Τίτλος:
Dominant efficiency of nonregular patterns of subthalamic nucleus deep
brain stimulation for Parkinson's disease and obsessive-compulsive
disorder in a data-driven computational model
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
Objective. Almost 30 years after the start of the modern era of deep
brain stimulation (DBS), the subthalamic nucleus (STN) still constitutes
a standard stimulation target for advanced Parkinson's disease (PD), but
the use of STN-DBS is also now supported by level I clinical evidence
for treatment-refractory obsessive-compulsive disorder (OCD). Disruption
of neural synchronization in the STN has been suggested as one of the
possible mechanisms of action of standard and alternative patterns of
STN-DBS at a local level. Meanwhile, recent experimental and
computational modeling evidence has signified the efficiency of
alternative patterns of stimulation; however, no indications exist for
treatment-refractory OCD. Here, we comparatively simulate the
desynchronizing effect of standard (regular at 130 Hz) versus temporally
alternative (in terms of frequency, temporal variability and the
existence of bursts or pauses) patterns of STN-DBS for PD and OCD, by
means of a stochastic dynamical model and two microelectrode recording
(MER) datasets. Approach. The stochastic model is fitted to subthalamic
MERs acquired during eight surgical interventions for PD and eight
surgical interventions for OCD. For each dynamical system simulated, we
comparatively assess the invariant density (steady-state phase
distribution) as a measure inversely related to the desynchronizing
effect yielded by the applied patterns of stimulation. Main results. We
demonstrate that high (130 Hz)-and low (80 Hz)-frequency irregular
patterns of stimulation, and low-frequency periodic stimulation
interrupted by bursts of pulses, yield in both pathologic conditions a
significantly stronger desynchronizing effect compared with standard
STN-DBS, and distinct alternative patterns of stimulation. In PD, values
of the invariant density measure are proven to be optimal at the
dorsolateral oscillatory region of the STN including sites with the
optimal therapeutic window. Significance. In addition to providing novel
insights into the efficiency of low-frequency nonregular patterns of
STN-DBS for advanced PD and treatment-refractory OCD, this work points
to a possible correlation of a model-based outcome measure with clinical
effectiveness of stimulation and may have significant implications for
an energy-and therapeutically-efficient configuration of a closed-loop
neuromodulation system.
Συγγραφείς:
Karamintziou, Sofia D.
Deligiannis, Nick G.
Piallat, Brigitte
and Polosan, Mircea
Chabardes, Stephan
David, Olivier and
Stathis, Pantelis G.
Tagaris, George A.
Boviatsis, Efstathios J.
and Sakas, Damianos E.
Polychronaki, Georgia E.
Tsirogiannis,
George L.
Nikita, Konstantina S.
Περιοδικό:
Journal of Neural Engineering
Εκδότης:
IOP Publishing Ltd
Λέξεις-κλειδιά:
subthalamic nucleus deep brain stimulation (STN-DBS); Parkinson's
disease (PD); obsessive-compulsive disorder (OCD); temporally
alternative patterns; stochastic dynamical model; microelectrode
recordings (MERs)
DOI:
10.1088/1741-2560/13/1/016013
