image: Cortical and subcortical motor neurones (red) and affective neurones (green). view more
Credit: Wyss Center www.wysscenter.ch
Wyss Center, Geneva, Switzerland - A new paper published in Nature Reviews Neurology suggests that recent advances in deep brain stimulation (DBS) for Parkinson disease could lead to treatments for conditions such as obsessive-compulsive disorder (OCD), Gilles de la Tourette syndrome and depression. The authors of the paper, from the Geneva University Hospitals (HUG), University of Geneva, University of Tübingen and the Wyss Center for Bio and Neuroengineering, argue that bi-directional electrodes which can both stimulate and record from deep brain structures - known as closed-loop DBS - could have applications beyond Parkinson disease.
Other bi-directional brain-computer interfaces (BCIs) have been in development in recent years, notably for the real-time signal processing of neuronal activity to allow control of a robotic arm directly from the brain in people with paralysis.
Professor John Donoghue, Director of the Wyss Center: "Interestingly the fields of brain-computer interfaces for movement restoration and deep brain stimulation for Parkinson disease have developed largely independently. Deep brain stimulation researchers tend to be neurologists or neurosurgeons while brain-computer interface researchers are often neuroscientists, roboticists and engineers. By working together and sharing information we can learn from each other and potentially expand the reach of this technology so that it can help more people."
DBS is typically used to relieve the shaking and rigidity associated with Parkinson disease. Although it has been tried in more than 40 other brain targets, very few other disease indications for the treatment have been established. The latest closed-loop DBS systems sense changes in the brain following stimulation and automatically adapt the level of the next stimulating pulse accordingly. This adjustment in the way that stimulation is delivered allows for tailored, accurate treatment that may prove suitable for other disorders.
Other areas that might benefit from closed-loop DBS include OCD - although early trials indicate that there may be a time delay before improvements are seen, Gilles de la Tourette syndrome - for the treatment of both movement tics and psychiatric symptoms, and depression - although early trials indicate that the exact position of the electrodes and stimulation parameters are critical.
The authors warn against the use of DBS for purposes beyond disease and call for strong ethical standards that require both artificial intelligence and neural interfaces to respect and preserve people's privacy, identity, agency and equality.
Neurostimulators with sensing capabilities are still in their infancy. They have still only been used in research settings and so closed-loop DBS is not yet a long-term treatment solution for Parkinson disease, or any other disorder. These new systems will however soon become commercially available and when they do they will bring with them new treatment possibilities and new hope.
These questions will be discussed at OptoDBS2019, the third edition of an international meeting held at Campus Biotech, Geneva later this year.
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'Biomarkers for closed-loop deep brain stimulation in Parkinson disease and beyond' by Walid Bouthour, Pierre Mégevand, John Donoghue, Christian Lüscher, Niels Birbaumer & Paul Krack was published in Nature Reviews Neurology on 1 April 2019 https://www.nature.com/articles/s41582-019-0166-4
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Jo Bowler, Media and Public Relations Manager
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About the Wyss Center for Bio and Neuroengineering, Geneva, Switzerland
The Wyss Center is an independent, non-profit, neurotechnology research and development organization. The Center provides the expertise, facilities and financial resources to transform creative neuroscience research into clinical solutions that will improve the lives of people with nervous system disorders.
The Center's experienced multidisciplinary neurotechnology development team from industry and academia provides the integrated scientific, engineering, clinical, regulatory and business expertise required to guide high risk, high reward projects on their journey from research to product.
Based at Campus Biotech in Geneva, Switzerland, the Center provides advanced neuroscience and engineering facilities for the development of technology that will prevent, diagnose or treat nervous system disorders, or has the potential to improve lives.
The Center has ongoing projects in movement restoration, stoke rehabilitation, neural circuits, sensory function, and advanced technology. It is currently seeking new partners from anywhere in the world that can fill scientific or technical gaps in the development of novel neurotechnologies in current Wyss Center projects.
A major goal of the Center is to ensure that innovative neurotechnologies advance until they are sufficiently mature to attract corporate partnerships, venture funding, or other mechanisms necessary to make them broadly available to society.
Established by a generous donation from the Swiss entrepreneur and philanthropist Hansjörg Wyss, the Wyss (pronounced "Veese") Center, is a partner in a progressive new neuroscience hub at Campus Biotech. http://www.wysscenter.ch/
About OptoDBS 2019
June 20 - 22, Campus Biotech, Geneva, Switzerland.
The OptoDBS 2019 meeting will discuss the current state-of-the-art therapies for DBS and ask how a better understanding of neural circuit dysfunction in pathology could inspire novel protocols. A particular emphasis will be on novel DBS indications such as obsessive compulsive disorders (OCD), depression or addiction.
About the University of Geneva
The University of Geneva (UNIGE) enjoys worlwide recognition and ranks amongst the top 100 best universities in the world. Founded in 1559 by Jean Calvin and Theodore de Beze, it welcomes more than 17 000 students in its nine faculties and fourteen interdisciplinary centres and constantly strengthens its links with the International and Non-Governmental Organisations based in Geneva, one of the world's capitals for multilateralism. A member of the League of European Research-intensive Universities, the UNIGE fullfills three missions: education, research and knowledge-sharing. http://www.unige.ch
About The HUG: Care, Teaching, and leading-edge research
The Geneva University Hospitals (HUG) comprise eight public hospitals and two health clinics. Their missions include providing health care to the community in all medical specialties, contributing to training physicians and health professionals, and conducting medical research as well as finding treatments. The HUG operate as a national reference centre for influenza and emerging viral infections, as well as for liver disease in children and paediatric liver transplant. They are a WHO Collaborating Centre in seven areas. In 2017, with their 11,560 staff, the HUG treated 63,000 inpatients, 118,000 emergencies, and more than a million outpatients, and performed 27,041 surgeries and 4,182 birth deliveries. The HUG ensure the training of 945 physicians, 2,230 interns and 203 apprentices. They collaborate closely with the Faculty of Medicine of the University of Geneva, the WHO, CHUV, EPFL, CERN and other actors in the Lemanic Health Valley on a number of training and research projects. The HUG have an annual budget of 1.9 billion Swiss francs.
More information on:
the HUG: http://www.hug-ge.ch - presse-hug@hcuge.ch
Activity Report, Key Figures, and Strategic Plan: http://www.hug-ge.ch/publications-hug
Journal
Nature Reviews Neurology