucial to improve therapeutic efficacy and battery life. We report the potentialities and pitfalls of one of the first commercially available devices capable of recording brain local field potentials (LFPs) from the implanted DBS leads, chronically and during stimulation. The aim was to provide clinicians with well-grounded tips on how to maximize the capabilities of this novel device, both in everyday practice and for research purposes. Approach. We collected clinical and neurophysiological data of the first 20 patients (14 with Parkinson's disease (PD), five with dystonia, one with chronic pain) that received the Percept (TM) PC in our centres. We also performed tests in a saline bath to validate the recordings quality. Main results. The Percept PC reliably recorded the LFP of the implanted site, wirelessly and in real time. We recorded the most promising clinically useful biomarkers for PD and dystonia (beta and theta oscillations) with and without stimulation. Furthermore, we provide an open-source code to facilitate export and analysis of data. Critical aspects of the system are presently related to contact selection, artefact detection, data loss, and synchronization with other devices. Significance. New technologies will soon allow closed-loop neuromodulation therapies, capable of adapting stimulation based on real-time symptom-specific and task-dependent input signals. However, technical aspects need to be considered to ensure reliable recordings. The critical use by a growing number of DBS experts will alert new users about the currently observed shortcomings and inform on how to overcome them.