Deep Brain Stimulation

Our next NeuroMeetup talk will be dedicated to Deep Brain Stimulation. Dr. med. gerd Tinkhauser, from the Inselspital, and Eduardo Martin Moraud, from the CHUV, will share their latest insights on the subject. As usual, the talk will be followed by an apéro, to continue the discussion in an informal setting.

First speaker : Gerd Tinkhauser (Inselspital)

Presentation: Combining deep brain stimulation with physiology in Parkinson’s disease

Abstract : Deep brain stimulation is an established treatment for Parkinson’s disease and other movement disorders. This therapy however is limited by the slow manual and error-prone programming algorithms to identify the optimal stimulation site and by the stimulation induced side-effects. Electrophysiological recordings from the basal ganglia, the structures where the electrodes are implanted, revealed the presence of electrophysiological markers related to the motor symptoms. Studying distribution and behavioral characteristics of these markers led to the first pilot studies toward automatized programming and closed-loop stimulation in Parkinson’s disease.

Second speaker : Eduardo Martin Moraud (CHUV)

Presentation : Towards closed-loop neuromodulation of brain and spinal circuits to alleviate gait and balance deficits in Parkinson's disease.

Abstract : Impairments of gait and balance are amongst the most incapacitating and least well-understood symptoms of Parkinson's disease (PD). Well-established neuromodulation therapies for PD, which are highly effective for the treatment of upper-limb motor signs, often exhibit modest results to alleviate gait deficits. This discrepancy is presumably due to the divergence in the nature and dynamics of the circuits that control leg versus upper limb movements.

To date, the brain signatures underlying leg motor function and dysfunction, their involvement in leg muscle recruitment and force modulation across locomotor activities, and their utility to help refine therapies remains unclear. Similarly, the impact of combining brain and spinal neuromodulation therapies to specifically address locomotor deficits remains controversial.

In this talk, I will present results on these two questions: First, we aimed to identify the neural correlates of leg force modulation from local field potentials (LFPs) recorded from deep brain stimulation electrodes implanted in the subthalamic nucleus (STN) of patients with PD, and to leverage this framework to develop decoding algorithms able to automatically predict leg force intention in real-time.

Second, we employed brain-decoded intention to trigger and control spinal cord neuromodulation therapies during unconstrained movements in non-human primate model of PD.

These combined results confirm the capacity to leverage brain signals to decode force production and leg motor intention in real-time, and to further exploit them to provide personalised therapies of brain and spinal cord to address gait deficits.