z-logo
open-access-imgOpen Access
The Emerging Role of Biomarkers in Adaptive Modulation of Clinical Brain Stimulation
Author(s) -
Kevin Hoang,
Dennis A. Turner
Publication year - 2019
Publication title -
neurosurgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.455
H-Index - 198
eISSN - 1081-1281
pISSN - 0148-396X
DOI - 10.1093/neuros/nyz096
Subject(s) - medicine , neuroscience , stimulation , brain stimulation , optogenetics , disease , deep brain stimulation , pathology , parkinson's disease , biology
Therapeutic brain stimulation has proven efficacious for treatment of nervous system diseases, exerting widespread influence via disease-specific neural networks. Activation or suppression of neural networks could theoretically be assessed by either clinical symptom modification (ie, tremor, rigidity, seizures) or development of specific biomarkers linked to treatment of symptomatic disease states. For example, biomarkers indicative of disease state could aid improved intraoperative localization of electrode position, optimize device efficacy or efficiency through dynamic control, and eventually serve to guide automatic adjustment of stimulation settings. Biomarkers to control either extracranial or intracranial stimulation span from continuous physiological brain activity, intermittent pathological activity, and triggered local phenomena or potentials, to wearable devices, blood flow, biochemical or cardiac signals, temperature perturbations, optical or magnetic resonance imaging changes, or optogenetic signals. The goal of this review is to update new approaches to implement control of stimulation through relevant biomarkers. Critical questions include whether adaptive systems adjusted through biomarkers can optimize efficiency and eventually efficacy, serve as inputs for stimulation adjustment, and consequently broaden our fundamental understanding of abnormal neural networks in pathologic states. Neurosurgeons are at the forefront of translating and developing biomarkers embedded within improved brain stimulation systems. Thus, criteria for developing and validating biomarkers for clinical use are important for the adaptation of device approaches into clinical practice.

The content you want is available to Zendy users.

Already have an account? Click here to sign in.
Having issues? You can contact us here