Abstract
Closed-loop or intelligent neuromodulation allows adjustable, personalized neuromodulation which usually incorporates the recording of a biomarker, followed by implementation of an algorithm which decides the timing (when?) and strength (how much?) of stimulation. Closed-loop neuromodulation has been shown to have greater benefits compared to open-loop neuromodulation, particularly for therapeutic applications such as pharmacoresistant epilepsy, movement disorders and potentially for psychological disorders such as depression or drug addiction. However, an important aspect of the technique is selection of an appropriate, preferably neural biomarker. Neurochemical sensing can provide high resolution biomarker monitoring for various neurological disorders as well as offer deeper insight into neurological mechanisms. The chemicals of interest being measured, could be ions such as potassium (K+), sodium (Na+), calcium (Ca2+), chloride (Cl−), hydrogen (H+) or neurotransmitters such as dopamine, serotonin and glutamate. This review focusses on the different building blocks necessary for a neurochemical, closed-loop neuromodulation system including biomarkers, sensors and data processing algorithms. Furthermore, it also highlights the merits and drawbacks of using this biomarker modality.
Highlights
The idea of treating intractable diseases with little or no known pharmacological interventions through the nervous system has led to a new area of therapeutic treatment, known as electroceuticals or bio-electronic medicine (Kristoffer et al, 2013)
Potentiometry is the measurement of the potential of a solution with the help of two different electrodes, the working electrode which detects the change in chemical reaction and a reference electrode whose potential is known in reference to a standard electrode, such as the Standard Hydrogen Electrode (SHE)
Data collected during neurochemical recordings are highly complex with multiple variables affecting readings, a multivariate dimensionality reduction technique needs to be utilized in order to ensure accurate analysis of the data and for detection of target neurochemical signature
Summary
The idea of treating intractable diseases with little or no known pharmacological interventions through the nervous system has led to a new area of therapeutic treatment, known as electroceuticals or bio-electronic medicine (Kristoffer et al, 2013). The therapeutic effects of electroceutical techniques are observed by modulating signals on the nervous system through external agents such as electrical stimulation. There are two potential feedback loops within DBS; electrical activity of the neural network, and neurochemical activity In the former category, there are studies that are advancing the technology to a closed-loop system (Priori et al, 2013; Rosa et al, 2015), whereby the electrical activity of the surrounding population of neurons is used as a feedback signal. Discussion and Conclusions related to the above mentioned topics are presented in sections 5 and 6, respectively
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