Analysis of phase-amplitude coupling in the STN for coordinated-reset stimulation
Coordinated reset (CR) has been proposed as a more efficient stimulation protocol for deep brain stimulation  as opposed to continuous stimulation, which is being used conventionally . This novel stimulation protocol consists of stimulation with a cycling pattern of brief high-frequency pulse trains at multiple electrode contacts. This type of stimulation is done to consecutively reset the phases of the different stimulated neuronal subpopulations. This is hypothesized to divide the neuronal population into phase-shifted subpopulations, causing an unlearning of both pathological neuronal synchrony and pathological synaptic connectivity. This means that once the connectivity has been changed, in contrast to the conventional stimulation, the high frequency stimulation temporarily can be turned off. If the mean frequency of stimulation, pulse amplitude can be reduced with CR stimulation, less energy is needed, and batteries can be replaced or recharged after longer intervals. Moreover, smaller stimulators can be developed. Most importantly, a reduced stimulation current could result in less side effects. Such improvements can result in a further improved quality of life for patients undergoing DBS. Hypothetically the CR protocol by plastic changes would affect the pathological neural circuits and reset them in a persistent way.
To apply CR stimulation optimally the new LFP data will allow to investigate the synchronization within the STN in a much higher spatial and temporal resolution. In particular it could reveal whether the synchronization in the STN is homogeneous, or that there are substructures with a particular phase difference in their activity. This can be revealed through a Phase-Amplitude Coupling (PAC) analysis . This kind of analysis may reveal substructures within the STN and thismay aid in the design of CR-protocols. Also our understanding of the spatial distribution of neural activity at particular frequencies in STN will be increased.
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