Brain stimulation for PTSD patients

Summary: Sweat response could make brain stimulators more responsive for those with PTSD and other psychological disorders.

Source: University of Houston

For 8-million adults who suffer from post-traumatic stress disorder in any given year, medication and cognitive therapy have been the treatment protocol. Now, University of Houston assistant professor of electrical engineering Rose T. Faghih is reporting in Frontiers in Neuroscience that a closed-loop brain stimulator, based on sweat response, can be developed not only for PTSD patients but also for those who suffer an array of neuropsychiatric disorders.

“Sweat primarily helps maintain body temperature; however, tiny bursts of sweat are also released in response to psychologically arousing stimuli. Tracking the associated changes in the conductivity of the skin, which can be seamlessly measured using wearables in real-world settings, thus provides a window into a person’s emotions,” reports Faghih.

For people with movement disorders like Parkinson’s disease and essential tremor, who have not responded to medication, application of high-frequency electric current to the brain, or deep brain stimulation, is regarded as most effective. Electrodes are placed in certain areas of the brain to regulate abnormal functions and a pacemaker-like device, placed in the upper chest, controls the amount of stimulation the brain receives. Open-loop stimulators, the most widely-used, deliver continuous stimulation until manually re-adjusted by a physician. Closed-loop stimulators, which provide stimulation in response to biomarkers of pathologic brain activity, have been developed for movement disorders, but are yet to be explored for the treatment of neuropsychiatric disorders.

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The ultimate goal will be to develop closed-loop prototypes that can eventually be used for treating patients in a variety of neuropsychiatric disorders. The image is in the public domain.

Signaling the onset of a PTSD episode, skin develops the tiniest sheen of perspiration. That symptom of the body’s fight or flight response signals a change in the skin’s electrical conductivity and provides a window into the brain’s state of emotional arousal. Using skin conductance to create the framework for a deep brain stimulator seemed logical to Faghih after reviewing group studies of Vietnam combat veterans with PTSD. Among the findings, PTSD subjects had the largest skin conductance responses when confronted with combat-related words. In a similar study comparing Vietnam combat veterans with and without PTSD and non-combat controls, PTSD veterans had the highest baseline skin conductance levels.

“Skin conductance additionally has the advantage of being easily measured with wearable devices that afford convenience, seamless integration into clothing and do not involve risk of surgically implanted sensors,” said Faghih.

The ultimate goal will be to develop closed-loop prototypes that can eventually be used for treating patients in a variety of neuropsychiatric disorders. Faghih’s graduate researchers Dilranjan Wickramasuriya and Md. Rafiul Amin were first and second authors, respectively, of the article.

Funding: This project was supported, in part, by a grant from the National Science Foundation.

About this neuroscience research article

Source:
University of Houston
Media Contacts:
Laurie Fickman – University of Houston
Image Source:
The image is in the public domain.

Original Research: Open access
“Skin Conductance as a Viable Alternative for Closing the Deep Brain Stimulation Loop in Neuropsychiatric Disorders”. Dilranjan S. Wickramasuriya, Md., Rafiul Amin and Rose T. Faghih.
Frontiers in Neuroscience. doi:10.3389/fnins.2019.00780

Abstract

Skin Conductance as a Viable Alternative for Closing the Deep Brain Stimulation Loop in Neuropsychiatric Disorders

Markers from local field potentials, neurochemicals, skin conductance, and hormone concentrations have been proposed as a means of closing the loop in Deep Brain Stimulation (DBS) therapy for treating neuropsychiatric and movement disorders. Developing a closed-loop DBS controller based on peripheral signals would require: (i) the recovery of a biomarker from the source neural stimuli underlying the peripheral signal variations; (ii) the estimation of an unobserved brain or central nervous system related state variable from the biomarker. The state variable is application-specific. It is emotion-related in the case of depression or post-traumatic stress disorder, and movement-related for Parkinson’s or essential tremor. We present a method for closing the DBS loop in neuropsychiatric disorders based on the estimation of sympathetic arousal from skin conductance measurements. We deconvolve skin conductance via an optimization formulation utilizing sparse recovery and obtain neural impulses from sympathetic nerve fibers stimulating the sweat glands. We perform this deconvolution via a two-step coordinate descent procedure that recovers the sparse neural stimuli and estimates physiological system parameters simultaneously. We next relate an unobserved sympathetic arousal state to the probability that these neural impulses occur and use Bayesian filtering within an Expectation-Maximization framework for estimation. We evaluate our method on a publicly available data-set examining the effect of different types of stress on peripheral signal changes including body temperature, skin conductance and heart rate. A high degree of arousal is estimated during cognitive tasks, as are much lower levels during relaxation. The results demonstrate the ability to decode psychological arousal from neural activity underlying skin conductance signal variations. The complete pipeline from recovering neural stimuli to decoding an emotion-related brain state using skin conductance presents a promising methodology for the ultimate realization of a closed-loop DBS controller. Closed-loop DBS treatment would additionally help reduce unnecessary power consumption and improve therapeutic gains.

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