A Chaotic Study on Tremor Behavior of Parkinsonian Patients under Deep Brain Stimulation

Authors: M. Sadeghi, A.H. Jafari, S.M.P. Firoozabadi

Abstract:

Deep Brain Stimulation or DBS is a surgical treatment for Parkinson-s Disease with three stimulation parameters: frequency, pulse width, and voltage. The parameters should be selected appropriately to achieve effective treatment. This selection now, performs clinically. The aim of this research is to study chaotic behavior of recorded tremor of patients under DBS in order to present a computational method to recognize stimulation optimum voltage. We obtained some chaotic features of tremor signal, and discovered embedding space of it has an attractor, and its largest Lyapunov exponent is positive, which show tremor signal has chaotic behavior, also we found out, in optimal voltage, entropy and embedding space variance of tremor signal have minimum values in comparison with other voltages. These differences can help neurologists recognize optimal voltage numerically, which leads to reduce patients' role and discomfort in optimizing stimulation parameters and to do treatment with high accuracy.

Keywords: Chaos, Deep Brain Stimulation, Parkinson's Disease, Stimulation Parameters, tremor.

Digital Object Identifier (DOI): doi.org/10.5281/zenodo.1084726

References:

[1] H. Yu, J. S. Neimat, "The Treatment of Movement Disorders by Deep Brain Stimulation", Vol. 5, 26-36, January 2008 ┬® The American Society for Experimental NeuroTherapeutics, Inc.
[2] S. S. HACISALIHZADE, M. MANSOUR, C. Albani, "Optimization of Symptomatic Therapy in Parkinson-s Disease", IEEE TRANSACTIONS ON BIOMEDICAL ENGINEERING, VOL. 36, NO. 3, MARCH 1989.
[3] M. Haeri, Y. Sarbaz, Sh. Gharibzadeh, "Modeling the Parkinson-s tremor and its treatments", Journal of Theoretical Biology 236, 311-322, 2005.
[4] A. H. V. Schapira, E. Bezard, J. Brotchie, F. Calon, G. L. Collingridge, B. Ferger, et al.," Novel Pharmacological Targets for the Treatment of Parkinson-s Disease" NATURE REVIEWS DRUG DISCOVER, OCTOBER 2008.
[5] C. R. Butson, C. C. McIntyre, "Differences among implanted pulse generator waveforms cause variations in the neural response to deep brain stimulation", Clinical Neurophysiology 118 (2007) 1889-1894.
[6] S. Breit, J.B. Schulz , A.-L. Benabid, "Deep brain stimulation", Cell Tissue Res (2004) 318: 275-288, DOI 10.1007/s00441-004-0936-0.
[7] Th. Wichmann, M.R. DeLong, "Deep Brain Stimulation for Neurologic and Neuropsychiatric Disorders", Neuron 52, 197-204, October 5, 2006 ª2006 Elsevier Inc. DOI 10.1016/j.neuron.2006.09.022.
[8] D. S. Kern, R. Kumar, "Deep Brain Stimulation", The Neurologist ÔÇó Volume 13, Number 5, September 2007.
[9] T. Fiegele, G. Feuchtner, F. Sohm, R. Bauer, J. V. Anton, T. Gotwald and et al "Accuracy of stereotactic electrode placement in deep brain stimulation by intraoperative computed tomography"., Department of Neurosurgery, Innsbruck Medical University, Anichstrasse 35, 6020 Innsbruck, Austria b Department of Radiology II, Innsbruck Medical University, Innsbruck, Austria Received 16 August 2007; received in revised form 13 November 2007; accepted 3 January 2008
[10] L. Garcia1, G. D-Alessandro2, B. Bioulac1 and C. Hammond2 "Highfrequency stimulation in Parkinson-s disease: more or less? " Laboratoire de neurophysiologie (Centre National de la Recherche Scientifique UMR 5543), Universite' de Bordeaux 2, 146 rue Le'o Saignat, 33076 Bordeaux Cedex, France 2Institut de Neurobiologie de la Me' diterrane'e (Institut National de la Recherche Me' dicale U 29), 163 route de Luminy, BP 13, 13273 Marseille Cedex 9, France
[11] J. E. Arle and J. L. Shils "Motor Cortex Stimulation for Pain and Movement Disorders" Department of Neurosurgery, Lahey Clinic, Burlington, Massachusetts 01805, and Department of Neurosurgery, Tufts University School of Medicine, Boston, Massachusetts 02110
[12] A. M. Kuncel, W. M. Grill, "Selection of stimulus parameters for deep brain stimulation", Clinical Neurophysiology 115 (2004) 2431-2441.
[13] Erwin B. Montgomery Jra,_, John T. Galeb "Mechanisms of action of deep brain stimulation (DBS)" Department of Neurology, National Primate Research Center, University of Wisconsin-Madison, H6/538 CSC, 600 Highland Ave., Madison, WI 53792, USA Department of Neurosurgery, Massachusetts General Hospital/Harvard Medical School, Edwards Research Building, EDR 410, 50 Blossom St., Boston, MA 02114, USA
[14] J. Y. Chang, L. H. Shi, F. Luo, W.M. Zhang, D.J Woodward, "Studies of the neural mechanisms of deep brain stimulation in rodent models of Parkinson-s disease" , Neuroscience and Biobehavioral Reviews 31 (2007) 643-657.
[15] M.S. Titcombe, L. Glass, A. Beuter , "Dynamics of Parkinsonian tremor during deep brain stimulation", American Institute of Physics, DECEMBER 2001.
[16] T. O. Videen, M. C. Campbell , S. D. Tabbal, M. Karimi, T. Hershey, J. S. Perlmutter, "Validation of a fiducial-based atlas localization method for deep brain stimulation contacts in the area of the subthalamic nucleus", Department of Neurology, Washington University School of Medicine, St. Louis, MO 63110, USA Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO 63110, USA Department of Psychiatry, Washington University School of Medicine, St. Louis, MO 63110, USA Department of Anatomy & Neurobiology, Washington University School of Medicine, St. Louis, MO 63110, USA Program in Physical Therapy, Washington University School of Medicine, St. Louis, MO 63110, USA Received 7 June 2007; received in revised form 11 October 2007; accepted 11 October 2007
[17] B. Blad, L. Bertenstam, S. Rehncrona, H. Bjartmarz, A.-L. Törnqvist, "Measurement of contact impedance of electrodes used for deep brain stimulation", ITBM-RBM 26 (2005) 344-346.
[18] D. M. Durand, "Electrical Stimulation of Excitable Systems" case western reserved university