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Author Spotlight: Therapeutic Benefit of Closed-Loop Deep Brain Stimulation in Depression Treatment
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Closing the loop of deep brain stimulation.

Romain Carron1, Antoine Chaillet2, Anton Filipchuk3

  • 1Aix Marseille Université UMR 901 Marseille, France ; Institut national de la Recherche Médicale et de la Santé Inserm, INMED UMR 901 Marseille, France ; APHM, Hopital de la Timone, Service de Neurochirurgie Fonctionnelle et Stereotaxique Marseille, France.

Frontiers in Systems Neuroscience
|January 7, 2014
PubMed
Summary

High-frequency deep brain stimulation (HFS) offers a reversible functional de-afferentation for brain disorders. Closed-loop deep brain stimulation (DBS) presents promising, adaptable strategies for improved clinical outcomes in conditions like Parkinson's disease.

Keywords:
DBSantidromicclosed loopmechanismsopen loop

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Area of Science:

  • Neuroscience
  • Biomedical Engineering
  • Neurological Disorders

Background:

  • High-frequency deep brain stimulation (HFS) is a clinical tool for brain disorders, including Parkinson's disease.
  • HFS aims to alleviate symptoms by modulating hyperactive and dysrhythmic neural networks.
  • Current open-loop HFS may have limitations in achieving optimal clinical outcomes without adverse effects.

Purpose of the Study:

  • To review the mechanisms of HFS-evoked axonal spikes and their functional consequences.
  • To explore advancements in closed-loop deep brain stimulation (DBS) for improved therapeutic potential.
  • To assess current research and theoretical frameworks for closed-loop DBS strategies.

Main Methods:

  • Review of literature on HFS mechanisms, including orthodromic and antidromic spike propagation.
  • Analysis of mathematical models of basal ganglia in Parkinson's disease.
  • Classification of closed-loop DBS strategies based on control-theory techniques.

Main Results:

  • HFS induces a reversible functional de-afferentation of the stimulated nucleus.
  • Orthodromic spikes de-afferent downstream networks; antidromic spikes modulate afferent input.
  • Closed-loop DBS approaches include adaptive, on-demand, delayed, multi-site, and optimal control strategies.

Conclusions:

  • Closed-loop DBS offers potential for more refined and effective treatment of neurological disorders.
  • Theoretical advancements in closed-loop DBS require further experimental validation.
  • Optimizing DBS strategies is crucial for enhancing clinical efficacy and minimizing side effects.