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Stimulating at the right time: phase-specific deep brain stimulation.

Cagnan, H; Pedrosa, D; Little, S; Pogosyan, A; Cheeran, B; Aziz, T; Green, A; Fitzgerald, J; Foltynie, T; Limousin, P; et al. Cagnan, H; Pedrosa, D; Little, S; Pogosyan, A; Cheeran, B; Aziz, T; Green, A; Fitzgerald, J; Foltynie, T; Limousin, P; Zrinzo, L; Hariz, M; Friston, KJ; Denison, T; Brown, P (2017) Stimulating at the right time: phase-specific deep brain stimulation. Brain, 140 (1). pp. 132-145. ISSN 1460-2156 https://doi.org/10.1093/brain/aww286
SGUL Authors: Cheeran, Binith

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Abstract

SEE MOLL AND ENGEL DOI101093/AWW308 FOR A SCIENTIFIC COMMENTARY ON THIS ARTICLE: Brain regions dynamically engage and disengage with one another to execute everyday actions from movement to decision making. Pathologies such as Parkinson's disease and tremor emerge when brain regions controlling movement cannot readily decouple, compromising motor function. Here, we propose a novel stimulation strategy that selectively regulates neural synchrony through phase-specific stimulation. We demonstrate for the first time the therapeutic potential of such a stimulation strategy for the treatment of patients with pathological tremor. Symptom suppression is achieved by delivering stimulation to the ventrolateral thalamus, timed according to the patient's tremor rhythm. Sustained locking of deep brain stimulation to a particular phase of tremor afforded clinically significant tremor relief (up to 87% tremor suppression) in selected patients with essential tremor despite delivering less than half the energy of conventional high frequency stimulation. Phase-specific stimulation efficacy depended on the resonant characteristics of the underlying tremor network. Selective regulation of neural synchrony through phase-locked stimulation has the potential to both increase the efficiency of therapy and to minimize stimulation-induced side effects.

Item Type: Article
Additional Information: © The Author (2016). Published by Oxford University Press on behalf of the Guarantors of Brain. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/ 4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
Keywords: closed-loop stimulation, dystonic tremor, essential tremor, synchrony, ventrolateral thalamus, Neurology & Neurosurgery, 11 Medical And Health Sciences, 17 Psychology And Cognitive Sciences
SGUL Research Institute / Research Centre: Academic Structure > Molecular and Clinical Sciences Research Institute (MCS)
Journal or Publication Title: Brain
ISSN: 1460-2156
Language: eng
Dates:
DateEvent
January 2017Published
22 December 2016Published Online
18 September 2016Accepted
Publisher License: Creative Commons: Attribution 4.0
Projects:
Project IDFunderFunder ID
MC_UU_12024/1Medical Research Councilhttp://dx.doi.org/10.13039/501100000265
MR/M014762/1Medical Research Councilhttp://dx.doi.org/10.13039/501100000265
PubMed ID: 28007997
Go to PubMed abstract
URI: http://openaccess.sgul.ac.uk/id/eprint/108794
Publisher's version: https://doi.org/10.1093/brain/aww286

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