Herron Jeffrey, Kullmann Aura, Denison Timothy, Goodman Wayne K, Gunduz Aysegul, Neumann Wolf-Julian, Provenza Nicole R, Shanechi Maryam M, Sheth Sameer A, Starr Philip A, Widge Alik S
Department of Neurological Surgery, University of Washington, Seattle, WA, USA.
NeuroOne Medical Technologies Corporation, Eden Prairie, MN, USA.
Nat Biomed Eng. 2025 May;9(5):606-617. doi: 10.1038/s41551-024-01314-3. Epub 2024 Dec 27.
Deep brain stimulation (DBS), a proven treatment for movement disorders, also holds promise for the treatment of psychiatric and cognitive conditions. However, for DBS to be clinically effective, it may require DBS technology that can alter or trigger stimulation in response to changes in biomarkers sensed from the patient's brain. A growing body of evidence suggests that such adaptive DBS is feasible, it might achieve clinical effects that are not possible with standard continuous DBS and that some of the best biomarkers are signals from the cerebral cortex. Yet capturing those markers requires the placement of cortex-optimized electrodes in addition to standard electrodes for DBS. In this Perspective we argue that the need for cortical biomarkers in adaptive DBS and the unfortunate convergence of regulatory and financial factors underpinning the unavailability of cortical electrodes for chronic uses threatens to slow down or stall research on adaptive DBS and propose public-private partnerships as a potential solution to such a critical technological gap.
深部脑刺激（DBS）是一种已被证实的治疗运动障碍的方法，对精神疾病和认知疾病的治疗也有前景。然而，要使DBS具有临床疗效，可能需要能够根据从患者大脑感知到的生物标志物变化来改变或触发刺激的DBS技术。越来越多的证据表明，这种适应性DBS是可行的，它可能实现标准连续DBS无法达到的临床效果，并且一些最佳的生物标志物是来自大脑皮层的信号。然而，要捕捉这些标志物，除了用于DBS的标准电极外，还需要放置经过皮层优化的电极。在这篇观点文章中，我们认为适应性DBS中对皮层生物标志物的需求，以及监管和财务因素的不幸共同作用导致皮层电极无法用于长期使用，这有可能减缓或阻碍适应性DBS的研究，并提出公私合作作为解决这一关键技术差距的潜在方案。
