Closed Loop Deep Brain Stimulation for PTSD, Addiction, and Disorders of Affective Facial Interpretation: Review and Discussion of Potential Biomarkers and Stimulation Paradigms

Frontiers in Neuroscience
Robert W Bina, Jean-Phillipe Langevin

Abstract

The treatment of psychiatric diseases with Deep Brain Stimulation (DBS) is becoming more of a reality as studies proliferate the indications and targets for therapies. Opinions on the initial failures of DBS trials for some psychiatric diseases point to a certain lack of finesse in using an Open Loop DBS (OLDBS) system in these dynamic, cyclical pathologies. OLDBS delivers monomorphic input into dysfunctional brain circuits with modulation of that input via human interface at discrete time points with no interim modulation or adaptation to the changing circuit dynamics. Closed Loop DBS (CLDBS) promises dynamic, intrinsic circuit modulation based on individual physiologic biomarkers of dysfunction. Discussed here are several psychiatric diseases which may be amenable to CLDBS paradigms as the neurophysiologic dysfunction is stochastic and not static. Post-Traumatic Stress Disorder (PTSD) has several peripheral and central physiologic and neurologic changes preceding stereotyped hyper-activation behavioral responses. Biomarkers for CLDBS potentially include skin conductance changes indicating changes in the sympathetic nervous system, changes in serum and central neurotransmitter concentrations, and limbic circuit activation. Che...Continue Reading

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Citations

Aug 2, 2018·Neurosurgical Focus·Justin D Hilliard, Kelly D Foote
Jul 3, 2019·Journal of Neural Engineering·Kabir Uddin SikderDavid J Garrett
Jul 2, 2019·Database : the Journal of Biological Databases and Curation·Daniel Domingo-FernándezMagali Haas
Jan 31, 2019·Frontiers in Behavioral Neuroscience·Arun AsokJoseph B Rayman
Aug 27, 2019·Frontiers in Neuroscience·Dilranjan S WickramasuriyaRose T Faghih
Jan 3, 2019·International Neurourology Journal·Eunkyoung ParkKyu-Sung Lee
Jan 20, 2020·Neuroscience Research·Yuichi Takeuchi, Antal Berényi

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Software Mentioned

Medtronic RC + S
Matlab
CLDBS
Neuropace RNS
Neuropace

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