Individualizing deep brain stimulation in patients with Parkinson's disease
Working with colleagues from Harvard Medical School and Würzburg, researchers from Charité - Universitätsmedizin Berlin have been examining the use of deep brain stimulation in the treatment of Parkison's disease in an attempt to optimize treatment effectiveness. Specifically, they have been looking at which brain regions need to be connected to the electrode used for deep brain stimulation.
The researchers found a way to use brain connectivity (i.e. connections in the brain) to predict the best possible relief of Parkinson's Disease symptoms. The results, describing an effective network profile of deep brain stimulation has been reported in the journal Annals of Neurology*.
Deep brain stimulation (DBS) is an established treatment for Parkinson's disease, usually leading to significant improvement in motor symptoms and quality of life. Symptoms such as movement restrictions, muscle rigidity, or tremor can be alleviated using the neurosurgical procedure which places small electrodes into deep structures of the brain. Whether optimal symptom relief is achieved depends on the correct placement of the electrode.
Characteristic connectivity patterns can be observed between the area surrounding the implant and other areas of the brain. "An optimally-positioned neurostimulator disposes of an optimal connectivity profile," explains Dr. Andreas Horn, a researcher at Charité's Department of Neurology and Experimental Neurology. "High treatment effectivity is associated with strong connections between the DBS electrode and specific frontal areas of the brain, such as the 'supplementary motor area'," says Dr. Horn. This relationship was not previously known.
The researchers were also able to show that an electrode's connectivity profile can be used to predict the extent to which treatment can alleviate a patient's movement restrictions. They did so by using a special electrode localization procedure which was developed at Charité in the laboratory of Prof. Dr. Andrea Kühn over a period of several years. The procedure continues to be based on exact brain connectivity maps which were developed in cooperation with Harvard Medical School.
The researchers used the MRI sequences of more than 1,000 test subjects to create a 'connectivity map' of the average human brain. Using both of these methods in combination, it is possible to produce connectivity profiles for any DBS electrode. Using basic principles from the field of machine learning, the researchers succeeded in producing and validating an optimal connectivity profile. Dr. Andreas Horn and his international research partners successfully ensured the high-precision placement of more than 90 DBS electrodes.
The researchers are planning to conduct further studies to develop a patient-specific, 'made-to-measure' method of brain stimulation. This may become feasible since it is possible to analyze a patient's specific connectivity profile using MRI training data even before he or she undergoes DBS electrode placement surgery. "It would be possible to determine the optimal location for stimulation even before the invasive part of the procedure starts," says Dr. Horn.
"We are now in the process of developing a complete procedure for connectivity-based deep brain stimulation, which will then need to undergo further validation studies." At some point in the distant future, this will make it possible to run a computer simulation prior to using the treatment in a specific patient.
* Andreas Horn, Martin Reich, Johannes Vorwerk, Ningfei Li, Gregor Wenzel, Qianqian Fang, Tanja Schmitz-Hübsch, Robert Nickl, Andreas Kupsch, Jens Volkmann, Andrea A. Kühn, Michael D. Fox. Connectivity predicts deep brain stimulation outcome in Parkinson's disease. Ann. Neurol. http://dx.
Prof. Dr. Andrea Kühn
Department of Neurology and Experimental Neurology
Campus Charité Mitte
Tel: +49 30 450 560 203
Links: Department of Neurology and Experimental Neurology https:/
Prof. Dr. Andrea Kühn | EurekAlert!
Novel bone imaging approach provides insights into the progression of knee osteoarthritis
15.07.2020 | Society of Nuclear Medicine and Molecular Imaging
UTMB researchers have discovered a new antiviral mechanism for dengue therapeutics
14.07.2020 | University of Texas Medical Branch at Galveston
A novel mechanism for electron optics in two-dimensional solid-state systems opens up a route to engineering quantum-optical phenomena in a variety of materials
Electrons can interfere in the same manner as water, acoustical or light waves do. When exploited in solid-state materials, such effects promise novel...
Biochemists at Martin Luther University Halle-Wittenberg (MLU) have used a standard electron cryo-microscope to achieve surprisingly good images that are on par with those taken by far more sophisticated equipment. They have succeeded in determining the structure of ferritin almost at the atomic level. Their results were published in the journal "PLOS ONE".
Electron cryo-microscopy has become increasingly important in recent years, especially in shedding light on protein structures. The developers of the new...
New insight into the spin behavior in an exotic state of matter puts us closer to next-generation spintronic devices
Aside from the deep understanding of the natural world that quantum physics theory offers, scientists worldwide are working tirelessly to bring forth a...
Kiel physics team observed extremely fast electronic changes in real time in a special material class
In physics, they are currently the subject of intensive research; in electronics, they could enable completely new functions. So-called topological materials...
Solar cells based on perovskite compounds could soon make electricity generation from sunlight even more efficient and cheaper. The laboratory efficiency of these perovskite solar cells already exceeds that of the well-known silicon solar cells. An international team led by Stefan Weber from the Max Planck Institute for Polymer Research (MPI-P) in Mainz has found microscopic structures in perovskite crystals that can guide the charge transport in the solar cell. Clever alignment of these "electron highways" could make perovskite solar cells even more powerful.
Solar cells convert sunlight into electricity. During this process, the electrons of the material inside the cell absorb the energy of the light....
07.07.2020 | Event News
02.07.2020 | Event News
19.05.2020 | Event News
15.07.2020 | Physics and Astronomy
15.07.2020 | Materials Sciences
15.07.2020 | Physics and Astronomy