Paper Info
Title
A Fuzzy Inference System for Closed-Loop Deep Brain Stimulation in Parkinson’s Disease
Abstract
Parkinsons disease is a complex neurodegenerative disorder for which patients present many symptoms, tremor being the main one. In advanced stages of the disease, Deep Brain Stimulation is a generalized therapy which can significantly improve the motor symptoms. However despite its beneficial effects on treating the symptomatology, the technique can be improved. One of its main limitations is that the parameters are fixed, and the stimulation is provided uninterruptedly, not taking into account any fluctuation in the patients state. A closed-loop system which provides stimulation by demand would adjust the stimulation to the variations in the state of the patient, stimulating only when it is necessary. It would not only perform a more intelligent stimulation, capable of adapting to the changes in real time, but also extending the devices battery life, thereby avoiding surgical interventions. In this work we design a tool that learns to recognize the principal symptom of Parkinsons disease and particularly the tremor. The goal of the designed system is to detect the moments the patient is suffering from a tremor episode and consequently to decide whether stimulation is needed or not. For that, local field potentials were recorded in the subthalamic nucleus of ten Parkinsonian patients, who were diagnosed with tremor-dominant Parkinsons disease and who underwent surgery for the implantation of a neurostimulator. Electromyographic activity in the forearm was simultaneously recorded, and the relation between both signals was evaluated using two different synchronization measures. The results of evaluating the synchronization indexes on each moment represent the inputs to the designed system. Finally, a fuzzy inference system was applied with the goal of identifying tremor episodes. Results are favourable, reaching accuracies of higher 98.7 % in 70 % of the patients.
Year
DOI
Venue
2015
10.1007/s10916-015-0328-x
J. Medical Systems
Keywords
Field
DocType
Parkinson’s disease, Deep brain stimulation, Fuzzy logic, Bicoherence, Mutual information
Data mining,Deep brain stimulation,Synchronization,Parkinson's disease,Disease,Physical therapy,Electromyography,Local field potential,Physical medicine and rehabilitation,Subthalamic nucleus,Medicine,Stimulation
Journal
Volume
Issue
ISSN
39
11
1573-689X
Citations 
PageRank 
References 
18
0.46
4
Authors
7
Name
Order
Citations
PageRank
carmen camara1441.42
Kevin Warwick212921.37
ricardo bruna3352.75
Tipu Z. Aziz416813.34
Francisco del Pozo520925.65
fernando maestu6180.80
AzizTipu7180.46