Matteo Guidetti1, Sara Marceglia2, Aaron Loh3, Irene E Harmsen4, Sara Meoni5, Guglielmo Foffani6, Andres M Lozano7, Elena Moro8, Jens Volkmann9, Alberto Priori10. 1. Aldo Ravelli Research Center for Neurotechnology and Experimental Neurotherapeutics, Department of Health Sciences, University of Milan, Via Antonio di Rudinì, 8, 20142, Milan, Italy; Department of Electronics, Information and Bioengineering, Politecnico di Milano, Piazza Leonardo da Vinci, 32, 20133, Milan, Italy. Electronic address: matteo.guidetti@unimi.it. 2. Department of Engineering and Architecture, University of Trieste, 34127, Trieste, Italy. Electronic address: smarceglia@units.it. 3. Division of Neurosurgery, Department of Surgery, Toronto Western Hospital, University of Toronto, Toronto, Ontario, Canada; Krembil Research Institute, University Health Network, Toronto, Ontario, Canada. Electronic address: aaron.loh@mail.utoronto.ca. 4. Division of Neurosurgery, Department of Surgery, Toronto Western Hospital, University of Toronto, Toronto, Ontario, Canada; Krembil Research Institute, University Health Network, Toronto, Ontario, Canada. Electronic address: irene.harmsen@mail.utoronto.ca. 5. Aldo Ravelli Research Center for Neurotechnology and Experimental Neurotherapeutics, Department of Health Sciences, University of Milan, Via Antonio di Rudinì, 8, 20142, Milan, Italy; Movement Disorders Unit, Division of Neurology, CHU Grenoble Alpes, Grenoble, France; Grenoble Institute of Neurosciences, INSERM U1216, University Grenoble Alpes, Grenoble, France. Electronic address: smeoni@chu-grenoble.fr. 6. HM CINAC (Centro Integral de Neurociencias Abarca Campal), Hospital Universitario HM Puerta del Sur, HM Hospitales, Madrid, Spain; Hospital Nacional de Parapléjicos, SESCAM, Toledo, Spain. Electronic address: gfoffani.hmcinac@hmhospitales.com. 7. Division of Neurosurgery, Department of Surgery, Toronto Western Hospital, University of Toronto, Toronto, Ontario, Canada; Krembil Research Institute, University Health Network, Toronto, Ontario, Canada. Electronic address: andres.lozano@uhnresearch.ca. 8. Movement Disorders Unit, Division of Neurology, CHU Grenoble Alpes, Grenoble, France; Grenoble Institute of Neurosciences, INSERM U1216, University Grenoble Alpes, Grenoble, France. Electronic address: emoro@chu-grenoble.fr. 9. Department of Neurology, University of Wurzburg, Germany. Electronic address: volkmann_j@ukw.de. 10. Aldo Ravelli Research Center for Neurotechnology and Experimental Neurotherapeutics, Department of Health Sciences, University of Milan, Via Antonio di Rudinì, 8, 20142, Milan, Italy; ASST Santi Paolo e Carlo, Milan, Italy. Electronic address: alberto.priori@unimi.it.
Abstract
BACKGROUND: The application of stimulators implanted directly over deep brain structures (i.e., deep brain stimulation, DBS) was developed in the late 1980s and has since become a mainstream option to treat several neurological conditions. Conventional DBS involves the continuous stimulation of the target structure, which is an approach that cannot adapt to patients' changing symptoms or functional status in real-time. At the beginning of 2000, a more sophisticated form of stimulation was conceived to overcome these limitations. Adaptive deep brain stimulation (aDBS) employs on-demand, contingency-based stimulation to stimulate only when needed. So far, aDBS has been tested in several pathological conditions in animal and human models. OBJECTIVE: To review the current findings obtained from application of aDBS to animal and human models that highlights effects on motor, cognitive and psychiatric behaviors. FINDINGS: while aDBS has shown promising results in the treatment of Parkinson's disease and essential tremor, the possibility of its use in less common DBS indications, such as cognitive and psychiatric disorders (Alzheimer's disease, obsessive-compulsive disorder, post-traumatic stress disorder) is still challenging. CONCLUSIONS: While aDBS seems to be effective to treat movement disorders (Parkinson's disease and essential tremor), its role in cognitive and psychiatric disorders is to be determined, although neurophysiological assumptions are promising.
BACKGROUND: The application of stimulators implanted directly over deep brain structures (i.e., deep brain stimulation, DBS) was developed in the late 1980s and has since become a mainstream option to treat several neurological conditions. Conventional DBS involves the continuous stimulation of the target structure, which is an approach that cannot adapt to patients' changing symptoms or functional status in real-time. At the beginning of 2000, a more sophisticated form of stimulation was conceived to overcome these limitations. Adaptive deep brain stimulation (aDBS) employs on-demand, contingency-based stimulation to stimulate only when needed. So far, aDBS has been tested in several pathological conditions in animal and human models. OBJECTIVE: To review the current findings obtained from application of aDBS to animal and human models that highlights effects on motor, cognitive and psychiatric behaviors. FINDINGS: while aDBS has shown promising results in the treatment of Parkinson's disease and essential tremor, the possibility of its use in less common DBS indications, such as cognitive and psychiatric disorders (Alzheimer's disease, obsessive-compulsive disorder, post-traumatic stress disorder) is still challenging. CONCLUSIONS: While aDBS seems to be effective to treat movement disorders (Parkinson's disease and essential tremor), its role in cognitive and psychiatric disorders is to be determined, although neurophysiological assumptions are promising.
Authors: Jessica Frey; Jackson Cagle; Kara A Johnson; Joshua K Wong; Justin D Hilliard; Christopher R Butson; Michael S Okun; Coralie de Hemptinne Journal: Front Neurol Date: 2022-03-09 Impact factor: 4.003
Authors: Mattia Arlotti; Matteo Colombo; Andrea Bonfanti; Tomasz Mandat; Michele Maria Lanotte; Elena Pirola; Linda Borellini; Paolo Rampini; Roberto Eleopra; Sara Rinaldo; Luigi Romito; Marcus L F Janssen; Alberto Priori; Sara Marceglia Journal: Front Neurosci Date: 2021-12-07 Impact factor: 4.677