Phase specific Deep Brain Stimulation

Lead Research Organisation: University of Oxford
Department Name: Clinical Neurosciences

Abstract

Deep Brain Stimulation (DBS) is a widely used surgical intervention in the treatment of motor
disorders and has also been explored in other neurological and neuropsychiatric conditions.
DBS involves surgical placement of a stimulating electrode at key brain regions followed by
long-term electrical stimulation using a battery-powered stimulator. High frequency (130-180
Hz) stimulation is the standard stimulation protocol to date and has proven to be effective in
suppressing motor symptoms of Parkinson's disease and tremor observed during essential
tremor. Nevertheless, in certain cases, such stimulation has also affected other functions giving
rise to side effects, impacting patients' speech, balance, and impulsivity. This is because the
form of stimulation presently applied does not distinguish between disease and normal brain
circuits. Phase specific DBS is a novel stimulation strategy that aims to tailor the stimulation
pattern to patients' symptoms. A recent study on the therapeutic effects of phase specific DBS
has highlighted that patients' symptoms can be suppressed by up to 87% while delivering a
fraction of energy with respect to conventional DBS.
The present research project aims to focus on pathology types that best respond to phase -
controlled DBS, and efficient identification of individualized stimulation patterns. Stimulation
efficacy assessment will include comparing stimulation effects of phase-controlled DBS with
conventional high frequency stimulation. More specifically, we are interested in assessing the
therapeutic advantages of personalized medicine while contrasting the effects of phasecontrolled
DBS with conventional DBS in those who side effects have been previously observed.
This project will focus on essential tremor due to fact that such motor symptom can be more
easily monitored. This way data collection can be optimally obtained in a relatively short period
of time and a robust data analysis can be achieved within the time available for the completion
of the project.
Our goal is to further explore the interaction of DBS with the underlying causal network
mechanisms to attain an optimal therapeutic strategy (phase-specific stimulation), which we
believe can be extended to other conditions with well described circuit mechanisms.
This research project appeals greatly to me as potential results can directly contribute to the
improvement of human health and wellbeing. Also, by merging the realms of science and
technology we have the opportunity to provide further understanding on the healthy and
aberrant human brain condition.
Personally, I believe such project will allow me to deepen my understanding of theoretical and
applied skills in research and I am eager to learn from leading scientists in the field of temporal
brain network dynamics in health and disease, and the development of novel braincomputer
interface therapies. Finally, beside holding fundamental concepts of neural
synchrony in pathology as well as the right set of computational skills (MATLAB) for the analysis
of data and biomedical signals, I have the motivation, competence and wit to develop a
successful research project.

Publications

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Studentship Projects

Project Reference Relationship Related To Start End Student Name
MR/R502224/1 01/10/2017 31/05/2022
1961891 Studentship MR/R502224/1 01/10/2017 30/09/2021 Carolina Reis
 
Description In control by Design 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Patients, carers and/or patient groups
Results and Impact In brief, the idea of this project would be to exchange between the different participants about the common daily-life problems faced by the people affected by Parkinson's, and also around the practical solutions and approaches that have been tested by patients, researchers and others, to improve symptoms and/or to measure the effectiveness of such solutions.

In a second time we would like that the patients themselves decide to put forward one or two projects that we would develop, in collaboration with all involved participants, around monthly-ish meetings. The main point of this project would be to let the patient themselves to take informed decisions about how to guide a joint effort from involved people of the unit toward designing one/two simple devices that could for example help to relieve patients for freezing or abnormal stepping, or to evaluate such parameters under different conditions.
Year(s) Of Engagement Activity 2019,2020