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A Computational Model of Phase-Delayed Balanced Biphasic Deep Brain Stimulation for Essential Tremor in a Cerebellar-Basal Ganglia-Thalamocortical Network

Authors :

Shabnam Andalibi Miandoab¹ Nazlar Ghasemzadeh²

1- دانشگاه آزاد اسلامی واحد تبریز 2- دانشگاه آزاد اسلامی واحد تبریز

Keywords :

Essential Tremor (ET)،CBGTHC network model،Monophasic DBS،Biphasic DBS،Parkinson’s Disease (PD)

Abstract :

Essential Tremor is one of the most common movement disorders that significantly reduces the quality of life of patients. Deep brain stimulation (DBS) has been proposed as an effective treatment for this disease, but the selection of optimal stimulation parameters remains a major challenge and is often based on trial and error. The use of comprehensive computational models to simulate brain networks and investigate the effects of different DBS pulses could be an important step in improving the understanding of the disease mechanism and designing more accurate and efficient treatment protocols. For this purpose, in this study, a computational model of the cerebellar-basal ganglia thalamocortical (CBGTHC) network has been developed, including key areas such as basal ganglia with neurons of the Subthalamic Nucleus (STN), Globus Pallidus Externa (GPe) and Globus Pallidus Interna (GPi), the striatum with neurons of D1 Medium Spiny Neuron (D1 MSN), D2 Medium Spiny Neuron (D2 MSN) and Fast Spiking Interneuron (FSI), and the thalamocortical with neurons of the Nucleus Reticularis Thalami (nRT), Cortex, Deep Cerebellar Nuclei (DCN), Thalamus (Th) and or Ventral Intermediate Nucleus of the Thalamus (Vim). Then, three types of stimulation, including rectangular monophasic DBS, symmetrical rectangular biphasic DBS, and phase-delayed balanced rectangular biphasic DBS have been simulated on GPi and GPe neurons in Parkinsonian conditions. The results show that phase-delayed balanced rectangular biphasic DBS stimulation at a frequency of 100 Hz and a pulse width of 4 ms is the most effective pattern in reducing beta band oscillations (0.1-0.2) and controlling GPi and GPe burst discharges, and ultimately controlling tremor. On the other hand, phase-delayed balanced rectangular biphasic DBS stimulation has led to a reduction in power loss and heat and causes minimal damage to brain tissue. These findings indicate that the correct selection of pulse type and DBS parameters can provide the greatest therapeutic efficacy for patients with essential tremor in Parkinson's disease by reducing side effects.