Alternative patterns of deep brain stimulation in neurologic and neuropsychiatric disorders

Ricardo A Najera; Anil K Mahavadi; Anas U Khan; Ujwal Boddeti; Victor A Del Bene; Harrison C Walker; J Nicole Bentley

doi:10.3389/fninf.2023.1156818

Alternative patterns of deep brain stimulation in neurologic and neuropsychiatric disorders

Front Neuroinform. 2023 Jun 21:17:1156818. doi: 10.3389/fninf.2023.1156818. eCollection 2023.

Authors

Ricardo A Najera¹, Anil K Mahavadi¹, Anas U Khan¹, Ujwal Boddeti², Victor A Del Bene³, Harrison C Walker³, J Nicole Bentley¹

Affiliations

¹ Department of Neurosurgery, University of Alabama at Birmingham, Birmingham, AL, United States.
² Department of Neurosurgery, University of Maryland School of Medicine, Baltimore, MD, United States.
³ Department of Neurology, University of Alabama at Birmingham, Birmingham, AL, United States.

Abstract

Deep brain stimulation (DBS) is a widely used clinical therapy that modulates neuronal firing in subcortical structures, eliciting downstream network effects. Its effectiveness is determined by electrode geometry and location as well as adjustable stimulation parameters including pulse width, interstimulus interval, frequency, and amplitude. These parameters are often determined empirically during clinical or intraoperative programming and can be altered to an almost unlimited number of combinations. Conventional high-frequency stimulation uses a continuous high-frequency square-wave pulse (typically 130-160 Hz), but other stimulation patterns may prove efficacious, such as continuous or bursting theta-frequencies, variable frequencies, and coordinated reset stimulation. Here we summarize the current landscape and potential clinical applications for novel stimulation patterns.

Keywords: closed-loop; coordinated reset stimulation (CRS); cycling stimulation; deep brain stimulation; interleaved stimulation; neuromodulation; paired pulses; theta-burst stimulation.

Publication types

Review