Novel Deep Brain Stimulation Techniques based on Stochastic Phase Resetting Principles

Synchronization of neuronal activity appears to be the hallmark of several neurological diseases like Parkinson's disease and essential tremor. In patients who do not respond to medication, permanent electrical high-frequency (>100Hz) deep brain stimulation (DBS) turned out to be the therapeutic gold standard. This standard DBS basically mimics the effect of tissue lesioning. However, its mechanism is still not sufficiently understood. For this reason, we have investigated stimulation-induced dynamics in mathematical models of relevant target areas. We have developed novel stimulation techniques using methods from statistical physics, especially from the field of stochastic phase resetting. The standard DBS seems to block the neuronal firing, in particular neuronal populations. In contrast, our novel DBS techniques work on demand and desynchronize the pathologically synchronized activity. In this way the neuronal firing is maintained and modulated in a way that comes closer to the physiological mode. In this poster we explain how our novel DBS techniques have been optimized by means of real-time model simulations. Furthermore, we show our first successful results obtained in intraoperative test stimulations during deep electrode implantation. We expect our novel, model-based and physiologically oriented DBS techniques to be milder and more effective compared to the standard high-frequency DBS.