Creating the feedback loop: closed-loop neurostimulation.
Creating the feedback loop: closed-loop neurostimulation.
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创建反馈环：闭环神经刺激。
DOI：
10.1016/j.nec.2013.08.006
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发表时间：
2014-01
影响因子：
2.6
通讯作者：
Pouratian, Nader
中科院分区：
文献类型：
--
作者：
Hebb, Adam O.;Zhang, Jun Jason;Mahoor, Mohammad H.;Tsiokos, Christos;Matlack, Charles;Chizeck, Howard Jay;Pouratian, Nader
关键词：
自1997年第一个商业脑深部电刺激（DBS）系统被批准用于治疗震颤1以来，用于脑电刺激的植入式器械一直在常规临床使用。这些DBS设备以固定频率提供不变的刺激脉冲串。DBS治疗的这种“开环”模式（意味着从设备产生并传递到大脑的单向信号）已被证明可有效治疗原发性震颤2、帕金森病3，4和肌张力障碍5，6。随着我们对DBS和运动障碍的神经生理学机制的理解的扩展，开环治疗DBS的缺点是显而易见的，并将在本文中进行讨论。用于生理信号感知和响应的“闭环”植入式脉冲发生器（IPG）的设计（“闭环”意味着在感测和响应两个方向上移动的双向信号，允许使用传感器信号来提供刺激的反馈调制）脑内或脑外被认为是脑刺激研究的下一个前沿，并可能扩大该领域，包括新的应用，植入式闭环刺激系统在心律失常的治疗中得到了很好的建立。能够感知和响应心房活动的心脏起搏器器械是闭环模式心脏刺激器械，自19637年以来一直在临床使用。尽管具有双重感知和刺激功能的IPG在50年前就有先例，但将类似概念引入DBS设备的努力已经推迟了50年，部分原因是大脑信号的复杂性。心脏起搏器检测心房起搏器的P波信号，而大脑产生的信号在统计学上是复杂的。也许
Implantable devices for electrical stimulation of the brain have been in routine clinical use since 1997, when the first commercial deep brain stimulation (DBS) system was approved for the treatment of tremor1. These DBS devices provide an invariant train of stimulatory pulses at a fixed frequency. This “open-loop” mode (meaning unidirectional signal generated from the device and delivered to the brain) of DBS therapy has proven to be effective for treatment of essential tremor2, Parkinson’s disease3, 4, and dystonia5, 6. As we expand our understanding of the neurophysiological mechanisms of both DBS and movement disorders, the shortcomings of open loop therapy DBS are evident and will be discussed in this review. The design of a “closed-loop” implantable pulse generator (IPG) to sense and respond to physiological signals (“closed-loop” meaning bidirectional signals moving in both sensing and responding directions, allowing for the use of sensor signals to provide feedback modulation of stimulation) within or outside the brain is considered the next frontier in brain stimulation research and will likely broaden the field to include new applications for neuromodulation.Implantable closed loop stimulation systems are well established in the treatment of cardiac arrhythmias. Cardiac pacemaker devices capable of sensing and responding to atrial activity are closed loop mode cardiac stimulation devices and have been in clinical use since 19637. Despite the precedent for an IPG with dual sensing and stimulating functionality set 50 years ago, efforts to bring similar concepts to DBS devices8, 9 have been delayed 50-years in part due to the complexity of brain signals. Whereas cardiac pacemakers detect the P-wave signal of the atrial pacemaker, brain-generated signals are statistically complex. Perhaps
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影响因子：
--
作者：
Bashashati A;Ward RK;Birch GE
通讯作者：
Birch GE
DOI：
10.1109/tsmcb.2009.2018469
发表时间：
2009-12-01
影响因子：
--
作者：
Coyle, Damien;Prasad, Girijesh;McGinnity, Thomas Martin
通讯作者：
McGinnity, Thomas Martin
影响因子：
7.5
作者：
CORTES, C;VAPNIK, V
通讯作者：
VAPNIK, V
影响因子：
3.5
作者：
Beverlin, Bryce, II;Netoff, Theoden I.
通讯作者：
Netoff, Theoden I.
DOI：
10.1016/j.yebeh.2011.09.001
发表时间：
2011-12
期刊：
Epilepsy & behavior : E&B
影响因子：
--
作者：
Carney PR;Myers S;Geyer JD
通讯作者：
Geyer JD