Neuromodulation最新文献

{"title":"Electrical Nerve Stimulation Induces Synaptic Plasticity in the Brain and the Spinal Cord: A Systematic Review.","authors":"Patricia Beltrá, Nuria Viudes-Sarrión, María José Giner, Emilio Tomás-Muñoz, Laura Pérez-Cervera, Rodrigo Martín-San Agustín, Francisco Javier Ortega, Raúl Valdesuso, Luis Suso-Martí, Alexander Binshtok, Miguel Delicado-Miralles, Enrique Velasco","doi":"10.1016/j.neurom.2025.02.008","DOIUrl":"https://doi.org/10.1016/j.neurom.2025.02.008","url":null,"abstract":"<p><strong>Objectives: </strong>This review aimed to compile the literature on synaptic plasticity induced by electrical nerve stimulation (ENS) in nociceptive and somatosensory circuits within the central nervous system, with a particular focus on its effects on both the brain and spinal cord. Understanding the mechanisms underlying synaptic changes, enhances our comprehension of how ENS contributes to both pain relief and the development of experimental pain models.</p><p><strong>Materials and methods: </strong>We conducted a systematic search of PubMed, Scopus, PEDro, SciELO, and Cochrane databases, adhering to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, and evaluated the quality of evidence using SYRCLE's risk of bias tool. The inclusion criteria were application of ENS to peripheral nerves, reporting of a detailed methodology, providing direct physiological measurements of synaptic activity (eg, field potentials or intracellular recordings), and publication in English or Spanish. From 8094 results, 85 studies met the inclusion criteria.</p><p><strong>Results: </strong>ENS was found to induce synaptic potentiation in 70 studies, depression in 7, and both effects in 8. These outcomes were determined by specific stimulation parameters and individual characteristics, with distinct molecular mechanisms involved in each case. Notably, most research focused on long-term potentiation in nociceptive pathways to create experimental pain models, with most studies conducted in the spinal cord. Few studies explored the link between ENS-induced synaptic plasticity and its analgesic effects or the role of plasticity in supraspinal brain regions, suggesting promising areas for future research.</p><p><strong>Conclusions: </strong>ENS-induced synaptic plasticity presents a valuable opportunity for both pain management and the development of experimental pain models. Further research is needed to explore the connections between plasticity, analgesia, and higher brain regions.</p>","PeriodicalId":19152,"journal":{"name":"Neuromodulation","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143803760","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Meta-analysis of Randomized Controlled Trials on the Efficacy of Sacral Neuromodulation in Chronic Constipation.","authors":"Sameh Hany Emile, Justin Dourado, Anjelli Wignakumar, Nir Horesh, Zoe Garoufalia, Rachel Gefen, Marylise Boutros, Steven D Wexner","doi":"10.1016/j.neurom.2025.03.001","DOIUrl":"https://doi.org/10.1016/j.neurom.2025.03.001","url":null,"abstract":"<p><strong>Objectives: </strong>The present systematic review aimed to assess the outcome of sacral neuromodulation (SNM) in adult patients with chronic constipation.</p><p><strong>Materials and methods: </strong>A systematic review of randomized controlled trials (RCTs) that assessed the efficacy of SNM in chronic constipation was conducted and reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 guideline. PubMed, Scopus, and Web of Science were screened from their inception through March 2024. The primary outcome was improvement in constipation and quality of life (QoL), and the secondary outcome was adverse events after treatment. The risk of bias and certainty of evidence were assessed by the risk of bias 2 tool and Grading of Recommendations Assessment, Development, and Evaluation approach.</p><p><strong>Results: </strong>Five RCTs incorporating 187 patients (93.6% female) with a median age of 42.5 years were included; 154 patients underwent SNM whereas 86 patients were crossed over to sham stimulation, and 33 received conservative treatment, amounting to a control group of 119 patients. The odds of relief of constipation after SNM were similar to those in the control group in the random-effect model (odds ratio [OR]: 1.92, 95% CI: 0.68-5.42, p = 0.217). The median percentage of reduction in the Cleveland Clinic Florida/Wexner Constipation Score was 27.9% in the SNM group vs 18.4% in the control group. No significant differences were observed in QoL. Both groups had similar odds of adverse events (OR: 2.22, 95% CI: 0.19-25.53, p = 0.521).</p><p><strong>Conclusion: </strong>Although a relatively safe treatment, SNM was not associated with any tangible improvements in either constipation or QoL.</p>","PeriodicalId":19152,"journal":{"name":"Neuromodulation","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143803766","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of Ultrasound-Guided Percutaneous Neuromodulation on Shoulder Muscle Strength in CrossFit Athletes: A Pilot Randomized Controlled Trial.","authors":"Romina Sangiacomo, Fermín Valera, Francisco Minaya-Muñoz, Alberto Carcasona-Otal, Pablo Herrero, Diego Lapuente-Hernández","doi":"10.1016/j.neurom.2025.03.072","DOIUrl":"https://doi.org/10.1016/j.neurom.2025.03.072","url":null,"abstract":"<p><strong>Background: </strong>CrossFit integrates diverse functional movements to optimize overall fitness, with muscle strength training being a core component. Ultrasound-guided percutaneous neuromodulation (US-guided PNM) has emerged as a potential adjunct to enhance muscle strength gains; however, its efficacy in the upper limb in healthy individuals remains unexplored.</p><p><strong>Objective: </strong>This study evaluated the efficacy of two US-guided PNM protocols (three sessions and one session) targeting the axillary and suprascapular nerves in improving shoulder muscle strength in healthy CrossFit athletes.</p><p><strong>Materials and methods: </strong>A pilot, randomized, controlled, single-blind clinical trial was conducted with 39 healthy CrossFit athletes randomly allocated to one of three groups: control (G1, no intervention), one session of US-guided PNM (G2), or three sessions of US-guided PNM (G3). Shoulder muscle strength was assessed using a hand-held dynamometer to measure external and internal rotation muscle strength at various shoulder positions before each treatment session (days 1, 7, and 14) and one week after the last session (day 21). Moreover, the one-repetition maximum (1RM) shoulder press exercise was evaluated on day 1 and day 21.</p><p><strong>Results: </strong>No statistically significant differences were observed among groups for any outcome. However, the within-group analysis indicated statistically significant improvements over time in the treated limbs of intervention groups (G2 and G3), whereas no statistically significant changes were observed in the control (G1) or the untreated limbs of G2 and G3. The improvements were more consistent for shoulder strength measured in the neutral position than at 90° abduction.</p><p><strong>Conclusions: </strong>Although US-guided PNM did not yield significantly greater improvements than did the control group, both one and three sessions targeting the axillary and suprascapular nerves enhanced rotational shoulder muscle strength in treated limbs and 1RM shoulder press performance. These findings should be interpreted with caution, and further investigation is warranted, particularly in populations with lower baseline strength and in exploring varied application parameters to optimize efficacy.</p><p><strong>Clinical trial registration: </strong>The Clinicaltrials.gov registration number for the study is NCT06529770.</p>","PeriodicalId":19152,"journal":{"name":"Neuromodulation","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143780726","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Computational Optimization of Spinal Cord Stimulation for Dorsal Horn Interneuron Polarization.","authors":"Adantchede Louis Zannou, Mojtaba Belali Koochesfahani, Gabriel Gaugain, Denys Nikolayev, Marc Russo, Marom Bikson","doi":"10.1016/j.neurom.2025.01.015","DOIUrl":"https://doi.org/10.1016/j.neurom.2025.01.015","url":null,"abstract":"<p><strong>Objectives: </strong>The proposed mechanisms of spinal cord stimulation (SCS) follow the polarization of dorsal column axons; however, the development of subparesthesia SCS has encouraged the consideration of different targets. Given their relative proximity to the stimulation electrodes and their role in pain processing (eg, synaptic processing and gate control theory), spinal cord dorsal horn interneurons may be attractive stimulation targets.</p><p><strong>Materials and methods: </strong>We developed a computational modeling pipeline termed \"quasiuniform-mirror assumption\" and applied it to predict polarization of dorsal horn interneuron cell types (islet type, central type, stellate/radial, vertical-like) to SCS. The quasiuniform-mirror assumption allows the prediction of the peak and directional axes of dendrite polarization for each cell type and location in the dorsal horn, in addition to the impact of the stimulation pulse width and electrode configuration.</p><p><strong>Results: </strong>For long pulses, the peak polarization per milliampere of SCS with a spaced bipolar configuration was islet type 3.5mV, central type 1.3mV, stellate/radial 1.4mV, and vertical-like 1.6mV. For stellate/radial, the peak dendrite polarization was dorsal-ventral, and for islet-type, the peak dendrite polarization was in the rostral-caudal axis. For islet type and central type cells, peak dendrite polarization was between stimulation electrodes, whereas for stellate/radial and vertical-like cells, peak dendrite polarization was under the stimulation electrodes. The impact of the pulse width depends on the membrane time constants. Assuming a 1-millisecond time constant, for a 1-millisecond or 100-μs pulse width, the peak dendrite polarization decreases (from direct current values) by approximately 33% and approximately 88%, respectively. Increasing the interelectrode distance beyond approximately 3 cm did not significantly increase the peak polarization but expanded the region of interneuron polarization.</p><p><strong>Conclusions: </strong>Predicted maximum polarization of islet-cells in the superficial dorsal horn at locations between electrodes is 4.6mV for 2 mA, 1-millisecond pulse SCS. A polarization of a few millivolts is sufficient to modulate synaptic processing through subthreshold mechanisms. Our simulations provide support for SCS approaches optimized to modulate the dendrites of dorsal horn neurons.</p>","PeriodicalId":19152,"journal":{"name":"Neuromodulation","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143780723","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adverse Events Associated With Peripheral Nerve Stimulation: An Analysis of the MAUDE Data base and Implications for Pain and Spine Clinicians.","authors":"Amanda N Cooper, Hasan Sen, Napatpaphan Kanjanapanang, Kristen Saad, Garret Wahl, Matthew Essman, Alexandra E Fogarty, Taylor Burnham, Aaron M Conger, Zachary L McCormick, Allison Glinka Przybysz, Chase Young","doi":"10.1016/j.neurom.2025.02.002","DOIUrl":"https://doi.org/10.1016/j.neurom.2025.02.002","url":null,"abstract":"<p><strong>Of background data: </strong>The use of peripheral nerve stimulation (PNS) devices within pain and spine-related care has increased significantly in recent years. The United States Food and Drug Administration (FDA)-approved indications for PNS have expanded rapidly with technologic advances and randomized controlled trials demonstrating its efficacy. Analysis of real-world data regarding the complications associated with PNS can help inform clinical decision-making and patient counseling as the use of this neuromodulation therapy continues to evolve.</p><p><strong>Objectives: </strong>This study aimed to categorize adverse events (AEs) described in medical device reports (MDRs) within the FDA Manufacturer and User Facility Device Experience (MAUDE) data base related to the use of PNS for pain and spinal indications.</p><p><strong>Materials and methods: </strong>A comprehensive search within the MAUDE data base was conducted to identify AEs related to FDA-approved PNS devices reported between January 1, 2023 and December 31, 2023, specifically to capture AEs related to current PNS technology in clinical use. AEs were manually categorized according to event descriptions.</p><p><strong>Results: </strong>We identified 594 unique MDRs associated with the five PNS devices currently approved by the FDA for use in the spine. While most MDRs (77.1%) did not specify lead location, spinal lead placements were implicated in 9.1% of cases, and appendicular lead placement accounted for 13.8%. Infection (22.7%), migration (14.7%), and skin erosion (9.4%) were the most common AEs reported. Most entries were categorized as device-related (40.1%) or procedural AEs (32.7%), and the remainder as patient complaints (17.3%), serious AEs (1.0%), and \"other\" complications (6.1%). Most complications were managed with explantations (43.8%) rather than revisions (29.5%).</p><p><strong>Discussion/conclusion: </strong>New technologies and their applications must be regularly evaluated for safety and effectiveness. Our analysis of the MAUDE data base revealed that infection, lead migration, and skin erosion were the most commonly reported AEs associated with the use of PNS technology during 2023. Most AEs were deemed to be device- or procedure-related.</p>","PeriodicalId":19152,"journal":{"name":"Neuromodulation","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143772944","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Novel Closed-Loop Electrical Brain Stimulation Device Featuring Wireless Low-Energy Ultrasound Power and Communication","authors":"Joseph S. Neimat MD, MS ,&nbsp;Robert W. Bina MD, MS ,&nbsp;Steven C. Koenig PhD ,&nbsp;Emrecan Demirors PhD ,&nbsp;Raffaele Guida PhD ,&nbsp;Ryan Burke PhD ,&nbsp;Tommaso Melodia PhD ,&nbsp;Jorge Jimenez PhD","doi":"10.1016/j.neurom.2024.02.008","DOIUrl":"10.1016/j.neurom.2024.02.008","url":null,"abstract":"<div><h3>Objectives</h3><div>This study aimed to indicate the feasibility of a prototype electrical neuromodulation system using a closed-loop energy-efficient ultrasound-based mechanism for communication, data transmission, and recharging.</div></div><div><h3>Materials and Methods</h3><div><span>Closed-loop deep brain stimulation (DBS) prototypes were designed and fabricated with ultrasonic wideband (UsWB) communication technology and miniaturized custom electronics. Two devices were implanted short term in anesthetized Göttingen minipigs (</span><em>N</em><span> = 2). Targeting was performed using preoperative magnetic resonance imaging, and locations were confirmed postoperatively by computerized tomography<span>. DBS systems were tested over a wide range of stimulation settings to mimic minimal, typical, and/or aggressive clinical settings, and evaluated for their ability to transmit data through scalp tissue and to recharge the DBS system using UsWB.</span></span></div></div><div><h3>Results</h3><div>Stimulation, communication, reprogramming, and recharging protocols were successfully achieved in both subjects for amplitude (1V–6V), frequency (50–250 Hz), and pulse width (60–200 μs) settings and maintained for ≥six hours. The precision of pulse settings was verified with &lt;5% error. Communication rates of 64 kbit/s with an error rate of 0.05% were shown, with no meaningful throughput degradation observed. Time to recharge to 80% capacity was &lt;9 minutes. Two DBS systems also were implanted in the second test animal, and independent bilateral stimulation was successfully shown.</div></div><div><h3>Conclusions</h3><div><span><span>The system performed at clinically relevant implant depths and settings. Independent bilateral stimulation for the duration of the study with a 4F energy storage and full rapid recharge were achieved. Continuous function extrapolates to six days of continuous stimulation in future design iterations implementing </span>application specific integrated circuit </span>level efficiency<span> and 15F storage capacitance. UsWB increases energy efficiency, reducing storage requirements and thereby enabling device miniaturization. The device can enable intelligent closed-loop stimulation, remote system monitoring, and optimization and can serve as a power/data gateway to interconnect the intrabody network with the Internet of Medical Things.</span></div></div>","PeriodicalId":19152,"journal":{"name":"Neuromodulation","volume":"28 3","pages":"Pages 455-463"},"PeriodicalIF":3.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141180266","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Systematic Review of Experimental Deep Brain Stimulation in Rodent Models of Epilepsy","authors":"Rafi Matin HBSc ,&nbsp;Kristina Zhang BMSc ,&nbsp;George M. Ibrahim MD, PhD ,&nbsp;Flavia Venetucci Gouveia PhD","doi":"10.1016/j.neurom.2024.11.001","DOIUrl":"10.1016/j.neurom.2024.11.001","url":null,"abstract":"<div><h3>Objectives</h3><div>Deep brain stimulation (DBS) is an established neuromodulatory technique for treating drug-resistant epilepsy. Despite its widespread use in carefully selected patients, the mechanisms underlying the antiseizure effects of DBS remain unclear. Herein, we provide a detailed overview of the current literature pertaining to experimental DBS in rodent models of epilepsy and identify relevant trends in this field.</div></div><div><h3>Materials and Methods</h3><div>A systematic review was conducted using the PubMed MEDLINE database, following PRISMA guidelines. Data extraction focused on study characteristics, including stimulation protocol, seizure and behavioral outcomes, and reported mechanisms of action.</div></div><div><h3>Results</h3><div>Of the 1788 resultant articles, 164 were included. The number of published articles has grown exponentially in recent decades. Most studies used chemically or electrically induced models of epilepsy. DBS targeting the anterior nucleus of the thalamus, hippocampal formation, or amygdala was most extensively studied. Effective stimulation parameters were identified, and novel stimulation designs were explored, such as closed-loop and unstructured stimulation approaches. Common mechanisms included synaptic modulation through the depression of excitatory neurotransmission and inhibitory release of GABA. At the network level, antiseizure effects were associated with the desynchronization of neural networks, characterized by decreased low-frequency oscillations.</div></div><div><h3>Conclusions</h3><div>Rodent models have significantly advanced the understanding of disease pathophysiology and the development of novel therapies. However, fundamental questions remain regarding DBS mechanisms, optimal targets, and parameters. Further research is necessary to improve DBS therapy and tailor treatment to individual patient circumstances.</div></div>","PeriodicalId":19152,"journal":{"name":"Neuromodulation","volume":"28 3","pages":"Pages 401-413"},"PeriodicalIF":3.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142786257","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Modulation of Local Field Potentials in the Deep Brain of Minipigs Through Transcranial Temporal Interference Stimulation","authors":"Hsiao-Chun Lin PhD ,&nbsp;Yi-Hui Wu PhD ,&nbsp;Ming-Dou Ker PhD","doi":"10.1016/j.neurom.2024.10.002","DOIUrl":"10.1016/j.neurom.2024.10.002","url":null,"abstract":"<div><h3>Objectives</h3><div>Transcranial temporal interference stimulation (tTIS) is a novel, noninvasive neuromodulation technique to modulate deep brain neural activity. Despite its potential, direct electrophysiological evidence of tTIS effects remains limited. This study investigates the impact of tTIS on local field potentials (LFPs) in the deep brain using minipigs implanted with deep brain electrodes.</div></div><div><h3>Materials and Methods</h3><div>Three minipigs were implanted with electrodes in the subthalamic nucleus, and tTIS was applied using patch electrode pairs positioned on both sides of the scalp. Stimulation was delivered in sinewave voltage mode with intensities ≤2V. We evaluated the stimulus-response relationship, effects of different carrier frequencies, the range of entrained envelope oscillations, and changes resulting from adjusting the left-right stimulation intensity ratio.</div></div><div><h3>Results</h3><div>The results indicated that tTIS modulates deep-brain LFPs in an intensity-dependent manner. Carrier frequencies of 1 or 2 kHz were most effective in influencing LFP. Envelope oscillations &lt;200 Hz were effectively entrained into deep-brain LFPs. Adjustments to the stimulation intensity ratio between the left and right sides yielded inconsistent responses, with right-sided stimulation playing a dominant role.</div></div><div><h3>Conclusion</h3><div>These findings indicate that tTIS can regulate LFP changes in the deep brain, highlighting its potential as a promising tool for future noninvasive neuromodulation applications.</div></div>","PeriodicalId":19152,"journal":{"name":"Neuromodulation","volume":"28 3","pages":"Pages 434-443"},"PeriodicalIF":3.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142624302","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinically Implemented Sensing-Based Initial Programming of Deep Brain Stimulation for Parkinson’s Disease: A Retrospective Study","authors":"Bart E.K.S. Swinnen MD, PhD ,&nbsp;Andrea Fuentes MD ,&nbsp;Monica M. Volz FNP, MSN ,&nbsp;Susan Heath ,&nbsp;Philip A. Starr MD, PhD ,&nbsp;Simon J. Little MD, PhD ,&nbsp;Jill L. Ostrem MD","doi":"10.1016/j.neurom.2024.11.002","DOIUrl":"10.1016/j.neurom.2024.11.002","url":null,"abstract":"<div><h3>Objectives</h3><div>Initial deep brain stimulation (DBS) programming using a monopolar review is time-consuming, subjective, and burdensome. Incorporating neurophysiology has the potential to expedite, objectify, and automatize initial DBS programming. We aimed to assess the feasibility and performance of clinically implemented sensing-based initial DBS programming for Parkinson’s disease (PD).</div></div><div><h3>Materials and Methods</h3><div>We conducted a single-center retrospective study in 15 patients with PD (25 hemispheres) implanted with a sensing-enabled neurostimulator in whom initial subthalamic nucleus/globus pallidus pars interna DBS programming was guided by beta power in real-time local field potential recordings, instead of a monopolar review.</div></div><div><h3>Results</h3><div>The initial sensing-based programming visit lasted on average 42.2 minutes (SD 18) per hemisphere. During the DBS optimization phase, a conventional monopolar clinical review was not required in any patients. The initial stimulation contact level remained the same at the final follow-up visit in all hemispheres except three. The final amplitude was on average 0.8 mA (SD 0.9) higher than initially set after the original sensing-based programming visit. One year after surgery, off-medication International Parkinson and Movement Disorder Society Unified Parkinson’s Disease Rating Scale (MDS-UPDRS) III total score, tremor subscore, MDS-UPDRS IV, and levodopa-equivalent dose improved by 47.0% (<em>p</em> &lt; 0.001), 77.7% (<em>p</em> = 0.001), 51.1% (<em>p</em> = 0.006), and 44.8% (<em>p</em> = 0.011) compared with preoperatively using this approach.</div></div><div><h3>Conclusions</h3><div>This study shows that sensing-based initial DBS programming for PD is feasible and rapid, and selected clinically effective contacts in most patients, including those with tremor. Technologic innovations and practical developments could improve sensing-based programming.</div></div>","PeriodicalId":19152,"journal":{"name":"Neuromodulation","volume":"28 3","pages":"Pages 501-510"},"PeriodicalIF":3.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142770558","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Closed-Loop Deep Brain Stimulation Platform for Translational Research","authors":"Yan Li MEng ,&nbsp;Yingnan Nie PhD ,&nbsp;Xiao Li PhD ,&nbsp;Xi Cheng MCS ,&nbsp;Guanyu Zhu MD ,&nbsp;Jianguo Zhang MD ,&nbsp;Zhaoyu Quan PhD ,&nbsp;Shouyan Wang PhD","doi":"10.1016/j.neurom.2024.10.012","DOIUrl":"10.1016/j.neurom.2024.10.012","url":null,"abstract":"<div><h3>Objective</h3><div>This study aims to facilitate the translation of innovative closed-loop deep brain stimulation (DBS) strategies from theory to practice by establishing a research platform. The platform addresses the challenges of real-time stimulation artifact removal, low-latency feedback stimulation, and rapid translation from animal to clinical experiments.</div></div><div><h3>Materials and Methods</h3><div>The platform comprises hardware for neural sensing and stimulation, a closed-loop software framework for real-time data streaming and computation, and an algorithm library for implementing closed-loop DBS strategies. The platform integrates hardware for both animal and clinical research. The closed-loop software framework handles the entire closed-loop stimulation, including data streaming, stimulation artifact removal, preprocessing, a closed-loop stimulation strategy, and stimulation control. It provides a unified programming interface for both C/C++ and Python, enabling secondary development to integrate new closed-loop stimulation strategies. Additionally, the platform includes an algorithm library with signal processing and machine learning methods to facilitate the development of new closed-loop DBS strategies.</div></div><div><h3>Results</h3><div>The platform can achieve low-latency feedback stimulation control with response times of 6.23 ± 0.85 ms and 6.95 ± 1.11 ms for animal and clinical experiments, respectively. It effectively removed stimulation artifacts and demonstrated flexibility in implementing new closed-loop DBS algorithms. The platform has integrated several typical closed-loop protocols, including threshold-adaptive DBS, amplitude-modulation DBS, dual-threshold DBS and neural state–dependent DBS.</div></div><div><h3>Conclusions</h3><div>This work provides a research tool for rapidly deploying innovative closed-loop strategies for translational research in both animal and clinical studies. The platform’s capabilities in real-time data processing and low-latency control represent a significant advancement in translational DBS research, with potential implications for the development of more effective therapeutic interventions.</div></div>","PeriodicalId":19152,"journal":{"name":"Neuromodulation","volume":"28 3","pages":"Pages 464-471"},"PeriodicalIF":3.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142828726","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}