Institute of Neuroscience and Medicine - Brain & Behaviour (INM-7), Research Centre Juelich, Juelich, Germany.
Department of Neurosurgery, Stanford University, Stanford, California, United States.
Sci Rep. 2019 Jul 22;9(1):10585. doi: 10.1038/s41598-019-47036-4.
Adaptive deep brain stimulation (aDBS) is a closed-loop method, where high-frequency DBS is turned on and off according to a feedback signal, whereas conventional high-frequency DBS (cDBS) is delivered permanently. Using a computational model of subthalamic nucleus and external globus pallidus, we extend the concept of adaptive stimulation by adaptively controlling not only continuous, but also demand-controlled stimulation. Apart from aDBS and cDBS, we consider continuous pulsatile linear delayed feedback stimulation (cpLDF), specifically designed to induce desynchronization. Additionally, we combine adaptive on-off delivery with continuous delayed feedback modulation by introducing adaptive pulsatile linear delayed feedback stimulation (apLDF), where cpLDF is turned on and off using pre-defined amplitude thresholds. By varying the stimulation parameters of cDBS, aDBS, cpLDF, and apLDF we obtain optimal parameter ranges. We reveal a simple relation between the thresholds of the local field potential (LFP) for aDBS and apLDF, the extent of the stimulation-induced desynchronization, and the integral stimulation time required. We find that aDBS and apLDF can be more efficient in suppressing abnormal synchronization than continuous simulation. However, apLDF still remains more efficient and also causes a stronger reduction of the LFP beta burst length. Hence, adaptive on-off delivery may further improve the intrinsically demand-controlled pLDF.
自适应深度脑刺激（aDBS）是一种闭环方法，其中高频 DBS 根据反馈信号开启和关闭，而传统的高频 DBS（cDBS）则持续提供。我们使用丘脑底核和外部苍白球的计算模型，通过自适应控制不仅连续而且需求控制的刺激来扩展自适应刺激的概念。除了 aDBS 和 cDBS，我们还考虑了连续脉冲线性延迟反馈刺激（cpLDF），专门设计用于诱导去同步。此外，我们通过引入自适应脉冲线性延迟反馈刺激（apLDF）将自适应开-关输送与连续延迟反馈调制相结合，其中 cpLDF 使用预定义的幅度阈值开启和关闭。通过改变 cDBS、aDBS、cpLDF 和 apLDF 的刺激参数，我们获得了最佳的参数范围。我们揭示了 aDBS 和 apLDF 的局部场电位（LFP）阈值之间的简单关系、刺激诱导去同步的程度以及所需的积分刺激时间。我们发现，aDBS 和 apLDF 比连续模拟更有效地抑制异常同步。然而，apLDF 仍然更有效，并且还导致 LFP β爆发长度的更强降低。因此，自适应开-关输送可能会进一步改善内在需求控制的 pLDF。
