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Mechanisms and Targeting of Deep-Brain Stimulation Therapies

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Handbook of Neuroengineering

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Abstract

Deep-brain stimulation (DBS) is an effective neurosurgical treatment option for individuals with medication-refractory brain disorders. DBS therapy involves sending high-frequency electrical stimulus pulses through one or more chronically implanted electrodes to override pathophysiological information propagating through a particular brain network. The biophysical changes that result from DBS have multiple spatial modes and time scales. These mechanistic concepts will be discussed in the first half of the chapter in which we will emphasize how the biophysical changes can vary across clinical indications, anatomical DBS targets, and methods of stimulation. As the relationship between physiological mechanisms and clinical effects of DBS therapy is better understood, actions can be taken to further optimize the therapy. In the second half of this chapter, we will focus on technological advances in the field of DBS. These include refining the spatial and temporal precision of targeting in DBS therapy, and leveraging control engineering and machine learning approaches to automate and optimize stimulation parameters on an individual basis.

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Abbreviations

BA25:

Brodmann Area 25

CE:

European Conformity

CL or CT:

Central lateral nucleus of thalamus

clDBS:

closed-loop DBS

CR:

Coordinated Reset

CT:

Computed Tomography

DBS:

Deep-Brain Stimulation

DTTm:

medial dorsal tegmental tract

EPSC:

Evoked postsynaptic current

ET:

Essential tremor

FDA:

Food and Drug Administration

GPe:

Globus pallidus, external

GPi:

Globus pallidus, internal

HDE:

Humanitarian device exemption

IDE:

Investigational device exemption

IPG:

Implantable pulse generator

MRI:

Magnetic resonance imaging

PD:

Parkinson’s disease

PSO:

Particle swarm optimization

STN:

Subthalamic nucleus

TBI:

Traumatic brain injury

TRD:

Treatment-resistant depression

Vim:

Ventral intermediate nucleus of thalamus

VTA:

volume of tissue activated

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    AnneMarie K. Brinda & Matthew D. Johnson

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    Nuan Chen Ph.D

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    Nuan Chen Ph.D

  3. The N.1 Institute for Health, National University of Singapore, Singapore, Singapore

    Nuan Chen Ph.D

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Brinda, A.K., Johnson, M.D. (2022). Mechanisms and Targeting of Deep-Brain Stimulation Therapies. In: Thakor, N.V. (eds) Handbook of Neuroengineering. Springer, Singapore. https://doi.org/10.1007/978-981-15-2848-4_133-1

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