Closed-loop DBS triggered by real-time movement and tremor decoding based on thalamic LFPs for essential tremor
Open accessAbstract
High frequency Deep Brain Stimulation (DBS) targeting the motor thalamus is an effective therapy for essential tremor (ET). However, since tremor mainly affects periods of voluntary movements and sustained postures in ET, conventional continuous stimulation may deliver unnecessary current to the brain. Here we tried to decode movement states based on local field potentials (LFPs) recorded from motor thalamus and zona incerta in real-time to trigger the switching on and off of DBS in three patients with ET. Patient-specific models were first identified using thalamic LFPs recorded while the patient performed movements that tended to trigger tremor in everyday life. During the real-time test, LFPs were continuously recorded to decode movements and tremor, and the detection triggered stimulation. Results show that voluntary movements can be detected with a mean sensitivity ranging from 76.8% to 88.6% and a false positive rate ranging from 16.0% to 23.1% Postural tremor was detected with similar accuracy. The closed-loop DBS triggered by tremor detection suppressed intention tremor by 90.5% with a false positive rate of 20.3%.Clinical Relevance- This is the first study on closed-loop DBS triggered by real-time movement and tremor decoding based solely on thalamic LFPs. The results suggest that responsive DBS based on movement and tremor detection can be achieved without any requirement for external sensors or additional electrocorticography strips.
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Cites
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Claims the paper makes
8 of 14 cited sources checked · 2 supported · 1 flagged · accuracy not yet measured
- Premisecitation
Prior closed-loop deep brain stimulation studies have used wearable inertial sensors, surface electromyography, or electrocorticography from a cortical strip to provide feedback for stimulator control.
“Some existing studies have used wearable inertial sensors [7], surface electromyography (EMG) [8], or electrocorticography (ECoG) recorded from a Neurosciences strip of intracranial electrodes implanted over the surface of the motor cortex [9] to provide feedback for the control of the stimulator in closed-loop DBS systems.”
Quote in the paperSubstantial claim2 of 3 sources checked- cites [7] Cagnan H Stimulating at the right time: phase-specific deep brain stimulation Brain 2017 140 132 145 28007997 PMC5226063 source
The citation [9] is attached to the electrocorticography claim. The Introduction says this study derived stimulation timing from peripheral inertial sensors rather than sensing brain oscillations directly, and Figure 1 describes an accelerometer attached to the hand controlling the neurostimulator. It does not describe feedback from a cortical electrode strip. (LLM, conf=0.90)
Checked by a reasoning model — may be wrong.
Experimental — accuracy not yet measured - cites [8] Yamamoto T On-demand control system for deep brain stimulation for treatment of intention tremor Neuromodulation J Int Neuromodulation Soc 2013 16 230 235 23094990 source
- cites [9] Herron JA Chronic electrocorticography for sensing movement intention and closed-loop deep brain stimulation with wearable sensors in an essential tremor patient J Neurosurg 2017 127 580 587 27858575 source
The citation [9] is attached to the ECoG example. The Patients and Methods section describes thalamic DBS with constant-voltage stimulation and clinician-adjusted settings, but our copy does not describe cortical-strip ECoG recordings used as feedback for closed-loop control. Searches for ECoG, cortical recording, feedback, and adaptive stimulation found no supporting passage. (LLM, conf=0.75)
Experimental — accuracy not yet measured
- Findingcitation
Offline movement decoding with stimulation off had accuracy similar to that reported in the authors' previous study.
“The offline movement decoding when the stimulation was off had similar accuracy to that shown in our previous study [10].”
Quote in the paperNot a substantial claim1 of 1 sources checked- cites [10] Tan H Decoding voluntary movements and postural tremor based on thalamic LFPs as a basis for closed-loop stimulation for essential tremor Brain stimulation 2019 12 4 858 867 30827864 PMC6600875 source
The Results section (‘Both cued brief movements and blocks of continuous movements are detected’; page unavailable) reports movement-decoding accuracy, and the Discussion (‘Implications for closed loop DBS for essential tremor’; page unavailable) says the reported recordings were made with stimulation off. Our copy does not compare that accuracy with the authors’ previous study. Its statement about ‘similar accuracy’ instead compares decoding with stimulation on versus off. (LLM, conf=0.85)
Experimental — accuracy not yet measured
- Rests on an assumption: The electromyography and accelerometer signals provide accurate ground-truth labels for voluntary movement and tremor.
- Premisecitation
In a previous study, local field potentials from the ventral intermediate thalamus were used to decode voluntary movement and postural tremor with promising offline accuracy.
“In our previous study, local field potentials (LFPs) recorded from ventral intermediate (VIM) thalamus were used to decode voluntary movement and postural tremor and achieved a promising offline decoding accuracy [10].”
Quote in the paperSubstantial claim1 of 1 sources checked- cites [10] Tan H Decoding voluntary movements and postural tremor based on thalamic LFPs as a basis for closed-loop stimulation for essential tremor Brain stimulation 2019 12 4 858 867 30827864 PMC6600875 source
- Findingown data
Using the support vector machine, posture and any associated tremor were decoded with an average area under the curve of 0.88 without stimulation and 0.82 with stimulation.
“We were also able to decode posture and any associated tremor with an average AUC of 0.88 without stimulation or 0.82 with stimulation using SVM (shown in Fig. 4).”
Quote in the paperSubstantial claim- Rests on an assumption: The electromyography and accelerometer signals provide accurate ground-truth labels for voluntary movement and tremor.
- Findingown data
In three participants, both voluntary movement and posture/tremor were detected with sensitivity around 80% and a false positive rate around 20%.
“Results from three participants showed that both voluntary movements and posture and any associated tremor can be detected with a sensitivity around 80 % and a false positive rate of around 20%.”
Quote in the paperSubstantial claim- Rests on an assumption: The electromyography and accelerometer signals provide accurate ground-truth labels for voluntary movement and tremor.
- Findingown data
The support vector machine achieved an average area under the curve of about 0.9 for voluntary movement decoding both with and without stimulation.
“This achieved an averaged AUC of about 0.9 for voluntary movement decoding either with (Fig. 3B) or without (Fig. 3A) stimulation.”
Quote in the paperSubstantial claim- Rests on an assumption: The electromyography and accelerometer signals provide accurate ground-truth labels for voluntary movement and tremor.
- Findingown data
The support vector machine gave the best decoding for every participant regardless of whether stimulation was on or off.
“SVM provided the best decoding across all participants no matter whether stimulation was switched on or off.”
Quote in the paperNot a substantial claim- Rests on an assumption: The electromyography and accelerometer signals provide accurate ground-truth labels for voluntary movement and tremor.
- Premisecitation
High-frequency deep brain stimulation of the motor thalamus is an effective treatment for essential tremor.
“Continuous deep brain stimulation (DBS) is an approved and effective therapy for ET [3].”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [3] Louis ED Treatment of medically refractory essential tremor N Engl J Med 2016 375 792 793 27557307 source
- Interpretationcitation
Compared with other adaptive deep brain stimulation systems that use external sensors or cortical strip electrodes, the proposed method has the advantage of requiring no external sensor or additional invasive electrode.
“Compared with other adaptive DBS systems developed based on external sensors or cortical strip electrodes in [7]-[9], the advantage of the method proposed here is it doesn't require any external sensor or additional invasive electrode.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [7]-[9]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- Rests on an assumption: The three essential tremor patients studied are representative of the broader essential tremor population for whom responsive deep brain stimulation is intended.
- Premisecitation
Many patients with essential tremor eventually lose the benefit of deep brain stimulation because of disease progression or habituation.
“However, due to disease progression or habituation to stimulation, many patients lose the benefit of DBS over time [4].”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [4] Shih LC Loss of benefit in VIM thalamic deep brain stimulation (DBS) for essential tremor (ET): how prevalent is it? Park Relat Disord 2013 19 676 679 23582712 source
- Premisecitation
Increasing stimulation intensity to maintain the therapeutic effect may cause side effects such as unpleasant sensations, slurred speech, and walking unsteadiness.
“In these circumstances, an increased stimulation intensity is usually required in order to maintain the therapy effect, which may be associated with side effects including unpleasant sensations, slurred speech and unsteadiness walking [5].”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [5] Hedera P Emerging strategies in the management of essential tremor Ther Adv Neurol Disord 2017 10 137 148 28382111 PMC5367648 source
- Interpretationown data
The results indicate that both voluntary movement and posture with any associated tremor can be detected from VIM-ZI local field potentials in real time to trigger deep brain stimulation.
“Our results suggest that both voluntary movements and posture and any associated tremor could be detected based on VIM-ZI LFPs in real time for triggering DBS.”
Quote in the paperSubstantial claim- Rests on an assumption: The electromyography and accelerometer signals provide accurate ground-truth labels for voluntary movement and tremor.
- Rests on an assumption: The three essential tremor patients studied are representative of the broader essential tremor population for whom responsive deep brain stimulation is intended.
- Interpretationown data
The results suggest that responsive deep brain stimulation for essential tremor can be achieved without external sensors or additional electrocorticography strips.
“These results suggest that responsive DBS for ET can be achieved without the requirement of external sensors or additional electrocorticography strips.”
Quote in the paperSubstantial claim- Rests on an assumption: The three essential tremor patients studied are representative of the broader essential tremor population for whom responsive deep brain stimulation is intended.
- Interpretationreasoning
Detecting both voluntary movement and posture/tremor states helps ensure that stimulation is switched on whenever needed.
“Detecting both states helps ensure that stimulation will be switched on wherever needed.”
Quote in the paperSubstantial claim
- May combine two claims. 11
- Classified as probably not a substantial claim. 5
May combine two claims.
PremisecitationSeparate models for detecting voluntary movement and posture/tremor are required because a previous study showed that different features contribute to detecting these two states.
“This is based on our previous study showing that different features contributed to the detection of postural tremor and voluntary movements, suggesting different models would be required to detect these two different states [10].”
Quote in the paperSubstantial claim1 of 1 sources checked- cites [10] Tan H Decoding voluntary movements and postural tremor based on thalamic LFPs as a basis for closed-loop stimulation for essential tremor Brain stimulation 2019 12 4 858 867 30827864 PMC6600875 source
May combine two claims.
PremisecitationAll these existing closed-loop deep brain stimulation solutions require external sensors or additional invasive recording, which limits their clinical use in essential tremor.
“However, all these solutions require external sensors and/or additional invasive recording, which constrains their clinical application in the treatment of ET.”
Quote in the paperSubstantial claim2 of 3 sources checked- cites [7] Cagnan H Stimulating at the right time: phase-specific deep brain stimulation Brain 2017 140 132 145 28007997 PMC5226063 source
The Introduction (page unavailable) says this study derives stimulation timing from peripheral inertial sensors rather than direct brain recordings, and the Study procedure describes an attached accelerometer. But the paper calls its approach “clinically tractable”; it does not establish that all existing solutions require external sensors or additional invasive recording, or that those requirements constrain clinical use in essential tremor. (LLM, conf=0.85)
Experimental — accuracy not yet measured - cites [8] Yamamoto T On-demand control system for deep brain stimulation for treatment of intention tremor Neuromodulation J Int Neuromodulation Soc 2013 16 230 235 23094990 source
- cites [9] Herron JA Chronic electrocorticography for sensing movement intention and closed-loop deep brain stimulation with wearable sensors in an essential tremor patient J Neurosurg 2017 127 580 587 27858575 source
The Patients and Methods section describes constant-voltage DBS with parameters adjusted after implantation, while the Results and Discussion address long-term outcomes and complications. Searches for closed-loop stimulation, external sensors, and additional invasive recording found no passage addressing whether such requirements constrain clinical use in essential tremor. (LLM, conf=0.76)
Experimental — accuracy not yet measured
May combine two claims.
PremisecitationEssential tremor is usually intermittent and occurs mainly during voluntary movement or while holding a posture.
“Tremor in ET is typically intermittent, predominantly occurring during voluntary movement and/or while maintaining a certain posture[2].”
Quote in the paperSubstantial claim1 of 1 sources checked- cites [2] Baizabal-Carvallo JF The safety and efficacy of thalamic deep brain stimulation in essential tremor: 10 years and beyond J Neurol Neurosurg Psychiatry 2014 85 567 572 24096713 source
The Results and Table 2 report postural and action tremor in patients with essential tremor, consistent with tremor occurring while holding a posture or moving. The paper does not describe tremor as typically intermittent, and its measurements in a small DBS-treated group do not establish that these are the predominant circumstances for essential tremor generally. (LLM, conf=0.83)
Experimental — accuracy not yet measured
May combine two claims.
FindingreasoningThis means that stimulation was switched on for about 80% of the time during voluntary movement and for about 20% of the time at rest.
“This means the stimulation was on average switched on for 80% of time when the participants were making any voluntary movements and for 20% of time when the participants were at rest.”
Quote in the paperNot a substantial claim- Rests on an assumption: The electromyography and accelerometer signals provide accurate ground-truth labels for voluntary movement and tremor.
May combine two claims.
Findingown dataClosed-loop deep brain stimulation triggered by tremor detection lowered postural tremor by 90.5%, with 20.3% false detections when the participant was at rest.
“The closed loop DBS based on tremor detection suppressed postural tremor by 90.5% with a false detection rate of 20.3% when the participant was at rest (Fig. 6).”
Quote in the paperSubstantial claim- Rests on an assumption: The electromyography and accelerometer signals provide accurate ground-truth labels for voluntary movement and tremor.
May combine two claims.
Findingown dataDecoding accuracy remained similar when stimulation was on, even though stimulation artifacts substantially reduced the signal-to-noise ratio of the local field potentials.
“Similar decoding accuracy was achieved even when the stimulation was switched on (Fig. 3B), with stimulation artefacts that significantly lowered the signal-to-noise ratio in the LFP recording.”
Quote in the paperSubstantial claim- Rests on an assumption: The electromyography and accelerometer signals provide accurate ground-truth labels for voluntary movement and tremor.
May combine two claims.
Findingown dataIn online testing, voluntary movement detection had an average accuracy and true positive rate of about 80% and a false positive rate of about 20%.
“On average, we achieved an accuracy and TPR of about 80%, with an FPR of about 20% (Fig. 5).”
Quote in the paperSubstantial claim- Rests on an assumption: The electromyography and accelerometer signals provide accurate ground-truth labels for voluntary movement and tremor.
Classified as probably not a substantial claim.
InterpretationreasoningFour decoding models may be necessary for this paradigm.
“Four decoding models may be necessary. These were determined by our paradigm in the current study, but clinical application may need state identification tools to allow for the selection of the context-appropriate decoding models.”
Quote in the paperSubstantial claimProbably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
Study design and conductnone givenThe study received approval from the local ethics committee, and all patients provided informed written consent.
“The study was approved by the local ethics committee and all patients gave informed written consent before the experiment.”
Quote in the paperNot a substantial claimMay combine two claims.
Interpretationown dataEven with the stimulation artifact, VIM-ZI local field potentials contain sufficient information to detect voluntary movement and posture/tremor, making them suitable as feedback signals for adaptive deep brain stimulation in essential tremor.
“our results also demonstrated that even with the stimulation artifact, VIM-ZI LFPs still contain enough information for the detection of voluntary movements and posture and any associated tremor, and thus are suitable as the feedback signals for adaptive DBS for ET.”
Quote in the paperSubstantial claim- Rests on an assumption: The three essential tremor patients studied are representative of the broader essential tremor population for whom responsive deep brain stimulation is intended.
May combine two claims.
Interpretationown dataOther classification methods produced comparable results, suggesting that a true positive rate near 0.8 and a false positive rate between 0.2 and 0.3 are attainable for decoding voluntary movement and posture/tremor from VIM-ZI local field potentials with or without stimulation.
“Similar results were also achieved using other classification methods, suggesting that it is possible to have a sensitivity of 0.8 with a false positive rate of 0.2-0.3 in voluntary movement and posture and any associated tremor decoding based on VIM-ZI LFPs either with or without stimulation.”
Quote in the paperSubstantial claim- Rests on an assumption: The electromyography and accelerometer signals provide accurate ground-truth labels for voluntary movement and tremor.
Classified as probably not a substantial claim. May combine two claims.
InterpretationreasoningSeparate decoding models were trained for stimulation-on and stimulation-off conditions because the signal-to-noise ratios differ and stimulation may alter brain activity.
“Separate models were also trained for the conditions when the stimulation was switched on and switched off, due to the difference in the signal-to-noise ratios in these two states and potential differences in the brain activities induced by stimulation.”
Quote in the paperSubstantial claimClassified as probably not a substantial claim.
Study design and conductown dataFor online movement detection, accuracy, true positive rate, and false positive rate were compared with those derived from electromyography and accelerometer measurements.
“The accuracy, true positive rate (TRP), and false positive rate (FPR) for the online detection of movements were compared against those detected from EMG and accelerometer measurements.”
Quote in the paperSubstantial claim- Rests on an assumption: The electromyography and accelerometer signals provide accurate ground-truth labels for voluntary movement and tremor.
Probably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductown dataFive-fold cross-validation was used to assess receiver operating characteristic curves and area under the curve values for the different models on the training data.
“Five-fold cross-validation was used to evaluate the receiver operating characteristics (ROC) curves and reported the area under curves (AUCs) of different models derived from the training data.”
Quote in the paperNot a substantial claim
The paper relies on this without support.
The electromyography and accelerometer signals provide accurate ground-truth labels for voluntary movement and tremor.
“The labels of ‘Movement’ vs ‘Rest’ and ‘Tremor’ vs ‘No-tremor’ for model training were determined based on the recorded accelerometer and EMG signals, respectively.”
“The accuracy, true positive rate (TRP), and false positive rate (FPR) for the online detection of movements were compared against those detected from EMG and accelerometer measurements.”
The paper relies on this without support.
The three essential tremor patients studied are representative of the broader essential tremor population for whom responsive deep brain stimulation is intended.
“Results from three participants showed that both voluntary movements and posture and any associated tremor can be detected with a sensitivity around 80 % and a false positive rate of around 20%.”
“These results suggest that responsive DBS for ET can be achieved without the requirement of external sensors or additional electrocorticography strips.”
The paper relies on this without support.
The movement and posture tasks performed during the training session are sufficiently similar to those performed during the real-time test session for the trained models to remain valid.
“During the training session, the patients performed voluntary self-paced upper limb movements such as a pegboard movement or pouring rice from one cup to another using the worst affected hand.”
“During the test session, the patients were asked to repeat the voluntary movements and to maintain the postures which tend to provoke tremor, while the trained models were applied to detect the movement and tremor in real-time in order to drive the switching on and off of the stimulation.”
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
Each contradiction between two passages listed here was confirmed by an independent check.
The 90.5% suppression result is attributed to different tremor types
MajorThe abstract attributes the 90.5% reduction to intention tremor, while the results attribute the same value to postural tremor. These are different outcomes, so the reported result is internally inconsistent.
“The closed-loop DBS triggered by tremor detection suppressed intention tremor by 90.5% with a false positive rate of 20.3%.”
“The closed loop DBS based on tremor detection suppressed postural tremor by 90.5% with a false detection rate of 20.3% when the participant was at rest (Fig. 6).”
Cites
EEG analysis based on time domain properties
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MethodStimulating at the right time: phase-specific deep brain stimulation
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“Compared with other adaptive DBS systems developed based on external sensors or cortical strip electrodes in [7]-[9], the advantage of the method proposed here is it doesn’t require any external sensor or additional invasive electrode.”
BackgroundSelf-citationThe safety and efficacy of thalamic deep brain stimulation in essential tremor: 10 years and beyond
Baizabal-Carvallo, J. F., Kagnoff, M. N., Jimenez-Shahed, J., Fekete, R., & Jankovic, J. (2014) · Journal of Neurology, Neurosurgery & Psychiatry · doi:10.1136/jnnp-2013-304943 · Cited by 181 · cited 1× · see citing works
“Tremor in ET is typically intermittent, predominantly occurring during voluntary movement and/or while maintaining a certain posture [2].”
BackgroundHerron, J. A., Thompson, M. C., Brown, T., Chizeck, H. J., Ojemann, J. G., & Ko, A. L. (2017) · Journal of Neurosurgery · doi:10.3171/2016.8.jns16536 · Cited by 139 · cited 2× · see citing works
“(2)Neurosciences strip of intracranial electrodes implanted over the surface of the motor cortex [9] to provide feedback for the control of the stimulator in closed-loop DBS systems.”
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“However, due to disease progression or habituation to stimulation, many patients lose the benefit of DBS over time [4].”
BackgroundOn-Demand Control System for Deep Brain Stimulation for Treatment of Intention Tremor
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“A bipolar electromyography (EMG) channel and a 3D accelerometer were placed on each hand to monitor the presence of voluntary movement and/or tremor.”
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“This is based on our previous study showing that different features contributed to the detection of postural tremor and voluntary movements, suggesting different models would be required to detect these two different states [10].”
BackgroundMethodResultInfluentialSelf-citationTreatment of Medically Refractory Essential Tremor
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“Continuous deep brain stimulation (DBS) is an approved and effective therapy for ET [3].”
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“Closed-loop or adaptive DBS, aiming to only deliver stimulation when necessary and thus reduce side effects and prolong clinical efficacy, is seen to be a promising innovative DBS treatment of ET [6].”
BackgroundEmerging strategies in the management of essential tremor
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“In these circumstances, an increased stimulation intensity is usually required in order to maintain the therapy effect, which may be associated with side effects including unpleasant sensations, slurred speech and unsteadiness walking [5].”
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Local field potentials in Parkinson's disease: A frequency-based review
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A New Implantable Closed-Loop Clinical Neural Interface: First Application in Parkinson’s Disease
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“DBS devices allowing real-time recording of LFPs foreshadow closed loop stimulation; the first study demonstrating successful ambulatory recording of VIM and cZI LFPs corresponding to voluntary movements and tremor with highly effective tremor suppression when DBS was delivered closed-loop triggered by LFP activity (9…”
BackgroundCircuits for State-Dependent Modulation of Locomotion
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“In patients with primary epilepsy, the characteristics extracted from thalamic field potentials have been used to decode epileptic seizures (Tan et al., 2019; He et al., 2020).”
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Alternative patterns of deep brain stimulation in neurologic and neuropsychiatric disorders
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“Finally, our literature search of aDBS yielded 576 studies, of which 31 were included (Little et al., 2013, 2016a,b; Rosa et al., 2015, 2017; Malekmohammadi et al., 2016; Cagnan et al., 2017; Herron et al., 2017a; Piña-Fuentes et al., 2017, 2019, 2020a,b; Tinkhauser et al., 2017; Arlotti et al., 2018, 2021; Swann et a…”
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“Treatment can be aligned to changes of therapeutic demand, paving the way for a precision medicine approach toward individualized symptom-specific DBS (He et al., 2020; Neumann and Rodriguez‐Oroz, 2021; Neumann et al., 2019a; Opri et al., 2020a).”
BackgroundInfluentialMovement Decoding using Spatio-Spectral Features of Cortical and Subcortical Local Field Potentials
Peterson, V., Merk, T., Bush, A., Nikulin, V. V., Kühn, A. A., Neumann, W., & Richardson, R. M. (2021) · Experimental Neurology · doi:10.1016/j.expneurol.2022.114261 · Cited by 13 · see citing works
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Usefulness of thalamic beta activity for closed-loop therapy in essential tremor
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“They concluded that both voluntary movements and postural tremor can be detected online with a sensitivity around 80% 54 .”
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“12 (sensed via EMG of the upper limb [35,36] or decoded from cortical[37] or thalamic local field potentials[34]).”
BackgroundSelf-citationSpectral changes in motor thalamus field potentials during movement
Klassen, B. T., Baker, M. R., Jensen, M. A., Valencia, G. O., & Miller, K. J. (2024) · Journal of Neurophysiology · doi:10.1152/jn.00419.2024 · Cited by 4 · see citing works
Movement Decoding using Spatio-Spectral Features of Cortical and Subcortical Local Field PotentialsPreprint
Peterson, V., Merk, T., Bush, A., et al. (2021) · bioRxiv (Cold Spring Harbor Laboratory) · doi:10.1101/2021.06.06.447145 · Cited by 2 · see citing works
“Most of those studies based their analyses in single electrode approaches [19, 21].”
BackgroundAn artefact-resilient wide bandwidth bidirectional graphene neural interface
Prokop, M., Esparza-Iaizzo, M., Masvidal‐Codina, E., Illa, X., Codadu, N. K., Rathore, D., Ria, N., Kostarelos, K., del Corro, E., Garcia‐Cortadella, R., et al. (2026) · Nature Communications · doi:10.1038/s41467-026-73790-x · Cited by 2 · see citing works
“The ability to simultaneously record and modulate neural activity is critical for next-generation bidirectional neural interfaces aiming to enable adaptive neuromodulation therapies for neurological disorders.”
Evaluating Thalamic Biomarkers for Closed-Loop Deep Brain Stimulation in Essential Tremor *
Bender, M., Zheng, H. J. V., Ramirez‐Zamora, A., Vaillancourt, D. E., Foote, K. D., & Oweiss, K. G. (2025) · Annual International Conference of the IEEE Engineering in Medicine and Biology Society (EMBC) · doi:10.1109/embc58623.2025.11253119 · Cited by 1 · see citing works
“Our findings concur with previous studies that have identified Beta oscillations in thalamic LFPs as reliable biomarkers for movement [3], [14], [15].”
Detection methods of Parkinson's Disease based on physiological signals and machine learning methods
Xu, J. (2023) · Highlights in Science Engineering and Technology · doi:10.54097/hset.v36i.6105 · Cited by 1 · see citing works
“The results of Shenghong He [15] showed that the average sensitivity of autonomous motion detection was 76.”
ResultLeung, B., Shcherbakova, M., Yao, J., Cernera, S., Oehrn, C. R., Hahn, A., Little, S. J., Starr, P. A., & Hammer, L. H. (2026) · Journal of Neural Engineering · doi:10.1088/1741-2552/ae62a5
“In current aDBS implementations, neural features (i.e., bandpower derived from embedded spectral analysis) are typically computed at intervals on the scale of 100 ms, with stimulation parameter changes therefore occurring at similar or slower timescales [8, 30].”
Deepa, N. (2026) · doi:10.1109/icict68280.2026.11510941
“Few models suffer from providing the limited insight on making decisions as a result of which there is restriction over usage of medical applications which are sensitive in nature [7].”
Surgical Treatment of Tremor Syndromes: A Guide to the Clinician
Peters, J., Maamary, J., Barnett, Y., Kühn, A. A., Jonker, B., & Tisch, S. H. (2025) · Movement Disorders Clinical Practice · doi:10.1002/mdc3.70441
“159”
Ríos, A. L. L., Hutchison, W. D., Moreno, J. S. S., et al. (2025) · NeuroTarget · doi:10.47924/neurotarget2025559
Bender, M., Zheng, H., Ramirez‐Zamora, A., Vaillancourt, D. E., Foote, K. D., & Oweiss, K. G. (2025) · International IEEE/EMBS Conference on Neural Engineering · doi:10.1109/ner61569.2025.11589093
“Adaptive DBS or closed-loop DBS, in which stimulation is dynamically adjusted based on real-time biomarkers, has the potential to overcome these limitations by reducing unnecessary stimulation and optimizing symptom control [9]–[11].”
Adaptive Deep Brain Stimulation for the Treatment of Parkinson Disease and Essential Tremor
Peprah, K., & Horton, J. (2021) · Canadian Journal of Health Technologies · doi:10.51731/cjht.2021.214
- Authors
- He, S., Debarros, J., Khawaldeh, S., Pogosyan, A., Mostofi, A., Baig, F., Pereira, E., Brown, P., & Tan, H.
- Affiliations
- University of Oxford (GB)
- University of London (GB)
- ORCID
- Venue
- 2020 42nd Annual International Conference of the IEEE Engineering in Medicine & Biology Society (EMBC)
- Publisher
- IEEE
- Published
- 2020-07
- Volume
- 2020
- Pages
- 3602-3605
- ISSN
- 2375-7477 (ISSN-L)
- PMC
- PMC7116198
- OpenAlex
- W3081555188
- Semantic Scholar
- 54d997562429c74dbc0c7e9a13559236bf0345f4
- Cited by
- 22
- References
- 11
- Citations by year
- 2026: 3 · 2025: 4 · 2024: 2 · 2023: 3 · 2022: 3 · 2021: 7
- FWCI
- 13.49
- Type
- conference paper
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Annual International Conference of the IEEE Engineering in Medicine and Biology Society (EMBC) (publishedVersion)
- PubMed (publishedVersion)
- St George's Online Research Archive (St George's University of London) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute for Health and Care Research (CL-2019-16-502)
- Rosetrees Trust (M235-CD2, M526-B-CD1, M235-CD1)
- Medical Research Council (MC_UU_00003/2, MC_UU_12024, MR/P012272/1, MC_UU_12024/1)
- Topics
- Health Sciences › Medicine › Neurology › Neurological disorders and treatments
- Social Sciences › Psychology › Clinical Psychology › Obsessive-Compulsive Spectrum Disorders
- Health Sciences › Medicine › Neurology › Botulinum Toxin and Related Neurological Disorders
- Keywords
- closed-loop deep brain stimulation, essential tremor, motor thalamus, local field potentials, motion detection, tremor detection, intention tremor, postural tremor, zona incerta, real-time neural decoding, patient-specific models
- MeSH terms
- Humans, Movement, Thalamus, Tremor, Essential Tremor, Deep Brain Stimulation
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