Phase dependence of response curves to stimulation and their relationship: from a Wilson-Cowan model to essential tremor patient data

Essential tremor manifests predominantly as a tremor of the upper limbs. One therapy option is high-frequency deep brain stimulation, which continuously delivers electrical stimulation to the ventral intermediate nucleus of the thalamus at about 130 Hz. Investigators have been looking at stimulating less, chiefly to reduce side effects. One strategy, phase-locked deep brain stimulation, consists of stimulating according to the phase of the tremor, once per period. In this study, we aim to reproduce the phase dependent effects of stimulation seen in patient data with a biologically inspired Wilson-Cowan model. To this end, we first analyse patient data, and conclude that half of the datasets have response curves that are better described by sinusoidal curves than by straight lines, while an effect of phase cannot be consistently identified in the remaining half. Using the Hilbert phase we derive analytical expressions for phase and amplitude responses to phase-dependent stimulation and study their relationship in the linearisation of a stable focus model, a simplification of the Wilson-Cowan model in the stable focus regime. Analytical results provide a good approximation for response curves observed in patients with consistent significance. Additionally, we fitted the full non-linear Wilson-Cowan model to these patients, and we show that the model can fit in each case to the dynamics of patient tremor as well as the phase response curve, and the best fits are found to be stable foci for each patients (tied best fit in one instance). The model provides satisfactory prediction of how patient tremor will react to phase-locked stimulation by predicting patient amplitude response curves although they were not explicitly fitted. This can be partially explained by the relationship between the response curves in the model being compatible with what is found in the data. We also note that the non-linear Wilson-Cowan model is able to describe response to stimulation more precisely than the linearisation.