Evidence map›Paper›PMID 37649907›Full record

ArticlemedRxiv : the preprint server for health sciences2023

Personalized chronic adaptive deep brain stimulation outperforms conventional stimulation in Parkinson's disease.

Carina R Oehrn, Stephanie Cernera, Lauren H Hammer, Maria Shcherbakova, Jiaang Yao, Amelia Hahn, Sarah Wang, Jill L Ostrem, Simon Little, Philip A Starr

Abstract readPreprint
PubMed Full text at PMC Publisher
In one paragraph

Article in medRxiv : the preprint server for health sciences, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

10 authors.

Carina R OehrnDepartment of Neurological Surgery, University of California, San Francisco, San Francisco, CA, USA.
Stephanie CerneraDepartment of Neurological Surgery, University of California, San Francisco, San Francisco, CA, USA.
Lauren H HammerDepartment of Neurology, University of California, San Francisco, San Francisco, California, USA.
Maria ShcherbakovaDepartment of Neurological Surgery, University of California, San Francisco, San Francisco, CA, USA.
Jiaang YaoDepartment of Neurological Surgery, University of California, San Francisco, San Francisco, CA, USA.
Amelia HahnDepartment of Neurological Surgery, University of California, San Francisco, San Francisco, CA, USA.
Sarah WangDepartment of Neurology, University of California, San Francisco, San Francisco, California, USA.
Jill L OstremDepartment of Neurology, University of California, San Francisco, San Francisco, California, USA.
Simon LittleDepartment of Neurology, University of California, San Francisco, San Francisco, California, USA.
Philip A StarrDepartment of Neurological Surgery, University of California, San Francisco, San Francisco, CA, USA.

Funding

NINDS Research Education Programs for Residents and Fellows in Neurology, Neurosurgery, Neuropathology, Neuroradiology and Emergency Medicine (R25)R25NS070680 · NINDS · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI JOSEPHSON, SCOTT ANDREW · 2010 to 2023
$6.8M
Closed Loop Deep Brain Stimulation for Parkinson's DiseaseUH3NS100544 · NINDS · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI STARR, PHILIP ANDREW · 2016 to 2022
$4.1M
Determining the circuits and signals of sleep dysfunction in Parkinson's disease through chronic intracranial recordings and closed-loop Deep Brain StimulationR01NS131405 · NINDS · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI Simon Little · 2023 to 2026
$2.6M
Uncovering the neurophysiology of motivation in Parkinson™s disease with implanted adaptive brain stimulationK23NS120037 · NINDS · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI LITTLE, SIMON · 2021 to 2024
$809k
Beyond theta: analyzing oscillations across the frequency spectrum in patients with dystonia implanted with sensing-enabled pulse generatorsF32NS129627 · NINDS · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI CERNERA, STEPHANIE LYNN · 2023 to 2023
$69k
NINDS NIH HHS F32 NS129627NINDS NIH HHS K23 NS120037NINDS NIH HHS R01 NS131405NINDS NIH HHS R25 NS070680NINDS NIH HHS UH3 NS100544
6 · The paper itself

Abstract

Deep brain stimulation is a widely used therapy for Parkinson's disease (PD) but currently lacks dynamic responsiveness to changing clinical and neural states. Feedback control has the potential to improve therapeutic effectiveness, but optimal control strategy and additional benefits of "adaptive" neurostimulation are unclear. We implemented adaptive subthalamic nucleus stimulation, controlled by subthalamic or cortical signals, in three PD patients (five hemispheres) during normal daily life. We identified neurophysiological biomarkers of residual motor fluctuations using data-driven analyses of field potentials over a wide frequency range and varying stimulation amplitudes. Narrowband gamma oscillations (65-70 Hz) at either site emerged as the best control signal for sensing during stimulation. A blinded, randomized trial demonstrated improved motor symptoms and quality of life compared to clinically optimized standard stimulation. Our approach highlights the promise of personalized adaptive neurostimulation based on data-driven selection of control signals and may be applied to other neurological disorders.

Identifiers

PMID37649907
PMCPMC10463549

What OpenQuestion holds

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LicenceCC BY-NC-ND
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.