TY - JOUR
T1 - Perspectives of Implementation of Closed-Loop Deep Brain Stimulation
T2 - From Neurological to Psychiatric Disorders
AU - Groppa, Sergiu
AU - Gonzalez-Escamilla, Gabriel
AU - Tinkhauser, Gerd
AU - Baqapuri, Halim Ibrahim
AU - Sajonz, Bastian
AU - Wiest, Christoph
AU - Pereira, Joana
AU - Herz, Damian M
AU - Dold, Matthias R
AU - Bange, Manuel
AU - Ciolac, Dumitru
AU - Almeida, Viviane
AU - Neuber, John
AU - Mirzac, Daniela
AU - Martín-Rodríguez, Juan Francisco
AU - Dresel, Christian
AU - Muthuraman, Muthuraman
AU - Adarmes Gomez, Astrid D
AU - Navas, Marta
AU - Temiz, Gizem
AU - Gunduz, Aysegul
AU - Rotaru, Lilia
AU - Winter, Yaroslav
AU - Schuurman, Rick
AU - Contarino, Maria F
AU - Glaser, Martin
AU - Tangermann, Michael
AU - Leentjens, Albert F G
AU - Mir, Pablo
AU - Torres Diaz, Cristina V
AU - Karachi, Carine
AU - Linden, David E J
AU - Tan, Huiling
AU - Coenen, Volker A
AU - EuroDBS
PY - 2024/2
Y1 - 2024/2
N2 - 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.
AB - 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.
KW - Closed loop
KW - Deep brain stimulation
KW - Electrophysiology
KW - Neuroimaging
U2 - 10.1159/000535114
DO - 10.1159/000535114
M3 - (Systematic) Review article
SN - 1011-6125
VL - 102
SP - 40
EP - 54
JO - Stereotactic and Functional Neurosurgery
JF - Stereotactic and Functional Neurosurgery
IS - 1
ER -