Deep brain stimulation (DBS) is a proven effective treatment for Parkinson’s disease (PD). However, titrating DBS stimulation parameters is a labourious process and requires frequent hospital visits. Additionally, its current application uses continuous high-frequency stimulation at a constant intensity, which may reduce efficacy and cause side effects. The objective of the AI-DBS study is to identify patient-specific patterns of neuronal activity that are associated with the severity of motor symptoms of PD. This information is essential for the development of advanced responsive stimulation algorithms, which may improve the efficacy of DBS.
This longitudinal prospective observational cohort study will enrol 100 patients with PD who are bilaterally implanted with a sensing-enabled DBS system (Percept PC, Medtronic) in the subthalamic nucleus as part of standard clinical care. Local neuronal activity, specifically local field potential (LFP) signals, will be recorded during the first 6 months after DBS implantation. Correlations will be tested between spectral features of LFP data and symptom severity, which will be assessed using (1) inertial sensor data from a wearable smartwatch, (2) clinical rating scales and (3) patient diaries and analysed using conventional descriptive statistics and artificial intelligence algorithms. The primary objective is to identify patient-specific profiles of neuronal activity that are associated with the presence and severity of motor symptoms, forming a ‘neuronal fingerprint’.
Ethical approval was granted by the local ethics committee of the Amsterdam UMC (registration number 2022.0368). Study findings will be disseminated through scientific journals and presented at national and international conferences.
by Paige K. Marty, Balaji Pathakumari, Thomas M. Cox, Virginia P. Van Keulen, Courtney L. Erskine, Maleeha Shah, Mounika Vadiyala, Pedro Arias-Sanchez, Snigdha Karnakoti, Kelly M. Pennington, Elitza S. Theel, Cecilia S. Lindestam Arlehamn, Tobias Peikert, Patricio Escalante
Clinical prediction of nontuberculous mycobacteria lung disease (NTM-LD) progression remains challenging. We aimed to evaluate antigen-specific immunoprofiling utilizing flow cytometry (FC) of activation-induced markers (AIM) and IFN-γ enzyme-linked immune absorbent spot assay (ELISpot) accurately identifies patients with NTM-LD, and differentiate those with progressive from nonprogressive NTM-LD. A Prospective, single-center, and laboratory technician-blinded pilot study was conducted to evaluate the FC and ELISpot based immunoprofiling in patients with NTM-LD (n = 18) and controls (n = 22). Among 18 NTM-LD patients, 10 NTM-LD patients were classified into nonprogressive, and 8 as progressive NTM-LD based on clinical and radiological features. Peripheral blood mononuclear cells were collected from patients with NTM-LD and control subjects with negative QuantiFERON results. After stimulation with purified protein derivative (PPD), mycobacteria-specific peptide pools (MTB300, RD1-peptides), and control antigens, we performed IFN-γ ELISpot and FC AIM assays to access their diagnostic accuracies by receiver operating curve (ROC) analysis across study groups. Patients with NTM-LD had significantly higher percentage of CD4+/CD8+ T-cells co-expressing CD25+CD134+ in response to PPD stimulation, differentiating between NTM-LD and controls. Among patients with NTM-LD, there was a significant difference in CD25+CD134+ co-expression in MTB300-stimulated CD8+ T-cells (p