Sergiu Groppa, Gabriel Gonzalez-Escamilla, Gerd Tinkhauser, Halim Ibrahim Baqapuri, Bastian Sajonz, Christoph Wiest, Joana Pereira, Damian M Herz, Matthias R Dold, Manuel Bange, Dumitru Ciolac, Viviane Almeida, John Neuber, Daniela Mirzac, Juan Francisco Martín-Rodríguez, Christian Dresel, Muthuraman Muthuraman, Astrid D Adarmes Gomez, Marta Navas, Gizem Temiz, Aysegul Gunduz, Lilia Rotaru, Yaroslav Winter, Rick Schuurman, Maria F Contarino, Martin Glaser, Michael Tangermann, Albert F G Leentjens, Pablo Mir, Cristina V Torres Diaz, Carine Karachi, David E J Linden, Huiling Tan, Volker A Coenen
{"title":"Perspectives of Implementation of Closed-Loop Deep Brain Stimulation: From Neurological to Psychiatric Disorders.","authors":"Sergiu Groppa, Gabriel Gonzalez-Escamilla, Gerd Tinkhauser, Halim Ibrahim Baqapuri, Bastian Sajonz, Christoph Wiest, Joana Pereira, Damian M Herz, Matthias R Dold, Manuel Bange, Dumitru Ciolac, Viviane Almeida, John Neuber, Daniela Mirzac, Juan Francisco Martín-Rodríguez, Christian Dresel, Muthuraman Muthuraman, Astrid D Adarmes Gomez, Marta Navas, Gizem Temiz, Aysegul Gunduz, Lilia Rotaru, Yaroslav Winter, Rick Schuurman, Maria F Contarino, Martin Glaser, Michael Tangermann, Albert F G Leentjens, Pablo Mir, Cristina V Torres Diaz, Carine Karachi, David E J Linden, Huiling Tan, Volker A Coenen","doi":"10.1159/000535114","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Deep brain stimulation (DBS) is a highly efficient, evidence-based therapy to alleviate symptoms and improve quality of life in movement disorders such as Parkinson's disease, essential tremor, and dystonia, which is also being applied in several psychiatric disorders, such as obsessive-compulsive disorder and depression, when they are otherwise resistant to therapy.</p><p><strong>Summary: </strong>At present, DBS is clinically applied in the so-called open-loop approach, with fixed stimulation parameters, irrespective of the patients' clinical state(s). This approach ignores the brain states or feedback from the central nervous system or peripheral recordings, thus potentially limiting its efficacy and inducing side effects by stimulation of the targeted networks below or above the therapeutic level.</p><p><strong>Key messages: </strong>The currently emerging closed-loop (CL) approaches are designed to adapt stimulation parameters to the electrophysiological surrogates of disease symptoms and states. CL-DBS paves the way for adaptive personalized DBS protocols. This review elaborates on the perspectives of the CL technology and discusses its opportunities as well as its potential pitfalls for both clinical and research use in neuropsychiatric disorders.</p>","PeriodicalId":22078,"journal":{"name":"Stereotactic and Functional Neurosurgery","volume":" ","pages":"40-54"},"PeriodicalIF":1.9000,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Stereotactic and Functional Neurosurgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1159/000535114","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2023/12/12 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"NEUROIMAGING","Score":null,"Total":0}
引用次数: 0
Abstract
Background: Deep brain stimulation (DBS) is a highly efficient, evidence-based therapy to alleviate symptoms and improve quality of life in movement disorders such as Parkinson's disease, essential tremor, and dystonia, which is also being applied in several psychiatric disorders, such as obsessive-compulsive disorder and depression, when they are otherwise resistant to therapy.
Summary: At present, DBS is clinically applied in the so-called open-loop approach, with fixed stimulation parameters, irrespective of the patients' clinical state(s). This approach ignores the brain states or feedback from the central nervous system or peripheral recordings, thus potentially limiting its efficacy and inducing side effects by stimulation of the targeted networks below or above the therapeutic level.
Key messages: The currently emerging closed-loop (CL) approaches are designed to adapt stimulation parameters to the electrophysiological surrogates of disease symptoms and states. CL-DBS paves the way for adaptive personalized DBS protocols. This review elaborates on the perspectives of the CL technology and discusses its opportunities as well as its potential pitfalls for both clinical and research use in neuropsychiatric disorders.
期刊介绍：
''Stereotactic and Functional Neurosurgery'' provides a single source for the reader to keep abreast of developments in the most rapidly advancing subspecialty within neurosurgery. Technological advances in computer-assisted surgery, robotics, imaging and neurophysiology are being applied to clinical problems with ever-increasing rapidity in stereotaxis more than any other field, providing opportunities for new approaches to surgical and radiotherapeutic management of diseases of the brain, spinal cord, and spine. Issues feature advances in the use of deep-brain stimulation, imaging-guided techniques in stereotactic biopsy and craniotomy, stereotactic radiosurgery, and stereotactically implanted and guided radiotherapeutics and biologicals in the treatment of functional and movement disorders, brain tumors, and other diseases of the brain. Background information from basic science laboratories related to such clinical advances provides the reader with an overall perspective of this field. Proceedings and abstracts from many of the key international meetings furnish an overview of this specialty available nowhere else. ''Stereotactic and Functional Neurosurgery'' meets the information needs of both investigators and clinicians in this rapidly advancing field.
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