Cookies on this website

We use cookies to ensure that we give you the best experience on our website. If you click 'Accept all cookies' we'll assume that you are happy to receive all cookies and you won't see this message again. If you click 'Reject all non-essential cookies' only necessary cookies providing core functionality such as security, network management, and accessibility will be enabled. Click 'Find out more' for information on how to change your cookie settings.

AbstractBackgroundHigh‐frequency thalamic stimulation is an effective therapy for essential tremor, which mainly affects voluntary movements and/or sustained postures. However, continuous stimulation may deliver unnecessary current to the brain due to the intermittent nature of the tremor.ObjectiveWe proposed to close the loop of thalamic stimulation by detecting tremor‐provoking movement states using local field potentials recorded from the same electrodes implanted for stimulation, so that the stimulation is only delivered when necessary.MethodsEight patients with essential tremor participated in this study. Patient‐specific support vector machine classifiers were first trained using data recorded while the patient performed tremor‐provoking movements. Then, the trained models were applied in real‐time to detect these movements and triggered the delivery of stimulation.ResultsUsing the proposed method, stimulation was switched on for 80.37 ± 7.06% of the time when tremor‐evoking movements were present. In comparison, the stimulation was switched on for 12.71 ± 7.06% of the time when the patients were at rest and tremor‐free. Compared with continuous stimulation, a similar amount of tremor suppression was achieved while only delivering 36.62 ± 13.49% of the energy used in continuous stimulation.ConclusionsThe results suggest that responsive thalamic stimulation for essential tremor based on tremor‐provoking movement detection can be achieved without any requirement for external sensors or additional electrocorticography strips. Further research is required to investigate whether the decoding model is stable across time and generalizable to the variety of activities patients may engage with in everyday life. © 2021 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society

Original publication

DOI

10.1002/mds.28513

Type

Journal article

Journal

Movement Disorders

Publisher

Wiley

Publication Date

04/2021

Volume

36

Pages

863 - 873