Model-based optimized phase-deviation deep brain stimulation for Parkinson 's disease

摘要

High-frequency deep brain stimulation (HF-DBS) of the subthalamic nucleus (STN), globus pallidus interna (GPi) and globus pallidus externa (GPe) are often considered as effective methods for the treatment of Parkinson's disease (PD). However, the stimulation of a single nucleus by HF-DBS can cause specific physical damage, produce side effects and usually consume more electrical energy. Therefore, we use a biophysically-based model of basal ganglia-thalamic circuits to explore more effective stimulation patterns to reduce adverse effects and save energy. In this paper, we computationally investigate the combined DBS of two nuclei with the phase deviation between two stimulation waveforms (CDBS). Three different stimulation combination strategies are proposed, i.e., STN and GPe CDBS (SED), STN and GPi CDBS (SID), as well as GPi and GPe CDBS (GGD). Resultantly, it is found that anti-phase CDBS is more effective in improving parkinsonian dynamical properties, including desynchronization of neurons and the recovery of the thalamus relay ability. Detailed simulation investigation shows that anti-phase SED and GGD are superior to SID. Besides, the energy consumption can be largely reduced by SED and GGD (72.5% and 65.5%), compared to HF-DBS. These results provide new insights into the optimal stimulation parameter and target choice of PD, which may be helpful for the clinical practice. (c) 2019 Published by Elsevier Ltd.