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Toward adaptive deep brain stimulation in Parkinson's disease: a review

Mohammed, A; Bayford, R; Demosthenous, A; (2018) Toward adaptive deep brain stimulation in Parkinson's disease: a review. Neurodegenerative Disease Management , 8 (2) pp. 115-136. 10.2217/nmt-2017-0050. Green open access

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Abstract

Clinical deep brain stimulation (DBS) is now regarded as the therapeutic intervention of choice at the advanced stages of Parkinson's disease. However, some major challenges of DBS are stimulation induced side effects and limited pacemaker battery life. Side effects and shortening of pacemaker battery life are mainly as a result of continuous stimulation and poor stimulation focus. These drawbacks can be mitigated using adaptive DBS (aDBS) schemes. Side effects resulting from continuous stimulation can be reduced through adaptive control using closed-loop feedback, while those due to poor stimulation focus can be mitigated through spatial adaptation. Other advantages of aDBS include automatic, rather than manual, initial adjustment and programming, and long-term adjustments to maintain stimulation parameters with changes in patient's condition. Both result in improved efficacy. This review focuses on the major areas that are essential in driving technological advances for the various aDBS schemes. Their challenges, prospects and progress so far are analyzed. In addition, important advances and milestones in state-of-the-art aDBS schemes are highlighted – both for closed-loop adaption and spatial adaption. With perspectives and future potentials of DBS provided at the end.

Type: Article
Title: Toward adaptive deep brain stimulation in Parkinson's disease: a review
Open access status: An open access version is available from UCL Discovery
DOI: 10.2217/nmt-2017-0050
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: adaptive stimulation, biosignal processing, closed-loop, deep brain stimulation, directional steering, neural control, Parkinson's disease
UCL classification: UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > UCL BEAMS
UCL > Provost and Vice Provost Offices > UCL BEAMS > Faculty of Engineering Science
UCL > Provost and Vice Provost Offices > UCL BEAMS > Faculty of Engineering Science > Dept of Electronic and Electrical Eng
URI: https://discovery.ucl.ac.uk/id/eprint/10049969
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