Adaptive deep brain stimulation for Parkinson’s disease and dystonia
|PhD ceremony:||Mr D.A.I. (Dan) Piña Fuentes|
|When:||May 17, 2021|
|Supervisors:||prof. dr. J.M.C. van Dijk, prof. dr. M.A.J. (Marina) de Koning-Tijssen|
|Co-supervisor:||dr. M. Beudel|
|Where:||Academy building RUG|
|Faculty:||Medical Sciences / UMCG|
Deep brain stimulation (DBS) is a neurosurgical treatment, in which electrodes are implanted in deep regions of the brain. This procedure has been applied for more than 30 years to treat patients with movement disorders, such as Parkinson’s disease (PD) and dystonia, especially in patients without a good medication effect. The implanted electrodes deliver electrical pulses, that help to control the main disease symptoms. Until recently, the stimulation was only applied continuously, without taking into account the symptom fluctuations each patient experiences throughout the day.
Adaptive DBS (aDBS) is an innovative upgrade of this treatment. With aDBS, the stimulation is regulated (in real time) based on the symptom severity. To indicate when and how stimulation should be delivered, brain oscillations can be measured through the electrodes implanted in the brain, and used as feedback signal. These oscillations are able to reflect the clinical state of the patients. By dynamically adjusting the stimulation according to the needs of each patient, aDBS might be able to provide a better symptom control. In addition to this, aDBS could prevent the occurrence of side effects caused by excessive stimulation.
This thesis investigates the intraoperative efficacy of aDBS in patients with PD and dystonia at the University Medical Center Groningen, The Netherlands. The first part of this thesis describes the characteristics of the signals that can be used to estimate the severity of symptoms. The second and third part of the thesis evaluate the immediate effects of aDBS in patients with PD and dystonia, respectively.