Closed-loop DBS in the non-human primate model of Parkinsonism. Issue 3 (March 2016)

• Record Type: Journal Article
• Authors: Rosin, B.; Slovik, M.; Bergman, H.
• Is Part Of: Clinical neurophysiology. Volume 127:Issue 3(2016:Mar.)
• Page Start: e40
• Publication Date: 2016-03
• Subjects: Neurophysiology -- Periodicals; Electroencephalography -- Periodicals; Electromyography -- Periodicals; Neurology -- Periodicals; 612.8
• DOI: 10.1016/j.clinph.2015.11.127
• Languages: English
• ISSNs: 1388-2457

Abstract

Abstract : High-frequency deep brain stimulation (DBS) is a widely used therapy for advanced Parkinson's disease (PD) management. However, the mechanisms by which DBS exerts its alleviating effect remain to be described. Furthermore, due to its non-adaptive nature, standard DBS is not ideally suited for the treatment of this highly dynamic and progressive disorder. We have devised several closed-loop stimulation strategies for PD and tested them in the 1-methyl-4-phenyl-1, 2, 3, 6-tetrahydropyridine (MPTP) primate model of PD. These included stimulation of the internal pallidal segment (GPi) according to a predefined trigger in the ongoing neuronal activity. Application of pallido-pallidal closed-loop stimulation leads to dissociation between changes in basal ganglia (BG) discharge rates and patterns, providing insights into PD pathophysiology. Notably, 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. These results demonstrate that 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.