Closed loop DBS for Essential Tremor
Research type
Research Study
Full title
Decoding presence of movement and tremor for closed-loop Deep Brain Stimulation for the treatment of Essential Tremor
IRAS ID
249989
Contact name
Huiling Tan
Contact email
Sponsor organisation
University of Oxford / Clinical Trials & Research Governance
Duration of Study in the UK
2 years, 11 months, 29 days
Research summary
Essential tremor (ET) is one of the most common movement disorders, causing uncontrollable and debilitating rhythmic motions during volitional movements. Deep brain stimulation (DBS) is an effective therapy for ET. However, high DBS output is commonly associated with pronounced adverse effects. Furthermore, since tremor in ET predominantly occur during voluntary movements, currently available continuous DBS may deliver unnecessary current thereby increasing undesirable side effects, hastening the depletion of device batteries, and necessitating extra surgery to exchange batteries.
Closed-loop DBS with stimulation parameters automatically adjusted could be a solution to the drawbacks of the continuous open-loop DBS currently employed. Prior studies have used wearable movement sensors and/or electromyography to provide the measurement of tremor and to control the stimulator. However, the wireless communication between external sensors and the pacemaker consumes extra power, negating the power saving that closed-loop DBS could deliver. More recently, signals recorded from electrodes chronically implanted over motor cortex are used to decode movement and to activate the DBS when a movement is detected. Nevertheless, the use of a cortical electrode introduces further instrumentation, surgical risks, and increased cost.
Here we propose to decode movement intention and/or the presence of tremor from brain signals recorded from the same electrodes that are implanted in ventral thalamus as used for therapeutic DBS, with the aim to use this information to actuate DBS only when needed and at the right intensity to treat symptoms. The proposed project will provide proof-of-concept for closed-loop DBS for the treatment of ET, so that the target area is stimulated only when necessary, saving on battery power, limiting habituation, reducing side-effects and improving patient outcome. Importantly, this will be achieved without the need for additional electrodes or hardware.
REC name
South Central - Oxford B Research Ethics Committee
REC reference
18/SC/0436
Date of REC Opinion
23 Oct 2018
REC opinion
Further Information Favourable Opinion