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Closed loop deep brain stimulation: A systematic scoping review.

Andrea Cuschieri1, Nicole Borg1, Christian Zammit1

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Clinical Neurology and Neurosurgery
|November 10, 2022
PubMed
Summary
This summary is machine-generated.

Closed-loop deep brain stimulation (CL-DBS) shows promise for neurological and psychiatric disorders, with potential for improved energy efficiency. However, current evidence is insufficient to confirm superior clinical outcomes compared to open-loop deep brain stimulation (OL-DBS).

Keywords:
Adaptive neuromodulationClosed-loop deep brain stimulationDeep brain stimulation

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Area of Science:

  • Neuromodulation
  • Neuroscience
  • Medical Technology

Background:

  • Closed-loop deep brain stimulation (CL-DBS) integrates real-time feedback to optimize neuromodulation.
  • CL-DBS offers potential advantages over traditional open-loop deep brain stimulation (OL-DBS).
  • A review of current clinical outcomes for CL-DBS therapy is lacking.

Purpose of the Study:

  • To systematically review and characterize the clinical outcomes of CL-DBS therapy.
  • To assess the efficacy of CL-DBS in treating neurological and psychiatric disorders.
  • To evaluate the energy-saving capacity of CL-DBS systems.

Main Methods:

  • Systematic literature search of seven major databases (2011-2021).
  • Inclusion of non-randomized cohort studies, clinical trials, case reports, and non-randomized control trials.
  • Analysis of studies investigating CL-DBS for neurological and psychiatric conditions.

Main Results:

  • Seven studies met inclusion criteria, with six on neurological and one on psychiatric disorders.
  • Improvements in clinical outcomes were observed for essential tremor, major depressive disorder, and Tourette syndrome.
  • Parkinson's disease patients showed heterogeneous outcomes; CL-DBS systems demonstrated significant energy savings (avg. 51.94%) over OL-DBS.

Conclusions:

  • Insufficient evidence currently supports CL-DBS providing superior clinical outcomes to OL-DBS.
  • CL-DBS shows potential for symptom improvement in specific disorders and enhanced energy efficiency, reducing battery replacement needs.
  • Real-time symptom adjustment via CL-DBS may improve patient quality of life; further validation studies are required.