PMID- 37148553
OWN - NLM
STAT- MEDLINE
DCOM- 20230724
LR  - 20230725
IS  - 1531-8257 (Electronic)
IS  - 0885-3185 (Linking)
VI  - 38
IP  - 6
DP  - 2023 Jun
TI  - Adaptive Deep Brain Stimulation: From Experimental Evidence Toward Practical 
      Implementation.
PG  - 937-948
LID - 10.1002/mds.29415 [doi]
AB  - Closed-loop adaptive deep brain stimulation (aDBS) can deliver individualized 
      therapy at an unprecedented temporal precision for neurological disorders. This 
      has the potential to lead to a breakthrough in neurotechnology, but the 
      translation to clinical practice remains a significant challenge. Via 
      bidirectional implantable brain-computer-interfaces that have become commercially 
      available, aDBS can now sense and selectively modulate pathophysiological brain 
      circuit activity. Pilot studies investigating different aDBS control strategies 
      showed promising results, but the short experimental study designs have not yet 
      supported individualized analyses of patient-specific factors in biomarker and 
      therapeutic response dynamics. Notwithstanding the clear theoretical advantages 
      of a patient-tailored approach, these new stimulation possibilities open a vast 
      and mostly unexplored parameter space, leading to practical hurdles in the 
      implementation and development of clinical trials. Therefore, a thorough 
      understanding of the neurophysiological and neurotechnological aspects related to 
      aDBS is crucial to develop evidence-based treatment regimens for clinical 
      practice. Therapeutic success of aDBS will depend on the integrated development 
      of strategies for feedback signal identification, artifact mitigation, signal 
      processing, and control policy adjustment, for precise stimulation delivery 
      tailored to individual patients. The present review introduces the reader to the 
      neurophysiological foundation of aDBS for Parkinson's disease (PD) and other 
      network disorders, explains currently available aDBS control policies, and 
      highlights practical pitfalls and difficulties to be addressed in the upcoming 
      years. Finally, it highlights the importance of interdisciplinary clinical 
      neurotechnological research within and across DBS centers, toward an 
      individualized patient-centered approach to invasive brain stimulation. (c) 2023 
      The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of 
      International Parkinson and Movement Disorder Society.
CI  - (c) 2023 The Authors. Movement Disorders published by Wiley Periodicals LLC on 
      behalf of International Parkinson and Movement Disorder Society.
FAU - Neumann, Wolf-Julian
AU  - Neumann WJ
AUID- ORCID: 0000-0002-6758-9708
AD  - Movement Disorder and Neuromodulation Unit, Department of Neurology, 
      Charite-Universitatsmedizin Berlin, Berlin, Germany.
FAU - Gilron, Roee
AU  - Gilron R
AD  - Rune Labs, San Francisco, California, USA.
FAU - Little, Simon
AU  - Little S
AD  - Movement Disorders and Neuromodulation Centre, University of California San 
      Francisco, San Francisco, California, USA.
FAU - Tinkhauser, Gerd
AU  - Tinkhauser G
AUID- ORCID: 0000-0002-1954-1873
AD  - Department of Neurology, Bern University Hospital and University of Bern, Bern, 
      Switzerland.
LA  - eng
GR  - K23 NS120037/NS/NINDS NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
PT  - Research Support, Non-U.S. Gov't
PT  - Review
DEP - 20230506
PL  - United States
TA  - Mov Disord
JT  - Movement disorders : official journal of the Movement Disorder Society
JID - 8610688
SB  - IM
MH  - Humans
MH  - *Deep Brain Stimulation/methods
MH  - *Parkinson Disease/therapy
MH  - Neurophysiology
OTO - NOTNLM
OT  - Parkinson's disease
OT  - adaptive DBS
OT  - basal ganglia
OT  - closed loop DBS
OT  - local field potentials
EDAT- 2023/05/06 19:42
MHDA- 2023/07/24 06:42
CRDT- 2023/05/06 15:36
PHST- 2023/03/27 00:00 [revised]
PHST- 2022/07/21 00:00 [received]
PHST- 2023/04/05 00:00 [accepted]
PHST- 2023/07/24 06:42 [medline]
PHST- 2023/05/06 19:42 [pubmed]
PHST- 2023/05/06 15:36 [entrez]
AID - 10.1002/mds.29415 [doi]
PST - ppublish
SO  - Mov Disord. 2023 Jun;38(6):937-948. doi: 10.1002/mds.29415. Epub 2023 May 6.