Adaptive Parameter Selection for Deep Brain Stimulation in Parkinson's Disease
General Material Designation
[Thesis]
First Statement of Responsibility
Daneshzand, Mohammad
Subsequent Statement of Responsibility
Faezipour, Miad
.PUBLICATION, DISTRIBUTION, ETC
Name of Publisher, Distributor, etc.
University of Bridgeport
Date of Publication, Distribution, etc.
2019
PHYSICAL DESCRIPTION
Specific Material Designation and Extent of Item
99
DISSERTATION (THESIS) NOTE
Dissertation or thesis details and type of degree
Ph.D.
Body granting the degree
University of Bridgeport
Text preceding or following the note
2019
SUMMARY OR ABSTRACT
Text of Note
Each year, around 60,000 people are diagnosed with Parkinson's disease (PD) and the economic burden of PD is at least usd14.4 billion a year in the United States. Pharmaceutical costs for a Parkinson's patient can be reduced from usd12,000 to usd6,000 per year with the addition of neuromodulation therapies such as Deep Brain Stimulation (DBS), transcranial Direct Current Stimulation (tDCS), Transcranial Magnetic Stimulation (TMS), etc. In neurodegenerative disorders such as PD, deep brain stimulation (DBS) is a desirable approach when the medication is less effective for treating the symptoms. DBS incorporates transferring electrical pulses to a specific tissue of the central nervous system and obtaining therapeutic results by modulating the neuronal activity of that region. The hyperkinetic symptoms of PD are associated with the ensembles of interacting oscillators that cause excess or abnormal synchronous behavior within the Basal Ganglia (BG) circuitry. Delayed feedback stimulation is a closed loop technique shown to suppress this synchronous oscillatory activity. Deep Brain Stimulation via delayed feedback is known to destabilize the complex intermittent synchronous states. Computational models of the BG network are often introduced to investigate the effect of delayed feedback high frequency stimulation on partially synchronized dynamics. In this work, we developed several computational models of four interacting nuclei of the BG as well as considering the Thalamo-Cortical local effects on the oscillatory dynamics. These models are able to capture the emergence of 34 Hz beta band oscillations seen in the Local Field Potential (LFP) recordings of the PD state. Traditional High Frequency Stimulations (HFS) has shown deficiencies such as strengthening the synchronization in case of highly fluctuating neuronal activities, increasing the energy consumed as well as the incapability of activating all neurons in a large-scale network. To overcome these drawbacks, we investigated the effects of the stimulation waveform and interphase delays on the overall efficiency and efficacy of DBS. We also propose a new feedback control variable based on the filtered and linearly delayed LFP recordings. The proposed control variable is then used to modulate the frequency of the stimulation signal rather than its amplitude. In strongly coupled networks, oscillations reoccur as soon as the amplitude of the stimulus signal declines. Therefore, we show that maintaining a fixed amplitude and modulating the frequency might ameliorate the desynchronization process, increase the battery lifespan and activate substantial regions of the administered DBS electrode. The charge balanced stimulus pulse itself is embedded with a delay period between its charges to grant robust desynchronization with lower amplitude needed. The efficiency and efficacy of the proposed Frequency Adjustment Stimulation (FAS) protocol in a delayed feedback method might contribute to further investigation of DBS modulations aspired to address a wide range of abnormal oscillatory behaviors observed in neurological disorders. Adaptive stimulation can open doors towards simultaneous stimulation with MRI recordings. We additionally propose a new pipeline to investigate the effect of Transcranial Magnetic Stimulation (TMS) on patient specific models. The pipeline allows us to generate a full head segmentation based on each individual MRI data. In the next step, the neurosurgeon can adaptively choose the proper location of stimulation and transmit accurate magnetic field with this pipeline.