Adaptive, personalized closed-loop therapy for Parkinson's disease: biochemical, neurophysiological, and wearable sensing systems.

di Biase, Lazzaro; Tinkhauser, Gerd; Martin Moraud, Eduardo; Caminiti, Maria Letizia; Pecoraro, Pasquale Maria; Di Lazzaro, Vincenzo (2021). Adaptive, personalized closed-loop therapy for Parkinson's disease: biochemical, neurophysiological, and wearable sensing systems. Expert review of neurotherapeutics, 21(12), pp. 1371-1388. Taylor & Francis 10.1080/14737175.2021.2000392

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INTRODUCTION

Motor complication management is one of the main unmet needs in Parkinson's disease patients.

AREAS COVERED

Among the most promising emerging approaches for handling motor complications in Parkinson's disease, adaptive deep brain stimulation strategies operating in closed-loop have emerged as pivotal to deliver sustained, near-to-physiological inputs to dysfunctional basal ganglia-cortical circuits over time. Existing sensing systems that can provide feedback signals to close the loop include biochemical-, neurophysiological- or wearable-sensors. Biochemical sensing allows to directly monitor the pharmacokinetic and pharmacodynamic of antiparkinsonian drugs and metabolites. Neurophysiological sensing relies on neurotechnologies to sense cortical or subcortical brain activity and extract real-time correlates of symptom intensity or symptom control during DBS. A more direct representation of the symptom state, particularly the phenomenological differentiation and quantification of motor symptoms, can be realized via wearable sensor technology.

EXPERT OPINION

Biochemical, neurophysiologic, and wearable-based biomarkers are promising technological tools that either individually or in combination could guide adaptive therapy for Parkinson's disease motor symptoms in the future.

Item Type:

Journal Article (Review Article)

Division/Institute:

04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Neurology

UniBE Contributor:

Tinkhauser, Gerd

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1744-8360

Publisher:

Taylor & Francis

Language:

English

Submitter:

Chantal Kottler

Date Deposited:

17 Dec 2021 12:01

Last Modified:

05 Dec 2022 15:55

Publisher DOI:

10.1080/14737175.2021.2000392

PubMed ID:

34736368

Additional Information:

Kein Zugriff auf Manuskript

Uncontrolled Keywords:

Closed-loop therapy aDBS adaptive therapy biochemical sensing dyskinesias lfp motor fluctuations symptoms monitoring therapy management wearable sensing

URI:

https://boris.unibe.ch/id/eprint/162036

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