Towards adaptive deep brain stimulation: clinical and technical notes on a novel commercial device for chronic brain sensing
Abstract
ABSTRACT Background Technical advances in deep brain stimulation (DBS) are crucial to improve therapeutic efficacy and battery life. A prerogative of new devices is the recording and processing of a given input signal to instruct the delivery of stimulation. Objective We studied the advances and pitfalls of one of the first commercially available devices capable of recording brain local field potentials (LFP) from the implanted DBS leads, chronically and during stimulation. Methods We collected clinical and neurophysiological data of the first 20 patients (14 with Parkinson’s disease [PD], five with various types of dystonia, one with chronic pain) that received the Percept™ PC in our centers. We also performed tests in a saline bath to validate the recordings quality. Results The Percept PC reliably recorded the LFP of the implanted site, wirelessly and in real time. We recorded the most promising clinically useful biomarkers for PD and dystonia (beta and theta oscillations) with and without stimulation. Critical aspects of the system are presently related to contact selection, artefact detection, data loss, and synchronization with other devices. Furthermore, we provide an open-source code to facilitate export and analysis of data. Conclusion New technologies will soon allow closed-loop neuromodulation therapies, capable of adapting the stimulation based on real-time symptom-specific and task-dependent input signals. However, technical aspects need to be considered to ensure clean synchronized recordings. The critical use by a growing number of DBS experts will alert new users about the currently observed shortcomings and inform on how to overcome them.
Authors 17
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Centre Hospitalier Universitaire Vaudois · École Polytechnique Fédérale de Lausanne
Affiliation as printed
Defitech Center for Interventional Neurotherapies (NeuroRestore), University Hospital Lausanne and Ecole Polytechnique Fédérale de Lausanne, Switzerland
Department of Clinical Neurosciences, Lausanne University Hospital (CHUV), Lausanne, Switzerland
Deprtment of Clinicl Neurosciences, Lusnne University Hospitl (CHUV), Lusnne, Switzerlnd
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University of Würzburg · Universitätsklinikum Würzburg
Affiliation as printed
Department of Neurology, University Hospital and Julius Maximilian University, Würzburg, Germany
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University of Würzburg · Universitätsklinikum Würzburg · University of Genoa
Affiliation as printed
Department of Informatics, Bioengineering, Robotics and System Engineering, University of Genoa, Genoa, Italy
Department of Neurology, University Hospital and Julius Maximilian University, Würzburg, Germany
Department of Informatics, Bioengineering, Robotics an System Engineering, University of Genoa, Genoa, Italy
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Bart J. Keulen Aachen
Leiden University Medical Center · Erasmus MC · Haga Hospital · Delft University of Technology
Affiliation as printed
Department of Neurology, Haga Teaching Hospital, The Hague, The Netherlands
Educational Programme, Technical Medicine, Delft University of Technology, Delft; Leiden University Medical Center, Leiden; Erasmus Medical Center, Rotterdam, The Netherlands
Dpartmnt of Nurology, Haga Taching Hospital, Th Hagu, Th Nthrlands
Educational Programme, Technical Medicine, Delt University o Technology, Delt
Erasmus Medical Center, Rotterdam, The Netherlands
Leiden University Medical Center, Leiden
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University of Würzburg · Universitätsklinikum Würzburg
Affiliation as printed
Department of Neurology, University Hospital and Julius Maximilian University, Würzburg, Germany
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Centre Hospitalier Universitaire Vaudois · University of Lausanne
Affiliation as printed
Service of Neurology, Department of clinical neurosciences, Lausanne university hospital and university of Lausanne, Lausanne, Switzerland
Service of Neuroloy, Department of clinical neurosciences, Lausanne university hospital and university of Lausanne, Lausanne, Switzerland
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Centre Hospitalier Universitaire Vaudois · University of Lausanne
Affiliation as printed
Service of Neurology, Department of clinical neurosciences, Lausanne university hospital and university of Lausanne, Lausanne, Switzerland
Service of Neuroloy, Department of clinical neurosciences, Lausanne university hospital and university of Lausanne, Lausanne, Switzerland
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Scuola Superiore Sant'Anna · University of Würzburg · Universitätsklinikum Würzburg
Affiliation as printed
Department of Neurology, University Hospital and Julius Maximilian University, Würzburg, Germany
The BioRobotics Institute and Department of Excellence of Robotics and AI, Scuola Superiore Sant’Anna, Pisa, Italy
Te BioRobotics Institute and Department of Excellence of Robotics and AI, Scuola Superiore Sant'Anna, Pisa, Italy
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University of Würzburg · Universitätsklinikum Würzburg
Affiliation as printed
Department of Neurology, University Hospital and Julius Maximilian University, Würzburg, Germany
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Affiliation as printed
Department of Neurology, Haga Teaching Hospital, The Hague, The Netherlands
Dpartmnt of Nurology, Haga Taching Hospital, Th Hagu, Th Nthrlands
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Centre Hospitalier Universitaire Vaudois · École Polytechnique Fédérale de Lausanne
Affiliation as printed
Center for Neuroprosthetics and Brain Mind Institute, School of Life Sciences, Swiss Federal Institute of Technology (EPFL), Lausanne, Switzerland
Defitech Center for Interventional Neurotherapies (NeuroRestore), University Hospital Lausanne and Ecole Polytechnique Fédérale de Lausanne, Switzerland
Department of Neurosurgery, Lausanne University Hospital, Lausanne, Switzerland
Center for Neuroprosthetics and Brain Mind Institute, Schoo of Life Sciences, Swiss Federa Institute of Technoogy (EPFL), Lausanne, Switzerand
Department of Neurosurgery, Lausanne Unversty Hosptal, Lausanne, Swtzerland
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Centre Hospitalier Universitaire Vaudois · École Polytechnique Fédérale de Lausanne
Affiliation as printed
Defitech Center for Interventional Neurotherapies (NeuroRestore), University Hospital Lausanne and Ecole Polytechnique Fédérale de Lausanne, Switzerland
Department of Neurosurgery, Lausanne University Hospital, Lausanne, Switzerland
Department of Neurosurgery, Lausanne Unversty Hosptal, Lausanne, Swtzerland
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Affiliation as printed
Department of Neurosurgery, Haga Teaching Hospital, The Hague, The Netherlands
Departent of Neurosurgery, Haga Teaching Hospital, The Hague, The Netherlands
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Affiliation as printed
Department of Neurosurgery, Haga Teaching Hospital, The Hague, The Netherlands
Departent of Neurosurgery, Haga Teaching Hospital, The Hague, The Netherlands
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Centre Hospitalier Universitaire Vaudois · École Polytechnique Fédérale de Lausanne
Affiliation as printed
Defitech Center for Interventional Neurotherapies (NeuroRestore), University Hospital Lausanne and Ecole Polytechnique Fédérale de Lausanne, Switzerland
Department of Clinical Neurosciences, Lausanne University Hospital (CHUV), Lausanne, Switzerland
Deprtment of Clinicl Neurosciences, Lusnne University Hospitl (CHUV), Lusnne, Switzerlnd
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University of Würzburg · Universitätsklinikum Würzburg
Affiliation as printed
Department of Neurology, University Hospital and Julius Maximilian University, Würzburg, Germany
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Maria Fiorella Contarino corresponding Aachen Department of Neurology, Leiden University Medical Center (LUMC)
Leiden University Medical Center · Haga Hospital
Affiliation as printed
Department of Neurology, Haga Teaching Hospital, The Hague, The Netherlands
Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands
Departmet of Neurology, Leide Uiversity Medical Ceter, Leide, The Netherlads
Dpartmnt of Nurology, Haga Taching Hospital, Th Hagu, Th Nthrlands
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