A new biomarker for subthalamic deep brain stimulation for patients with advanced Parkinson's disease-a pilot study

Gmel, Gerrit E., Hamilton, Tara J., Obradovic, Milan, Gorman, Robert B., Single, Peter S., Chenery, Helen J., Coyne, Terry, Silburn, Peter A. and Parker, John L. (2015) A new biomarker for subthalamic deep brain stimulation for patients with advanced Parkinson's disease-a pilot study. Journal of Neural Engineering, 12 6: 1-11. doi:10.1088/1741-2560/12/6/066013

Author Gmel, Gerrit E.
Hamilton, Tara J.
Obradovic, Milan
Gorman, Robert B.
Single, Peter S.
Chenery, Helen J.
Coyne, Terry
Silburn, Peter A.
Parker, John L.
Title A new biomarker for subthalamic deep brain stimulation for patients with advanced Parkinson's disease-a pilot study
Journal name Journal of Neural Engineering   Check publisher's open access policy
ISSN 1741-2560
Publication date 2015-12
Year available 2015
Sub-type Article (original research)
DOI 10.1088/1741-2560/12/6/066013
Open Access Status Not Open Access
Volume 12
Issue 6
Start page 1
End page 11
Total pages 11
Place of publication Bristol, United Kingdom
Publisher Institute of Physics Publishing
Collection year 2017
Language eng
Formatted abstract
Objective. Deep brain stimulation (DBS) has become the standard treatment for advanced stages of Parkinson's disease (PD) and other motor disorders. Although the surgical procedure has improved in accuracy over the years thanks to imaging and microelectrode recordings, the underlying principles that render DBS effective are still debated today. The aim of this paper is to present initial findings around a new biomarker that is capable of assessing the efficacy of DBS treatment for PD which could be used both as a research tool, as well as in the context of a closed-loop stimulator. Approach. We have used a novel multi-channel stimulator and recording device capable of measuring the response of nervous tissue to stimulation very close to the stimulus site with minimal latency, rejecting most of the stimulus artefact usually found with commercial devices. We have recorded and analyzed the responses obtained intraoperatively in two patients undergoing DBS surgery in the subthalamic nucleus (STN) for advanced PD. Main results. We have identified a biomarker in the responses of the STN to DBS. The responses can be analyzed in two parts, an initial evoked compound action potential arising directly after the stimulus onset, and late responses (LRs), taking the form of positive peaks, that follow the initial response. We have observed a morphological change in the LRs coinciding with a decrease in the rigidity of the patients. Significance. These initial results could lead to a better characterization of the DBS therapy, and the design of adaptive DBS algorithms that could significantly improve existing therapies and help us gain insights into the functioning of the basal ganglia and DBS.
Keyword Neuromodulation
Parkinson's disease
Deep brain stimulation
Evoked compound action potentials
Evoked potentials
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: UQ Centre for Clinical Research Publications
Official 2016 Collection
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