Bilateral Closed Loop Deep Brain Stimulation for Freezing of Gait using Neural and Kinematic Feedback
利用神经和运动学反馈进行双边闭环深部脑刺激以冻结步态
基本信息
- 批准号:10218278
- 负责人:
- 金额:$ 120.42万
- 依托单位:
- 依托单位国家:美国
- 项目类别:
- 财政年份:2019
- 资助国家:美国
- 起止时间:2019-08-01 至 2024-07-31
- 项目状态:已结题
- 来源:
- 关键词:Adverse effectsAffectAgeAlgorithmsBehavior ControlBehavioralBilateralBluetoothBradykinesiaBrainCessation of lifeClinical ResearchComplicationDataDeep Brain StimulationDevelopmentDevice or Instrument DevelopmentDevicesDiseaseDoseEmerging TechnologiesEnvironmentFamilyFeedbackFreezingFrequenciesFutureGaitGap JunctionsGluesHomeHome environmentImpairmentImplantIncidenceIndependent LivingIndustry CollaborationInjuryLeadLegLewy Body DementiaLocomotionMeasurementMeasuresMotorMovement Disorder Society Unified Parkinson&aposs Disease Rating ScaleNational Institute of Neurological Disorders and StrokeNeurodegenerative DisordersOutcomeOutcome MeasureParkinson DiseasePatientsPeriodicityPharmaceutical PreparationsPoliciesPopulationProgressive Supranuclear PalsyResearchResearch PrioritySafetySignal TransductionStructure of subthalamic nucleusSystemTechnologyTestingTimeTranslatingTremorWalkingarmbasebench to bedsidecohortdesigndisabilityeffective therapyexperienceexperimental studyfall injuryfallsfeasibility testingfoothome testimprovedkinematicsmotor disordermotor symptomnervous system disorderneuroregulationnext generationnovelpartial responseparticipant safetypatient safetypreventprimary outcomerelating to nervous systemresponsesafety and feasibilitysafety testingsecondary outcomesensorside effectsymposiumwearable sensor technology
项目摘要
Gait impairment and Freezing of gait (FOG), lead to falls, injury (even death), loss of independent living, and are
common in neurodegenerative diseases such as Parkinson’s Disease (PD), affecting over 7 million people
worldwide. The incidence of neurodegenerative diseases increases with age and as the population lives longer,
the societal consequences of FOG, will be very significant. Gait impairment and FOG have a partial response to
medication and subthalamic nucleus (STN) open loop deep brain stimulation (olDBS), which cannot adjust
therapy in response to underlying brain signals or motor symptoms such as FOG. One reason is that FOG may
respond to different parameters of DBS, such as lower frequency, than that needed for tremor and most patients
do not tolerate 60 Hz DBS for long periods of time. Emerging technology using sensing neurostimulators and
Bluetooth enabled wearable sensors has allowed research into closed loop or adaptive (a)DBS using neural or
behavioral control variables. FOG is episodic and usually occurs in predictable environments, so it is well suited
for ‘on demand’ aDBS. ADBS, responding to markers of gait impairment and intermittent FOG, with changes in
DBS intensity or frequency, could then prevent FOG, falls and injury, while still treating other motor signs of PD.
From over four years of research and regulatory experience in an academic-industry collaboration with
Medtronic, we have provided design inputs for the next generation aDBS devices, and have determined that
aDBS for tremor and bradykinesia is safe and tolerable in the largest freely-moving PD cohort implanted with a
Medtronic investigative neurostimulation/sensing system (Activa® PC+S-Nexus D/D3/E). We have discovered
neural and behavioral markers of gait impairment and FOG using synchronized neural and kinematic recordings
during gait tasks that elicit FOG. Our research findings and the technological advances embedded in the
Medtronic Summit® RC+S-system now enable the next step: the first clinical studies of lateralized, independent,
bilateral STN aDBS control algorithms for FOG in PD, driven by subject-specific neural (Aim 1) or behavioral
(Aim 2) control variables, and in response to medication (Aim 3). The project will translate stepwise in a ‘bench
to bedside’ manner, testing aDBS during the stepping in place (SIP) task, where the subject is in a harness and
steps in place on dual force-plates. Then aDBS will be tested during the forward walking Turning and Barrier
Course, which mimics environments known to trigger FOG in the real world, and then how aDBS responds to
subject-specific doses of medication, while freely moving. The outcome of these experiments will provide critical
next-steps for safety and feasibility of testing aDBS for gait impairment and FOG in the subject’s home
environment, and on their normal medication. Patient safety, tolerability, adverse effects, gait parameters, and
the number and duration of freezing episodes (FEs), during no DBS, olDBS, aDBS and a control, intermittent
(i)olDBS will provide inputs for future devices and novel algorithms applicable to NaDBS or KaDBS for gait
impairment and FOG in other neurological diseases.
步态障碍和步态冻结(FOG)会导致跌倒、受伤(甚至死亡)、丧失独立生活能力
项目成果
期刊论文数量(0)
专著数量(0)
科研奖励数量(0)
会议论文数量(0)
专利数量(0)
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Helen Bronte-Stewart其他文献
Helen Bronte-Stewart的其他文献
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{{ truncateString('Helen Bronte-Stewart', 18)}}的其他基金
Neurostimulation of the Nucleus Basalis of Meynert for the cognitive-motor syndrome in Parkinson's disease
梅纳特基底核神经刺激治疗帕金森病认知运动综合征
- 批准号:
10510424 - 财政年份:2022
- 资助金额:
$ 120.42万 - 项目类别:
Neurostimulation of the Nucleus Basalis of Meynert for the cognitive-motor syndrome in Parkinson's disease
梅纳特基底核神经刺激治疗帕金森病认知运动综合征
- 批准号:
10686249 - 财政年份:2022
- 资助金额:
$ 120.42万 - 项目类别:
Bilateral Closed Loop Deep Brain Stimulation for Freezing of Gait using Neural and Kinematic Feedback
利用神经和运动学反馈进行双边闭环深部脑刺激以冻结步态
- 批准号:
10670150 - 财政年份:2019
- 资助金额:
$ 120.42万 - 项目类别:
Bilateral Closed Loop Deep Brain Stimulation for Freezing of Gait using Neural and Kinematic Feedback
利用神经和运动学反馈进行双边闭环深部脑刺激以冻结步态
- 批准号:
10455532 - 财政年份:2019
- 资助金额:
$ 120.42万 - 项目类别:
Neural and Kinematic Features of Freezing of Gait for Adaptive Neurostimulation
自适应神经刺激步态冻结的神经和运动学特征
- 批准号:
9360002 - 财政年份:2016
- 资助金额:
$ 120.42万 - 项目类别:
THE DURATION OF THERAPEUTIC EFFECT OF DEEP BRAIN STIMULATION PARKINSON'S
脑深部刺激帕金森病治疗效果的持续时间
- 批准号:
7605170 - 财政年份:2007
- 资助金额:
$ 120.42万 - 项目类别:
THE DURATION OF THERAPEUTIC EFFECT OF DEEP BRAIN STIMULATION PARKINSON'S DISEASE
脑深部刺激帕金森病治疗效果的持续时间
- 批准号:
7375206 - 财政年份:2005
- 资助金额:
$ 120.42万 - 项目类别:
THE DURATION OF THERAPEUTIC EFFECT OF DEEP BRAIN STIMULATION PARKINSON'S DISEASE
脑深部刺激帕金森病治疗效果的持续时间
- 批准号:
7202041 - 财政年份:2004
- 资助金额:
$ 120.42万 - 项目类别:
Duration of therapeutic effect of deep brain stimulation
脑深部刺激治疗效果的持续时间
- 批准号:
6980924 - 财政年份:2003
- 资助金额:
$ 120.42万 - 项目类别:
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