The Novel Closed-Loop Deep Brain Stimulation in Speech of Parkinson$S Disease: Explore the Superiority and Mechanism

high frequency deep brain stimulation (DBS) at subthalamic area (STN) is an effective treatment for patients with advanced Parkinson’s disease (PD), with improvement of tremor, rigidity and bradykinesia. However, the efficacy of STN DBS is limited by the undesirable adverse effects and cost of battery. Decline in verbal fluency is the most documented adverse effect in cognitive function after STN DBS in patients with PD. Though some reports have suggested improvement in dysarthria and motor control on oral and larynx. In several studies speech difficulties were often seen in post-operative period. The mechanism of action of DBS remains unclear. Converging evidences suggest that the high frequency stimulation suppresses the pathological activity in basal ganglia. Nevertheless, residual physiological activity at the same target would be over-ridden inevitably with the conventional DBS. Accordingly, a more optimal stimulation paradigm would be a closed-loop stimulation system that senses feedback signals relating to pathological and clinical state of PD, and delivers stimulation when it is necessary. Recently, there are several studies compared the effect of closed-loop stimulation and conventional open-loop DBS in motor symptoms in parkinsonian primate and patients with PD. Both showed the later is superior in ameliorating akinesia. However, the effect of the closed-loop system on speech difficulties of PD remains unclear. . In the proposed study, we plan to use a novel signals analysis paradigm to reconstruct the local field potentials (LFP) recorded from the DBS electrodes implanted to STN of PD. The reconstructed LFPs will be used to trigger the stimulation of this target. This system was test intensively and met IEC 60601-1 and IEC/EN 60101-1-2 medical safety standard. To this end, we will test whether the therapeutic effects of closed-loop stimulations is superior to conventional DBS in speech difficulties in patients with PD.

Project ID:PC10608-1474
External Project ID:MOST106-2314-B182-035