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Closed-Loop Deep Brain Stimulation Is Superior in Ameliorating Parkinsonism

Neuron (Cambridge, Mass.), 2011-10, Vol.72 (2), p.370-384 [Peer Reviewed Journal]

2011 Elsevier Inc. ;Copyright © 2011 Elsevier Inc. All rights reserved. ;Copyright Elsevier Limited Oct 20, 2011 ;ISSN: 0896-6273 ;EISSN: 1097-4199 ;DOI: 10.1016/j.neuron.2011.08.023 ;PMID: 22017994

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Title:
Closed-Loop Deep Brain Stimulation Is Superior in Ameliorating Parkinsonism
Author: Rosin, Boris ; Slovik, Maya ; Mitelman, Rea ; Rivlin-Etzion, Michal ; Haber, Suzanne N. ; Israel, Zvi ; Vaadia, Eilon ; Bergman, Hagai
Subjects: Animals ; Basal Ganglia - physiopathology ; Cercopithecus aethiops ; Deep Brain Stimulation - methods ; Electrodes ; Globus Pallidus - physiopathology ; Monkeys & apes ; MPTP Poisoning - chemically induced ; MPTP Poisoning - physiopathology ; MPTP Poisoning - therapy ; Neurons - physiology ; Neurosciences ; Parkinson Disease, Secondary - chemically induced ; Parkinson Disease, Secondary - physiopathology ; Parkinson Disease, Secondary - therapy ; Parkinsons disease ; Primates ; Treatment Outcome
Is Part Of: Neuron (Cambridge, Mass.), 2011-10, Vol.72 (2), p.370-384
Description: Continuous high-frequency deep brain stimulation (DBS) is a widely used therapy for advanced Parkinson's disease (PD) management. However, the mechanisms underlying DBS effects remain enigmatic and are the subject of an ongoing debate. Here, we present and test a closed-loop stimulation strategy for PD in the 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) primate model of PD. Application of pallidal closed-loop stimulation leads to dissociation between changes in basal ganglia (BG) discharge rates and patterns, providing insights into PD pathophysiology. Furthermore, cortico-pallidal closed-loop stimulation has a significantly greater effect on akinesia and on cortical and pallidal discharge patterns than standard open-loop DBS and matched control stimulation paradigms. Thus, closed-loop DBS paradigms, by modulating pathological oscillatory activity rather than the discharge rate of the BG-cortical networks, may afford more effective management of advanced PD. Such strategies have the potential to be effective in additional brain disorders in which a pathological neuronal discharge pattern can be recognized. ► Novel DBS based on neuronal activity (closed-loop, CL-DBS) is superior to standard DBS ► Corticopallidal CL-DBS yields greater alleviation of parkinsonian akinesia ► Corticopallidal CL-DBS yields greater reduction of oscillatory neuronal discharge ► Pallidopallidal CL-DBS leads to dissociation between discharge rate and patterns
Publisher: United States: Elsevier Inc
Language: English
Identifier: ISSN: 0896-6273
EISSN: 1097-4199
DOI: 10.1016/j.neuron.2011.08.023
PMID: 22017994
Source: Cell Press Free Archives
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Closed-Loop Deep Brain Stimulation Is Superior in Ameliorating Parkinsonism

2011 Elsevier Inc. ;Copyright © 2011 Elsevier Inc. All rights reserved. ;Copyright Elsevier Limited Oct 20, 2011 ;ISSN: 0896-6273 ;EISSN: 1097-4199 ;DOI: 10.1016/j.neuron.2011.08.023 ;PMID: 22017994

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