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In-Depth Information
Chapter 13
Advances Toward Closed-Loop Deep Brain
Stimulation
Stathis S. Leondopulos and Evangelia Micheli-Tzanakou
Abstract
A common treatment for advanced stage Parkinsonism is the application
of a periodic pulse stimulus to specific regions in the brain, also known as
deep brain
stimulation
(or DBS). Almost immediately following this discovery, the idea of dy-
namically controlling the apparatus in a “closed-loop” or neuromodulatory capacity
using neural activity patterns obtained in “real-time” became a fascination for many
researchers in the field. However, the problems associated with the reliability of sig-
nal detection criteria, robustness across particular cases, as well as computational
aspects, have delayed the practical realization of such a system. This review seeks
to present many of the advances made toward closed-loop deep brain stimulation
and hopefully provides some insight to further avenues of study toward this end.
13.1 Introduction
The uses of electrical stimulation and recording in medicine have a history dat-
ing back to the first century AD [95, 139, 121, 153, 76, 85, 21, 97, 138, 37, 30, 47].
However, since the first advances in microelectronics began to appear [7], med-
ical electro-stimulation and recording equipment became portable and even im-
plantable [23]. Soon after that, with the invention of the integrated circuit [84, 115],
an ever-increasing number of components became available on a silicon chip of
millimeter or even micron dimensions [107]. As a consequence, the availability and
sophistication of electronic bio-implants began to greatly increase starting with the
work of House [68] on the cochlear implant in 1969, the work of Humayun and
de Juan [69] on the retinal implant in 1996, and the cortical implant reported by
Donoghue [35] and Nicolelis [111] in 2002 and 2003.
