Key Laboratory of Biomedical Engineering of Education Ministry, College of Biomedical Engineering and Instrumentation Science, Zhejiang University, Hangzhou 310027, China
This work was supported by a grant from The National Natural Science Foundation of China (30970753).
Deep brain stimulation (DBS) has become one of the common treatments for movement disorders such as Parkinson's disease. It is also a promising treatment for other neurological and psychiatric disorders. However, the stimulation paradigms of regular DBS are not diversified enough to meet the needs for extending its applications, because current DBS therapy usually utilizes single-channel high-frequency stimulation of electrical pulses with a constant inter-pulse-interval. According to the desynchronization mechanisms of DBS, new stimulation paradigms have been developed by designing the temporal and spatial patterns of pulse sequences to improve the therapeutic efficacy, to extend its application and to save the electric energy of impulse generator. The new paradigms include: stimulations of varying-frequency sequences (including regular varying-frequency and random varying-frequency), multi-channel asynchronous stimulations at different spatial locations, as well as the combined stimulations of varying-frequency and multi-channels. These new paradigms may improve the efficacy of DBS and reduce the energy consumption thereby showing good prospects in treating Parkinson's disease and other brain diseases such as epilepsy, obsessive-compulsive and minimally conscious state. Notably, in addition to the better acute effect during the stimulations, the efficacy of multi-channel stimulations may last for a long time after the termination of stimulations, indicating a sustained effect or an after-effect. This performance breaks the limitation of regular DBS that has only acute effects and opens out a new prospect for DBS. Based on a summary of the stimulation paradigms of regular DBS and their underlying mechanisms, this review presents the development of new DBS paradigms on the stimulations of varying-frequency and multi-channels to generate asynchronous effects, thereby providing valuable information for the development of DBS.
WANG Zhao-Xiang, FENG Zhou-Yan, YANG Gang-Sheng, ZHENG Lü-Piao. Advances in The Development of New Stimulation Paradigms of Deep Brain Stimulation[J]. Progress in Biochemistry and Biophysics,2021,48(3):263-274
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