Proceedings of the Eighth Annual Deep Brain Stimulation Think Tank: Advances in Optogenetics, Ethical Issues Affecting DBS Research, Neuromodulatory Approaches for Depression, Adaptive Neurostimulation, and Emerging DBS Technologies

We estimate that 208,000 deep brain stimulation (DBS) devices have been implanted to address neurological and neuropsychiatric disorders worldwide. DBS Think Tank presenters pooled data and determined that DBS expanded in its scope and has been applied to multiple brain disorders in an effort to modulate neural circuitry. The DBS Think Tank was founded in 2012 providing a space where clinicians, engineers, researchers from industry and academia discuss current and emerging DBS technologies and logistical and ethical issues facing the field. The emphasis is on cutting edge research and collaboration aimed to advance the DBS field. The Eighth Annual DBS Think Tank was held virtually on September 1 and 2, 2020 (Zoom Video Communications) due to restrictions related to the COVID-19 pandemic. The meeting focused on advances in: (1) optogenetics as a tool for comprehending neurobiology of diseases and on optogenetically-inspired DBS, (2) cutting edge of emerging DBS technologies, (3) ethical issues affecting DBS research and access to care, (4) neuromodulatory approaches for depression, (5) advancing novel hardware, software and imaging methodologies, (6) use of neurophysiological signals in adaptive neurostimulation, and (7) use of more advanced technologies to improve DBS clinical outcomes. There were 178 attendees who participated in a DBS Think Tank survey, which revealed the expansion of DBS into several indications such as obesity, post-traumatic stress disorder, addiction and Alzheimer’s disease. This proceedings summarizes the advances discussed at the Eighth Annual DBS Think Tank.

[1]  Y. Shimo,et al.  Closed-loop programming using external responses for deep brain stimulation in Parkinson's disease. , 2021, Parkinsonism & related disorders.

[2]  G. Deuschl,et al.  Cross-frequency coupling between gamma oscillations and deep brain stimulation frequency in Parkinson’s disease , 2020, Brain : a journal of neurology.

[3]  Hesheng Liu,et al.  Neuromodulation effects of deep brain stimulation on beta rhythm: A longitudinal local field potential study , 2020, Brain Stimulation.

[4]  K. Deisseroth,et al.  Deep brain optogenetics without intracranial surgery , 2020, Nature Biotechnology.

[5]  Hoon-Ki Min,et al.  Orientation-selective and directional deep brain stimulation in swine assessed by functional MRI at 3T , 2020, NeuroImage.

[6]  G. Baltuch,et al.  Deep Brain Stimulation Is Effective for Treatment-Resistant Depression: A Meta-Analysis and Meta-Regression , 2020, Journal of clinical medicine.

[7]  R. Uitti,et al.  Neuroimaging Advances in Deep Brain Stimulation: Review of Indications, Anatomy, and Brain Connectomics , 2020, American Journal of Neuroradiology.

[8]  E. Storch,et al.  Neurostimulation for treatment-resistant posttraumatic stress disorder: an update on neurocircuitry and therapeutic targets. , 2020, Journal of neurosurgery.

[9]  R. Malenka,et al.  Brain-Responsive Neurostimulation for Loss of Control Eating: Early Feasibility Study. , 2020, Neurosurgery.

[10]  K. Bötzel,et al.  Bilateral double beta peaks in a PD patient with STN electrodes , 2020, Acta Neurochirurgica.

[11]  Andreas Horn,et al.  Opportunities of connectomic neuromodulation , 2020, NeuroImage.

[12]  Kara A. Johnson,et al.  Structural connectivity predicts clinical outcomes of deep brain stimulation for Tourette syndrome. , 2020, Brain : a journal of neurology.

[13]  A. Schnitzler,et al.  Neuroimaging and electrophysiology meet invasive neurostimulation for causal interrogations and modulations of brain states , 2020, NeuroImage.

[14]  H. Bronte-Stewart,et al.  Neural closed-loop deep brain stimulation for freezing of gait , 2020, Brain Stimulation.

[15]  B. Strange,et al.  A unified connectomic target for deep brain stimulation in obsessive-compulsive disorder , 2020, Nature Communications.

[16]  Karl Deisseroth,et al.  Comprehensive Dual- and Triple-Feature Intersectional Single-Vector Delivery of Diverse Functional Payloads to Cells of Behaving Mammals , 2020, Neuron.

[17]  M. Okun,et al.  Implementation of a Novel Bluetooth Technology for Remote Deep Brain Stimulation Programming: The Pre– and Post–COVID‐19 Beijing Experience , 2020, Movement disorders : official journal of the Movement Disorder Society.

[18]  H. Mayberg,et al.  Rapid Antidepressant Effects of Deep Brain Stimulation and Their Relation to Surgical Protocol , 2020, Biological Psychiatry.

[19]  J. Cohn,et al.  Deep Brain Stimulation for Intractable Obsessive-Compulsive Disorder: Progress and Opportunities. , 2020, The American journal of psychiatry.

[20]  Ningfei Li,et al.  Normative vs. patient-specific brain connectivity in deep brain stimulation , 2020, NeuroImage.

[21]  M. Okun,et al.  Functional and Structural Connectivity Patterns Associated with Clinical Outcomes in Deep Brain Stimulation of the Globus Pallidus Internus for Generalized Dystonia , 2020, American Journal of Neuroradiology.

[22]  Itzhak Fried,et al.  Wireless Programmable Recording and Stimulation of Deep Brain Activity in Freely Moving Humans , 2020, Neuron.

[23]  I. Bergfeld.  Putting deep brain stimulation for depression in a wider perspective. , 2020, The lancet. Psychiatry.

[24]  D. Denys,et al.  Long-term deep brain stimulation of the ventral anterior limb of the internal capsule for treatment-resistant depression , 2019, Journal of Neurology, Neurosurgery, and Psychiatry.

[25]  Helen Mayberg,et al.  Addressing the Credit Assignment Problem in Treatment Outcome Prediction Using Temporal DifferenceLearning , 2019, PSB.

[26]  Anca Velisar,et al.  Neural Closed Loop Deep Brain Stimulation for Freezing of Gait , 2019 .

[27]  Martin Parent,et al.  Holographic Reconstruction of Axonal Pathways in the Human Brain , 2019, Neuron.

[28]  H. Mayberg,et al.  Long-Term Outcomes of Subcallosal Cingulate Deep Brain Stimulation for Treatment-Resistant Depression. , 2019, The American journal of psychiatry.

[29]  V. Visser-Vandewalle,et al.  Directional DBS leads show large deviations from their intended implantation orientation. , 2019, Parkinsonism & related disorders.

[30]  A. Horn,et al.  Connectivity profile of thalamic deep brain stimulation to effectively treat essential tremor , 2019, bioRxiv.

[31]  Joost B. Wagenaar,et al.  Proceedings of the Sixth Deep Brain Stimulation Think Tank Modulation of Brain Networks and Application of Advanced Neuroimaging, Neurophysiology, and Optogenetics , 2019, Front. Neurosci..

[32]  M. Beauchamp,et al.  Device Removal Following Brain Implant Research , 2019, Neuron.

[33]  B. Fischl,et al.  The Ansa Subthalamica: A Neglected Fiber Tract , 2019, Movement disorders : official journal of the Movement Disorder Society.

[34]  Surya Ganguli,et al.  Cortical layer–specific critical dynamics triggering perception , 2019, Science.

[35]  Justin K. Rajendra,et al.  Field potential 1/f activity in the subcallosal cingulate region as a candidate signal for monitoring deep brain stimulation for treatment resistant depression. , 2019, Journal of neurophysiology.

[36]  H. Bronte-Stewart,et al.  Dual threshold neural closed loop deep brain stimulation in Parkinson disease patients , 2019, Brain Stimulation.

[37]  M. Dylan Tisdall,et al.  7 Tesla MRI of the ex vivo human brain at 100 micron resolution , 2019, Scientific Data.

[38]  Kara A. Johnson,et al.  Image-based analysis and long-term clinical outcomes of deep brain stimulation for Tourette syndrome: a multisite study , 2019, Journal of Neurology, Neurosurgery, and Psychiatry.

[39]  J Borggrefe,et al.  Directional DBS Leads Show Large Deviations from their Intended Implantation Orientation , 2019, bioRxiv.

[40]  Siobhan Ewert,et al.  Probabilistic mapping of the antidystonic effect of pallidal neurostimulation: a multicentre imaging study. , 2019, Brain : a journal of neurology.

[41]  V. Visser-Vandewalle,et al.  Connectivity Profile Predictive of Effective Deep Brain Stimulation in Obsessive-Compulsive Disorder , 2019, Biological Psychiatry.

[42]  William E. Allen,et al.  Thirst regulates motivated behavior through modulation of brainwide neural population dynamics , 2019, Science.

[43]  Andrea A. Kühn,et al.  Beta bursts during continuous movements accompany the velocity decrement in Parkinson's disease patients , 2019, Neurobiology of Disease.

[44]  H. Bergman,et al.  Deep brain stimulation: current challenges and future directions , 2019, Nature Reviews Neurology.

[45]  James H. Marshel,et al.  Interacting neural ensembles in orbitofrontal cortex for social and feeding behaviour , 2019, Nature.

[46]  A. Horn,et al.  Optimization and comparative evaluation of nonlinear deformation algorithms for atlas-based segmentation of DBS target nuclei , 2019, NeuroImage.

[47]  Matthew D. Johnson,et al.  Bayesian adaptive dual control of deep brain stimulation in a computational model of Parkinson’s disease , 2018, PLoS Comput. Biol..

[48]  G. Deuschl,et al.  Cortical network fingerprints predict deep brain stimulation outcome in dystonia , 2018, bioRxiv.

[49]  Matthew D. Johnson,et al.  Multi-objective particle swarm optimization for postoperative deep brain stimulation targeting of subthalamic nucleus pathways , 2018, Journal of neural engineering.

[50]  A. Kalmbach,et al.  Dopamine neuron glutamate cotransmission evokes a delayed excitation in lateral dorsal striatal cholinergic interneurons , 2018, eLife.

[51]  Matthew D. Johnson,et al.  Clinical deep brain stimulation strategies for orientation-selective pathway activation , 2018, Journal of neural engineering.

[52]  D. Denys,et al.  Telemedical Deep Brain Stimulation: Merits and Limitations , 2018, Stereotactic and Functional Neurosurgery.

[53]  M. Okun,et al.  Deep Brain Stimulation at Variable Frequency to Improve Motor Outcomes in Parkinson's Disease , 2018, Movement disorders clinical practice.

[54]  H. Bergman,et al.  Longer β oscillatory episodes reliably identify pathological subthalamic activity in Parkinsonism , 2018, Movement disorders : official journal of the Movement Disorder Society.

[55]  Karl Deisseroth,et al.  Mapping projections of molecularly defined dopamine neuron subtypes using intersectional genetic approaches , 2018, Nature Neuroscience.

[56]  Gregory A Worrell,et al.  Differences in functional connectivity profiles as a predictor of response to anterior thalamic nucleus deep brain stimulation for epilepsy: a hypothesis for the mechanism of action and a potential biomarker for outcomes. , 2018, Neurosurgical focus.

[57]  T. Sanger,et al.  Pediatric Deep Brain Stimulation Using Awake Recording and Stimulation for Target Selection in an Inpatient Neuromodulation Monitoring Unit , 2018, Brain sciences.

[58]  Robert E. Gross,et al.  Initial Unilateral Exposure to Deep Brain Stimulation in Treatment-Resistant Depression Patients Alters Spectral Power in the Subcallosal Cingulate , 2018, Front. Comput. Neurosci..

[59]  K. G. Mideksa,et al.  Cerebello-cortical network fingerprints differ between essential, Parkinson’s and mimicked tremors , 2018, Brain : a journal of neurology.

[60]  Siobhan Ewert,et al.  Lead-DBS v2: Towards a comprehensive pipeline for deep brain stimulation imaging , 2018, NeuroImage.

[61]  Margaret C. Thompson,et al.  Adaptive deep brain stimulation for Parkinson’s disease using motor cortex sensing , 2018, Journal of neural engineering.

[62]  C. Verney,et al.  Human Motor Thalamus Reconstructed in 3D from Continuous Sagittal Sections with Identified Subcortical Afferent Territories , 2018, eNeuro.

[63]  M. Beauchamp,et al.  Continued access to investigational brain implants , 2018, Nature Reviews Neuroscience.

[64]  Prasad Shirvalkar,et al.  Closed-Loop Deep Brain Stimulation for Refractory Chronic Pain , 2018, Front. Comput. Neurosci..

[65]  Guglielmo Foffani,et al.  Eight-hours adaptive deep brain stimulation in patients with Parkinson disease , 2018, Neurology.

[66]  G. Deuschl,et al.  Frontal Lobe Connectivity and Network Community Characteristics are Associated with the Outcome of Subthalamic Nucleus Deep Brain Stimulation in Patients with Parkinson’s Disease , 2018, Brain Topography.

[67]  C. McIntyre,et al.  StimVision Software: Examples and Applications in Subcallosal Cingulate Deep Brain Stimulation for Depression , 2018, Neuromodulation : journal of the International Neuromodulation Society.

[68]  Robert E. Hampson,et al.  Evolving Applications, Technological Challenges and Future Opportunities in Neuromodulation: Proceedings of the Fifth Annual Deep Brain Stimulation Think Tank , 2018, Front. Neurosci..

[69]  Braxton Osting,et al.  Optimized programming algorithm for cylindrical and directional deep brain stimulation electrodes , 2018, Journal of neural engineering.

[70]  Yuan Feng,et al.  A Method for Removal of Deep Brain Stimulation Artifact From Local Field Potentials , 2017, IEEE Transactions on Neural Systems and Rehabilitation Engineering.

[71]  Warren M Grill,et al.  An improved genetic algorithm for designing optimal temporal patterns of neural stimulation , 2017, Journal of neural engineering.

[72]  P. Brown,et al.  Long term correlation of subthalamic beta band activity with motor impairment in patients with Parkinson’s disease , 2017, Clinical Neurophysiology.

[73]  Parag G. Patil,et al.  Subcallosal cingulate deep brain stimulation for treatment-resistant depression: a multisite, randomised, sham-controlled trial. , 2017, The lancet. Psychiatry.

[74]  Andrea A. Kühn,et al.  Beta burst dynamics in Parkinson’s disease OFF and ON dopaminergic medication , 2017, Brain : a journal of neurology.

[75]  Karl Deisseroth,et al.  The form and function of channelrhodopsin , 2017, Science.

[76]  M. Fox,et al.  Connectivity Predicts deep brain stimulation outcome in Parkinson disease , 2017, Annals of neurology.

[77]  Peter Brown,et al.  Adaptive DBS in a Parkinson's patient with chronically implanted DBS: A proof of principle , 2017, Movement disorders : official journal of the Movement Disorder Society.

[78]  Andreas Horn,et al.  Probabilistic conversion of neurosurgical DBS electrode coordinates into MNI space , 2017, NeuroImage.

[79]  Justin K. Rajendra,et al.  A connectomic approach for subcallosal cingulate deep brain stimulation surgery: prospective targeting in treatment-resistant depression , 2017, Molecular Psychiatry.

[80]  G. Deuschl,et al.  Effects of DBS in parkinsonian patients depend on the structural integrity of frontal cortex , 2017, Scientific Reports.

[81]  Peter Brown,et al.  The modulatory effect of adaptive deep brain stimulation on beta bursts in Parkinson’s disease , 2017, Brain : a journal of neurology.

[82]  Luming Li,et al.  A platform for long-term monitoring the deep brain rhythms , 2017 .

[83]  Matthew D. Johnson,et al.  Orientation selective deep brain stimulation , 2017, Journal of neural engineering.

[84]  Matthew D. Johnson,et al.  Particle swarm optimization for programming deep brain stimulation arrays , 2017, Journal of neural engineering.

[85]  Warren M. Grill,et al.  Optimized temporal pattern of brain stimulation designed by computational evolution , 2017, Science Translational Medicine.

[86]  Jens Volkmann,et al.  Innovations in deep brain stimulation methodology , 2017, Movement disorders : official journal of the Movement Disorder Society.

[87]  H. Bronte-Stewart,et al.  Subthalamic beta oscillations are attenuated after withdrawal of chronic high frequency neurostimulation in Parkinson's disease , 2016, Neurobiology of Disease.

[88]  P. Starr,et al.  An unexpectedly high rate of revisions and removals in deep brain stimulation surgery: Analysis of multiple databases. , 2016, Parkinsonism & related disorders.

[89]  Timothy Denison,et al.  Proceedings of the Fourth Annual Deep Brain Stimulation Think Tank: A Review of Emerging Issues and Technologies , 2016, Front. Integr. Neurosci..

[90]  Siobhan Ewert,et al.  Toward defining deep brain stimulation targets in MNI space: A subcortical atlas based on multimodal MRI, histology and structural connectivity , 2016, NeuroImage.

[91]  J. Giordano.  Commentary: The Value of Patient Benefit: Consideration of Framing Contingencies to Guide the Ethical Use of DBS-a Case Analysis. , 2016, Cambridge quarterly of healthcare ethics : CQ : the international journal of healthcare ethics committees.

[92]  Luming Li,et al.  Chronically monitoring the deep brain rhythms: from stimulation to recording , 2016 .

[93]  Matthew D. Johnson,et al.  Model-Based Comparison of Deep Brain Stimulation Array Functionality with Varying Number of Radial Electrodes and Machine Learning Feature Sets , 2016, Front. Comput. Neurosci..

[94]  Matthew D. Johnson,et al.  Theoretical Optimization of Stimulation Strategies for a Directionally Segmented Deep Brain Stimulation Electrode Array , 2016, IEEE Transactions on Biomedical Engineering.

[95]  Anca Velisar,et al.  Beta oscillations in freely moving Parkinson's subjects are attenuated during deep brain stimulation , 2015, Movement disorders : official journal of the Movement Disorder Society.

[96]  Patrick T. Hickey,et al.  Postmortem diffusion MRI of the human brainstem and thalamus for deep brain stimulator electrode localization , 2015, Human brain mapping.

[97]  Warren M Grill,et al.  Design and in vivo evaluation of more efficient and selective deep brain stimulation electrodes , 2015, Journal of neural engineering.

[98]  Bruce R. Rosen,et al.  Brain Genomics Superstruct Project initial data release with structural, functional, and behavioral measures , 2015, Scientific Data.

[99]  Sara Marceglia,et al.  Adaptive deep brain stimulation in a freely moving parkinsonian patient , 2015, Movement disorders : official journal of the Movement Disorder Society.

[100]  Justin K. Rajendra,et al.  Defining Critical White Matter Pathways Mediating Successful Subcallosal Cingulate Deep Brain Stimulation for Treatment-Resistant Depression , 2014, Biological Psychiatry.

[101]  J. Dorszewska.  Genetics of Parkinson's Disease and Other Diseases of the Extrapyramidal System , 2014, Current genomics.

[102]  C. McIntyre,et al.  Artificial neural network based characterization of the volume of tissue activated during deep brain stimulation , 2013, Journal of neural engineering.

[103]  P. Brown,et al.  Adaptive Deep Brain Stimulation In Advanced Parkinson Disease , 2013, Annals of neurology.

[104]  Alan C. Evans,et al.  BigBrain: An Ultrahigh-Resolution 3D Human Brain Model , 2013, Science.

[105]  John A Wolf,et al.  Amelioration of Binge Eating by Nucleus Accumbens Shell Deep Brain Stimulation in Mice Involves D2 Receptor Modulation , 2013, The Journal of Neuroscience.

[106]  James H. Marshel,et al.  Diverging neural pathways assemble a behavioural state from separable features in anxiety , 2013, Nature.

[107]  Benjamin F. Grewe,et al.  Two-photon optogenetic toolbox for fast inhibition, excitation and bistable modulation , 2012, Nature Methods.

[108]  Alberto Priori,et al.  Subthalamic local field potentials after seven-year deep brain stimulation in Parkinson's disease , 2012, Experimental Neurology.

[109]  N. Ince,et al.  Long-term recordings of local field potentials from implanted deep brain stimulation electrodes. , 2012, Neurosurgery.

[110]  Dennis C Harrison.  Form and function , 2012, Canadian Medical Association Journal.

[111]  Megan M. Filkowski,et al.  Subcallosal cingulate deep brain stimulation for treatment-resistant unipolar and bipolar depression. , 2012, Archives of general psychiatry.

[112]  Steen Moeller,et al.  The Human Connectome Project: A data acquisition perspective , 2012, NeuroImage.

[113]  D. Yurgelun-Todd,et al.  Functional Connectivity Targeting for Deep Brain Stimulation in Essential Tremor , 2011, American Journal of Neuroradiology.

[114]  Marisa O. Hollinshead,et al.  The organization of the human cerebral cortex estimated by intrinsic functional connectivity. , 2011, Journal of neurophysiology.

[115]  B. Mädler,et al.  A role of diffusion tensor imaging fiber tracking in deep brain stimulation surgery: DBS of the dentato-rubro-thalamic tract (drt) for the treatment of therapy-refractory tremor , 2011, Acta Neurochirurgica.

[116]  Sidney H. Kennedy,et al.  Deep brain stimulation for treatment-resistant depression: follow-up after 3 to 6 years. , 2011, The American journal of psychiatry.

[117]  P. Brown,et al.  Deep brain stimulation can suppress pathological synchronisation in parkinsonian patients , 2010, Journal of Neurology, Neurosurgery & Psychiatry.

[118]  A. Lozano,et al.  Treatment resistant depression as a failure of brain homeostatic mechanisms: Implications for deep brain stimulation , 2009, Experimental Neurology.

[119]  Volker A Coenen,et al.  MEDIAL FOREBRAIN BUNDLE STIMULATION AS A PATHOPHYSIOLOGICAL MECHANISM FOR HYPOMANIA IN SUBTHALAMIC NUCLEUS DEEP BRAIN STIMULATION FOR PARKINSON'S DISEASE , 2009, Neurosurgery.

[120]  Andrea A. Kühn,et al.  High-Frequency Stimulation of the Subthalamic Nucleus Suppresses Oscillatory β Activity in Patients with Parkinson's Disease in Parallel with Improvement in Motor Performance , 2008, The Journal of Neuroscience.

[121]  K. Deisseroth,et al.  Neural substrates of awakening probed with optogenetic control of hypocretin neurons , 2007, Nature.

[122]  P. Brown,et al.  Reduction in subthalamic 8–35 Hz oscillatory activity correlates with clinical improvement in Parkinson's disease , 2006, The European journal of neuroscience.

[123]  A. Lozano,et al.  Deep Brain Stimulation for Treatment-Resistant Depression , 2005, Neuron.

[124]  A. Oliviero,et al.  Patterning of globus pallidus local field potentials differs between Parkinson's disease and dystonia. , 2003, Brain : a journal of neurology.

[125]  E. Bamberg,et al.  Channelrhodopsin-1: A Light-Gated Proton Channel in Green Algae , 2002, Science.

[126]  E. Spiegel,et al.  Ansotomy in paralysis agitans. , 1954, A.M.A. archives of neurology and psychiatry.

[127]  E. Spiegel,et al.  Stereotaxic Apparatus for Operations on the Human Brain. , 1947, Science.

[128]  P. Petersson,et al.  Basal ganglia oscillations as biomarkers for targeting circuit dysfunction in Parkinson's disease. , 2020, Progress in brain research.

[129]  Yanan Sui,et al.  Automatic Sleep Stage Classification Based on Subthalamic Local Field Potentials , 2019, IEEE Transactions on Neural Systems and Rehabilitation Engineering.

[130]  M. Okun,et al.  The Problem of Funding Off-label Deep Brain Stimulation: Bait-and-Switch Tactics and the Need for Policy Reform. , 2017, JAMA neurology.

[131]  J. Giordano.  A preparatory neuroethical approach to assessing developments in neurotechnology. , 2015, The virtual mentor : VM.

[132]  Pallidum Gpi,et al.  The Basal Ganglia , 2022 .