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Controlling Parkinson's Disease With Adaptive Deep Brain Stimulation
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Multivariable closed-loop control of deep brain stimulation for Parkinson's disease.

John E Fleming1,2, Sageanne Senneff1, Madeleine M Lowery1

  • 1Neuromuscular Systems Laboratory, UCD School of Electrical & Electronic Engineering, University College Dublin, Dublin, Ireland.

Journal of Neural Engineering
|September 21, 2023
PubMed
Summary

This study introduces a new multivariable control system for deep brain stimulation (DBS) in Parkinson's disease (PD). It effectively controls tremor and beta activity while preventing side effects and saving power.

Keywords:
Parkinson’s diseaseadaptivebeta-band activityclosed-loop deep brain stimulationcomputational modelproportional-integral controllertremor-band activity

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Area of Science:

  • Neuroscience
  • Biomedical Engineering
  • Control Systems

Background:

  • Current closed-loop deep brain stimulation (DBS) for Parkinson's disease (PD) typically controls a single biomarker, leading to suboptimal regulation for uncorrelated symptoms or varying biomarker-symptom relationships.
  • The control of stimulation-induced side effects is often not addressed in existing DBS methods.

Purpose of the Study:

  • To present a multivariable control architecture for selectively suppressing tremor or subthalamic nucleus beta band oscillations in PD.
  • To modulate DBS pulse amplitude and duration to maintain amplitude below a threshold, avoiding stimulation of distal axons and associated side effects.
  • To investigate a computational model of the PD motor network to simulate the proposed control architecture.

Main Methods:

  • A multivariable control architecture was developed, modulating DBS pulse amplitude and duration.
  • A supervisor controller selected between tremor or beta activity control based on detected muscle electromyographic (EMG) activity.
  • A secondary controller limited pulse amplitude and modulated pulse duration to target smaller diameter axons, preventing side effects.

Main Results:

  • The system achieved good control of both rest tremor and beta activity, with reduced power consumption compared to open-loop stimulation.
  • The supervisor controller prevented over- or under-stimulation issues encountered with single-biomarker controllers.
  • When DBS amplitude was limited, the secondary controller maintained stimulation efficacy by adjusting pulse duration, demonstrating dual-parameter control benefits.

Conclusions:

  • Non-linear multivariable control offers targeted suppression of motor symptoms in PD patients.
  • Dual-parameter control enables automatic regulation of DBS therapeutic dosage, preventing overstimulation and improving power efficiency.