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Permezel F, Alty J, Harding IH, Thyagarajan D. Brain Networks Involved in Sensory Perception in Parkinson's Disease: A Scoping Review. Brain Sci 2023; 13:1552. [PMID: 38002513 PMCID: PMC10669548 DOI: 10.3390/brainsci13111552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Revised: 10/26/2023] [Accepted: 10/31/2023] [Indexed: 11/26/2023] Open
Abstract
Parkinson's Disease (PD) has historically been considered a disorder of motor dysfunction. However, a growing number of studies have demonstrated sensory abnormalities in PD across the modalities of proprioceptive, tactile, visual, auditory and temporal perception. A better understanding of these may inform future drug and neuromodulation therapy. We analysed these studies using a scoping review. In total, 101 studies comprising 2853 human participants (88 studies) and 125 animals (13 studies), published between 1982 and 2022, were included. These highlighted the importance of the basal ganglia in sensory perception across all modalities, with an additional role for the integration of multiple simultaneous sensation types. Numerous studies concluded that sensory abnormalities in PD result from increased noise in the basal ganglia and increased neuronal receptive field size. There is evidence that sensory changes in PD and impaired sensorimotor integration may contribute to motor abnormalities.
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Affiliation(s)
- Fiona Permezel
- Department of Neuroscience, Monash University, Melbourne 3004, Australia; (F.P.); (I.H.H.)
- Department of Neurology, Mayo Clinic, Rochester, MN 55901, USA
| | - Jane Alty
- Wicking Dementia Research and Education Centre, University of Tasmania, Hobart 7001, Australia;
| | - Ian H. Harding
- Department of Neuroscience, Monash University, Melbourne 3004, Australia; (F.P.); (I.H.H.)
| | - Dominic Thyagarajan
- Department of Neuroscience, Monash University, Melbourne 3004, Australia; (F.P.); (I.H.H.)
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2
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Fan JP, Zhang X, Han Y, Ji Y, Gu WX, Wu HC, Zhou C, Xiao C. Subthalamic neurons interact with nigral dopaminergic neurons to regulate movement in mice. Acta Physiol (Oxf) 2023; 237:e13917. [PMID: 36598331 DOI: 10.1111/apha.13917] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 11/05/2022] [Accepted: 01/02/2023] [Indexed: 01/05/2023]
Abstract
AIM This study aims to address the role of the interaction between subthalamic (STN) neurons and substantia nigra pars compacta (SNc) dopaminergic (DA) neurons in movement control. METHODS Fiber photometry and optogenetic/chemogenetic techniques were utilized to monitor and manipulate neuronal activity, respectively. Locomotion in mice was recorded in an open field arena and on a head-fixed apparatus. A hemiparkinsonian mouse model was established by unilateral injection of 6-OHDA in the medial forebrain bundle. Whole-cell patch-clamp techniques were applied to record electrophysiological signals in STN neurons and SNc DA neurons. c-Fos-immunostaining was used to label activated neurons. A rabies virus-based retrograde tracing system was used to visualize STN neurons projecting to SNc DA neurons. RESULTS The activity of STN neurons was enhanced upon locomotion in an open field arena and on a head-fixed apparatus, and the enhancement was significantly attenuated in parkinsonian mice. Optogenetic stimulation of STN neurons enhanced locomotion, increased activity of SNc DA neurons, meanwhile, reduced latency to movement initiation. Combining optogenetics with patch-clamp recordings, we confirmed that STN neurons innervated SNc DA neurons through glutamatergic monosynaptic connections. Moreover, STN neurons projecting to SNc DA neurons were evenly distributed in the STN. Either 6-OHDA-lesion or chemogenetic inhibition of SNc DA neurons attenuated the enhancement of locomotion by STN stimulation. CONCLUSION SNc DA neurons not only affect the response of STN neurons to movement, but also contribute to the enhancement of movement by STN stimulation. This study demonstrates the role of STN-SNc interaction in movement control.
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Affiliation(s)
- Jiang-Peng Fan
- School of basic medical sciences, Xuzhou Medical University, Xuzhou, China.,Institute of Nervous System Diseases, Xuzhou Medical University, Xuzhou, China
| | - Xue Zhang
- School of Anesthesiology, Xuzhou Medical University, Xuzhou, China
| | - Yu Han
- School of Anesthesiology, Xuzhou Medical University, Xuzhou, China
| | - Ying Ji
- School of Anesthesiology, Xuzhou Medical University, Xuzhou, China
| | - Wei-Xin Gu
- School of Anesthesiology, Xuzhou Medical University, Xuzhou, China.,Department of Anesthesiology, Drum Tower Hospital, affiliated to Nanjing University, Nanjing, China
| | - Hai-Chuan Wu
- School of Anesthesiology, Xuzhou Medical University, Xuzhou, China.,Department of Anesthesiology, Drum Tower Hospital, affiliated to Nanjing University, Nanjing, China
| | - Chunyi Zhou
- School of Anesthesiology, Xuzhou Medical University, Xuzhou, China.,Jiangsu Province Key Laboratory in Anesthesiology, Xuzhou Medical University, Xuzhou, China
| | - Cheng Xiao
- School of Anesthesiology, Xuzhou Medical University, Xuzhou, China.,Jiangsu Province Key Laboratory in Anesthesiology, Xuzhou Medical University, Xuzhou, China
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3
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Xiong Z, Tian Y, Wang X, Wei K, Bi Y. Gravity matters for the neural representations of action semantics. Cereb Cortex 2023:6995384. [PMID: 36682884 DOI: 10.1093/cercor/bhad006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 12/31/2022] [Accepted: 01/02/2023] [Indexed: 01/24/2023] Open
Abstract
The dynamic relationship between the neural representation of action word semantics and specific sensorimotor experience remains controversial. Here, we temporarily altered human subjects' sensorimotor experience in a 15-day head-down tilt bed rest setting, a ground-based analog of microgravity that disproportionally affects sensorimotor experiences of the lower limbs, and examined whether such effector-dependent activity deprivation specifically affected the neural processes of comprehending verbs of lower-limb actions (e.g. to kick) relative to upper-limb ones (e.g. to pinch). Using functional magnetic resonance imaging, we compared the multivoxel neural patterns for such action words prior to and after bed rest. We found an effector-specific (lower vs. upper limb) experience modulation in subcortical sensorimotor-related and anterior temporal regions. The neural action semantic representations in other effector-specific verb semantic regions (e.g. left lateral posterior temporal cortex) and motor execution regions were robust against such experience alterations. These effector-specific, sensorimotor-experience-sensitive and experience-independent patterns of verb neural representation highlight the multidimensional and dynamic nature of semantic neural representation, and the broad influence of microgravity (hence gravity) environment on cognition.
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Affiliation(s)
- Ziyi Xiong
- State Key Laboratory of Cognitive Neuroscience and Learning & IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing 100875, China.,Beijing Key Laboratory of Brain Imaging and Connectomics, Beijing Normal University, Beijing 100875, China
| | - Yu Tian
- National Key Laboratory of Human Factors Engineering, China Astronaut Research and Training Center, Beijing 100094, China.,School of Psychological and Cognitive Sciences, Peking University, Beijing 100871, China
| | - Xiaosha Wang
- State Key Laboratory of Cognitive Neuroscience and Learning & IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing 100875, China.,Beijing Key Laboratory of Brain Imaging and Connectomics, Beijing Normal University, Beijing 100875, China
| | - Kunlin Wei
- School of Psychological and Cognitive Sciences, Peking University, Beijing 100871, China.,Beijing Key Laboratory of Behavior and Mental Health, Beijing 100871, China.,Peking-Tsinghua Center for Life Sciences, Peking University, Beijing 100871, China
| | - Yanchao Bi
- State Key Laboratory of Cognitive Neuroscience and Learning & IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing 100875, China.,Beijing Key Laboratory of Brain Imaging and Connectomics, Beijing Normal University, Beijing 100875, China.,Chinese Institute for Brain Research, Beijing 102206, China
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Johari K, Kelley RM, Tjaden K, Patterson CG, Rohl AH, Berger JI, Corcos DM, Greenlee JDW. Human subthalamic nucleus neurons differentially encode speech and limb movement. Front Hum Neurosci 2023; 17:962909. [PMID: 36875233 PMCID: PMC9983637 DOI: 10.3389/fnhum.2023.962909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Accepted: 01/25/2023] [Indexed: 02/19/2023] Open
Abstract
Deep brain stimulation (DBS) of the subthalamic nucleus (STN), which consistently improves limb motor functions, shows mixed effects on speech functions in Parkinson's disease (PD). One possible explanation for this discrepancy is that STN neurons may differentially encode speech and limb movement. However, this hypothesis has not yet been tested. We examined how STN is modulated by limb movement and speech by recording 69 single- and multi-unit neuronal clusters in 12 intraoperative PD patients. Our findings indicated: (1) diverse patterns of modulation in neuronal firing rates in STN for speech and limb movement; (2) a higher number of STN neurons were modulated by speech vs. limb movement; (3) an overall increase in neuronal firing rates for speech vs. limb movement; and (4) participants with longer disease duration had higher firing rates. These data provide new insights into the role of STN neurons in speech and limb movement.
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Affiliation(s)
- Karim Johari
- Human Neurophysiology and Neuromodulation Lab, Department of Communication Science and Disorders, Louisiana State University, Baton Rouge, LA, United States.,Department of Neurosurgery, The University of Iowa, Iowa City, IA, United States
| | - Ryan M Kelley
- Medical Scientist Training Program, The University of Iowa, Iowa City, IA, United States.,Program in Neuroscience, The University of Iowa, Iowa City, IA, United States
| | - Kris Tjaden
- Department of Communicative Disorders and Sciences, University at Buffalo, Buffalo, NY, United States
| | - Charity G Patterson
- Department of Physical Therapy, University of Pittsburgh, Pittsburgh, PA, United States
| | - Andrea H Rohl
- Department of Neurosurgery, The University of Iowa, Iowa City, IA, United States
| | - Joel I Berger
- Department of Neurosurgery, The University of Iowa, Iowa City, IA, United States
| | - Daniel M Corcos
- Department of Physical Therapy & Human Movement Sciences, Northwestern University, Chicago, IL, United States
| | - Jeremy D W Greenlee
- Department of Neurosurgery, The University of Iowa, Iowa City, IA, United States.,Program in Neuroscience, The University of Iowa, Iowa City, IA, United States.,Iowa Neuroscience Institute, Iowa City, IA, United States
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Al Awadhi A, Tyrand R, Horn A, Kibleur A, Vincentini J, Zacharia A, Burkhard PR, Momjian S, Boëx C. Electrophysiological confrontation of Lead-DBS-based electrode localizations in patients with Parkinson's disease undergoing deep brain stimulation. Neuroimage Clin 2022; 34:102971. [PMID: 35231852 PMCID: PMC8885791 DOI: 10.1016/j.nicl.2022.102971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Revised: 01/06/2022] [Accepted: 02/21/2022] [Indexed: 11/06/2022]
Abstract
Lead-DBS agreed with microelectrode recordings with millimetric precision. Lead-DBS identified misplaced electrodes that microelectrodes could only help suspect. Lead-DBS location of the limbic STN was in agreement with electrophysiological markers. Phase duration and firing rates could help identify dopamine neurons in humans.
Microelectrode recordings (MERs) are often used during deep brain stimulation (DBS) surgeries to confirm the position of electrodes in patients with advanced Parkinson’s disease. The present study focused on 32 patients who had undergone DBS surgery for advanced Parkinson’s disease. The first objective was to confront the anatomical locations of intraoperative individual MERs as determined electrophysiologically with those determined postoperatively by image reconstructions. The second aim was to search for differences in cell characteristics among the three subthalamic nucleus (STN) subdivisions and between the STN and other identified subcortical structures. Using the DISTAL atlas implemented in the Lead-DBS image reconstruction toolbox, each MER location was determined postoperatively and attributed to specific anatomical structures (sensorimotor, associative or limbic STN; substantia nigra [SN], thalamus, nucleus reticularis polaris, zona incerta [ZI]). The STN dorsal borders determined intraoperatively from electrophysiology were then compared with the STN dorsal borders determined by the reconstructed images. Parameters of spike clusters (firing rates, amplitudes – with minimum amplitude of 60 μV -, spike durations, amplitude spectral density of β-oscillations) were compared between structures (ANOVAs on ranks). Two hundred and thirty one MERs were analyzed (144 in 34 STNs, 7 in 4 thalami, 5 in 4 ZIs, 34 in 10 SNs, 41 others). The average difference in depth of the electrophysiological dorsal STN entry in comparison with the STN entry obtained with Lead-DBS was found to be of 0.1 mm (standard deviation: 0.8 mm). All 12 analyzed MERs recorded above the electrophysiologically-determined STN entry were confirmed to be in the thalamus or zona incerta. All MERs electrophysiologically attributed to the SN were confirmed to belong to this nucleus. However, 6/34 MERs that were electrophysiologically attributed to the ventral STN were postoperatively reattributed to the SN. Furthermore, 44 MERs of 3 trajectories, which were intraoperatively attributed to the STN, were postoperatively reattributed to the pallidum or thalamus. MER parameters seemed to differ across the STN, with higher spike amplitudes (H = 10.64, p < 0.01) and less prevalent β-oscillations (H = 9.81, p < 0.01) in the limbic STN than in the sensorimotor and associative subdivisions. Some cells, especially in the SN, showed longer spikes with lower firing rates, in agreement with described characteristics of dopamine cells. However, these probabilistic electrophysiological signatures might become clinically less relevant with the development of image reconstruction tools, which deserve to be applied intraoperatively.
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Affiliation(s)
- Abdullah Al Awadhi
- Faculty of Medicine, University of Geneva, Geneva, Switzerland; Department of Neurosurgery, Geneva University Hospitals, Geneva, Switzerland
| | - Rémi Tyrand
- Faculty of Medicine, University of Geneva, Geneva, Switzerland; Department of Neurosurgery, Geneva University Hospitals, Geneva, Switzerland
| | - Andreas Horn
- Movement Disorders and Neuromodulation Section, Department of Neurology, Charité University Medicine, Berlin, Germany
| | - Astrid Kibleur
- Department of Neurology, Geneva University Hospitals, Geneva, Switzerland
| | - Julia Vincentini
- École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland
| | - André Zacharia
- Department of Neurology, Geneva University Hospitals, Geneva, Switzerland
| | - Pierre R Burkhard
- Faculty of Medicine, University of Geneva, Geneva, Switzerland; Department of Neurology, Geneva University Hospitals, Geneva, Switzerland
| | - Shahan Momjian
- Faculty of Medicine, University of Geneva, Geneva, Switzerland; Department of Neurosurgery, Geneva University Hospitals, Geneva, Switzerland
| | - Colette Boëx
- Faculty of Medicine, University of Geneva, Geneva, Switzerland; Department of Neurosurgery, Geneva University Hospitals, Geneva, Switzerland.
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Pujol S, Cabeen RP, Yelnik J, François C, Fernandez Vidal S, Karachi C, Bardinet E, Cosgrove GR, Kikinis R. Somatotopic Organization of Hyperdirect Pathway Projections From the Primary Motor Cortex in the Human Brain. Front Neurol 2022; 13:791092. [PMID: 35547388 PMCID: PMC9081715 DOI: 10.3389/fneur.2022.791092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Accepted: 03/04/2022] [Indexed: 11/25/2022] Open
Abstract
Background The subthalamic nucleus (STN) is an effective neurosurgical target to improve motor symptoms in Parkinson's Disease (PD) patients. MR-guided Focused Ultrasound (MRgFUS) subthalamotomy is being explored as a therapeutic alternative to Deep Brain Stimulation (DBS) of the STN. The hyperdirect pathway provides a direct connection between the cortex and the STN and is likely to play a key role in the therapeutic effects of MRgFUS intervention in PD patients. Objective This study aims to investigate the topography and somatotopy of hyperdirect pathway projections from the primary motor cortex (M1). Methods We used advanced multi-fiber tractography and high-resolution diffusion MRI data acquired on five subjects of the Human Connectome Project (HCP) to reconstruct hyperdirect pathway projections from M1. Two neuroanatomy experts reviewed the anatomical accuracy of the tracts. We extracted the fascicles arising from the trunk, arm, hand, face and tongue area from the reconstructed pathways. We assessed the variability among subjects based on the fractional anisotropy (FA) and mean diffusivity (MD) of the fibers. We evaluated the spatial arrangement of the different fascicles using the Dice Similarity Coefficient (DSC) of spatial overlap and the centroids of the bundles. Results We successfully reconstructed hyperdirect pathway projections from M1 in all five subjects. The tracts were in agreement with the expected anatomy. We identified hyperdirect pathway fascicles projecting from the trunk, arm, hand, face and tongue area in all subjects. Tract-derived measurements showed low variability among subjects, and similar distributions of FA and MD values among the fascicles projecting from different M1 areas. We found an anterolateral somatotopic arrangement of the fascicles in the corona radiata, and an average overlap of 0.63 in the internal capsule and 0.65 in the zona incerta. Conclusion Multi-fiber tractography combined with high-resolution diffusion MRI data enables the identification of the somatotopic organization of the hyperdirect pathway. Our preliminary results suggest that the subdivisions of the hyperdirect pathway projecting from the trunk, arm, hand, face, and tongue motor area are intermixed at the level of the zona incerta and posterior limb of the internal capsule, with a predominantly overlapping topographical organization in both regions. Subject-specific knowledge of the hyperdirect pathway somatotopy could help optimize target definition in MRgFUS intervention.
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Affiliation(s)
- Sonia Pujol
- Surgical Planning Laboratory, Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States
| | - Ryan P Cabeen
- Laboratory of Neuro Imaging, Stevens Institute for Neuroimaging and Informatics, Keck School of Medicine of the USC, University of Southern California, Los Angeles, CA, United States
| | - Jérôme Yelnik
- Sorbonne Université, CNRS, INSERM, APHP GH Pitié-Salpêtriére, Paris Brain Institute - Institut du Cerveau (ICM), Paris, France.,CENIR Platform, Institut du Cerveau (ICM), Paris, France
| | - Chantal François
- Sorbonne Université, CNRS, INSERM, APHP GH Pitié-Salpêtriére, Paris Brain Institute - Institut du Cerveau (ICM), Paris, France.,CENIR Platform, Institut du Cerveau (ICM), Paris, France
| | - Sara Fernandez Vidal
- Sorbonne Université, CNRS, INSERM, APHP GH Pitié-Salpêtriére, Paris Brain Institute - Institut du Cerveau (ICM), Paris, France.,CENIR Platform, Institut du Cerveau (ICM), Paris, France
| | - Carine Karachi
- Sorbonne Université, CNRS, INSERM, APHP GH Pitié-Salpêtriére, Paris Brain Institute - Institut du Cerveau (ICM), Paris, France.,CENIR Platform, Institut du Cerveau (ICM), Paris, France.,Department of Neurosurgery, APHP, Hôpitaux Universitaires Pitié-Salpêtriére/Charles Foix, Paris, France
| | - Eric Bardinet
- Sorbonne Université, CNRS, INSERM, APHP GH Pitié-Salpêtriére, Paris Brain Institute - Institut du Cerveau (ICM), Paris, France.,CENIR Platform, Institut du Cerveau (ICM), Paris, France
| | - G Rees Cosgrove
- Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States
| | - Ron Kikinis
- Surgical Planning Laboratory, Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States
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Pineda-Pardo JA, Sánchez-Ferro Á, Monje MHG, Pavese N, Obeso JA. Onset pattern of nigrostriatal denervation in early Parkinson's disease. Brain 2022; 145:1018-1028. [PMID: 35349639 DOI: 10.1093/brain/awab378] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Revised: 09/06/2021] [Accepted: 09/09/2021] [Indexed: 12/12/2022] Open
Abstract
The striatal dopaminergic deficit in Parkinson's disease exhibits a typical pattern, extending from the caudal and dorsal putamen at onset to its more rostral region as the disease progresses. Clinically, upper-limb onset of cardinal motor features is the rule. Thus, according to current understanding of striatal somatotopy (i.e. the lower limb is dorsal to the upper limb) the assumed pattern of early dorsal striatal dopaminergic denervation in Parkinson's disease does not fit with an upper-limb onset. We have examined the topography of putaminal denervation in a cohort of 23 recently diagnosed de novo Parkinson's disease patients and 19 age-/gender-matched healthy subjects assessed clinically and by 18F-DOPA PET; 15 patients were re-assessed after 2 years. There was a net upper-limb predominance of motor features at onset. Caudal denervation of the putamen was confirmed in both the more- and less-affected hemispheres and corresponding hemibodies. Spatial covariance analysis of the most affected hemisphere revealed a pattern of 18F-DOPA uptake rate deficit that suggested focal dopamine loss starting in the posterolateral and intermediate putamen. Functional MRI group-activation maps during a self-paced motor task were used to represent the somatotopy of the putamen and were then used to characterize the decline in 18F-DOPA uptake rate in the upper- and lower-limb territories. This showed a predominant decrement in both hemispheres, which correlated significantly with severity of bradykinesia. A more detailed spatial analysis revealed a dorsoventral linear gradient of 18F-DOPA uptake rate in Parkinson's disease patients, with the highest putamen denervation in the caudal intermediate subregion (dorsoventral plane) compared to healthy subjects. The latter area coincides with the functional representation of the upper limb. Clinical motor assessment at 2-year follow-up showed modest worsening of parkinsonism in the primarily affected side and more noticeable increases in the upper limb in the less-affected side. Concomitantly, 18F-DOPA uptake rate in the less-affected putamen mimicked that recognized on the most-affected side. Our findings suggest that early dopaminergic denervation in Parkinson's disease follows a somatotopically related pattern, starting with the upper-limb representation in the putamen and progressing over a 2-year period in the less-affected hemisphere. These changes correlate well with the clinical presentation and evolution of motor features. Recognition of a precise somatotopic onset of nigrostriatal denervation may help to better understand the onset and progression of dopaminergic neurodegeneration in Parkinson's disease and eventually monitor the impact of putative therapies.
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Affiliation(s)
- José A Pineda-Pardo
- HM CINAC (Centro Integral de Neurociencias Abarca Campal), Hospital Universitario HM Puerta del Sur, HM Hospitales, Madrid, Spain.,Universidad San Pablo-CEU, Madrid, Spain.,CIBERNED, Instituto de Salud Carlos III, Madrid, Spain
| | - Álvaro Sánchez-Ferro
- HM CINAC (Centro Integral de Neurociencias Abarca Campal), Hospital Universitario HM Puerta del Sur, HM Hospitales, Madrid, Spain.,Neurology Department, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Mariana H G Monje
- HM CINAC (Centro Integral de Neurociencias Abarca Campal), Hospital Universitario HM Puerta del Sur, HM Hospitales, Madrid, Spain.,Universidad San Pablo-CEU, Madrid, Spain.,CIBERNED, Instituto de Salud Carlos III, Madrid, Spain.,Ken and Ruth Davee Department of Neurology, Northwestern University, Feinberg School of Medicine, Chicago, IL, USA
| | - Nicola Pavese
- Department of Nuclear Medicine and PET Centre, Aarhus University Hospital, Aarhus, Denmark.,Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK
| | - José A Obeso
- HM CINAC (Centro Integral de Neurociencias Abarca Campal), Hospital Universitario HM Puerta del Sur, HM Hospitales, Madrid, Spain.,Universidad San Pablo-CEU, Madrid, Spain.,CIBERNED, Instituto de Salud Carlos III, Madrid, Spain
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Bokulić E, Medenica T, Knezović V, Štajduhar A, Almahariq F, Baković M, Judaš M, Sedmak G. The Stereological Analysis and Spatial Distribution of Neurons in the Human Subthalamic Nucleus. Front Neuroanat 2022; 15:749390. [PMID: 34970124 PMCID: PMC8712451 DOI: 10.3389/fnana.2021.749390] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Accepted: 11/17/2021] [Indexed: 11/13/2022] Open
Abstract
The subthalamic nucleus (STN) is a small, ovoid structure, and an important site of deep brain stimulation (DBS) for the treatment of Parkinson’s disease. Although the STN is a clinically important structure, there are many unresolved issues with regard to it. These issues are especially related to the anatomical subdivision, neuronal phenotype, neuronal composition, and spatial distribution. In this study, we have examined the expression pattern of 8 neuronal markers [nNOS, NeuN, parvalbumin (PV), calbindin (CB), calretinin (CR), FOXP2, NKX2.1, and PAX6] in the adult human STN. All of the examined markers, except CB, were present in the STN. To determine the neuronal density, we have performed stereological analysis on Nissl-stained and immunohistochemical slides of positive markers. The stereology data were also used to develop a three-dimensional map of the spatial distribution of neurons within the STN. The nNOS population exhibited the largest neuronal density. The estimated total number of nNOS STN neurons is 281,308 ± 38,967 (± 13.85%). The STN neuronal subpopulations can be divided into two groups: one with a neuronal density of approximately 3,300 neurons/mm3 and the other with a neuronal density of approximately 2,200 neurons/mm3. The largest density of STN neurons was observed along the ventromedial border of the STN and the density gradually decreased toward the dorsolateral border. In this study, we have demonstrated the presence of 7 neuronal markers in the STN, three of which were not previously described in the human STN. The human STN is a collection of diverse, intermixed neuronal subpopulations, and our data, as far as the cytoarchitectonics is concerned, did not support the tripartite STN subdivision.
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Affiliation(s)
- Ema Bokulić
- Croatian Institute for Brain Research, University of Zagreb School of Medicine, Zagreb, Croatia.,Centre of Excellence for Basic, Clinical and Translational Neuroscience, Zagreb, Croatia
| | - Tila Medenica
- Croatian Institute for Brain Research, University of Zagreb School of Medicine, Zagreb, Croatia.,Centre of Excellence for Basic, Clinical and Translational Neuroscience, Zagreb, Croatia
| | - Vinka Knezović
- Croatian Institute for Brain Research, University of Zagreb School of Medicine, Zagreb, Croatia.,Centre of Excellence for Basic, Clinical and Translational Neuroscience, Zagreb, Croatia
| | - Andrija Štajduhar
- Croatian Institute for Brain Research, University of Zagreb School of Medicine, Zagreb, Croatia.,Centre of Excellence for Basic, Clinical and Translational Neuroscience, Zagreb, Croatia.,School of Public Health "Andrija Štampar," University of Zagreb School of Medicine, Zagreb, Croatia
| | - Fadi Almahariq
- Centre of Excellence for Basic, Clinical and Translational Neuroscience, Zagreb, Croatia.,Department of Neurosurgery, Clinical Hospital "Dubrava," Zagreb, Croatia
| | - Marija Baković
- Department of Forensic Medicine, University of Zagreb School of Medicine, Zagreb, Croatia
| | - Miloš Judaš
- Croatian Institute for Brain Research, University of Zagreb School of Medicine, Zagreb, Croatia.,Centre of Excellence for Basic, Clinical and Translational Neuroscience, Zagreb, Croatia
| | - Goran Sedmak
- Croatian Institute for Brain Research, University of Zagreb School of Medicine, Zagreb, Croatia.,Centre of Excellence for Basic, Clinical and Translational Neuroscience, Zagreb, Croatia
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9
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Arruda BS, Reis C, Sermon JJ, Pogosyan A, Brown P, Cagnan H. Identifying and modulating distinct tremor states through peripheral nerve stimulation in Parkinsonian rest tremor. J Neuroeng Rehabil 2021; 18:179. [PMID: 34953492 PMCID: PMC8709974 DOI: 10.1186/s12984-021-00973-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Accepted: 12/07/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Resting tremor is one of the most common symptoms of Parkinson's disease. Despite its high prevalence, resting tremor may not be as effectively treated with dopaminergic medication as other symptoms, and surgical treatments such as deep brain stimulation, which are effective in reducing tremor, have limited availability. Therefore, there is a clinical need for non-invasive interventions in order to provide tremor relief to a larger number of people with Parkinson's disease. Here, we explore whether peripheral nerve stimulation can modulate resting tremor, and under what circumstances this might lead to tremor suppression. METHODS We studied 10 people with Parkinson's disease and rest tremor, to whom we delivered brief electrical pulses non-invasively to the median nerve of the most tremulous hand. Stimulation was phase-locked to limb acceleration in the axis with the biggest tremor-related excursion. RESULTS We demonstrated that rest tremor in the hand could change from one pattern of oscillation to another in space. Median nerve stimulation was able to significantly reduce (- 36%) and amplify (117%) tremor when delivered at a certain phase. When the peripheral manifestation of tremor spontaneously changed, stimulation timing-dependent change in tremor severity could also alter during phase-locked peripheral nerve stimulation. CONCLUSIONS These results highlight that phase-locked peripheral nerve stimulation has the potential to reduce tremor. However, there can be multiple independent tremor oscillation patterns even within the same limb. Parameters of peripheral stimulation such as stimulation phase may need to be adjusted continuously in order to sustain systematic suppression of tremor amplitude.
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Affiliation(s)
- Beatriz S Arruda
- Medical Research Council Brain Network Dynamics Unit, Nuffield Department of Clinical Neurosciences, University of Oxford, Mansfield Road, Oxford, OX1 3TH, UK
| | - Carolina Reis
- Medical Research Council Brain Network Dynamics Unit, Nuffield Department of Clinical Neurosciences, University of Oxford, Mansfield Road, Oxford, OX1 3TH, UK
| | - James J Sermon
- Medical Research Council Brain Network Dynamics Unit, Nuffield Department of Clinical Neurosciences, University of Oxford, Mansfield Road, Oxford, OX1 3TH, UK
| | - Alek Pogosyan
- Medical Research Council Brain Network Dynamics Unit, Nuffield Department of Clinical Neurosciences, University of Oxford, Mansfield Road, Oxford, OX1 3TH, UK
| | - Peter Brown
- Medical Research Council Brain Network Dynamics Unit, Nuffield Department of Clinical Neurosciences, University of Oxford, Mansfield Road, Oxford, OX1 3TH, UK
| | - Hayriye Cagnan
- Medical Research Council Brain Network Dynamics Unit, Nuffield Department of Clinical Neurosciences, University of Oxford, Mansfield Road, Oxford, OX1 3TH, UK.
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10
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Rodriguez-Rojas R, Pineda-Pardo JA, Mañez-Miro J, Sanchez-Turel A, Martinez-Fernandez R, Del Alamo M, DeLong M, Obeso JA. Functional Topography of the Human Subthalamic Nucleus: Relevance for Subthalamotomy in Parkinson's Disease. Mov Disord 2021; 37:279-290. [PMID: 34859498 DOI: 10.1002/mds.28862] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 10/26/2021] [Accepted: 11/03/2021] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND The subthalamic nucleus (STN) is considered a key structure in motor, behavioral, and emotional control. Although identification of the functional topography of the STN has therapeutic implications in the treatment of the motor features of Parkinson's disease (PD), the details of its functional and somatotopic organization in humans are not well understood. OBJECTIVE The aim of this study was to characterize the functional organization of the STN and its correlation with the motor outcomes induced by subthalamotomy. METHODS We used diffusion-weighted imaging to assess STN connectivity patterns in 23 healthy control subjects and 86 patients with PD, of whom 39 received unilateral subthalamotomy. Analytical tractography was used to reconstruct structural cortico-subthalamic connectivity. A diffusion-weighted imaging/functional magnetic resonance imaging-driven somatotopic parcellation of the STN was defined to delineate the representation of the upper and lower limb in the STN. RESULTS We confirmed a connectional gradient to sensorimotor, supplementary-motor, associative, and limbic cortical regions, spanning from posterior-dorsal-lateral to anterior-ventral-medial portions of the STN, with intermediate overlapping zones. Functional magnetic resonance imaging-driven parcellation demonstrated dual segregation of motor cortico-subthalamic projections in humans. Moreover, the relationship between lesion topography and functional anatomy of the STN explains specific improvement in bradykinesia, rigidity, and tremor induced by subthalamotomy. CONCLUSIONS Our results support an interplay between segregation and integration of cortico-subthalamic projections, suggesting the coexistence of parallel and convergent information processing. Identifying the functional topography of the STN will facilitate better definition of the optimal location for functional neurosurgical approaches, that is, electrode placement and lesion location, and improve specific cardinal features in PD. © 2021 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Rafael Rodriguez-Rojas
- HM CINAC (Centro Integral de Neurociencias Abarca Campal), Hospital Universitario HM Puerta del Sur, HM Hospitales, Madrid, Spain.,Universidad CEU-San Pablo University, Madrid, Spain.,Network Center for Biomedical Research on Neurodegenerative Diseases (CIBERNED), Carlos III Institute, Madrid, Spain
| | - Jose A Pineda-Pardo
- HM CINAC (Centro Integral de Neurociencias Abarca Campal), Hospital Universitario HM Puerta del Sur, HM Hospitales, Madrid, Spain.,Universidad CEU-San Pablo University, Madrid, Spain.,Network Center for Biomedical Research on Neurodegenerative Diseases (CIBERNED), Carlos III Institute, Madrid, Spain
| | - Jorge Mañez-Miro
- HM CINAC (Centro Integral de Neurociencias Abarca Campal), Hospital Universitario HM Puerta del Sur, HM Hospitales, Madrid, Spain
| | - Alicia Sanchez-Turel
- HM CINAC (Centro Integral de Neurociencias Abarca Campal), Hospital Universitario HM Puerta del Sur, HM Hospitales, Madrid, Spain
| | - Raul Martinez-Fernandez
- HM CINAC (Centro Integral de Neurociencias Abarca Campal), Hospital Universitario HM Puerta del Sur, HM Hospitales, Madrid, Spain.,Universidad CEU-San Pablo University, Madrid, Spain.,Network Center for Biomedical Research on Neurodegenerative Diseases (CIBERNED), Carlos III Institute, Madrid, Spain
| | - Marta Del Alamo
- HM CINAC (Centro Integral de Neurociencias Abarca Campal), Hospital Universitario HM Puerta del Sur, HM Hospitales, Madrid, Spain
| | - Mahlon DeLong
- Department of Neurology, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Jose A Obeso
- HM CINAC (Centro Integral de Neurociencias Abarca Campal), Hospital Universitario HM Puerta del Sur, HM Hospitales, Madrid, Spain.,Universidad CEU-San Pablo University, Madrid, Spain.,Network Center for Biomedical Research on Neurodegenerative Diseases (CIBERNED), Carlos III Institute, Madrid, Spain
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11
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Wei J, Zou Z, Li J, Zhang Y. Gamma Oscillations and Coherence Are Weaker in the Dorsomedial Subregion of STN in Parkinson's Disease. Front Neurol 2021; 12:710206. [PMID: 34557146 PMCID: PMC8453062 DOI: 10.3389/fneur.2021.710206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2021] [Accepted: 07/13/2021] [Indexed: 11/24/2022] Open
Abstract
Background: Deep-brain stimulation (DBS) of the subthalamic nucleus (STN) is an effective treatment for motor symptoms of advanced Parkinson's disease (PD). Due to a lack of detailed somatotopic organization in STN, the clinically most effective part of the STN for stimulation has already become one of the hot research focuses. At present, there are some reports about topographic distribution for different depths within the STN, but few about a mediolateral topography in this area. Objective: The objective was to investigate the local field potential (LFP) distribution patterns in dorsomedial and dorsolateral subparts of STN. Methods: In total, 18 PD patients eventually enrolled in this study. The DBS electrodes were initially located on the lateral portion of dorsolateral STN. Because of internal capsule side effects presented at low threshold (below 1.5 mA), the electrode was reimplanted more medially to the dorsomedial STN. In this process, intraoperative LFPs from dorsomedial and dorsolateral STN were recorded from the inserted electrode. Both beta power and gamma power of the LFPs were calculated using the power spectral density (PSD) for each DBS contact pair. Furthermore, coherence between any two pairs of contacts was computed in the dorsomedial and dorsolateral parts of STN, respectively. Meanwhile, the Unified Parkinson's Disease Rating Scale part III (UPDRS-III) was monitored prior to surgery and at the 6-month follow-up. Results: Compared to the dorsolateral part of STN, gamma oscillations (p < 0.01) and coherence (p < 0.05) were all weaker in the dorsomedial part. However, no obvious differences in beta oscillations and coherence were observed between the two groups (p > 0.05). Moreover, it should be noted that DBS of the dorsomedial STN resulted in significant improvement in the UPDRS-III in PD patients. There was a 61.50 ± 21.30% improvement in UPDRS-III scores in Med-off/Stim-on state relative to the Med-off state at baseline (from 15.44 ± 6.84 to 43.94 ± 15.79, p < 0.01). Conclusions: The specific features of gamma activity may be used to differentiate STN subregions. Moreover, the dorsomedial part of STN might be a potential target for DBS in PD.
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Affiliation(s)
- Jing Wei
- School of Biomedical Engineering, Capital Medical University, Beijing, China
| | - Zhifan Zou
- Department of Physiology and Pathophysiology, Capital Medical University, Beijing, China
| | - Jiping Li
- Beijing Institute of Functional Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Yuqing Zhang
- Beijing Institute of Functional Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China
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12
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Mosher CP, Mamelak AN, Malekmohammadi M, Pouratian N, Rutishauser U. Distinct roles of dorsal and ventral subthalamic neurons in action selection and cancellation. Neuron 2021; 109:869-881.e6. [PMID: 33482087 PMCID: PMC7933114 DOI: 10.1016/j.neuron.2020.12.025] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2020] [Revised: 12/12/2020] [Accepted: 12/30/2020] [Indexed: 12/11/2022]
Abstract
The subthalamic nucleus (STN) supports action selection by inhibiting all motor programs except the desired one. Recent evidence suggests that STN can also cancel an already selected action when goals change, a key aspect of cognitive control. However, there is little neurophysiological evidence for dissociation between selecting and cancelling actions in the human STN. We recorded single neurons in the STN of humans performing a stop-signal task. Movement-related neurons suppressed their activity during successful stopping, whereas stop-signal neurons activated at low-latencies near the stop-signal reaction time. In contrast, STN and motor-cortical beta-bursting occurred only later in the stopping process. Task-related neuronal properties varied by recording location from dorsolateral movement to ventromedial stop-signal tuning. Therefore, action selection and cancellation coexist in STN but are anatomically segregated. These results show that human ventromedial STN neurons carry fast stop-related signals suitable for implementing cognitive control.
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Affiliation(s)
- Clayton P Mosher
- Department of Neurosurgery, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Adam N Mamelak
- Department of Neurosurgery, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Mahsa Malekmohammadi
- Department of Neurosurgery, University of California, Los Angeles, Los Angeles, CA 90095, USA
| | - Nader Pouratian
- Department of Neurosurgery, University of California, Los Angeles, Los Angeles, CA 90095, USA
| | - Ueli Rutishauser
- Department of Neurosurgery, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA; Division of Biology and Biological Engineering, California Institute of Technology, Pasadena, CA 91125, USA; Department of Neurology, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA; Center for Neural Science and Medicine, Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA.
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13
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Bolier E, Bot M, van den Munckhof P, Pal G, Sani S, Verhagen Metman L. The Medial Subthalamic Nucleus Border as a New Anatomical Reference in Stereotactic Neurosurgery for Parkinson's Disease. Stereotact Funct Neurosurg 2020; 99:187-195. [PMID: 33207350 DOI: 10.1159/000510802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Accepted: 07/24/2020] [Indexed: 11/19/2022]
Abstract
INTRODUCTION The intersection of Bejjani's line with the well-delineated medial subthalamic nucleus (STN) border on MRI has recently been proposed as an individualized reference in subthalamic deep brain stimulation (DBS) surgery for Parkinson's disease (PD). We, therefore, aimed to investigate the applicability across centers of the medial STN border as a patient-specific reference point in STN DBS for PD and explore anatomical variability between left and right mesencephalic area within patients. Furthermore, we aim to evaluate a recently defined theoretic stimulation "hotspot" in a different center. METHODS Preoperative 3-Tesla T2 and susceptibility-weighted images (SWI) were used to identify the intersection of Bejjani's line with the medial STN border in left and right mesencephalic area. The average stereotactic coordinates of the center of stimulation relative to the medial STN border were compared with the predefined theoretic stimulation "hotspot." RESULTS Fifty-four patients provided 108 stereotactic coordinates of medial STN borders on both sequences. Significant difference in means was found in the Y-(anteroposterior) and Z-(dorsoventral) directions (T2 vs. SWI; p < 0.001). Mean coordinates in the Y-(anteroposterior) direction differed significantly between left and right mesencephalic area (T2: p < 0.001; SWI: p = 0.021). Sixty-six DBS leads were placed in 36 patients that had finished stimulation programming, and the average stereotactic coordinates of the center of stimulation relative to the medial STN border on T2 sequences were 3.1 mm lateral, 0.7 mm anterior, and 1.8 mm superior, in proximity of the predefined theoretic stimulation "hotspot." CONCLUSION The medial STN border is applicable across centers as a reference point for STN DBS surgery for PD and seems suitable in order to account for interindividual and intraindividual anatomical variability if one is aware of the discrepancies between T2-weighted imaging and SWI.
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Affiliation(s)
- Erik Bolier
- Department of Neurological Sciences, Rush University Medical Center, Chicago, Illinois, USA, .,Department of Neurosurgery, Amsterdam University Medical Centers, Academic Medical Center, Amsterdam, The Netherlands,
| | - Maarten Bot
- Department of Neurosurgery, Amsterdam University Medical Centers, Academic Medical Center, Amsterdam, The Netherlands
| | - Pepijn van den Munckhof
- Department of Neurosurgery, Amsterdam University Medical Centers, Academic Medical Center, Amsterdam, The Netherlands
| | - Gian Pal
- Department of Neurological Sciences, Rush University Medical Center, Chicago, Illinois, USA
| | - Sepehr Sani
- Department of Neurosurgery, Rush University Medical Center, Chicago, Illinois, USA
| | - Leo Verhagen Metman
- Department of Neurological Sciences, Rush University Medical Center, Chicago, Illinois, USA
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14
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Somatotopic organization of STN and DBS implications in Parkinson’s disease - A case report of a woman “halved” by DBS stimulation. Brain Stimul 2020; 13:1384-1386. [DOI: 10.1016/j.brs.2020.07.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Revised: 07/21/2020] [Accepted: 07/22/2020] [Indexed: 11/17/2022] Open
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15
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van Wijk BCM, Alkemade A, Forstmann BU. Functional segregation and integration within the human subthalamic nucleus from a micro- and meso-level perspective. Cortex 2020; 131:103-113. [PMID: 32823130 DOI: 10.1016/j.cortex.2020.07.004] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2020] [Revised: 06/20/2020] [Accepted: 07/06/2020] [Indexed: 12/25/2022]
Abstract
The subthalamic nucleus (STN) is a core basal ganglia structure involved in the control of motor, cognitive, motivational and affective functions. The (challenged) tripartite subdivision hypothesis places these functions into distinct sensorimotor, cognitive/associative, and limbic subregions based on the topography of cortical projections. To a large extent, this hypothesis is used to motivate the choice of target coordinates for implantation of deep brain stimulation electrodes for treatment of neurological and psychiatric disorders. Yet, the parallel organization of basal ganglia circuits has been known to allow considerable cross-talk, which might contribute to the occurrence of neuropsychiatric side effects when stimulating the dorsolateral, putative sensorimotor, part of the STN for treatment of Parkinson's disease. Any functional segregation within the STN is expected to be reflected both at micro-level microscopy and meso-level neural population activity. As such, we review the current empirical evidence from anterograde tracing and immunocytochemistry studies and from local field potential recordings for delineating the STN into distinct subregions. The spatial distribution of immunoreactivity presents as a combination of gradients, and although neural activity in distinct frequency bands appears spatially clustered, there is substantial overlap in peak locations. We argue that regional specialization without sharply defined borders is likely most representative of the STN's functional organization.
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Affiliation(s)
- Bernadette C M van Wijk
- Integrative Model-based Cognitive Neuroscience Research Unit, Department of Psychology, University of Amsterdam, the Netherlands.
| | - Anneke Alkemade
- Integrative Model-based Cognitive Neuroscience Research Unit, Department of Psychology, University of Amsterdam, the Netherlands
| | - Birte U Forstmann
- Integrative Model-based Cognitive Neuroscience Research Unit, Department of Psychology, University of Amsterdam, the Netherlands
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16
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Ozturk M, Telkes I, Jimenez-Shahed J, Viswanathan A, Tarakad A, Kumar S, Sheth SA, Ince NF. Randomized, Double-Blind Assessment of LFP Versus SUA Guidance in STN-DBS Lead Implantation: A Pilot Study. Front Neurosci 2020; 14:611. [PMID: 32655356 PMCID: PMC7325925 DOI: 10.3389/fnins.2020.00611] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Accepted: 05/18/2020] [Indexed: 11/13/2022] Open
Abstract
Background: The efficacy of deep brain stimulation (DBS) therapy in Parkinson's disease (PD) patients is highly dependent on the precise localization of the target structures such as subthalamic nucleus (STN). Most commonly, microelectrode single unit activity (SUA) recordings are performed to refine the target. This process is heavily experience based and can be technically challenging. Local field potentials (LFPs), representing the activity of a population of neurons, can be obtained from the same microelectrodes used for SUA recordings and allow flexible online processing with less computational complexity due to lower sampling rate requirements. Although LFPs have been shown to contain biomarkers capable of predicting patients' symptoms and differentiating various structures, their use in the localization of the STN in the clinical practice is not prevalent. Methods: Here we present, for the first time, a randomized and double-blinded pilot study with intraoperative online LFP processing in which we compare the clinical benefit from SUA- versus LFP-based implantation. Ten PD patients referred for bilateral STN-DBS were randomly implanted using either SUA or LFP guided targeting in each hemisphere. Although both SUA and LFP were recorded for each STN, the electrophysiologist was blinded to one at a time. Three months postoperatively, the patients were evaluated by a neurologist blinded to the intraoperative recordings to assess the performance of each modality. While SUA-based decisions relied on the visual and auditory inspection of the raw traces, LFP-based decisions were given through an online signal processing and machine learning pipeline. Results: We found a dramatic agreement between LFP- and SUA-based localization (16/20 STNs) providing adequate clinical improvement (51.8% decrease in 3-month contralateral motor assessment scores), with LFP-guided implantation resulting in greater average improvement in the discordant cases (74.9%, n = 3 STNs). The selected tracks were characterized by higher activity in beta (11-32 Hz) and high-frequency (200-400 Hz) bands (p < 0.01) of LFPs and stronger non-linear coupling between these bands (p < 0.05). Conclusion: Our pilot study shows equal or better clinical benefit with LFP-based targeting. Given the robustness of the electrode interface and lower computational cost, more centers can utilize LFP as a strategic feedback modality intraoperatively, in conjunction to the SUA-guided targeting.
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Affiliation(s)
- Musa Ozturk
- Department of Biomedical Engineering, University of Houston, Houston, TX, United States
| | - Ilknur Telkes
- Department of Neuroscience and Experimental Therapeutics, Albany Medical College, Albany, NY, United States
| | - Joohi Jimenez-Shahed
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Ashwin Viswanathan
- Department of Neurosurgery, Baylor College of Medicine, Houston, TX, United States
| | - Arjun Tarakad
- Department of Neurology, Baylor College of Medicine, Houston, TX, United States
| | - Suneel Kumar
- Department of Neurology, Baylor College of Medicine, Houston, TX, United States
| | - Sameer A. Sheth
- Department of Neurosurgery, Baylor College of Medicine, Houston, TX, United States
| | - Nuri F. Ince
- Department of Biomedical Engineering, University of Houston, Houston, TX, United States
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17
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Bolier E, Bot M, van den Munckhof P, Pal G, Sani S, Stebbins GT, Verhagen Metman L. Kinesthetic Cells within the Subthalamic Nucleus and Deep Brain Stimulation for Parkinson Disease. World Neurosurg 2020; 139:e784-e791. [PMID: 32371080 DOI: 10.1016/j.wneu.2020.04.160] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Revised: 04/20/2020] [Accepted: 04/21/2020] [Indexed: 10/24/2022]
Abstract
OBJECTIVE We sought to determine the location of kinesthetic cell clusters within the subthalamic nucleus (STN) on magnetic resonance imaging, adjusted for interindividual anatomic variability by employing the medial STN border as a reference point. METHODS We retrospectively localized microelectrode recording-defined kinesthetic cells on 3-Tesla T2-weighted and susceptibility-weighted images in patients who underwent STN deep brain stimulation for Parkinson disease and averaged the stereotactic coordinates. These locations were calculated relative to the nonindividualized midcommissural point (MCP) and, in order to account for interindividual anatomic variability, also calculated relative to the patient-specific intersection of Bejjani line with the medial STN border. Two example patients were selected in order to visualize the discrepancies between the adjusted and nonadjusted theoretic kinesthetic cell clusters on magnetic resonance imaging. RESULTS Relative to the MCP, average kinesthetic cell coordinates were 12.3 ± 1.2 mm lateral, 1.7 ± 1.4 mm posterior, and 2.3 ± 1.5 mm inferior. Relative to the medial STN border, mean coordinates were 3.4 ± 1.0 mm lateral, 1.0 ± 1.4 mm anterior, and 1.7 ± 1.5 mm superior on T2-sequences, and on susceptibility-weighted images mean coordinates were 3.2 ± 1.1 mm lateral, 0.8 ± 1.5 mm anterior, and 2.1 ± 1.5 mm superior. The theoretic kinesthetic cell clusters may appear outside the sensorimotor STN when using the MCP, whereas these clusters fall well within the sensorimotor STN when employing the medial STN border as a reference point. CONCLUSIONS By using the medial STN border as a patient-specific anatomic reference point in STN deep brain stimulation for Parkinson disease, we accounted for interindividual anatomic variability and provided accurate insight in the clustering of kinesthetic cells within the dorsolateral STN.
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Affiliation(s)
- Erik Bolier
- Department of Neurological Sciences, Rush University Medical Center, Chicago, Illinois, USA; Department of Neurosurgery, Amsterdam University Medical Centers, Academic Medical Center, Amsterdam, The Netherlands.
| | - Maarten Bot
- Department of Neurosurgery, Amsterdam University Medical Centers, Academic Medical Center, Amsterdam, The Netherlands
| | - Pepijn van den Munckhof
- Department of Neurosurgery, Amsterdam University Medical Centers, Academic Medical Center, Amsterdam, The Netherlands
| | - Gian Pal
- Department of Neurological Sciences, Rush University Medical Center, Chicago, Illinois, USA
| | - Sepehr Sani
- Department of Neurosurgery, Rush University Medical Center, Chicago, Illinois, USA
| | - Glenn T Stebbins
- Department of Neurological Sciences, Rush University Medical Center, Chicago, Illinois, USA
| | - Leo Verhagen Metman
- Department of Neurological Sciences, Rush University Medical Center, Chicago, Illinois, USA
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18
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Ozturk M, Kaku H, Jimenez-Shahed J, Viswanathan A, Sheth SA, Kumar S, Ince NF. Subthalamic Single Cell and Oscillatory Neural Dynamics of a Dyskinetic Medicated Patient With Parkinson's Disease. Front Neurosci 2020; 14:391. [PMID: 32390796 PMCID: PMC7193777 DOI: 10.3389/fnins.2020.00391] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Accepted: 03/30/2020] [Indexed: 02/01/2023] Open
Abstract
Single cell neuronal activity (SUA) and local field potentials (LFP) in the subthalamic nucleus (STN) of unmedicated Parkinson's disease (PD) patients undergoing deep brain stimulation (DBS) surgery have been well-characterized during microelectrode recordings (MER). However, there is limited knowledge about the changes in the firing patterns and oscillations above and within the territories of STN after the intake of dopaminergic medication. Here, for the first time, we report the STN single cell and oscillatory neural dynamics in a medicated patient with idiopathic PD using intraoperative MER. We recorded LFP and SUA with microelectrodes at various depths during bilateral STN-DBS electrode implantation. We isolated 26 neurons in total and observed that tonic and irregular firing patterns of individual neurons predominated throughout the territories of STN. While burst-type firings have been well-characterized in the dorsal territories of STN in unmedicated patients, interestingly, this activity was not observed in our medicated subject. LFP recordings lacked the excessive beta (8-30 Hz) activity, characteristic of the unmedicated state and signal energy was mainly dominated by slow oscillations below 8 Hz. We observed sharp gamma oscillations between 70 and 90 Hz within and above the STN. Despite the presence of a broadband high frequency activity in 200-400 Hz range, no cross-frequency interaction in the form of phase-amplitude coupling was noted between low and high frequency oscillations of LFPs. While our results are in agreement with the previously reported LFP recordings from the DBS lead in medicated PD patients, the sharp gamma peak present throughout the depth recordings and the lack of bursting firings after levodopa intake have not been reported before. The lack of bursting in SUA, the lack of excessive beta activity and cross frequency coupling between HFOs and lower rhythms further validate the link between bursting firing regime of neurons and pathological oscillatory neural activity in PD-STN. Overall, these observations not only validate the existing literature on the PD electrophysiology in healthy/medicated animal models but also provide insights regarding the underlying electro-pathophysiology of levodopa-induced dyskinesias in PD patients through demonstration of multiscale relationships between single cell firings and field potentials.
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Affiliation(s)
- Musa Ozturk
- Department of Biomedical Engineering, University of Houston, Houston, TX, United States
| | - Heet Kaku
- Department of Biomedical Engineering, University of Houston, Houston, TX, United States
| | - Joohi Jimenez-Shahed
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Ashwin Viswanathan
- Department of Neurosurgery, Baylor College of Medicine, Houston, TX, United States
| | - Sameer A. Sheth
- Department of Neurosurgery, Baylor College of Medicine, Houston, TX, United States
| | - Suneel Kumar
- Department of Neurology, Baylor College of Medicine, Houston, TX, United States
| | - Nuri F. Ince
- Department of Biomedical Engineering, University of Houston, Houston, TX, United States
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19
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Sasaki T, Kuwahara K, Kin I, Okazaki M, Sasada S, Shinko A, Kameda M, Yasuhara T, Agari T, Date I. Identification of Somatotopic Organization and Optimal Stimulation Site Within the Subthalamic Nucleus for Parkinson's Disease. Oper Neurosurg (Hagerstown) 2019; 17:239-246. [PMID: 30445556 DOI: 10.1093/ons/opy351] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2018] [Accepted: 10/30/2018] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Details of the somatotopy within the subthalamic nucleus (STN) are still poorly understood; however, the STN is a common target of deep brain stimulation (DBS) for Parkinson disease. OBJECTIVE To examine somatotopic organization within the STN and identify optimal stimulation sites from 77 surgical cases with microelectrode recording. METHODS STN-DBS was performed for 77 patients with Parkinson disease between 2010 and 2014. We performed passive movements of each joint and captured single neuronal activities to identify movement-related cells (MRCs). The sites of MRCs and active contacts were determined by measuring their distances from the first contact of DBS electrode. Their positional correlations were directly and indirectly analyzed. RESULTS The number of obtained MRCs was 264, of which 151 responded to multiple joints. The average x-, y-, and z-coordinates of the cells of the upper and lower limbs from the midcommisural point were 13.1 ± 1.1 and 12.7 ± 1.2, 0.22 ± 1.3 and -0.45 ± 1.5, and -2.5 ± 1.1 and -3.0 ± 1.4 mm, respectively. Most MRCs were distributed in the upper third of the STN, in its superior, lateral, and posterior regions, along the DBS electrode routes. Active contacts were observed to lie slightly inferior, medial, and posterior to the average MRC position. CONCLUSION Somatotopic organization of the STN was easier to observe in the present study than in previous studies. Optimal stimulation sites were located inferior, medial, and posterior to the average MRC location. The sites may correspond to associative or motor parts through which fibers from the supplementary motor area pass.
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Affiliation(s)
- Tatsuya Sasaki
- Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Ken Kuwahara
- Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Ittetsu Kin
- Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Mihoko Okazaki
- Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Susumu Sasada
- Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Aiko Shinko
- Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Masahiro Kameda
- Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Takao Yasuhara
- Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Takashi Agari
- Department of Neurological Surgery, Kurashiki-Heisei Hospital, Okayama, Japan
| | - Isao Date
- Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
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20
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Dimov AV, Gupta A, Kopell BH, Wang Y. High-resolution QSM for functional and structural depiction of subthalamic nuclei in DBS presurgical mapping. J Neurosurg 2019; 131:360-367. [PMID: 30095333 DOI: 10.3171/2018.3.jns172145] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2017] [Accepted: 03/01/2018] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Faithful depiction of the subthalamic nucleus (STN) is critical for planning deep brain stimulation (DBS) surgery in patients with Parkinson's disease (PD). Quantitative susceptibility mapping (QSM) has been shown to be superior to traditional T2-weighted spin echo imaging (T2w). The aim of the study was to describe submillimeter QSM for preoperative imaging of the STN in planning of DBS. METHODS Seven healthy volunteers were included in this study. T2w and QSM were obtained for all healthy volunteers, and images of different resolutions were reconstructed. Image quality and visibility of STN anatomical features were analyzed by a radiologist using a 5-point scale, and contrast properties of the STN and surrounding tissue were calculated. Additionally, data from 10 retrospectively and randomly selected PD patients who underwent 3-T MRI for DBS were analyzed for STN size and susceptibility gradient measurements. RESULTS Higher contrast-to-noise ratio (CNR) values were observed in both high-resolution and low-resolution QSM images. Inter-resolution comparison demonstrated improvement in CNR for QSM, but not for T2w images. QSM provided higher inter-quadrant contrast ratios (CR) within the STN, and depicted a gradient in the distribution of susceptibility sources not visible in T2w images. CONCLUSIONS For 3-T MRI, submillimeter QSM provides accurate delineation of the functional and anatomical STN features for DBS targeting.
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Affiliation(s)
- Alexey V Dimov
- 1Meinig School of Biomedical Engineering, Cornell University, Ithaca
- 2Department of Radiology, Weill Medical College of Cornell University; and
| | - Ajay Gupta
- 2Department of Radiology, Weill Medical College of Cornell University; and
| | - Brian H Kopell
- 3Department of Neurosurgery, Mount Sinai Health System, New York, New York
| | - Yi Wang
- 1Meinig School of Biomedical Engineering, Cornell University, Ithaca
- 2Department of Radiology, Weill Medical College of Cornell University; and
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21
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Tankus A, Mirelman A, Giladi N, Fried I, Hausdorff JM. Pace of movement: the role of single neurons in the subthalamic nucleus. J Neurosurg 2019; 130:1835-1840. [PMID: 29932375 DOI: 10.3171/2018.1.jns171859] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2017] [Accepted: 01/04/2018] [Indexed: 11/06/2022]
Abstract
OBJECTIVE The ability to modulate the pace of movement is a critical factor in the smooth operation of the motor system. The authors recently described distinct and overlapping representations of movement kinematics in the subthalamic nucleus (STN), but it is still unclear how movement pace is modulated according to the demands of the task at the neuronal level in this area. The goal of this study was to clarify how different movement paces are being controlled by neurons in the STN. METHODS The authors performed direct recording of the electrical activity of single neurons in the STN of neurosurgical patients with Parkinson's disease undergoing implantation of a deep brain stimulator under local anesthesia while the patients performed repetitive foot and hand movements intraoperatively at multiple paces. RESULTS A change was observed in the neuronal population controlling the movement for each pace. The mechanism for switching between these controlling populations differs for hand and foot movements. CONCLUSIONS These findings suggest that disparate schemes are utilized in the STN for neuronal recruitment for motor control of the upper and lower extremities. The results indicate a distributed model of motor control within the STN, where the active neuronal population changes when modifying the task condition and pace.
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Affiliation(s)
- Ariel Tankus
- 1Functional Neurosurgery Unit
- 2Center for Study of Movement, Cognition, and Mobility
- 3Department of Neurology and Neurosurgery, Sackler Faculty of Medicine, and
- 4Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
| | - Anat Mirelman
- 2Center for Study of Movement, Cognition, and Mobility
- 3Department of Neurology and Neurosurgery, Sackler Faculty of Medicine, and
- 4Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
| | - Nir Giladi
- 3Department of Neurology and Neurosurgery, Sackler Faculty of Medicine, and
- 4Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
- 5Department of Neurology, Tel Aviv Sourasky Medical Center
| | - Itzhak Fried
- 1Functional Neurosurgery Unit
- 3Department of Neurology and Neurosurgery, Sackler Faculty of Medicine, and
- 6Department of Neurosurgery, University of California, Los Angeles, California
| | - Jeffrey M Hausdorff
- 2Center for Study of Movement, Cognition, and Mobility
- 4Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
- 7Department of Physical Therapy, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; and
- 8Rush Alzheimer's Disease Center and
- 9Department of Orthopedic Surgery, Rush University Medical Center, Chicago, Illinois
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22
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Jamali M, Grannan B, Haroush K, Moses ZB, Eskandar EN, Herrington T, Patel S, Williams ZM. Dorsolateral prefrontal neurons mediate subjective decisions and their variation in humans. Nat Neurosci 2019; 22:1010-1020. [PMID: 31011224 PMCID: PMC6535118 DOI: 10.1038/s41593-019-0378-3] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2018] [Accepted: 03/08/2019] [Indexed: 11/09/2022]
Abstract
Subjective decisions play a vital role in human behavior because, while often grounded in fact, they are inherently based on personal beliefs that can vary broadly within and between individuals. While these properties set subjective decisions apart from many other sensorimotor processes and are of wide sociological impact, their single-neuronal basis in humans is unknown. Here we find cells in the dorsolateral prefrontal cortex (dlPFC) that reflect variations in the subjective decisions of humans when performing opinion-based tasks. These neurons changed their activities gradually as the participants transitioned between choice options but also reflected their unique point of conversion at equipoise. Focal disruption of the dlPFC, by contrast, diminished gradation between opposing decisions but had little effect on sensory perceptual choices or their motor report. These findings suggest that the human dlPFC plays an important role in subjective decisions and propose a mechanism for mediating their variation during opinion formation.
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Affiliation(s)
- Mohsen Jamali
- Department of Neurosurgery, Harvard Medical School, Massachusetts General Hospital, Boston MA
| | - Ben Grannan
- Department of Neurosurgery, Harvard Medical School, Massachusetts General Hospital, Boston MA
| | - Keren Haroush
- Department of Neurobiology, Stanford University School of Medicine, Palo Alto CA
| | - Ziev B. Moses
- Department of Neurosurgery, Brigham and Women’s Hospital, Boston MA
| | - Emad N Eskandar
- Department of Neurosurgery, Albert Einstein University, Bronx NY
| | - Todd Herrington
- Department of Neurology, Harvard Medical School, Massachusetts General Hospital, Boston MA
| | - Shaun Patel
- Department of Neurology, Harvard Medical School, Massachusetts General Hospital, Boston MA
| | - Ziv M Williams
- Department of Neurosurgery, Harvard Medical School, Massachusetts General Hospital, Boston, MA, USA. .,Harvard-MIT Division of Health Sciences and Technology, Cambridge, MA, USA. .,Harvard Medical School, Program in Neuroscience, Boston, MA, USA.
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23
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Dubbioso R, Manganelli F, Siebner HR, Di Lazzaro V. Fast Intracortical Sensory-Motor Integration: A Window Into the Pathophysiology of Parkinson's Disease. Front Hum Neurosci 2019; 13:111. [PMID: 31024277 PMCID: PMC6463734 DOI: 10.3389/fnhum.2019.00111] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Accepted: 03/13/2019] [Indexed: 01/09/2023] Open
Abstract
Parkinson's Disease (PD) is a prototypical basal ganglia disorder. Nigrostriatal dopaminergic denervation leads to progressive dysfunction of the cortico-basal ganglia-thalamo-cortical sensorimotor loops, causing the classical motor symptoms. Although the basal ganglia do not receive direct sensory input, they are important for sensorimotor integration. Therefore, the basal ganglia dysfunction in PD may profoundly affect sensory-motor interaction in the cortex. Cortical sensorimotor integration can be probed with transcranial magnetic stimulation (TMS) using a well-established conditioning-test paradigm, called short-latency afferent inhibition (SAI). SAI probes the fast-inhibitory effect of a conditioning peripheral electrical stimulus on the motor response evoked by a TMS test pulse given to the contralateral primary motor cortex (M1). Since SAI occurs at latencies that match the peaks of early cortical somatosensory potentials, the cortical circuitry generating SAI may play an important role in rapid online adjustments of cortical motor output to changes in somatosensory inputs. Here we review the existing studies that have used SAI to examine how PD affects fast cortical sensory-motor integration. Studies of SAI in PD have yielded variable results, showing reduced, normal or even enhanced levels of SAI. This variability may be attributed to the fact that the strength of SAI is influenced by several factors, such as differences in dopaminergic treatment or the clinical phenotype of PD. Inter-individual differences in the expression of SAI has been shown to scale with individual motor impairment as revealed by UPDRS motor score and thus, may reflect the magnitude of dopaminergic neurodegeneration. The magnitude of SAI has also been linked to cognitive dysfunction, and it has been suggested that SAI also reflects cholinergic denervation at the cortical level. Together, the results indicate that SAI is a useful marker of disease-related alterations in fast cortical sensory-motor integration driven by subcortical changes in the dopaminergic and cholinergic system. Since a multitude of neurobiological factors contribute to the magnitude of inhibition, any mechanistic interpretation of SAI changes in PD needs to consider the group characteristics in terms of phenotypical spectrum, disease stage, and medication.
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Affiliation(s)
- Raffaele Dubbioso
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University Federico II of Naples, Napoli, Italy
| | - Fiore Manganelli
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University Federico II of Naples, Napoli, Italy
| | - Hartwig Roman Siebner
- Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark.,Department of Neurology, Copenhagen University Hospital Bispebjerg, Copenhagen, Denmark.,Institute for Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Vincenzo Di Lazzaro
- Unit of Neurology, Neurophysiology, Neurobiology, Department of Medicine, University Campus Bio-Medico, Rome, Italy
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24
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Chrabaszcz A, Neumann WJ, Stretcu O, Lipski WJ, Bush A, Dastolfo-Hromack CA, Wang D, Crammond DJ, Shaiman S, Dickey MW, Holt LL, Turner RS, Fiez JA, Richardson RM. Subthalamic Nucleus and Sensorimotor Cortex Activity During Speech Production. J Neurosci 2019; 39:2698-2708. [PMID: 30700532 PMCID: PMC6445998 DOI: 10.1523/jneurosci.2842-18.2019] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2018] [Revised: 01/11/2019] [Accepted: 01/18/2019] [Indexed: 11/21/2022] Open
Abstract
The sensorimotor cortex is somatotopically organized to represent the vocal tract articulators such as lips, tongue, larynx, and jaw. How speech and articulatory features are encoded at the subcortical level, however, remains largely unknown. We analyzed LFP recordings from the subthalamic nucleus (STN) and simultaneous electrocorticography recordings from the sensorimotor cortex of 11 human subjects (1 female) with Parkinson's disease during implantation of deep-brain stimulation (DBS) electrodes while they read aloud three-phoneme words. The initial phonemes involved either articulation primarily with the tongue (coronal consonants) or the lips (labial consonants). We observed significant increases in high-gamma (60-150 Hz) power in both the STN and the sensorimotor cortex that began before speech onset and persisted for the duration of speech articulation. As expected from previous reports, in the sensorimotor cortex, the primary articulators involved in the production of the initial consonants were topographically represented by high-gamma activity. We found that STN high-gamma activity also demonstrated specificity for the primary articulator, although no clear topography was observed. In general, subthalamic high-gamma activity varied along the ventral-dorsal trajectory of the electrodes, with greater high-gamma power recorded in the dorsal locations of the STN. Interestingly, the majority of significant articulator-discriminative activity in the STN occurred before that in sensorimotor cortex. These results demonstrate that articulator-specific speech information is contained within high-gamma activity of the STN, but with different spatial and temporal organization compared with similar information encoded in the sensorimotor cortex.SIGNIFICANCE STATEMENT Clinical and electrophysiological evidence suggest that the subthalamic nucleus (STN) is involved in speech; however, this important basal ganglia node is ignored in current models of speech production. We previously showed that STN neurons differentially encode early and late aspects of speech production, but no previous studies have examined subthalamic functional organization for speech articulators. Using simultaneous LFP recordings from the sensorimotor cortex and the STN in patients with Parkinson's disease undergoing deep-brain stimulation surgery, we discovered that STN high-gamma activity tracks speech production at the level of vocal tract articulators before the onset of vocalization and often before related cortical encoding.
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Affiliation(s)
- Anna Chrabaszcz
- Department of Psychology, University of Pittsburgh, Pittsburgh, Pennsylvania 15213
| | - Wolf-Julian Neumann
- Movement Disorder and Neuromodulation Unit, Department of Neurology, Campus Mitte, Charité, Universitätsmedizin Berlin, Berlin, Germany 10117
| | - Otilia Stretcu
- Machine Learning Department, School of Computer Science, Carnegie Mellon University, Pittsburgh, Pennsylvania 15213
| | - Witold J Lipski
- Brain Modulation Laboratory, Department of Neurological Surgery, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania 15213
| | - Alan Bush
- Brain Modulation Laboratory, Department of Neurological Surgery, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania 15213
- Department of Physics, FCEN, University of Buenos Aires and IFIBA-CONICET, Buenos Aires, Argentina 1428
| | - Christina A Dastolfo-Hromack
- Brain Modulation Laboratory, Department of Neurological Surgery, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania 15213
| | - Dengyu Wang
- Brain Modulation Laboratory, Department of Neurological Surgery, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania 15213
- School of Medicine, Tsinghua University, Beijing, China 100084
| | - Donald J Crammond
- Brain Modulation Laboratory, Department of Neurological Surgery, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania 15213
| | - Susan Shaiman
- Department of Communication Science and Disorders, University of Pittsburgh, Pittsburgh, Pennsylvania 15213
| | - Michael W Dickey
- Department of Communication Science and Disorders, University of Pittsburgh, Pittsburgh, Pennsylvania 15213
| | - Lori L Holt
- Department of Psychology, Carnegie Mellon University, Pittsburgh, Pennsylvania 15213
| | - Robert S Turner
- Department of Neurobiology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania 15213, and
- University of Pittsburgh Brain Institute, Pittsburgh, Pennsylvania 15213
| | - Julie A Fiez
- Department of Psychology, University of Pittsburgh, Pittsburgh, Pennsylvania 15213
- Department of Communication Science and Disorders, University of Pittsburgh, Pittsburgh, Pennsylvania 15213
- University of Pittsburgh Brain Institute, Pittsburgh, Pennsylvania 15213
| | - R Mark Richardson
- Brain Modulation Laboratory, Department of Neurological Surgery, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania 15213,
- Department of Neurobiology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania 15213, and
- University of Pittsburgh Brain Institute, Pittsburgh, Pennsylvania 15213
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25
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Telkes I, Viswanathan A, Jimenez-Shahed J, Abosch A, Ozturk M, Gupte A, Jankovic J, Ince NF. Local field potentials of subthalamic nucleus contain electrophysiological footprints of motor subtypes of Parkinson's disease. Proc Natl Acad Sci U S A 2018; 115:E8567-E8576. [PMID: 30131429 PMCID: PMC6130371 DOI: 10.1073/pnas.1810589115] [Citation(s) in RCA: 50] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Although motor subtypes of Parkinson's disease (PD), such as tremor dominant (TD) and postural instability and gait difficulty (PIGD), have been defined based on symptoms since the mid-1990s, no underlying neural correlates of these clinical subtypes have yet been identified. Very limited data exist regarding the electrophysiological abnormalities within the subthalamic nucleus (STN) that likely accompany the symptom severity or the phenotype of PD. Here, we show that activity in subbands of local field potentials (LFPs) recorded with multiple microelectrodes from subterritories of STN provide distinguishing neurophysiological information about the motor subtypes of PD. We studied 24 patients with PD and found distinct patterns between TD (n = 13) and PIGD (n = 11) groups in high-frequency oscillations (HFOs) and their nonlinear interactions with beta band in the superior and inferior regions of the STN. Particularly, in the superior region of STN, the power of the slow HFO (sHFO) (200-260 Hz) and the coupling of its amplitude with beta-band phase were significantly stronger in the TD group. The inferior region of STN exhibited fast HFOs (fHFOs) (260-450 Hz), which have a significantly higher center frequency in the PIGD group. The cross-frequency coupling between fHFOs and beta band in the inferior region of STN was significantly stronger in the PIGD group. Our results indicate that the spatiospectral dynamics of STN-LFPs can be used as an objective method to distinguish these two motor subtypes of PD. These observations might lead to the development of sensing and stimulation strategies targeting the subterritories of STN for the personalization of deep-brain stimulation (DBS).
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Affiliation(s)
- Ilknur Telkes
- Department of Biomedical Engineering, University of Houston, Houston, TX 77204-5060
| | - Ashwin Viswanathan
- Department of Neurosurgery, Baylor College of Medicine, Houston, TX 77030
| | - Joohi Jimenez-Shahed
- Parkinson's Disease Center and Movement Disorders Clinic, Department of Neurology, Baylor College of Medicine, Houston, TX 77030
| | - Aviva Abosch
- Department of Neurosurgery, University of Colorado School of Medicine, Aurora, CO 80045
| | - Musa Ozturk
- Department of Biomedical Engineering, University of Houston, Houston, TX 77204-5060
| | - Akshay Gupte
- Department of Neurosurgery, University of Minnesota Medical School, Minneapolis, MN 55455
| | - Joseph Jankovic
- Parkinson's Disease Center and Movement Disorders Clinic, Department of Neurology, Baylor College of Medicine, Houston, TX 77030
| | - Nuri F Ince
- Department of Biomedical Engineering, University of Houston, Houston, TX 77204-5060;
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26
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Subthalamic Nucleus Neurons Differentially Encode Early and Late Aspects of Speech Production. J Neurosci 2018; 38:5620-5631. [PMID: 29789378 DOI: 10.1523/jneurosci.3480-17.2018] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2017] [Revised: 05/09/2018] [Accepted: 05/15/2018] [Indexed: 11/21/2022] Open
Abstract
Basal ganglia-thalamocortical loops mediate all motor behavior, yet little detail is known about the role of basal ganglia nuclei in speech production. Using intracranial recording during deep brain stimulation surgery in humans with Parkinson's disease, we tested the hypothesis that the firing rate of subthalamic nucleus neurons is modulated in sync with motor execution aspects of speech. Nearly half of 79 unit recordings exhibited firing-rate modulation during a syllable reading task across 12 subjects (male and female). Trial-to-trial timing of changes in subthalamic neuronal activity, relative to cue onset versus production onset, revealed that locking to cue presentation was associated more with units that decreased firing rate, whereas locking to speech onset was associated more with units that increased firing rate. These unique data indicate that subthalamic activity is dynamic during the production of speech, reflecting temporally-dependent inhibition and excitation of separate populations of subthalamic neurons.SIGNIFICANCE STATEMENT The basal ganglia are widely assumed to participate in speech production, yet no prior studies have reported detailed examination of speech-related activity in basal ganglia nuclei. Using microelectrode recordings from the subthalamic nucleus during a single-syllable reading task, in awake humans undergoing deep brain stimulation implantation surgery, we show that the firing rate of subthalamic nucleus neurons is modulated in response to motor execution aspects of speech. These results are the first to establish a role for subthalamic nucleus neurons in encoding of aspects of speech production, and they lay the groundwork for launching a modern subfield to explore basal ganglia function in human speech.
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27
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Lee PS, Weiner GM, Corson D, Kappel J, Chang YF, Suski VR, Berman SB, Homayoun H, Van Laar AD, Crammond DJ, Richardson RM. Outcomes of Interventional-MRI Versus Microelectrode Recording-Guided Subthalamic Deep Brain Stimulation. Front Neurol 2018; 9:241. [PMID: 29695996 PMCID: PMC5904198 DOI: 10.3389/fneur.2018.00241] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2018] [Accepted: 03/26/2018] [Indexed: 12/14/2022] Open
Abstract
In deep brain stimulation (DBS) of the subthalamic nucleus (STN) for Parkinson’s disease (PD), there is debate concerning the use of neuroimaging alone to confirm correct anatomic placement of the DBS lead into the STN, versus the use of microelectrode recording (MER) to confirm functional placement. We performed a retrospective study of a contemporaneous cohort of 45 consecutive patients who underwent either interventional-MRI (iMRI) or MER-guided DBS lead implantation. We compared radial lead error, motor and sensory side effect, and clinical benefit programming thresholds, and pre- and post-operative unified PD rating scale scores, and levodopa equivalent dosages. MER-guided surgery was associated with greater radial error compared to the intended target. In general, side effect thresholds during initial programming were slightly lower in the MER group, but clinical benefit thresholds were similar. No significant difference in the reduction of clinical symptoms or medication dosage was observed. In summary, iMRI lead implantation occurred with greater anatomic accuracy, in locations demonstrated to be the appropriate functional region of the STN, based on the observation of similar programming side effect and benefit thresholds obtained with MER. The production of equivalent clinical outcomes suggests that surgeon and patient preference can be used to guide the decision of whether to recommend iMRI or MER-guided DBS lead implantation to appropriate patients with PD.
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Affiliation(s)
- Philip S Lee
- Department of Neurological Surgery, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States
| | - Gregory M Weiner
- Department of Neurological Surgery, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States
| | - Danielle Corson
- Department of Neurological Surgery, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States
| | - Jessica Kappel
- Department of Neurology, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States
| | - Yue-Fang Chang
- Department of Neurological Surgery, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States
| | - Valerie R Suski
- Department of Neurology, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States
| | - Sarah B Berman
- Department of Neurology, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States
| | - Houman Homayoun
- Department of Neurology, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States
| | - Amber D Van Laar
- Department of Neurology, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States
| | - Donald J Crammond
- Department of Neurological Surgery, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States
| | - R Mark Richardson
- Department of Neurological Surgery, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States.,University of Pittsburgh Brain Institute, University of Pittsburgh, Pittsburgh, PA, United States
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28
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Mogilner AY, Machado AG, Rezai AR. Deep Brain Stimulation. Neuromodulation 2018. [DOI: 10.1016/b978-0-12-805353-9.00036-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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29
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Lin SH, Lai HY, Lo YC, Chou C, Chou YT, Yang SH, Sun I, Chen BW, Wang CF, Liu GT, Jaw FS, Chen SY, Chen YY. Decreased Power but Preserved Bursting Features of Subthalamic Neuronal Signals in Advanced Parkinson's Patients under Controlled Desflurane Inhalation Anesthesia. Front Neurosci 2017; 11:701. [PMID: 29311782 PMCID: PMC5733027 DOI: 10.3389/fnins.2017.00701] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2017] [Accepted: 11/28/2017] [Indexed: 11/13/2022] Open
Abstract
Deep brain stimulation (DBS) surgery of the subthalamic nucleus (STN) under general anesthesia (GA) had been used in Parkinson's disease (PD) patients who are unable tolerate awake surgery. The effect of anesthetics on intraoperative microelectrode recording (MER) remains unclear. Understanding the effect of anesthetics on MER is important in performing STN DBS surgery with general anesthesia. In this study, we retrospectively performed qualitive and quantitative analysis of STN MER in PD patients received STN DBS with controlled desflurane anesthesia or LA and compared their clinical outcome. From January 2005 to March 2006, 19 consecutive PD patients received bilateral STN DBS surgery in Hualien Tzu-Chi hospital under either desflurane GA (n = 10) or LA (n = 9). We used spike analysis (frequency and modified burst index [MBI]) and the Hilbert transform to obtain signal power measurements for background and spikes, and compared the characterizations of intraoperative microelectrode signals between the two groups. Additionally, STN firing pattern characteristics were determined using a combined approach based on the autocorrelogram and power spectral analysis, which was employed to investigate differences in the oscillatory activities between the groups. Clinical outcomes were assessed using the Unified Parkinson's Disease Rating Scale (UPDRS) before and after surgery. The results revealed burst firing was observed in both groups. The firing frequencies were greater in the LA group and MBI was comparable in both groups. Both the background and spikes were of significantly greater power in the LA group. The power spectra of the autocorrelograms were significantly higher in the GA group between 4 and 8 Hz. Clinical outcomes based on the UPDRS were comparable in both groups before and after DBS surgery. Under controlled light desflurane GA, burst features of the neuronal firing patterns are preserved in the STN, but power is reduced. Enhanced low-frequency (4–8 Hz) oscillations in the MERs for the GA group could be a characteristic signature of desflurane's effect on neurons in the STN.
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Affiliation(s)
- Sheng-Huang Lin
- Institute of Biomedical Engineering, National Taiwan University, Taipei, Taiwan.,Department of Neurology, Tzu Chi General Hospital, Tzu Chi University, Hualien, Taiwan
| | - Hsin-Yi Lai
- Interdisciplinary Institute of Neuroscience and Technology, Qiushi Academy for Advanced Studies, Zhejiang University, Hangzhou, China
| | - Yu-Chun Lo
- The Ph.D. Program for Neural Regenerative Medicine, College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan
| | - Chin Chou
- Department of Biomedical Engineering, National Yang Ming University, Taipei, Taiwan
| | - Yi-Ting Chou
- Department of Biomedical Engineering, National Yang Ming University, Taipei, Taiwan
| | - Shih-Hung Yang
- Department of Mechanical and Computer Aided Engineering, Feng Chia University, Taichung, Taiwan
| | - I Sun
- Department of Life Sciences, Institute of Genome Sciences, National Yang Ming University, Taipei, China
| | - Bo-Wei Chen
- Department of Biomedical Engineering, National Yang Ming University, Taipei, Taiwan
| | - Ching-Fu Wang
- Department of Biomedical Engineering, National Yang Ming University, Taipei, Taiwan
| | - Guan-Tze Liu
- Department of Medicine, National Yang Ming University, Taipei, Taiwan
| | - Fu-Shan Jaw
- Institute of Biomedical Engineering, National Taiwan University, Taipei, Taiwan
| | - Shin-Yuan Chen
- Department of Neurosurgery, Tzu Chi General Hospital, Tzu Chi University, Hualien, Taiwan
| | - You-Yin Chen
- The Ph.D. Program for Neural Regenerative Medicine, College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan.,Department of Biomedical Engineering, National Yang Ming University, Taipei, Taiwan
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30
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Pasquereau B, Turner RS. A selective role for ventromedial subthalamic nucleus in inhibitory control. eLife 2017; 6:31627. [PMID: 29199955 PMCID: PMC5730370 DOI: 10.7554/elife.31627] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2017] [Accepted: 12/02/2017] [Indexed: 01/13/2023] Open
Abstract
The subthalamic nucleus (STN) is hypothesized to play a central role in the rapid stopping of movement in reaction to a stop signal. Single-unit recording evidence for such a role is sparse, however, and it remains uncertain how that role relates to the disparate functions described for anatomic subdivisions of the STN. Here we address that gap in knowledge using non-human primates and a task that distinguishes reactive and proactive action inhibition, switching and skeletomotor functions. We found that specific subsets of STN neurons have activity consistent with causal roles in reactive action stopping or switching. Importantly, these neurons were strictly segregated to a ventromedial region of STN. Neurons in other subdivisions encoded task dimensions such as movement per se and proactive control. We propose that the involvement of STN in reactive control is restricted to its ventromedial portion, further implicating this STN subdivision in impulse control disorders.
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Affiliation(s)
- Benjamin Pasquereau
- Department of Neurobiology, University of Pittsburgh, Pittsburgh, United States.,Institut des Sciences Cognitives Marc Jeannerod, CNRS UMR 5229, Bron, France.,Center for Neuroscience, University of Pittsburgh, Pittsburgh, United States.,Center for the Neural Basis of Cognition, University of Pittsburgh, Pittsburgh, United States
| | - Robert S Turner
- Department of Neurobiology, University of Pittsburgh, Pittsburgh, United States.,Center for Neuroscience, University of Pittsburgh, Pittsburgh, United States.,Center for the Neural Basis of Cognition, University of Pittsburgh, Pittsburgh, United States
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Iwamuro H, Tachibana Y, Ugawa Y, Saito N, Nambu A. Information processing from the motor cortices to the subthalamic nucleus and globus pallidus and their somatotopic organizations revealed electrophysiologically in monkeys. Eur J Neurosci 2017; 46:2684-2701. [PMID: 29044874 PMCID: PMC5725726 DOI: 10.1111/ejn.13738] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2017] [Revised: 10/07/2017] [Accepted: 10/09/2017] [Indexed: 11/26/2022]
Abstract
To understand how the information derived from different motor cortical areas representing different body parts is organized in the basal ganglia, we examined the neuronal responses in the subthalamic nucleus (STN), and the external (GPe) and internal (GPi) segments of the globus pallidus (input, relay and output nuclei, respectively) to stimulation of the orofacial, forelimb and hindlimb regions of the primary motor cortex (MI) and supplementary motor area (SMA) in macaque monkeys under the awake state. Most STN and GPe/GPi neurons responded exclusively to stimulation of either the MI or SMA, and one‐fourth to one‐third of neurons responded to both. STN neurons responding to the hindlimb, forelimb and orofacial regions of the MI were located along the medial–lateral axis in the posterolateral STN, while neurons responding to the orofacial region of the SMA were located more medially than the others in the anteromedial STN. GPe/GPi neurons responding to the hindlimb, forelimb and orofacial regions of the MI were found along the dorsal–ventral axis in the posterolateral GPe/GPi, and neurons responding to the corresponding regions of the SMA were similarly but less clearly distributed in more anteromedial regions. Moreover, neurons responding to the distal and proximal forelimb MI regions were found along the lateral–medial axis in the STN and the ventral–dorsal axis in the GPe/GPi. Most STN and GPe/GPi neurons showed kinaesthetic responses with similar somatotopic maps. These observations suggest that the somatotopically organized inputs from the MI and SMA are well preserved in the STN and GPe/GPi with partial convergence.
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Affiliation(s)
- Hirokazu Iwamuro
- Division of System Neurophysiology, National Institute for Physiological Sciences and Department of Physiological Sciences, SOKENDAI (Graduate University for Advanced Studies), 38 Nishigonaka, Myodaiji, Okazaki, Aichi, 444-8585, Japan.,Department of Neurosurgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.,Department of Research and Therapeutics for Movement Disorders, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Yoshihisa Tachibana
- Division of System Neurophysiology, National Institute for Physiological Sciences and Department of Physiological Sciences, SOKENDAI (Graduate University for Advanced Studies), 38 Nishigonaka, Myodaiji, Okazaki, Aichi, 444-8585, Japan.,Division of System Neuroscience, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Yoshikazu Ugawa
- Department of Neurology, School of Medicine, Fukushima Medical University and Fukushima Global Medical Science Center, Advanced Clinical Research Center, Fukushima Medical University, Fukushima, Japan
| | - Nobuhito Saito
- Department of Neurosurgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Atsushi Nambu
- Division of System Neurophysiology, National Institute for Physiological Sciences and Department of Physiological Sciences, SOKENDAI (Graduate University for Advanced Studies), 38 Nishigonaka, Myodaiji, Okazaki, Aichi, 444-8585, Japan
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Lee PS, Richardson RM. Interventional MRI–Guided Deep Brain Stimulation Lead Implantation. Neurosurg Clin N Am 2017; 28:535-544. [DOI: 10.1016/j.nec.2017.05.007] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
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Pötter-Nerger M, Reese R, Steigerwald F, Heiden JA, Herzog J, Moll CKE, Hamel W, Ramirez-Pasos U, Falk D, Mehdorn M, Gerloff C, Deuschl G, Volkmann J. Movement-Related Activity of Human Subthalamic Neurons during a Reach-to-Grasp Task. Front Hum Neurosci 2017; 11:436. [PMID: 28936169 PMCID: PMC5594073 DOI: 10.3389/fnhum.2017.00436] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2017] [Accepted: 08/15/2017] [Indexed: 12/31/2022] Open
Abstract
The aim of the study was to record movement-related single unit activity (SUA) in the human subthalamic nucleus (STN) during a standardized motor task of the upper limb. We performed microrecordings from the motor region of the human STN and registered kinematic data in 12 patients with Parkinson’s disease (PD) undergoing deep brain stimulation surgery (seven women, mean age 62.0 ± 4.7 years) while they intraoperatively performed visually cued reach-to-grasp movements using a grip device. SUA was analyzed offline in relation to different aspects of the movement (attention, start of the movement, movement velocity, button press) in terms of firing frequency, firing pattern, and oscillation. During the reach-to-grasp movement, 75/114 isolated subthalamic neurons exhibited movement-related activity changes. The largest proportion of single units showed modulation of firing frequency during several phases of the reach and grasp (polymodal neurons, 45/114), particularly an increase of firing rate during the reaching phase of the movement, which often correlated with movement velocity. The firing pattern (bursting, irregular, or tonic) remained unchanged during movement compared to rest. Oscillatory single unit firing activity (predominantly in the theta and beta frequency) decreased with movement onset, irrespective of oscillation frequency. This study shows for the first time specific, task-related, SUA changes during the reach-to-grasp movement in humans.
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Affiliation(s)
- Monika Pötter-Nerger
- Department of Neurology, Christian-Albrechts-UniversityKiel, Germany.,Department of Neurology, University Hamburg-EppendorfHamburg, Germany
| | - Rene Reese
- Department of Neurology, Christian-Albrechts-UniversityKiel, Germany.,Department of Neurology, University RostockRostock, Germany
| | - Frank Steigerwald
- Department of Neurology, Christian-Albrechts-UniversityKiel, Germany.,Department of Neurology, Julius-Maximilian UniversityWürzburg, Germany
| | - Jan Arne Heiden
- Department of Neurology, Christian-Albrechts-UniversityKiel, Germany
| | - Jan Herzog
- Department of Neurology, Christian-Albrechts-UniversityKiel, Germany
| | - Christian K E Moll
- Department of Neurophysiology, University Hamburg-EppendorfHamburg, Germany
| | - Wolfgang Hamel
- Department of Neurosurgery, University Hamburg-EppendorfHamburg, Germany
| | - Uri Ramirez-Pasos
- Department of Neurology, Julius-Maximilian UniversityWürzburg, Germany
| | - Daniela Falk
- Department of Neurosurgery, Christian-Albrechts-UniversityKiel, Germany
| | | | - Christian Gerloff
- Department of Neurology, University Hamburg-EppendorfHamburg, Germany
| | - Günther Deuschl
- Department of Neurology, Christian-Albrechts-UniversityKiel, Germany
| | - Jens Volkmann
- Department of Neurology, Christian-Albrechts-UniversityKiel, Germany.,Department of Neurology, Julius-Maximilian UniversityWürzburg, Germany
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Lipski WJ, Wozny TA, Alhourani A, Kondylis ED, Turner RS, Crammond DJ, Richardson RM. Dynamics of human subthalamic neuron phase-locking to motor and sensory cortical oscillations during movement. J Neurophysiol 2017; 118:1472-1487. [PMID: 28592690 PMCID: PMC5596141 DOI: 10.1152/jn.00964.2016] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2016] [Revised: 05/01/2017] [Accepted: 06/01/2017] [Indexed: 01/19/2023] Open
Abstract
Coupled oscillatory activity recorded between sensorimotor regions of the basal ganglia-thalamocortical loop is thought to reflect information transfer relevant to movement. A neuronal firing-rate model of basal ganglia-thalamocortical circuitry, however, has dominated thinking about basal ganglia function for the past three decades, without knowledge of the relationship between basal ganglia single neuron firing and cortical population activity during movement itself. We recorded activity from 34 subthalamic nucleus (STN) neurons, simultaneously with cortical local field potentials and motor output, in 11 subjects with Parkinson's disease (PD) undergoing awake deep brain stimulator lead placement. STN firing demonstrated phase synchronization to both low- and high-beta-frequency cortical oscillations, and to the amplitude envelope of gamma oscillations, in motor cortex. We found that during movement, the magnitude of this synchronization was dynamically modulated in a phase-frequency-specific manner. Importantly, we found that phase synchronization was not correlated with changes in neuronal firing rate. Furthermore, we found that these relationships were not exclusive to motor cortex, because STN firing also demonstrated phase synchronization to both premotor and sensory cortex. The data indicate that models of basal ganglia function ultimately will need to account for the activity of populations of STN neurons that are bound in distinct functional networks with both motor and sensory cortices and code for movement parameters independent of changes in firing rate.NEW & NOTEWORTHY Current models of basal ganglia-thalamocortical networks do not adequately explain simple motor functions, let alone dysfunction in movement disorders. Our findings provide data that inform models of human basal ganglia function by demonstrating how movement is encoded by networks of subthalamic nucleus (STN) neurons via dynamic phase synchronization with cortex. The data also demonstrate, for the first time in humans, a mechanism through which the premotor and sensory cortices are functionally connected to the STN.
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Affiliation(s)
- Witold J Lipski
- Brain Modulation Laboratory, Department of Neurological Surgery, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
- Center for the Neural Basis of Cognition, University of Pittsburgh, Pittsburgh, Pennsylvania; and
| | - Thomas A Wozny
- Brain Modulation Laboratory, Department of Neurological Surgery, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Ahmad Alhourani
- Brain Modulation Laboratory, Department of Neurological Surgery, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Efstathios D Kondylis
- Brain Modulation Laboratory, Department of Neurological Surgery, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Robert S Turner
- Department of Neurobiology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
- Center for the Neural Basis of Cognition, University of Pittsburgh, Pittsburgh, Pennsylvania; and
- University of Pittsburgh Brain Institute, Pittsburgh, Pennsylvania
| | - Donald J Crammond
- Brain Modulation Laboratory, Department of Neurological Surgery, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Robert Mark Richardson
- Brain Modulation Laboratory, Department of Neurological Surgery, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania;
- Department of Neurobiology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
- Center for the Neural Basis of Cognition, University of Pittsburgh, Pittsburgh, Pennsylvania; and
- University of Pittsburgh Brain Institute, Pittsburgh, Pennsylvania
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Tankus A, Strauss I, Gurevich T, Mirelman A, Giladi N, Fried I, Hausdorff JM. Subthalamic Neurons Encode Both Single- and Multi-Limb Movements in Parkinson's Disease Patients. Sci Rep 2017; 7:42467. [PMID: 28211850 PMCID: PMC5304178 DOI: 10.1038/srep42467] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2016] [Accepted: 01/11/2017] [Indexed: 11/30/2022] Open
Abstract
The subthalamic nucleus (STN) is the main target for neurosurgical treatment of motor signs of Parkinson’s disease (PD). Despite the therapeutic effect on both upper and lower extremities, its role in motor control and coordination and its changes in Parkinson’s disease are not fully clear. We intraoperatively recorded single unit activity in ten patients with PD who performed repetitive feet or hand movements while undergoing implantation of a deep brain stimulator. We found both distinct and overlapping representations of upper and lower extremity movement kinematics in subthalamic units and observed evidence for re-routing to a multi-limb representation that participates in limb coordination. The well-known subthalamic somatotopy showed a large overlap of feet and hand representations in the PD patients. This overlap and excessive amounts of kinematics or coordination units may reflect pathophysiology or compensatory mechanisms. Our findings thus explain, at the single neuron level, the important subthalamic role in motor control and coordination and indicate the effect of PD on the neuronal representation of movement.
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Affiliation(s)
- Ariel Tankus
- Center for study of Movement, Cognition and Mobility, Department of Neurology, Tel Aviv Sourasky Medical Center, Tel-Aviv 6423906, Israel.,Functional Neurosurgery Unit, Tel Aviv Sourasky Medical Center, Tel Aviv 6423906, Israel.,Department of Neurology and Neurosurgery, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel.,Sagol School of Neuroscience, Tel Aviv University, Tel Aviv 6997801, Israel
| | - Ido Strauss
- Functional Neurosurgery Unit, Tel Aviv Sourasky Medical Center, Tel Aviv 6423906, Israel
| | - Tanya Gurevich
- Department of Neurology and Neurosurgery, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel.,Sagol School of Neuroscience, Tel Aviv University, Tel Aviv 6997801, Israel.,Department of Neurology, Tel Aviv Sourasky Medical Center, Tel-Aviv 6423906, Israel
| | - Anat Mirelman
- Center for study of Movement, Cognition and Mobility, Department of Neurology, Tel Aviv Sourasky Medical Center, Tel-Aviv 6423906, Israel.,Department of Neurology and Neurosurgery, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel
| | - Nir Giladi
- Department of Neurology and Neurosurgery, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel.,Sagol School of Neuroscience, Tel Aviv University, Tel Aviv 6997801, Israel.,Department of Neurology, Tel Aviv Sourasky Medical Center, Tel-Aviv 6423906, Israel.,Sieratzki Chair in Neurology, Sackler School of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel
| | - Itzhak Fried
- Functional Neurosurgery Unit, Tel Aviv Sourasky Medical Center, Tel Aviv 6423906, Israel.,Department of Neurology and Neurosurgery, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel.,Department of Neurosurgery, University of California, Los Angeles, CA 90095, USA
| | - Jeffrey M Hausdorff
- Center for study of Movement, Cognition and Mobility, Department of Neurology, Tel Aviv Sourasky Medical Center, Tel-Aviv 6423906, Israel.,Sagol School of Neuroscience, Tel Aviv University, Tel Aviv 6997801, Israel.,Department of Physical Therapy, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel
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Tan H, Pogosyan A, Ashkan K, Green AL, Aziz T, Foltynie T, Limousin P, Zrinzo L, Hariz M, Brown P. Decoding gripping force based on local field potentials recorded from subthalamic nucleus in humans. eLife 2016; 5. [PMID: 27855780 PMCID: PMC5148608 DOI: 10.7554/elife.19089] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2016] [Accepted: 11/14/2016] [Indexed: 01/16/2023] Open
Abstract
The basal ganglia are known to be involved in the planning, execution and control of gripping force and movement vigour. Here we aim to define the nature of the basal ganglia control signal for force and to decode gripping force based on local field potential (LFP) activities recorded from the subthalamic nucleus (STN) in patients with deep brain stimulation (DBS) electrodes. We found that STN LFP activities in the gamma (55-90 Hz) and beta (13-30m Hz) bands were most informative about gripping force, and that a first order dynamic linear model with these STN LFP features as inputs can be used to decode the temporal profile of gripping force. Our results enhance the understanding of how the basal ganglia control gripping force, and also suggest that deep brain LFPs could potentially be used to decode movement parameters related to force and movement vigour for the development of advanced human-machine interfaces.
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Affiliation(s)
- Huiling Tan
- Medical Research Council Brain Network Dynamics Unit, University of Oxford, Oxford, United Kingdom.,Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, University of Oxford, Oxford, United Kingdom
| | - Alek Pogosyan
- Medical Research Council Brain Network Dynamics Unit, University of Oxford, Oxford, United Kingdom.,Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, University of Oxford, Oxford, United Kingdom
| | - Keyoumars Ashkan
- Department of Neurosurgery, Kings College Hospital, Kings College London, London, England
| | - Alexander L Green
- Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, University of Oxford, Oxford, United Kingdom
| | - Tipu Aziz
- Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, University of Oxford, Oxford, United Kingdom
| | - Thomas Foltynie
- Sobell Department of Motor Neuroscience and Movement Disorders, UCL Institute of Neurology, London, United Kingdom
| | - Patricia Limousin
- Sobell Department of Motor Neuroscience and Movement Disorders, UCL Institute of Neurology, London, United Kingdom
| | - Ludvic Zrinzo
- Sobell Department of Motor Neuroscience and Movement Disorders, UCL Institute of Neurology, London, United Kingdom
| | - Marwan Hariz
- Sobell Department of Motor Neuroscience and Movement Disorders, UCL Institute of Neurology, London, United Kingdom
| | - Peter Brown
- Medical Research Council Brain Network Dynamics Unit, University of Oxford, Oxford, United Kingdom.,Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, University of Oxford, Oxford, United Kingdom
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Use of intraoperative CT to predict the accuracy of microelectrode recording during deep brain stimulation surgery. A proof of concept study. Clin Neurol Neurosurg 2016; 150:164-168. [DOI: 10.1016/j.clineuro.2016.09.014] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2016] [Revised: 08/26/2016] [Accepted: 09/23/2016] [Indexed: 11/20/2022]
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Knieling S, Sridharan KS, Belardinelli P, Naros G, Weiss D, Mormann F, Gharabaghi A. An Unsupervised Online Spike-Sorting Framework. Int J Neural Syst 2016; 26:1550042. [DOI: 10.1142/s0129065715500422] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Extracellular neuronal microelectrode recordings can include action potentials from multiple neurons. To separate spikes from different neurons, they can be sorted according to their shape, a procedure referred to as spike-sorting. Several algorithms have been reported to solve this task. However, when clustering outcomes are unsatisfactory, most of them are difficult to adjust to achieve the desired results. We present an online spike-sorting framework that uses feature normalization and weighting to maximize the distinctiveness between different spike shapes. Furthermore, multiple criteria are applied to either facilitate or prevent cluster fusion, thereby enabling experimenters to fine-tune the sorting process. We compare our method to established unsupervised offline (Wave_Clus (WC)) and online (OSort (OS)) algorithms by examining their performance in sorting various test datasets using two different scoring systems (AMI and the Adamos metric). Furthermore, we evaluate sorting capabilities on intra-operative recordings using established quality metrics. Compared to WC and OS, our algorithm achieved comparable or higher scores on average and produced more convincing sorting results for intra-operative datasets. Thus, the presented framework is suitable for both online and offline analysis and could substantially improve the quality of microelectrode-based data evaluation for research and clinical application.
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Affiliation(s)
- Simeon Knieling
- Division of Functional and Restorative Neurosurgery & Division of Translational Neurosurgery, Department of Neurosurgery, and Neuroprosthetics Research Group, Werner Reichardt Centre for Integrative Neuroscience, Eberhard Karls University Tuebingen, Otfried-Mueller-Str.45, 72076 Tuebingen, Germany
- Cognitive and Clinical Neurophysiology, Department of Epileptology, University of Bonn, Bonn, Germany
| | - Kousik S. Sridharan
- Division of Functional and Restorative Neurosurgery & Division of Translational Neurosurgery, Department of Neurosurgery, and Neuroprosthetics Research Group, Werner Reichardt Centre for Integrative Neuroscience, Eberhard Karls University Tuebingen, Otfried-Mueller-Str.45, 72076 Tuebingen, Germany
| | - Paolo Belardinelli
- Division of Functional and Restorative Neurosurgery & Division of Translational Neurosurgery, Department of Neurosurgery, and Neuroprosthetics Research Group, Werner Reichardt Centre for Integrative Neuroscience, Eberhard Karls University Tuebingen, Otfried-Mueller-Str.45, 72076 Tuebingen, Germany
| | - Georgios Naros
- Division of Functional and Restorative Neurosurgery & Division of Translational Neurosurgery, Department of Neurosurgery, and Neuroprosthetics Research Group, Werner Reichardt Centre for Integrative Neuroscience, Eberhard Karls University Tuebingen, Otfried-Mueller-Str.45, 72076 Tuebingen, Germany
| | - Daniel Weiss
- Department for Neurodegenerative Diseases and Hertie Institute for Clinical Brain Research, and German Centre of Neurodegenerative Diseases (DZNE), Eberhard Karls University Tuebingen, Germany
| | - Florian Mormann
- Cognitive and Clinical Neurophysiology, Department of Epileptology, University of Bonn, Bonn, Germany
| | - Alireza Gharabaghi
- Division of Functional and Restorative Neurosurgery & Division of Translational Neurosurgery, Department of Neurosurgery, and Neuroprosthetics Research Group, Werner Reichardt Centre for Integrative Neuroscience, Eberhard Karls University Tuebingen, Otfried-Mueller-Str.45, 72076 Tuebingen, Germany
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Noda K, Hattori N, Okuma Y. Hemiballism with leg predominance caused by contralateral subthalamic haemorrhage. BMJ Case Rep 2015; 2015:bcr-2014-208525. [PMID: 25858962 DOI: 10.1136/bcr-2014-208525] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Hemiballism is a rare movement disorder characterised by high-amplitude movements of the limbs on one side of the body. Stroke of the contralateral basal ganglia, especially the subthalamic nucleus (STN) is the most common aetiology of acute development of hemiballism. Recently, the pathophysiology of hemiballism has been associated with abnormal firing patterns in the globus pallidus interna, with intermittent firing bursts followed by pauses, during which movements occur. An 87-year-old woman presented with a 5-day history of hemiballism predominantly in her leg. On the basis of her brain MRI findings, she was diagnosed as having vascular hemiballism caused by haemorrhage in the contralateral STN. Treatment with risperidone led to the clinical resolution of her condition. We discuss the distribution of the patient's ballistic movements on the basis of the somatotopic organisation of the STN.
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Affiliation(s)
- Kazuyuki Noda
- Department of Neurology, Juntendo University Shizuoka Hospital, Izunokuni, Japan
| | - Nobutaka Hattori
- Department of Neurology, Juntendo University School of Medicine, Bunkyo-ku, Japan
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Pal GD, Sani S, Verhagen L. Muscle Contraction as a False Localizing Sign During Intraoperative Macrostimulation of Subthalamic Nucleus. Mov Disord Clin Pract 2015; 2:64-65. [DOI: 10.1002/mdc3.12137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2014] [Revised: 11/21/2014] [Accepted: 12/10/2014] [Indexed: 11/11/2022] Open
Affiliation(s)
- Gian D. Pal
- Department of Neurological Sciences; Rush University Medical Center; Chicago Illinois USA
| | - Sepehr Sani
- Department of Neurosurgery; Rush University Medical Center; Chicago Illinois USA
| | - Leo Verhagen
- Department of Neurological Sciences; Rush University Medical Center; Chicago Illinois USA
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Wang J, Hirschmann J, Elben S, Hartmann CJ, Vesper J, Wojtecki L, Schnitzler A. High-frequency oscillations in Parkinson's disease: spatial distribution and clinical relevance. Mov Disord 2014; 29:1265-72. [PMID: 25041924 DOI: 10.1002/mds.25962] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2014] [Revised: 05/20/2014] [Accepted: 06/02/2014] [Indexed: 11/08/2022] Open
Abstract
The pathophysiology of Parkinson's disease (PD) has been related to excessive beta band oscillations in the basal ganglia. Recent recordings from the subthalamic nucleus of PD patients showed that beta oscillations show strong cross-frequency coupling with high-frequency oscillations (>200 Hz). However, little is known about the characteristics and functional properties of these oscillations. We studied the spatial distribution of high-frequency oscillations and their relation to PD motor symptoms. We included 10 PD patients in medication OFF who underwent implantation of deep brain stimulation (DBS) electrodes. Intraoperative five-channel microelectrode recordings were performed at 9 to 10 recording sites within the subthalamic nucleus and its immediate surroundings. We found a focal spatial distribution of high-frequency oscillations with highest power 2 mm below the dorsolateral border of the subthalamic nucleus. Within the subthalamic nucleus, power peaked slightly anterior to the DBS target site. In addition, contralateral akinesia/rigidity scores were negatively correlated with high-frequency oscillation power. Our results demonstrate a focal origin of high-frequency oscillations within the subthalamic nucleus and provide further evidence for their functional association with motor state.
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Affiliation(s)
- Jing Wang
- Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty, Heinrich Heine University, Düsseldorf, Germany; State Key Lab of Cognitive Neuroscience and Learning, Beijing Normal University, P. R. China
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Phonemic verbal fluency decline after subthalamic nucleus deep brain stimulation does not depend on number of microelectrode recordings or lead tip placement. Parkinsonism Relat Disord 2014; 20:400-4. [DOI: 10.1016/j.parkreldis.2014.01.008] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2013] [Revised: 01/08/2014] [Accepted: 01/11/2014] [Indexed: 11/20/2022]
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Eitan R, Shamir RR, Linetsky E, Rosenbluh O, Moshel S, Ben-Hur T, Bergman H, Israel Z. Asymmetric right/left encoding of emotions in the human subthalamic nucleus. Front Syst Neurosci 2013; 7:69. [PMID: 24194703 PMCID: PMC3810611 DOI: 10.3389/fnsys.2013.00069] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2013] [Accepted: 10/04/2013] [Indexed: 01/13/2023] Open
Abstract
Emotional processing is lateralized to the non-dominant brain hemisphere. However, there is no clear spatial model for lateralization of emotional domains in the basal ganglia. The subthalamic nucleus (STN), an input structure in the basal ganglia network, plays a major role in the pathophysiology of Parkinson's disease (PD). This role is probably not limited only to the motor deficits of PD, but may also span the emotional and cognitive deficits commonly observed in PD patients. Beta oscillations (12–30 Hz), the electrophysiological signature of PD, are restricted to the dorsolateral part of the STN that corresponds to the anatomically defined sensorimotor STN. The more medial, more anterior and more ventral parts of the STN are thought to correspond to the anatomically defined limbic and associative territories of the STN. Surprisingly, little is known about the electrophysiological properties of the non-motor domains of the STN, nor about electrophysiological differences between right and left STNs. In this study, microelectrodes were utilized to record the STN spontaneous spiking activity and responses to vocal non-verbal emotional stimuli during deep brain stimulation (DBS) surgeries in human PD patients. The oscillation properties of the STN neurons were used to map the dorsal oscillatory and the ventral non-oscillatory regions of the STN. Emotive auditory stimulation evoked activity in the ventral non-oscillatory region of the right STN. These responses were not observed in the left ventral STN or in the dorsal regions of either the right or left STN. Therefore, our results suggest that the ventral non-oscillatory regions are asymmetrically associated with non-motor functions, with the right ventral STN associated with emotional processing. These results suggest that DBS of the right ventral STN may be associated with beneficial or adverse emotional effects observed in PD patients and may relieve mental symptoms in other neurological and psychiatric diseases.
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Affiliation(s)
- Renana Eitan
- Department of Psychiatry, Hadassah-Hebrew University Medical Center Jerusalem, Israel
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Wagle Shukla A, Moro E, Gunraj C, Lozano A, Hodaie M, Lang A, Chen R. Long-term subthalamic nucleus stimulation improves sensorimotor integration and proprioception. J Neurol Neurosurg Psychiatry 2013; 84:1020-8. [PMID: 23616568 DOI: 10.1136/jnnp-2012-304102] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
OBJECTIVE Sensorimotor integration is impaired in patients with Parkinson's disease (PD). Short latency afferent inhibition (SAI) and long latency afferent inhibition (LAI) measured with transcranial magnetic stimulation (TMS) can be used to measure sensorimotor integration. Subthalamic nucleus (STN) deep brain stimulation (DBS) has been found to restore these abnormalities, but the time course of these changes is not known. We prospectively evaluated the short-term and long-term effects of STN DBS on SAI, LAI and proprioception. We hypothesised plasticity changes induced by chronic stimulation are necessary to normalise sensorimotor integration and proprioception. METHODS Patients with PD were studied preoperatively, at 1 month and more than 6 months postoperatively. SAI was tested with median nerve stimulation to the wrist preceding TMS pulse to motor cortex by ~20 ms and LAI by 200 ms. Proprioception (distance and spatial errors) in the arm was quantitatively assessed. For postoperative assessments, patients were studied in the medication-off/stimulator-off, medication-off/stimulator-on, medication-on/stimulator-off and medication-on/stimulator-on conditions. RESULTS 11 patients with PD and 10 controls were enrolled. Preoperatively, SAI and proprioception was abnormal during the medication-on conditions and LAI was reduced regardless of the medication status. STN DBS had no significant effect on SAI, LAI and proprioception at 1 month. However, at 6 months SAI, LAI and distance errors were normalised in the medication-on/stimulator-on condition. Spatial error was normalised with DBS on and off. CONCLUSIONS Chronic STN DBS in PD normalises sensorimotor integration and proprioception, likely through long-term plastic changes in the basal ganglia thalamocortical circuit.
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Affiliation(s)
- Aparna Wagle Shukla
- Center for Movement Disorders and Neurorestoration, University of Florida, Gainesville, Florida, USA
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LEE D, HENRIQUES DY, SNIDER J, SONG D, POIZNER H. Reaching to proprioceptively defined targets in Parkinson's disease: effects of deep brain stimulation therapy. Neuroscience 2013; 244:99-112. [PMID: 23590906 PMCID: PMC3780593 DOI: 10.1016/j.neuroscience.2013.04.009] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2012] [Revised: 04/04/2013] [Accepted: 04/05/2013] [Indexed: 11/26/2022]
Abstract
Deep brain stimulation of the subthalamic nucleus (STN DBS) provides a unique window into human brain function since it can reversibly alter the functioning of specific brain circuits. Basal ganglia-cortical circuits are thought to be excessively noisy in patients with Parkinson's disease (PD), based in part on the lack of specificity of proprioceptive signals in basal ganglia-thalamic-cortical circuits in monkey models of the disease. PD patients are known to have deficits in proprioception, but the effects are often subtle, with paradigms typically restricted to one or two joint movements in a plane. Moreover, the effects of STN DBS on proprioception are virtually unexplored. We tested the following hypotheses: first, that PD patients will show substantial deficits in unconstrained, multi-joint proprioception, and, second, that STN DBS will improve multi-joint proprioception. Twelve PD patients with bilaterally implanted electrodes in the subthalamic nucleus and 12 age-matched healthy subjects were asked to position the left hand at a location that was proprioceptively defined in 3D space with the right hand. In a second condition, subjects were provided visual feedback during the task so that they were not forced to rely on proprioception. Overall, with STN DBS switched off, PD patients showed significantly larger proprioceptive localization errors, and greater variability in endpoint localizations than the control subjects. Visual feedback partially normalized PD performance, and demonstrated that the errors in proprioceptive localization were not simply due to a difficulty in executing the movements or in remembering target locations. Switching STN DBS on significantly reduced localization errors from those of control subjects when patients moved without visual feedback relative to when they moved with visual feedback (when proprioception was not required). However, this reduction in localization errors without vision came at the cost of increased localization variability.
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Affiliation(s)
- D. LEE
- Institute for Neural Computation, University of California, San Diego, CA, United States
| | - D. Y. HENRIQUES
- School of Kinesiology & Health Science Centre for Vision Research, York University, Toronto, Canada
| | - J. SNIDER
- Institute for Neural Computation, University of California, San Diego, CA, United States
| | - D. SONG
- Department of Neurosciences, University of California, San Diego, CA, United States
| | - H. POIZNER
- Institute for Neural Computation, University of California, San Diego, CA, United States
- Graduate Program in Neurosciences, University of California, San Diego, CA, United States
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Burchiel KJ, McCartney S, Lee A, Raslan AM. Accuracy of deep brain stimulation electrode placement using intraoperative computed tomography without microelectrode recording. J Neurosurg 2013; 119:301-6. [PMID: 23724986 DOI: 10.3171/2013.4.jns122324] [Citation(s) in RCA: 180] [Impact Index Per Article: 16.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECT In this prospective study the authors' objective was to evaluate the accuracy of deep brain stimulation (DBS) electrode placement using image guidance for direct anatomical targeting with intraoperative CT. METHODS Preoperative 3-T MR images were merged with intraoperative CT images for planning. Electrode targets were anatomical, based on the MR images. A skull-mounted NexFrame system was used for electrode placement, and all procedures were performed under general anesthesia. After electrode placement, intraoperative CT images were merged with trajectory planning images to calculate accuracy. Accuracy was assessed by both vector error and deviation off the planned trajectory. RESULTS Sixty patients (33 with Parkinson disease, 26 with essential tremor, and 1 with dystonia) underwent the procedure. Patient's mean age was 64 ± 9.5 years. Over an 18-month period, 119 electrodes were placed (all bilateral, except one). Electrode implant locations were the ventral intermediate nucleus (VIM), globus pallidus internus (GPI), and subthalamic nucleus (STN) in 25, 23, and 12 patients, respectively. Target accuracy measurements were as follows: mean vector error 1.59 ± 1.11 mm and mean deviation off trajectory 1.24 ± 0.87 mm. There was no statistically significant difference between the accuracy of left and right brain electrodes. There was a statistically significant (negative) correlation between the distance of the closest approach of the electrode trajectory to the ventricular wall of the lateral ventricle and vector error (r(2) = -0.339, p < 0.05, n = 76), and the deviation from the planned trajectory (r(2) = -0.325, p < 0.05, n = 77). Furthermore, when the distance from the electrode trajectory and the ventricular wall was < 4 mm, the correlation of the ventricular distance to the deviation from the planned trajectory was stronger (r(2) = -0.419, p = 0.05, n = 19). Electrodes placed in the GPI were significantly more accurate than those placed in the VIM (p < 0.05). Only 1 of 119 electrodes required intraoperative replacement due to a vector error > 3 mm. In this series there was one infection and no intraparenchymal hemorrhages. CONCLUSIONS Placement of DBS electrodes using an intraoperative CT scanner and the NexFrame achieves an accuracy that is at least comparable to other methods.
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Affiliation(s)
- Kim J Burchiel
- Department of Neurological Surgery, Oregon Health & Science University, Portland, OR 97239-3098, USA
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Moore TR, Jacobs RU, Yang AC, Richter EO. Synchronizing microelectrode and electronic goniometer data using a pseudo-random binary signal. J Med Eng Technol 2013; 37:172-9. [PMID: 23547750 DOI: 10.3109/03091902.2012.762431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Intra-operative investigation of the subthalamic nucleus (STN) requires concurrent measurement of microelectrode voltage, electrode depth and joint movement during deep brain stimulation (DBS) surgery. Commercial solutions to this problem exist but are more expensive. Multiple instruments from different manufacturers can collect the same data, but data from incompatible instruments are collected on disparate clocks, precluding quantitative analysis. A pseudo-random binary signal recorded simultaneously by each set of instruments allows for chronological reconciliation. A custom program collects microelectrode data while simultaneously sending a pseudo-random binary signal to instruments measuring joint movement. The record of this signal is later used to express microelectrode voltage and joint position in a single chronological frame of reference. ClockSynch was used in 15 DBS procedures. After each surgery, records of microelectrode and joint movement were successfully chronologically reconciled. In conclusion, a pseudo-random binary signal integrates disparate systems of instrumentation at a significantly decreased cost.
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Affiliation(s)
- Tyler Robert Moore
- Department of Neurosurgery and Department of Cell Biology and Anatomy, Louisiana State University Health Sciences Center , New Orleans, Louisiana , USA
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Florin E, Dafsari HS, Reck C, Barbe MT, Pauls KAM, Maarouf M, Sturm V, Fink GR, Timmermann L. Modulation of local field potential power of the subthalamic nucleus during isometric force generation in patients with Parkinson's disease. Neuroscience 2013; 240:106-16. [PMID: 23454540 DOI: 10.1016/j.neuroscience.2013.02.043] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2012] [Revised: 02/15/2013] [Accepted: 02/20/2013] [Indexed: 11/17/2022]
Abstract
Investigations of local field potentials of the subthalamic nucleus of patients with Parkinson's disease have provided evidence for pathologically exaggerated oscillatory beta-band activity (13-30 Hz) which is amenable to physiological modulation by, e.g., voluntary movement. Previous functional magnetic resonance imaging studies in healthy controls have provided evidence for an increase of subthalamic nucleus blood-oxygenation-level-dependant signal in incremental force generation tasks. However, the modulation of neuronal activity by force generation and its relationship to peripheral feedback remain to be elucidated. We hypothesised that beta-band activity in the subthalamic nucleus is modulated by incremental force generation. Subthalamic nucleus local field potentials were recorded intraoperatively in 13 patients with Parkinson's disease (37 recording sites) during rest and five incremental isometric force generation conditions of the arm with applied loads of 0-400 g (in 100-g increments). Repeated measures analysis of variance (ANOVA) revealed a modulation of local field potential (LFP) power in the upper beta-band (in 24-30 Hz; F(₃.₀₄₂)=4.693, p=0.036) and the gamma-band (in 70-76 Hz; F(₄)=4.116, p=0.036). Granger-causality was computed with the squared partial directed coherence and showed no significant modulation during incremental isometric force generation. Our findings indicate that the upper beta- and gamma-band power of subthalamic nucleus local field potentials are modulated by the physiological task of force generation in patients with Parkinson's disease. This modulation seems to be not an effect of a modulation of peripheral feedback.
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Affiliation(s)
- E Florin
- Department of Neurology, University Hospital Cologne, Cologne, Germany.
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Lalys F, Haegelen C, Mehri M, Drapier S, Vérin M, Jannin P. Anatomo-clinical atlases correlate clinical data and electrode contact coordinates: Application to subthalamic deep brain stimulation. J Neurosci Methods 2013; 212:297-307. [DOI: 10.1016/j.jneumeth.2012.11.002] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2012] [Revised: 10/31/2012] [Accepted: 11/02/2012] [Indexed: 10/27/2022]
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