Abstract
Deep brain stimulation (DBS) is one of the most important clinical therapies for neurological disorders. DBS also has great potential to become a great tool for clinical neuroscience research. Recently, the National Engineering Laboratory for Neuromodulation at Tsinghua University held an international Deep Brain Stimulation Initiative workshop to discuss the cutting-edge technological achievements and clinical applications of DBS. We specifically addressed new clinical approaches and challenges in DBS for movement disorders (Parkinson's disease and dystonia), clinical application toward neurorehabilitation for stroke, and the progress and challenges toward DBS for neuropsychiatric disorders. This review highlighted key developments in (1) neuroimaging, with advancements in 3-Tesla magnetic resonance imaging DBS compatibility for exploration of brain network mechanisms; (2) novel DBS recording capabilities for uncovering disease pathophysiology; and (3) overcoming global healthcare burdens with online-based DBS programming technology for connecting patient communities. The successful event marks a milestone for global collaborative opportunities in clinical development of neuromodulation to treat major neurological disorders.
Highlights
The National Engineering Laboratory for Neuromodulation (NELN) at Tsinghua University organized its first deep brain stimulation (DBS) initiative meeting in Beijing on October 11–12, 2018
As we look to the future, there is a natural evolution toward machine learning algorithm applications for automatic movement evaluation and objective output readings
The finding that pedunculopontine nucleus (PPN) stimulation alleviated movement abnormalities in the MPTP-lesioned nonhuman primate (NHP) was translated rapidly to treat Parkinson’s disease (PD) patients by clinical groups in the UK (Bristol) and Italy (Rome), with low-frequency stimulation being employed [106, 107]. These early clinical studies noted an effect of PPN stimulation that mimicked those found in the NHPs, which was an improvement in akinesia, in addition to gait and posture
Summary
The National Engineering Laboratory for Neuromodulation (NELN) at Tsinghua University organized its first deep brain stimulation (DBS) initiative meeting in Beijing on October 11–12, 2018. With expert updates and reports on the latest clinical approaches, there were open discussions on the opportunities in neuromodulation with recent technological advancements This included an exchange of ideas on the connectome approach to DBS, novel developments of 3-Tesla magnetic resonance imaging (3T MRI)-compatible DBS devices and the use of neuroimaging to understand the neurocircuitry of effective DBS, including demonstrations of the latest DBS neural recording technology in real patients. This meeting came to provide reports of recent DBS application for unmet clinical needs, such as gait disability in Parkinson’s disease (PD) and stroke rehabilitation, and the challenges in the current transition of DBS therapy toward neuropsychiatric disorders, including depression and memory disorders. Marking a unique milestone in fostering international collaborations in DBS research, we report here a summary of the meeting that covers topic overviews, presentations, and follow-up discussions aiding to uncover expert perspectives and support advancements in the field of neuromodulation as we progress into the future
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