Title :
Customizing deep brain stimulation to the patient using computational models
Author :
McIntyre, Cameron C. ; Frankenmolle, Anneke M. ; Wu, Jennifer ; Noecker, Angela M. ; Alberts, Jay L.
Author_Institution :
Cleveland Clinic Found., Cleveland, OH, USA
Abstract :
Bilateral subthalamic (STN) deep brain stimulation (DBS) is effective in improving the cardinal motor signs of advanced Parkinson´s disease (PD); however declines in cognitive function have been associated with this procedure. The aim of this study was to assess cognitive-motor performance of 10 PD patients implanted with STN DBS systems during either clinically determined stimulation settings or settings derived from a computational model. Cicerone DBS software was used to define the model parameters such that current spread to non-motor areas of the STN was minimized. Clinically determined and model defined parameters were equally effective in improving motor scores on the traditional clinical rating scale (UPDRS-III). Under modest dual-task conditions, cognitive-motor performance was worse with clinically determined compared to model derived parameters. In addition, the model parameters provided a 66% reduction in power consumption. These results indicate that the cognitive-motor declines associated with bilateral STN can be mitigated, without compromising motor benefits, utilizing stimulation parameters that minimize current spread into non-motor regions of the STN.
Keywords :
brain; diseases; medical diagnostic computing; neurophysiology; power consumption; Parkinson disease patient; bilateral subthalamic deep brain stimulation; cicerone DBS software; cognitive-motor performance; computational models; nonmotor areas; power consumption; traditional clinical rating scale; Algorithms; Cognition; Computer Simulation; Computers; Deep Brain Stimulation; Electrodes; Electrophysiology; Equipment Design; Humans; Motor Neurons; Motor Skills; Parkinson Disease; Signal Processing, Computer-Assisted; Software;
Conference_Titel :
Engineering in Medicine and Biology Society, 2009. EMBC 2009. Annual International Conference of the IEEE
Conference_Location :
Minneapolis, MN
Print_ISBN :
978-1-4244-3296-7
Electronic_ISBN :
1557-170X
DOI :
10.1109/IEMBS.2009.5334592