Dominant efficiency of nonregular patterns of subthalamic nucleus deep brain stimulation for Parkinson's disease and obsessive-compulsive disorder in a data-driven computational model.

摘要: Objective. Almost 30 years after the start of modern era deep brain stimulation (DBS), subthalamic nucleus (STN) still constitutes a standard target for advanced Parkinson's disease (PD), but use STN-DBS is also now supported by level I clinical evidence treatment-refractory obsessive-compulsive disorder (OCD). Disruption neural synchronization in STN has been suggested as one possible mechanisms action and alternative patterns at local level. Meanwhile, recent experimental computational modeling signified efficiency stimulation; however, no indications exist OCD. Here, we comparatively simulate desynchronizing effect (regular 130 Hz) versus temporally (in terms frequency, temporal variability existence bursts or pauses) PD OCD, means stochastic dynamical model two microelectrode recording (MER) datasets. Approach. The fitted to MERs acquired during eight surgical interventions For each system simulated, assess invariant density (steady-state phase distribution) measure inversely related yielded applied stimulation. Main results. We demonstrate that high (130 Hz)—and low (80 Hz)—frequency irregular stimulation, low-frequency periodic interrupted pulses, yield both pathologic conditions significantly stronger compared with STN-DBS, distinct In PD, values are proven be optimal dorsolateral oscillatory region including sites therapeutic window. Significance. addition providing novel insights into nonregular this work points correlation model-based outcome effectiveness may have significant implications an energy- therapeutically-efficient configuration closed-loop neuromodulation system.