Closed-Loop Deep Brain Stimulation Is Superior in Ameliorating Parkinsonism
Continuous high-frequency deep brain stimulation (DBS) is a widely used therapy for advanced Parkinson's disease (PD) management. However, the mechanisms underlying DBS effects remain enigmatic and are the subject of an ongoing debate. Here, we present and test a closed-loop stimulation strateg...
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| Veröffentlicht in: | Neuron (Cambridge, Mass.) Mass.), 2011-10, Vol.72 (2), p.370-384 |
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| creator | Rosin, Boris Slovik, Maya Mitelman, Rea Rivlin-Etzion, Michal Haber, Suzanne N. Israel, Zvi Vaadia, Eilon Bergman, Hagai |
| description | Continuous high-frequency deep brain stimulation (DBS) is a widely used therapy for advanced Parkinson's disease (PD) management. However, the mechanisms underlying DBS effects remain enigmatic and are the subject of an ongoing debate. Here, we present and test a closed-loop stimulation strategy for PD in the 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) primate model of PD. Application of pallidal closed-loop stimulation leads to dissociation between changes in basal ganglia (BG) discharge rates and patterns, providing insights into PD pathophysiology. Furthermore, cortico-pallidal closed-loop stimulation has a significantly greater effect on akinesia and on cortical and pallidal discharge patterns than standard open-loop DBS and matched control stimulation paradigms. Thus, closed-loop DBS paradigms, by modulating pathological oscillatory activity rather than the discharge rate of the BG-cortical networks, may afford more effective management of advanced PD. Such strategies have the potential to be effective in additional brain disorders in which a pathological neuronal discharge pattern can be recognized.
► Novel DBS based on neuronal activity (closed-loop, CL-DBS) is superior to standard DBS ► Corticopallidal CL-DBS yields greater alleviation of parkinsonian akinesia ► Corticopallidal CL-DBS yields greater reduction of oscillatory neuronal discharge ► Pallidopallidal CL-DBS leads to dissociation between discharge rate and patterns |
| doi_str_mv | 10.1016/j.neuron.2011.08.023 |
| format | Article |
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► Novel DBS based on neuronal activity (closed-loop, CL-DBS) is superior to standard DBS ► Corticopallidal CL-DBS yields greater alleviation of parkinsonian akinesia ► Corticopallidal CL-DBS yields greater reduction of oscillatory neuronal discharge ► Pallidopallidal CL-DBS leads to dissociation between discharge rate and patterns</description><identifier>ISSN: 0896-6273</identifier><identifier>EISSN: 1097-4199</identifier><identifier>DOI: 10.1016/j.neuron.2011.08.023</identifier><identifier>PMID: 22017994</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Animals ; Basal Ganglia - physiopathology ; Cercopithecus aethiops ; Deep Brain Stimulation - methods ; Electrodes ; Globus Pallidus - physiopathology ; Monkeys & apes ; MPTP Poisoning - chemically induced ; MPTP Poisoning - physiopathology ; MPTP Poisoning - therapy ; Neurons - physiology ; Neurosciences ; Parkinson Disease, Secondary - chemically induced ; Parkinson Disease, Secondary - physiopathology ; Parkinson Disease, Secondary - therapy ; Parkinson's disease ; Primates ; Treatment Outcome</subject><ispartof>Neuron (Cambridge, Mass.), 2011-10, Vol.72 (2), p.370-384</ispartof><rights>2011 Elsevier Inc.</rights><rights>Copyright © 2011 Elsevier Inc. All rights reserved.</rights><rights>Copyright Elsevier Limited Oct 20, 2011</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c533t-e498185e762451bd2b960772abac158a0121599c80cc6bd735ad4b1342db749c3</citedby><cites>FETCH-LOGICAL-c533t-e498185e762451bd2b960772abac158a0121599c80cc6bd735ad4b1342db749c3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0896627311007768$$EHTML$$P50$$Gelsevier$$Hfree_for_read</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22017994$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Rosin, Boris</creatorcontrib><creatorcontrib>Slovik, Maya</creatorcontrib><creatorcontrib>Mitelman, Rea</creatorcontrib><creatorcontrib>Rivlin-Etzion, Michal</creatorcontrib><creatorcontrib>Haber, Suzanne N.</creatorcontrib><creatorcontrib>Israel, Zvi</creatorcontrib><creatorcontrib>Vaadia, Eilon</creatorcontrib><creatorcontrib>Bergman, Hagai</creatorcontrib><title>Closed-Loop Deep Brain Stimulation Is Superior in Ameliorating Parkinsonism</title><title>Neuron (Cambridge, Mass.)</title><addtitle>Neuron</addtitle><description>Continuous high-frequency deep brain stimulation (DBS) is a widely used therapy for advanced Parkinson's disease (PD) management. However, the mechanisms underlying DBS effects remain enigmatic and are the subject of an ongoing debate. Here, we present and test a closed-loop stimulation strategy for PD in the 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) primate model of PD. Application of pallidal closed-loop stimulation leads to dissociation between changes in basal ganglia (BG) discharge rates and patterns, providing insights into PD pathophysiology. Furthermore, cortico-pallidal closed-loop stimulation has a significantly greater effect on akinesia and on cortical and pallidal discharge patterns than standard open-loop DBS and matched control stimulation paradigms. Thus, closed-loop DBS paradigms, by modulating pathological oscillatory activity rather than the discharge rate of the BG-cortical networks, may afford more effective management of advanced PD. Such strategies have the potential to be effective in additional brain disorders in which a pathological neuronal discharge pattern can be recognized.
► Novel DBS based on neuronal activity (closed-loop, CL-DBS) is superior to standard DBS ► Corticopallidal CL-DBS yields greater alleviation of parkinsonian akinesia ► Corticopallidal CL-DBS yields greater reduction of oscillatory neuronal discharge ► Pallidopallidal CL-DBS leads to dissociation between discharge rate and patterns</description><subject>Animals</subject><subject>Basal Ganglia - physiopathology</subject><subject>Cercopithecus aethiops</subject><subject>Deep Brain Stimulation - methods</subject><subject>Electrodes</subject><subject>Globus Pallidus - physiopathology</subject><subject>Monkeys & apes</subject><subject>MPTP Poisoning - chemically induced</subject><subject>MPTP Poisoning - physiopathology</subject><subject>MPTP Poisoning - therapy</subject><subject>Neurons - physiology</subject><subject>Neurosciences</subject><subject>Parkinson Disease, Secondary - chemically induced</subject><subject>Parkinson Disease, Secondary - physiopathology</subject><subject>Parkinson Disease, Secondary - therapy</subject><subject>Parkinson's disease</subject><subject>Primates</subject><subject>Treatment Outcome</subject><issn>0896-6273</issn><issn>1097-4199</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2011</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNkU2LFDEQhoMo7rj6D0QaPHjqNpXPzkXYHb8WBxRWzyGdrpWM3UmbdAv-e7PM6sGDeKpAPW8VlYeQp0A7oKBeHruIW06xYxSgo31HGb9HdkCNbgUYc5_saG9Uq5jmZ-RRKUdKQUgDD8kZqxltjNiRD_spFRzbQ0pL8xpxaS6zC7G5XsO8TW4NKTZXpbneFswh5aa2Lmac6rP24tfmk8vfQiwphjI_Jg9u3FTwyV09J1_evvm8f98ePr672l8cWi85X1sUpodeolZMSBhGNhhFtWZucB5k7ygwkMb4nnqvhlFz6UYxABdsHLQwnp-TF6e5S07fNyyrnUPxOE0uYtqKNVQIw0DL_yCp4spIqOTzv8hj2nKsZ1iQwhipQPBKiRPlcyol441dcphd_mmB2lsr9mhPVuytFUt7W63U2LO74dsw4_gn9FtDBV6dAKzf9iNgtsUHjB7HkNGvdkzh3xt-AYPeneU</recordid><startdate>20111020</startdate><enddate>20111020</enddate><creator>Rosin, Boris</creator><creator>Slovik, Maya</creator><creator>Mitelman, Rea</creator><creator>Rivlin-Etzion, Michal</creator><creator>Haber, Suzanne N.</creator><creator>Israel, Zvi</creator><creator>Vaadia, Eilon</creator><creator>Bergman, Hagai</creator><general>Elsevier Inc</general><general>Elsevier Limited</general><scope>6I.</scope><scope>AAFTH</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QP</scope><scope>7QR</scope><scope>7TK</scope><scope>8FD</scope><scope>FR3</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>P64</scope><scope>RC3</scope><scope>7X8</scope></search><sort><creationdate>20111020</creationdate><title>Closed-Loop Deep Brain Stimulation Is Superior in Ameliorating Parkinsonism</title><author>Rosin, Boris ; 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Such strategies have the potential to be effective in additional brain disorders in which a pathological neuronal discharge pattern can be recognized.
► Novel DBS based on neuronal activity (closed-loop, CL-DBS) is superior to standard DBS ► Corticopallidal CL-DBS yields greater alleviation of parkinsonian akinesia ► Corticopallidal CL-DBS yields greater reduction of oscillatory neuronal discharge ► Pallidopallidal CL-DBS leads to dissociation between discharge rate and patterns</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>22017994</pmid><doi>10.1016/j.neuron.2011.08.023</doi><tpages>15</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Animals Basal Ganglia - physiopathology Cercopithecus aethiops Deep Brain Stimulation - methods Electrodes Globus Pallidus - physiopathology Monkeys & apes MPTP Poisoning - chemically induced MPTP Poisoning - physiopathology MPTP Poisoning - therapy Neurons - physiology Neurosciences Parkinson Disease, Secondary - chemically induced Parkinson Disease, Secondary - physiopathology Parkinson Disease, Secondary - therapy Parkinson's disease Primates Treatment Outcome |
| title | Closed-Loop Deep Brain Stimulation Is Superior in Ameliorating Parkinsonism |
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