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通过预测局部场电位中的β波爆发来改进帕金森病患者的闭环深部脑刺激模式。

Predicting beta bursts from local field potentials to improve closed-loop DBS paradigms in Parkinson's patients.

作者信息

Moraud Eduardo Martin, Tinkhauser Gerd, Agrawal Mayank, Brown Peter, Bogacz Rafal

出版信息

Annu Int Conf IEEE Eng Med Biol Soc. 2018 Jul;2018:3766-3796. doi: 10.1109/EMBC.2018.8513348.

Abstract

Motor symptoms in Parkinson's disease (PD) correlate with an excess in synchrony in the beta frequency band (13-30Hz) of local field potentials recorded from basal ganglia circuits. Recent results have suggested that this abnormal activity arises as a result of changes in specific dynamical features of the underlying neural signatures. In particular, patterns of activity in the beta band have been shown to be structured in bursts of longer durations and higher amplitudes in untreated patients with PD. Closed-loop deep brain stimulation (DBS) paradigms that specifically target these pathological bursts of activity hold promises to help trim, and thus normalize, their abnormal behavior in real-time. Here, we developed classification algorithms that predict pathological beta bursts based on ongoing changes in LFP frequency dynamics. We then compared simulations of prediction-based DBS profiles with existing 'adaptive DBS' alternatives. We show that model-driven stimulation profiles are more precise in restricting the delivery of stimulation to bursts that are considered pathological, while preserving physiological ones. The overall stimulation time required is also diminished, thus supporting longer battery life. These results represent a conceptual and algorithmic framework for the development of more precise DBS strategies that are selectively tailored to the electrophysiological profile of each patient.

摘要

帕金森病(PD)的运动症状与从基底神经节回路记录的局部场电位在β频段(13 - 30Hz)的同步性过高相关。最近的研究结果表明,这种异常活动是由潜在神经信号的特定动态特征变化引起的。特别是,在未经治疗的PD患者中,β频段的活动模式已被证明以持续时间更长、幅度更高的爆发形式存在。专门针对这些病理性活动爆发的闭环深部脑刺激(DBS)模式有望实时帮助调整并使其异常行为正常化。在此,我们开发了基于局部场电位(LFP)频率动态的持续变化来预测病理性β爆发的分类算法。然后,我们将基于预测的DBS模式模拟与现有的“自适应DBS”方案进行了比较。我们表明,模型驱动的刺激模式在将刺激传递限制于被认为是病理性的爆发,同时保留生理性爆发方面更为精确。所需的总体刺激时间也减少了,从而延长了电池寿命。这些结果代表了一个概念和算法框架,用于开发更精确的DBS策略,这些策略是根据每个患者的电生理特征进行选择性定制的。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/af61/6277014/ce9575cc5139/emss-80406-f001.jpg

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