Adaptive Deep Brain Stimulation for sleep stage targeting in Parkinson's disease

Clay Smyth; Md Fahim Anjum; Shravanan Ravi; Timothy Denison; Philip Starr; Simon Little

doi:10.1016/j.brs.2023.08.006

Adaptive Deep Brain Stimulation for sleep stage targeting in Parkinson's disease

Brain Stimul. 2023 Sep-Oct;16(5):1292-1296. doi: 10.1016/j.brs.2023.08.006. Epub 2023 Aug 9.

Authors

Clay Smyth¹, Md Fahim Anjum², Shravanan Ravi³, Timothy Denison⁴, Philip Starr⁵, Simon Little⁶

Affiliations

¹ Department of Bioengineering, University of California, San Francisco, UCSF Byers Hall Box 2520, 1700 Fourth St Ste 203, San Francisco, CA, 94143, United States. Electronic address: clay.smyth@ucsf.edu.
² Department of Neurology, University of California, San Francisco, Eighth Floor, 400 Parnassus Ave, San Francisco, CA, 94143, United States. Electronic address: fahim.anjum@ucsf.edu.
³ Department of Neurology, University of California, San Francisco, Eighth Floor, 400 Parnassus Ave, San Francisco, CA, 94143, United States. Electronic address: shravanan.ravi@gmail.com.
⁴ Department of Engineering Science, University of Oxford, Parks Road, Oxford, OX1 3PJ, UK. Electronic address: timothy.denison@eng.ox.ac.uk.
⁵ Department of Neurosurgery, University of California, San Francisco, Eighth Floor, 400 Parnassus Ave, San Francisco, CA, 94143, United States. Electronic address: philip.starr@ucsf.edu.
⁶ Department of Neurology, University of California, San Francisco, Eighth Floor, 400 Parnassus Ave, San Francisco, CA, 94143, United States. Electronic address: simon.little@ucsf.edu.

Abstract

Background: Sleep dysfunction is disabling in people with Parkinson's disease and is linked to worse motor and non-motor outcomes. Sleep-specific adaptive Deep Brain Stimulation has the potential to target pathophysiologies of sleep.

Objective: Develop an adaptive Deep Brain Stimulation algorithm that modulates stimulation parameters in response to intracranially classified sleep stages.

Methods: We performed at-home, multi-night intracranial electrocorticography and polysomnogram recordings to train personalized linear classifiers for discriminating the N3 NREM sleep stage. Classifiers were embedded into investigational Deep Brain Stimulators for N3 specific adaptive DBS.

Results: We report high specificity of embedded, autonomous, intracranial electrocorticography N3 sleep stage classification across two participants and provide proof-of-principle of successful sleep stage specific adaptive Deep Brain Stimulation.

Conclusion: Multi-night cortico-basal recordings and sleep specific adaptive Deep Brain Stimulation provide an experimental framework to investigate sleep pathophysiology and mechanistic interactions with stimulation, towards the development of therapeutic neurostimulation paradigms directly targeting sleep dysfunction.

Keywords: Adaptive Deep Brain Stimulation; Parkinson’s disease; Real-time neural control; Sleep.

Publication types

Research Support, Non-U.S. Gov't
Research Support, N.I.H., Extramural
Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

Deep Brain Stimulation*
Electrocorticography
Humans
Parkinson Disease* / therapy
Sleep / physiology
Sleep Stages

Abstract

Publication types

MeSH terms

Grants and funding