Ramp Rate Evaluation and Configuration for Safe and Tolerable Closed-Loop Deep Brain Stimulation.
Ramp Rate Evaluation and Configuration for Safe and Tolerable Closed-Loop Deep Brain Stimulation.
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DOI：
10.1109/ner49283.2021.9441336
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发表时间：
2021-05
期刊：
影响因子：
--
通讯作者：
Bronte-Stewart, Helen M.
中科院分区：
文献类型：
--
作者：
Petrucci, Matthew N.;Wilkins, Kevin B.;Orthlieb, Gerrit C.;Kehnemouyi, Yasmine M.;O'Day, Johanna J.;Herron, Jeffrey A.;Bronte-Stewart, Helen M.
闭环脑深部电刺激是一种新的治疗形式，在初步研究中已显示出益处，并可能在不久的将来在临床上可用。最初的闭环研究主要集中在通过调整刺激幅度来响应感测到的生物标志物，这通常是研究参与者可感知的，这取决于幅度变化的转换或“斜坡”速率。这些对刺激斜升的主观反应可能导致短暂的副作用，说明斜升速率是闭环神经系统的独特安全参数。这对闭环神经调节系统的未来提出了挑战：根据控制策略的目标，临床医生将需要平衡斜坡率以避免副作用，并通过及时响应以影响神经动力学来保持刺激治疗。在本文中，我们展示了初步调查的结果，发现安全和可耐受的斜坡率在四个人与帕金森氏病（PD）的方法。结果表明，与简单地在最大和最小强度水平之间切换相比，在不同刺激期间更准确地找到最佳斜坡率。此外，在治疗刺激水平下，瞬时开关频率是可耐受的。未来的工作应该集中在包括优化技术，以找到斜坡率。
Closed-loop deep brain stimulation is a novel form of therapy that has shown benefit in preliminary studies and may be clinically available in the near future. Initial closed-loop studies have primarily focused on responding to sensed biomarkers with adjustments to stimulation amplitude, which is often perceptible to study participants depending on the slew or “ramp” rate of the amplitude changes. These subjective responses to stimulation ramping can result in transient side effects, illustrating that ramp rate is a unique safety parameter for closed-loop neural systems. This presents a challenge to the future of closed-loop neuromodulation systems: depending on the goal of the control policy, clinicians will need to balance ramp rates to avoid side effects and keep the stimulation therapeutic by responding in time to affect neural dynamics. In this paper, we demonstrate the results of an initial investigation into methodology for finding safe and tolerable ramp rates in four people with Parkinson’s disease (PD). Results suggest that optimal ramp rates were found more accurately during varying stimulation when compared to simply toggling between maximal and minimal intensity levels. Additionally, switching frequency instantaneously was tolerable at therapeutic levels of stimulation. Future work should focus on including optimization techniques to find ramp rates.
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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
DOI：
10.1109/tbcas.2018.2880148
发表时间：
2018-12-01
影响因子：
5.1
作者：
Stanslaski, Scott;Herron, Jeffrey;Denison, Timothy
通讯作者：
Denison, Timothy
DOI：
10.1109/embc44109.2020.9176638
发表时间：
2020-07
期刊：
Annual International Conference of the IEEE Engineering in Medicine and Biology Society. IEEE Engineering in Medicine and Biology Society. Annual International Conference
影响因子：
--
作者：
O'Day JJ;Kehnemouyi YM;Petrucci MN;Anderson RW;Herron JA;Bronte-Stewart HM
通讯作者：
Bronte-Stewart HM
影响因子：
2.9
作者：
Bronte-Stewart, Helen M.;Petrucci, Matthew N.;Hoffman, Shannon L.
通讯作者：
Hoffman, Shannon L.
影响因子：
8.6
作者：
Volkmann, J;Moro, E;Pahwa, R
通讯作者：
Pahwa, R