Practical Closed-Loop Strategies for Deep Brain Stimulation: Lessons From Chronic Pain.
chronic pain
closed-loop
control
deep brain stimulation (DBS)
summit RC+S
Journal
Frontiers in neuroscience
ISSN: 1662-4548
Titre abrégé: Front Neurosci
Pays: Switzerland
ID NLM: 101478481
Informations de publication
Date de publication:
2021
2021
Historique:
received:
20
08
2021
accepted:
24
11
2021
entrez:
3
1
2022
pubmed:
4
1
2022
medline:
4
1
2022
Statut:
epublish
Résumé
Deep brain stimulation (DBS) is a plausible therapy for various neuropsychiatric disorders, though continuous tonic stimulation without regard to underlying physiology (open-loop) has had variable success. Recently available DBS devices can sense neural signals which, in turn, can be used to control stimulation in a closed-loop mode. Closed-loop DBS strategies may mitigate many drawbacks of open-loop stimulation and provide more personalized therapy. These devices contain many adjustable parameters that control how the closed-loop system operates, which need to be optimized using a combination of empirically and clinically informed decision making. We offer a practical guide for the implementation of a closed-loop DBS system, using examples from patients with chronic pain. Focusing on two research devices from Medtronic, the Activa PC+S and Summit RC+S, we provide pragmatic details on implementing closed- loop programming from a clinician's perspective. Specifically, by combining our understanding of chronic pain with data-driven heuristics, we describe how to tune key parameters to handle feature selection, state thresholding, and stimulation artifacts. Finally, we discuss logistical and practical considerations that clinicians must be aware of when programming closed-loop devices.
Identifiants
pubmed: 34975374
doi: 10.3389/fnins.2021.762097
pmc: PMC8716790
doi:
Types de publication
Journal Article
Langues
eng
Pagination
762097Subventions
Organisme : NINDS NIH HHS
ID : UH3 NS109556
Pays : United States
Organisme : NINDS NIH HHS
ID : UH3 NS115631
Pays : United States
Informations de copyright
Copyright © 2021 Prosky, Cagle, Sellers, Gilron, de Hemptinne, Schmitgen, Starr, Chang and Shirvalkar.
Déclaration de conflit d'intérêts
The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
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