Controlling Clinical States Governed by Different Temporal Dynamics With Closed-Loop Deep Brain Stimulation: A Principled Framework

Closed-loop strategies for deep brain stimulation (DBS) are paving the way for improving the efficacy of existing neuromodulation therapies across neurological disorders. Unlike continuous DBS, closed-loop DBS approaches (cl-DBS) optimize the delivery of stimulation in the temporal domain. However,...

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Autores principales:	Gerd Tinkhauser, Eduardo Martin Moraud
Formato:	article
Lenguaje:	EN
Publicado:	Frontiers Media S.A. 2021
Materias:	closed-loop DBS local field potentials (LFP) basal ganglia Parkinson’s disease multi-objective control Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571
Acceso en línea:	https://doaj.org/article/23f63d79bad64eedbc3ef365b9ee53c9
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spelling	oai:doaj.org-article:23f63d79bad64eedbc3ef365b9ee53c92021-11-11T06:51:20ZControlling Clinical States Governed by Different Temporal Dynamics With Closed-Loop Deep Brain Stimulation: A Principled Framework1662-453X10.3389/fnins.2021.734186https://doaj.org/article/23f63d79bad64eedbc3ef365b9ee53c92021-11-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fnins.2021.734186/fullhttps://doaj.org/toc/1662-453XClosed-loop strategies for deep brain stimulation (DBS) are paving the way for improving the efficacy of existing neuromodulation therapies across neurological disorders. Unlike continuous DBS, closed-loop DBS approaches (cl-DBS) optimize the delivery of stimulation in the temporal domain. However, clinical and neurophysiological manifestations exhibit highly diverse temporal properties and evolve over multiple time-constants. Moreover, throughout the day, patients are engaged in different activities such as walking, talking, or sleeping that may require specific therapeutic adjustments. This broad range of temporal properties, along with inter-dependencies affecting parallel manifestations, need to be integrated in the development of therapies to achieve a sustained, optimized control of multiple symptoms over time. This requires an extended view on future cl-DBS design. Here we propose a conceptual framework to guide the development of multi-objective therapies embedding parallel control loops. Its modular organization allows to optimize the personalization of cl-DBS therapies to heterogeneous patient profiles. We provide an overview of clinical states and symptoms, as well as putative electrophysiological biomarkers that may be integrated within this structure. This integrative framework may guide future developments and become an integral part of next-generation precision medicine instruments.Gerd TinkhauserEduardo Martin MoraudEduardo Martin MoraudFrontiers Media S.A.articleclosed-loop DBSlocal field potentials (LFP)basal gangliaParkinson’s diseasemulti-objective controlNeurosciences. Biological psychiatry. NeuropsychiatryRC321-571ENFrontiers in Neuroscience, Vol 15 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	closed-loop DBS local field potentials (LFP) basal ganglia Parkinson’s disease multi-objective control Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571
spellingShingle	closed-loop DBS local field potentials (LFP) basal ganglia Parkinson’s disease multi-objective control Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Gerd Tinkhauser Eduardo Martin Moraud Eduardo Martin Moraud Controlling Clinical States Governed by Different Temporal Dynamics With Closed-Loop Deep Brain Stimulation: A Principled Framework
description	Closed-loop strategies for deep brain stimulation (DBS) are paving the way for improving the efficacy of existing neuromodulation therapies across neurological disorders. Unlike continuous DBS, closed-loop DBS approaches (cl-DBS) optimize the delivery of stimulation in the temporal domain. However, clinical and neurophysiological manifestations exhibit highly diverse temporal properties and evolve over multiple time-constants. Moreover, throughout the day, patients are engaged in different activities such as walking, talking, or sleeping that may require specific therapeutic adjustments. This broad range of temporal properties, along with inter-dependencies affecting parallel manifestations, need to be integrated in the development of therapies to achieve a sustained, optimized control of multiple symptoms over time. This requires an extended view on future cl-DBS design. Here we propose a conceptual framework to guide the development of multi-objective therapies embedding parallel control loops. Its modular organization allows to optimize the personalization of cl-DBS therapies to heterogeneous patient profiles. We provide an overview of clinical states and symptoms, as well as putative electrophysiological biomarkers that may be integrated within this structure. This integrative framework may guide future developments and become an integral part of next-generation precision medicine instruments.
format	article
author	Gerd Tinkhauser Eduardo Martin Moraud Eduardo Martin Moraud
author_facet	Gerd Tinkhauser Eduardo Martin Moraud Eduardo Martin Moraud
author_sort	Gerd Tinkhauser
title	Controlling Clinical States Governed by Different Temporal Dynamics With Closed-Loop Deep Brain Stimulation: A Principled Framework
title_short	Controlling Clinical States Governed by Different Temporal Dynamics With Closed-Loop Deep Brain Stimulation: A Principled Framework
title_full	Controlling Clinical States Governed by Different Temporal Dynamics With Closed-Loop Deep Brain Stimulation: A Principled Framework
title_fullStr	Controlling Clinical States Governed by Different Temporal Dynamics With Closed-Loop Deep Brain Stimulation: A Principled Framework
title_full_unstemmed	Controlling Clinical States Governed by Different Temporal Dynamics With Closed-Loop Deep Brain Stimulation: A Principled Framework
title_sort	controlling clinical states governed by different temporal dynamics with closed-loop deep brain stimulation: a principled framework
publisher	Frontiers Media S.A.
publishDate	2021
url	https://doaj.org/article/23f63d79bad64eedbc3ef365b9ee53c9
work_keys_str_mv	AT gerdtinkhauser controllingclinicalstatesgovernedbydifferenttemporaldynamicswithclosedloopdeepbrainstimulationaprincipledframework AT eduardomartinmoraud controllingclinicalstatesgovernedbydifferenttemporaldynamicswithclosedloopdeepbrainstimulationaprincipledframework AT eduardomartinmoraud controllingclinicalstatesgovernedbydifferenttemporaldynamicswithclosedloopdeepbrainstimulationaprincipledframework
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Controlling Clinical States Governed by Different Temporal Dynamics With Closed-Loop Deep Brain Stimulation: A Principled Framework

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