- Title Information
- Title
- Behavioral Closed-Loop Deep Brain Stimulation for Parkinson’s Disease
- Type of Resource
- text
- Name:
Personal
- Name Part
- Amaya, Daniel
- Role
- Role Term:
Text
- creator
- Name:
Personal
- Name Part
- Frank, Michael
- Role
- Role Term:
Text
- Reader
- Name:
Personal
- Name Part
- Borton, David
- Role
- Role Term:
Text
- Reader
- Name:
Corporate
- Name Part
- Brown University. Department of Molecular Pharmacology, Physiology and Biotechnology
- Role
- Role Term:
Text
- sponsor
- Origin Information
- Copyright Date
- 2019
- Physical Description
- Extent
- , None p.
- digitalOrigin
- born digital
- Note:
thesis
- Thesis (Sc. M.)--Brown University, 2019
- Genre (aat)
- theses
- Abstract
- Objective: Deep brain stimulation (DBS) has become a widely adopted treatment for the advanced progression of Parkinson’s disease (PD) and is thought to modulate the balance of activity between the direct and indirect pathways of the basal ganglia. However, the current implementation of DBS is “Open-Loop” meaning stimulation is always being delivered, irrespective of the patient’s condition and/or state of symptoms. To counter this, we delivered stimulation by closing the loop between the patient’s DBS system and their current behavioral state. By delivering “Closed-Loop” stimulation, we can potentially show which set of parameters can push or pull a patient’s behavioral state from being more or less symptomatic through the modulation of the direct and indirect pathway of the basal ganglia.
Methods: We tested “Closed-Loop” stimulation of the subthalamic nucleus (STN) and substantia nigra pars reticulata (SNr) in 6 PD patients as they engaged in our task, with 6 controls recruited as comparison. Our platform consisted of an external assessment of patient behavior where performance was then translated into stimulation control decisions that allowed for rapid modification of individual stimulation parameters such as voltage, frequency and contact location. Results compared behavioral performance at both the clinically therapeutic contact and the deepest implanted contact closest to the SNr.
Results: We found significant difference in patient performance using the deepest implanted contact. Specifically high and low frequency stimulation at the deepest contact decreased motor performance in comparison to the same stimulation at the therapeutic contact (p<0.01). Lastly low frequency stimulation at the deepest contact, in comparison to high frequency, improved motor performance among patients showing nearly significant difference between the two parameters (p=0.066).
Conclusions: These results suggest that stimulation of the deepest contact at lower frequencies may in fact be more beneficial than high frequency at that location. Additionally, low frequency activation of both the SNr and STN in the direct and indirect pathways may work synergistically to improve patient behavior.
- Subject (fast)
(authorityURI="http://id.worldcat.org/fast", valueURI="http://id.worldcat.org/fast/01053693")
- Topic
- Parkinson's disease
- Subject
- Topic
- Deep Brain Stimulation
- Subject
- Topic
- Closed-Loop
- Subject (fast)
(authorityURI="http://id.worldcat.org/fast", valueURI="http://id.worldcat.org/fast/00827886")
- Topic
- Basal ganglia--Diseases
- Language
- Language Term (ISO639-2B)
- English
- Record Information
- Record Content Source (marcorg)
- RPB
- Record Creation Date
(encoding="iso8601")
- 20190603
- Identifier:
DOI
- 10.26300/q51r-sg72
- Access Condition:
rights statement
(href="http://rightsstatements.org/vocab/InC/1.0/")
- In Copyright
- Access Condition:
restriction on access
- Collection is open for research.