Deep Brain Stimulation therapies: A control-engineering perspective

Deep Brain Stimulation (DBS) is an established therapy for treating e.g. Parkinson's disease, essential tremor, as well as epilepsy. In DBS, chronic pulsatile electrical stimulation is administered to a certain target area of the brain through a surgically implanted lead. The stimuli parameters have to be properly tuned in order to achieve therapeutical effect that in most cases is alleviation of motor symptoms. Tuning of DBS currently is a tedious task since it is performed manually by medical personnel in a trial-and-error manner. It can be dramatically improved and expedited by means of recently developed mathematical models together with control and estimation technology. This paper presents a control engineering perspective on DBS, viewing it as a control system for minimizing the severity of the symptoms through coordinated manipulation of the stimuli parameters. The DBS model structure comprises a stimuli model, an activation model, and a symptoms model. Each of those is individualized from patient data obtained through medical imaging, electrical measurements, and objective symptom quantification. The proposed approach is illustrated by simulation and clinical data from an individualized DBS model being developed by the authors.