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Kremer NI, Roberts MJ, Potters WV, Dilai J, Mathiopoulou V, Rijks N, Drost G, van Laar T, van Dijk JMC, Beudel M, de Bie RMA, van den Munckhof P, Janssen MLF, Schuurman PR, Bot M. Dorsal subthalamic nucleus targeting in deep brain stimulation: microelectrode recording versus 7-Tesla connectivity. Brain Commun 2023; 5:fcad298. [PMID: 38025271 PMCID: PMC10664414 DOI: 10.1093/braincomms/fcad298] [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: 08/02/2022] [Revised: 09/02/2023] [Accepted: 11/09/2023] [Indexed: 12/01/2023] Open
Abstract
Connectivity-derived 7-Tesla MRI segmentation and intraoperative microelectrode recording can both assist subthalamic nucleus targeting for deep brain stimulation in Parkinson's disease. It remains unclear whether deep brain stimulation electrodes placed in the 7-Tesla MRI segmented subdivision with predominant projections to cortical motor areas (hyperdirect pathway) achieve superior motor improvement and whether microelectrode recording can accurately distinguish the motor subdivision. In 25 patients with Parkinson's disease, deep brain stimulation electrodes were evaluated for being inside or outside the predominantly motor-connected subthalamic nucleus (motor-connected subthalamic nucleus or non-motor-connected subthalamic nucleus, respectively) based on 7-Tesla MRI connectivity segmentation. Hemi-body motor improvement (Movement Disorder Society Unified Parkinson's Disease Rating Scale, Part III) and microelectrode recording characteristics of multi- and single-unit activities were compared between groups. Deep brain stimulation electrodes placed in the motor-connected subthalamic nucleus resulted in higher hemi-body motor improvement, compared with electrodes placed in the non-motor-connected subthalamic nucleus (80% versus 52%, P < 0.0001). Multi-unit activity was found slightly higher in the motor-connected subthalamic nucleus versus the non-motor-connected subthalamic nucleus (P < 0.001, receiver operating characteristic 0.63); single-unit activity did not differ between groups. Deep brain stimulation in the connectivity-derived 7-Tesla MRI subthalamic nucleus motor segment produced a superior clinical outcome; however, microelectrode recording did not accurately distinguish this subdivision within the subthalamic nucleus.
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Affiliation(s)
- Naomi I Kremer
- Department of Neurosurgery, Amsterdam University Medical Centers, Amsterdam 1105 AZ, The Netherlands
- Department of Neurosurgery, University of Groningen, University Medical Center Groningen, Groningen 9713 GZ, The Netherlands
| | - Mark J Roberts
- Faculty of Psychology and Neuroscience, Maastricht University, Maastricht 6211 LK, The Netherlands
| | - Wouter V Potters
- Department of Neurology and Clinical Neurophysiology, Amsterdam University Medical Centers, Amsterdam 1105 AZ, The Netherlands
| | - José Dilai
- Department of Neurology and Clinical Neurophysiology, Amsterdam University Medical Centers, Amsterdam 1105 AZ, The Netherlands
| | - Varvara Mathiopoulou
- Department of Neurosurgery, Amsterdam University Medical Centers, Amsterdam 1105 AZ, The Netherlands
| | - Niels Rijks
- Department of Neurosurgery, Amsterdam University Medical Centers, Amsterdam 1105 AZ, The Netherlands
| | - Gea Drost
- Department of Neurosurgery, University of Groningen, University Medical Center Groningen, Groningen 9713 GZ, The Netherlands
- Department of Neurology, University of Groningen, University Medical Center Groningen, Groningen 9713 GZ, The Netherlands
| | - Teus van Laar
- Department of Neurology, University of Groningen, University Medical Center Groningen, Groningen 9713 GZ, The Netherlands
| | - J Marc C van Dijk
- Department of Neurosurgery, University of Groningen, University Medical Center Groningen, Groningen 9713 GZ, The Netherlands
| | - Martijn Beudel
- Department of Neurology and Clinical Neurophysiology, Amsterdam University Medical Centers, Amsterdam 1105 AZ, The Netherlands
| | - Rob M A de Bie
- Department of Neurology and Clinical Neurophysiology, Amsterdam University Medical Centers, Amsterdam 1105 AZ, The Netherlands
| | - Pepijn van den Munckhof
- Department of Neurosurgery, Amsterdam University Medical Centers, Amsterdam 1105 AZ, The Netherlands
| | - Marcus L F Janssen
- Department of Clinical Neurophysiology, Maastricht University Medical Center, Maastricht 6229 HX, The Netherlands
| | - P Richard Schuurman
- Department of Neurosurgery, Amsterdam University Medical Centers, Amsterdam 1105 AZ, The Netherlands
| | - Maarten Bot
- Department of Neurosurgery, Amsterdam University Medical Centers, Amsterdam 1105 AZ, The Netherlands
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2
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Averna A, Debove I, Nowacki A, Peterman K, Duchet B, Sousa M, Bernasconi E, Alva L, Lachenmayer ML, Schuepbach M, Pollo C, Krack P, Nguyen TAK, Tinkhauser G. Spectral Topography of the Subthalamic Nucleus to Inform Next-Generation Deep Brain Stimulation. Mov Disord 2023; 38:818-830. [PMID: 36987385 PMCID: PMC7615852 DOI: 10.1002/mds.29381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 01/13/2023] [Accepted: 02/27/2023] [Indexed: 03/30/2023] Open
Abstract
BACKGROUND The landscape of neurophysiological symptoms and behavioral biomarkers in basal ganglia signals for movement disorders is expanding. The clinical translation of sensing-based deep brain stimulation (DBS) also requires a thorough understanding of the anatomical organization of spectral biomarkers within the subthalamic nucleus (STN). OBJECTIVES The aims were to systematically investigate the spectral topography, including a wide range of sub-bands in STN local field potentials (LFP) of Parkinson's disease (PD) patients, and to evaluate its predictive performance for clinical response to DBS. METHODS STN-LFPs were recorded from 70 PD patients (130 hemispheres) awake and at rest using multicontact DBS electrodes. A comprehensive spatial characterization, including hot spot localization and focality estimation, was performed for multiple sub-bands (delta, theta, alpha, low-beta, high-beta, low-gamma, high-gamma, and fast-gamma (FG) as well as low- and fast high-frequency oscillations [HFO]) and compared to the clinical hot spot for rigidity response to DBS. A spectral biomarker map was established and used to predict the clinical response to DBS. RESULTS The STN shows a heterogeneous topographic distribution of different spectral biomarkers, with the strongest segregation in the inferior-superior axis. Relative to the superiorly localized beta hot spot, HFOs (FG, slow HFO) were localized up to 2 mm more inferiorly. Beta oscillations are spatially more spread compared to other sub-bands. Both the spatial proximity of contacts to the beta hot spot and the distance to higher-frequency hot spots were predictive for the best rigidity response to DBS. CONCLUSIONS The spatial segregation and properties of spectral biomarkers within the DBS target structure can additionally be informative for the implementation of next-generation sensing-based DBS. © 2023 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Alberto Averna
- Department of Neurology, Bern University Hospital and University of Bern, Bern, Switzerland
| | - Ines Debove
- Department of Neurology, Bern University Hospital and University of Bern, Bern, Switzerland
| | - Andreas Nowacki
- Department of Neurosurgery, Bern University Hospital and University of Bern, Bern, Switzerland
| | - Katrin Peterman
- Department of Neurology, Bern University Hospital and University of Bern, Bern, Switzerland
| | - Benoit Duchet
- Nuffield Department of Clinical Neuroscience, University of Oxford, Oxford, United Kingdom
- MRC Brain Network Dynamics Unit, University of Oxford, Oxford, United Kingdom
| | - Mário Sousa
- Department of Neurology, Bern University Hospital and University of Bern, Bern, Switzerland
| | - Elena Bernasconi
- Department of Neurology, Bern University Hospital and University of Bern, Bern, Switzerland
| | - Laura Alva
- Department of Neurology, Bern University Hospital and University of Bern, Bern, Switzerland
| | - Martin L. Lachenmayer
- Department of Neurology, Bern University Hospital and University of Bern, Bern, Switzerland
| | | | - Claudio Pollo
- Department of Neurosurgery, Bern University Hospital and University of Bern, Bern, Switzerland
| | - Paul Krack
- Department of Neurology, Bern University Hospital and University of Bern, Bern, Switzerland
| | - Thuy-Anh K. Nguyen
- Department of Neurosurgery, Bern University Hospital and University of Bern, Bern, Switzerland
- ARTORG Center for Biomedical Engineering Research, University of Bern, Bern, Switzerland
| | - Gerd Tinkhauser
- Department of Neurology, Bern University Hospital and University of Bern, Bern, Switzerland
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3
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Sanmartino F, Cruz-Gómez ÁJ, Rashid-López R, Lozano-Soto E, López-Sosa F, Zuazo A, Riqué-Dormido J, Espinosa-Rosso R, González-Rosa JJ. Subthalamic Beta Activity in Parkinson's Disease May Be Linked to Dorsal Striatum Gray Matter Volume and Prefrontal Cortical Thickness: A Pilot Study. Front Neurol 2022; 13:799696. [PMID: 35401426 PMCID: PMC8985754 DOI: 10.3389/fneur.2022.799696] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Accepted: 02/24/2022] [Indexed: 11/30/2022] Open
Abstract
Background Excessive oscillations at beta frequencies (13–35 Hz) in the subthalamic nucleus (STN) represent a pathophysiological hallmark of Parkinson's disease (PD), which correlates well with parkinsonian symptoms and is reduced in response to standard disease treatments. However, the association of disease-specific regional gray matter (GM) atrophy or cortical thickness (CT) with the presence of STN beta oscillatory activity has been poorly investigated but is of relevance given the potential of these variables for extracting information about PD pathophysiology. This exploratory study investigated the involvement of regional GM volume and CT in the basal ganglia-cortical network and its potential association with the presence of STN beta oscillatory activity in PD. Methods We acquired preoperative GM densities on T1-weighted magnetic resonance imaging scans and we carried out regional estimation of GM volume and CT. LFP activities from the STN were recorded post-operatively in 7 cognitively preserved PD patients off dopaminergic medication undergoing deep-brain stimulation surgery. Oscillatory beta power was determined by power spectral density of 4-min resting state STN LFP activity. Spearman partial correlations and regression analysis were used to screen the presence of STN beta power for their relationship with GM volume and CT measurements. Results After controlling for the effects of age, educational level, and disease duration, and after correcting for multiple testing, enhanced STN beta power showed significant and negative correlations between, first, volume of the right putamen and left caudate nucleus, and second, smaller CT in frontal regions involving the left rostral middle frontal gyrus (MFG) and left medial orbitofrontal gyrus. A lower volume in the right putamen and a lower CT in the left MFG demonstrated the strongest associations with increased STN beta power. Conclusions These tentative results seem to suggest that STN LFP beta frequencies may be mainly linked to different but ongoing parallel neurodegenerative processes, on the one hand, to GM volume reduction in dorsal striatum, and on the other hand, to CT reduction of prefrontal-“associative” regions. These findings could further delineate the brain structural interactions underpinning the exaggerated STN beta activity commonly observed in PD patients.
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Affiliation(s)
- Florencia Sanmartino
- Department of Psychology, University of Cadiz, Cádiz, Spain.,Psychophysiology and Neuroimaging Group, Institute of Biomedical Research Cadiz (INiBICA), Cádiz, Spain
| | - Álvaro J Cruz-Gómez
- Department of Psychology, University of Cadiz, Cádiz, Spain.,Psychophysiology and Neuroimaging Group, Institute of Biomedical Research Cadiz (INiBICA), Cádiz, Spain
| | - Raúl Rashid-López
- Psychophysiology and Neuroimaging Group, Institute of Biomedical Research Cadiz (INiBICA), Cádiz, Spain.,Department of Neurology, Puerta del Mar University Hospital, Cádiz, Spain
| | - Elena Lozano-Soto
- Department of Psychology, University of Cadiz, Cádiz, Spain.,Psychophysiology and Neuroimaging Group, Institute of Biomedical Research Cadiz (INiBICA), Cádiz, Spain
| | - Fernando López-Sosa
- Psychophysiology and Neuroimaging Group, Institute of Biomedical Research Cadiz (INiBICA), Cádiz, Spain
| | - Amaya Zuazo
- Department of Radiodiagnostic and Medical Imaging, Puerta del Mar University Hospital, Cádiz, Spain
| | - Jesús Riqué-Dormido
- Department of Neurosurgery, Puerta del Mar University Hospital, Cádiz, Spain
| | - Raúl Espinosa-Rosso
- Psychophysiology and Neuroimaging Group, Institute of Biomedical Research Cadiz (INiBICA), Cádiz, Spain.,Department of Neurology, Puerta del Mar University Hospital, Cádiz, Spain.,Department of Neurology, Jerez de la Frontera University Hospital, Jerez de la Frontera, Spain
| | - Javier J González-Rosa
- Department of Psychology, University of Cadiz, Cádiz, Spain.,Psychophysiology and Neuroimaging Group, Institute of Biomedical Research Cadiz (INiBICA), Cádiz, Spain
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Pozzi NG, Isaias IU. Adaptive deep brain stimulation: Retuning Parkinson's disease. HANDBOOK OF CLINICAL NEUROLOGY 2022; 184:273-284. [PMID: 35034741 DOI: 10.1016/b978-0-12-819410-2.00015-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
A brain-machine interface represents a promising therapeutic avenue for the treatment of many neurologic conditions. Deep brain stimulation (DBS) is an invasive, neuro-modulatory tool that can improve different neurologic disorders by delivering electric stimulation to selected brain areas. DBS is particularly successful in advanced Parkinson's disease (PD), where it allows sustained improvement of motor symptoms. However, this approach is still poorly standardized, with variable clinical outcomes. To achieve an optimal therapeutic effect, novel adaptive DBS (aDBS) systems are being developed. These devices operate by adapting stimulation parameters in response to an input signal that can represent symptoms, motor activity, or other behavioral features. Emerging evidence suggests greater efficacy with fewer adverse effects during aDBS compared with conventional DBS. We address this topic by discussing the basics principles of aDBS, reviewing current evidence, and tackling the many challenges posed by aDBS for PD.
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Affiliation(s)
- Nicoló G Pozzi
- Department of Neurology, University Hospital Würzburg and Julius Maximilian University Würzburg, Würzburg, Germany
| | - Ioannis U Isaias
- Department of Neurology, University Hospital Würzburg and Julius Maximilian University Würzburg, Würzburg, Germany.
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5
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Eight cylindrical contact lead recordings in the subthalamic region localize beta oscillations source to the dorsal STN. Neurobiol Dis 2020; 146:105090. [PMID: 32977021 DOI: 10.1016/j.nbd.2020.105090] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Revised: 09/20/2020] [Accepted: 09/21/2020] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND In Parkinson's disease (PD) patients, the subthalamic nucleus (STN) has prominent oscillatory activity in the beta band, which may be related to the motor symptoms severity. Local field potential (LFP) studies using standard four-contact deep brain stimulation (DBS) leads indicate that the source of beta activity in the STN region is the dorsolateral segment of the nucleus. However, these leads have few contacts outside of the STN, making the source localization of beta activity around the STN region uncertain. OBJECTIVE This study aimed to investigate the electrophysiological characteristics of the STN and the surrounding area in PD to better locate the source of these oscillations and their clinical relevance. METHODS Eight PD patients were bilaterally implanted in the STN with the eight ring-contact DBS lead (Boston Scientific Corporation). LFPs were recorded intra-operatively from each DBS contact in the off medication state at rest. Each contact location was normalized relative to the STN borders based on microelectrode recordings. For each recording, power spectral density was computed, averaged over multiple frequency bands and phase reversal analysis was used to localize the source of oscillatory activity. Beta burst, high-frequency activity (HFA), and phase-amplitude coupling (PAC) were also computed. Neurophysiological signatures were correlated with hemibody symptoms severity and clinical outcomes. RESULTS Beta band power and phase reversal localized the beta oscillator to the dorsal STN and correlated with pre-operative off medication hemibody bradykinesia and rigidity score. The contact along the electrode with the largest beta oscillatory power co-localized with the independently chosen optimized contact used for long-term chronic DBS. Lastly, beta bursting, HFA, and Beta-HFA PAC co-localized with the beta oscillator at the dorsal STN, and Beta-HFA PAC correlated with DBS effect. CONCLUSIONS Our findings support the hypothesis that the primary source of beta oscillations is located in dorsal STN, and argue against the alternative hypothesis that beta activity in the STN region arises from volume conduction from other sources. We demonstrate intrinsic STN beta-HFA PAC as an independent marker of DBS effect.
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8
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Sukiban J, Voges N, Dembek TA, Pauli R, Visser-Vandewalle V, Denker M, Weber I, Timmermann L, Grün S. Evaluation of Spike Sorting Algorithms: Application to Human Subthalamic Nucleus Recordings and Simulations. Neuroscience 2019; 414:168-185. [PMID: 31299347 DOI: 10.1016/j.neuroscience.2019.07.005] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Revised: 06/30/2019] [Accepted: 07/01/2019] [Indexed: 11/24/2022]
Abstract
An important prerequisite for the analysis of spike synchrony in extracellular recordings is the extraction of single-unit activity from the multi-unit signal. To identify single units, potential spikes are separated with respect to their potential neuronal origins ('spike sorting'). However, different sorting algorithms yield inconsistent unit assignments, which seriously influences subsequent spike train analyses. We aim to identify the best sorting algorithm for subthalamic nucleus recordings of patients with Parkinson's disease (experimental data ED). Therefore, we apply various prevalent algorithms offered by the 'Plexon Offline Sorter' and evaluate the sorting results. Since this evaluation leaves us unsure about the best algorithm, we apply all methods again to artificial data (AD) with known ground truth. AD consists of pairs of single units with different shape similarity embedded in the background noise of the ED. The sorting evaluation depicts a significant influence of the respective methods on the single unit assignments. We find a high variability in the sortings obtained by different algorithms that increases with single units shape similarity. We also find significant differences in the resulting firing characteristics. We conclude that Valley-Seeking algorithms produce the most accurate result if the exclusion of artifacts as unsorted events is important. If the latter is less important ('clean' data) the K-Means algorithm is a better option. Our results strongly argue for the need of standardized validation procedures based on ground truth data. The recipe suggested here is simple enough to become a standard procedure.
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Affiliation(s)
- Jeyathevy Sukiban
- Department of Neurology, University Hospital Cologne, Germany; Institute of Neuroscience and Medicine (INM-6) and Institute for Advanced Simulation (IAS-6) and JARA BRAIN Institute I (INM-10), Jülich Research Centre, Germany
| | - Nicole Voges
- Institute of Neuroscience and Medicine (INM-6) and Institute for Advanced Simulation (IAS-6) and JARA BRAIN Institute I (INM-10), Jülich Research Centre, Germany.
| | - Till A Dembek
- Department of Neurology, University Hospital Cologne, Germany
| | - Robin Pauli
- Institute of Neuroscience and Medicine (INM-6) and Institute for Advanced Simulation (IAS-6) and JARA BRAIN Institute I (INM-10), Jülich Research Centre, Germany; Theoretical Systems Neurobiology, RWTH Aachen University, Germany
| | | | - Michael Denker
- Institute of Neuroscience and Medicine (INM-6) and Institute for Advanced Simulation (IAS-6) and JARA BRAIN Institute I (INM-10), Jülich Research Centre, Germany
| | - Immo Weber
- Department of Neurology, University Hospital Giessen & Marburg, Marburg, Germany
| | - Lars Timmermann
- Department of Neurology, University Hospital Cologne, Germany; Department of Neurology, University Hospital Giessen & Marburg, Marburg, Germany
| | - Sonja Grün
- Institute of Neuroscience and Medicine (INM-6) and Institute for Advanced Simulation (IAS-6) and JARA BRAIN Institute I (INM-10), Jülich Research Centre, Germany; Theoretical Systems Neurobiology, RWTH Aachen University, Germany
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9
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Verhagen R, Bour LJ, Odekerken VJJ, van den Munckhof P, Schuurman PR, de Bie RMA. Electrode Location in a Microelectrode Recording-Based Model of the Subthalamic Nucleus Can Predict Motor Improvement After Deep Brain Stimulation for Parkinson's Disease. Brain Sci 2019; 9:brainsci9030051. [PMID: 30832214 PMCID: PMC6469020 DOI: 10.3390/brainsci9030051] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2019] [Revised: 02/20/2019] [Accepted: 02/20/2019] [Indexed: 11/17/2022] Open
Abstract
Motor improvement after deep brain stimulation (DBS) in the subthalamic nucleus (STN) may vary substantially between Parkinson’s disease (PD) patients. Research into the relation between improvement and active contact location requires a correction for anatomical variation. We studied the relation between active contact location relative to the neurophysiological STN, estimated by the intraoperative microelectrode recordings (MER-based STN), and contralateral motor improvement after one year. A generic STN shape was transformed to fit onto the stereotactically defined MER sites. The location of 43 electrodes (26 patients), derived from MRI-fused CT images, was expressed relative to this patient-specific MER-based STN. Using regression analyses, the relation between contact location and motor improvement was studied. The regression model that predicts motor improvement based on levodopa effect alone was significantly improved by adding the one-year active contact coordinates (R2 change = 0.176, p = 0.014). In the combined prediction model (adjusted R2 = 0.389, p < 0.001), the largest contribution was made by the mediolateral location of the active contact (standardized beta = 0.490, p = 0.002). With the MER-based STN as a reference, we were able to find a significant relation between active contact location and motor improvement. MER-based STN modeling can be used to complement imaging-based STN models in the application of DBS.
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Affiliation(s)
- Rens Verhagen
- Department of Neurology and Clinical Neurophysiology, University of Amsterdam, Amsterdam UMC, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands.
- Department of Neurosurgery, University of Amsterdam, Amsterdam UMC, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands.
| | - Lo J Bour
- Department of Neurology and Clinical Neurophysiology, University of Amsterdam, Amsterdam UMC, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands.
| | - Vincent J J Odekerken
- Department of Neurology and Clinical Neurophysiology, University of Amsterdam, Amsterdam UMC, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands.
| | - Pepijn van den Munckhof
- Department of Neurosurgery, University of Amsterdam, Amsterdam UMC, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands.
| | - P Richard Schuurman
- Department of Neurosurgery, University of Amsterdam, Amsterdam UMC, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands.
| | - Rob M A de Bie
- Department of Neurology and Clinical Neurophysiology, University of Amsterdam, Amsterdam UMC, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands.
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Myrov V, Sedov A, Belova E. Neural activity clusterization for estimation of firing pattern. J Neurosci Methods 2019; 311:164-169. [DOI: 10.1016/j.jneumeth.2018.10.017] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2018] [Revised: 10/13/2018] [Accepted: 10/13/2018] [Indexed: 11/16/2022]
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A review on microelectrode recording selection of features for machine learning in deep brain stimulation surgery for Parkinson’s disease. Clin Neurophysiol 2019; 130:145-154. [DOI: 10.1016/j.clinph.2018.09.018] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Revised: 08/28/2018] [Accepted: 09/17/2018] [Indexed: 12/17/2022]
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Intra-operative characterisation of subthalamic oscillations in Parkinson's disease. Clin Neurophysiol 2018; 129:1001-1010. [PMID: 29567582 DOI: 10.1016/j.clinph.2018.01.075] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2017] [Revised: 12/21/2017] [Accepted: 01/31/2018] [Indexed: 12/12/2022]
Abstract
OBJECTIVE This study aims to use the activities recorded directly from the deep brain stimulation (DBS) electrode to address the focality and distinct nature of the local field potential (LFP) activities of different frequency. METHODS Pre-operative and intra-operative magnetic resonance imaging (MRI) were acquired from patients with Parkinson's disease (PD) who underwent DBS in the subthalamic nucleus and intra-operative LFP recording at rest and during cued movements. Images were reconstructed and 3-D visualized using Lead-DBS® toolbox to determine the coordinates of contact. The resting spectral power and movement-related power modulation of LFP oscillations were estimated. RESULTS Both subthalamic LFP activity recorded at rest and its modulation by movement had focal maxima in the alpha, beta and gamma bands. The spatial distribution of alpha band activity and its modulation was significantly different to that in the beta band. Moreover, there were significant differences in the scale and timing of movement related modulation across the frequency bands. CONCLUSION Subthalamic LFP activities within specific frequency bands can be distinguished by spatial topography and pattern of movement related modulation. SIGNIFICANCE Assessment of the frequency, focality and pattern of movement related modulation of subthalamic LFPs reveals a heterogeneity of neural population activity in this region. This could potentially be leveraged to finesse intra-operative targeting and post-operative contact selection.
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Methods for automatic detection of artifacts in microelectrode recordings. J Neurosci Methods 2017; 290:39-51. [DOI: 10.1016/j.jneumeth.2017.07.012] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2017] [Revised: 07/12/2017] [Accepted: 07/13/2017] [Indexed: 11/19/2022]
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14
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Tamir I, Marmor-Levin O, Eitan R, Bergman H, Israel Z. Posterolateral Trajectories Favor a Longer Motor Domain in Subthalamic Nucleus Deep Brain Stimulation for Parkinson Disease. World Neurosurg 2017; 106:450-461. [DOI: 10.1016/j.wneu.2017.06.178] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2017] [Revised: 06/26/2017] [Accepted: 06/29/2017] [Indexed: 01/08/2023]
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Pozzi NG, Arnulfo G, Canessa A, Steigerwald F, Nickl R, Homola GA, Fato MM, Matthies C, Pacchetti C, Volkmann J, Isaias IU. Distinctive neuronal firing patterns in subterritories of the subthalamic nucleus. Clin Neurophysiol 2016; 127:3387-3393. [DOI: 10.1016/j.clinph.2016.09.004] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2016] [Revised: 08/11/2016] [Accepted: 09/04/2016] [Indexed: 11/15/2022]
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Verhagen R, Schuurman PR, van den Munckhof P, Contarino MF, de Bie RMA, Bour LJ. Comparative study of microelectrode recording-based STN location and MRI-based STN location in low to ultra-high field (7.0 T) T2-weighted MRI images. J Neural Eng 2016; 13:066009. [DOI: 10.1088/1741-2560/13/6/066009] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Wichmann T, DeLong MR. Deep Brain Stimulation for Movement Disorders of Basal Ganglia Origin: Restoring Function or Functionality? Neurotherapeutics 2016; 13:264-83. [PMID: 26956115 PMCID: PMC4824026 DOI: 10.1007/s13311-016-0426-6] [Citation(s) in RCA: 95] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Deep brain stimulation (DBS) is highly effective for both hypo- and hyperkinetic movement disorders of basal ganglia origin. The clinical use of DBS is, in part, empiric, based on the experience with prior surgical ablative therapies for these disorders, and, in part, driven by scientific discoveries made decades ago. In this review, we consider anatomical and functional concepts of the basal ganglia relevant to our understanding of DBS mechanisms, as well as our current understanding of the pathophysiology of two of the most commonly DBS-treated conditions, Parkinson's disease and dystonia. Finally, we discuss the proposed mechanism(s) of action of DBS in restoring function in patients with movement disorders. The signs and symptoms of the various disorders appear to result from signature disordered activity in the basal ganglia output, which disrupts the activity in thalamocortical and brainstem networks. The available evidence suggests that the effects of DBS are strongly dependent on targeting sensorimotor portions of specific nodes of the basal ganglia-thalamocortical motor circuit, that is, the subthalamic nucleus and the internal segment of the globus pallidus. There is little evidence to suggest that DBS in patients with movement disorders restores normal basal ganglia functions (e.g., their role in movement or reinforcement learning). Instead, it appears that high-frequency DBS replaces the abnormal basal ganglia output with a more tolerable pattern, which helps to restore the functionality of downstream networks.
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Affiliation(s)
- Thomas Wichmann
- Department of Neurology, Emory University School of Medicine, Atlanta, GA, USA.
- Yerkes National Primate Research Center, Emory University, Atlanta, GA, USA.
| | - Mahlon R DeLong
- Department of Neurology, Emory University School of Medicine, Atlanta, GA, USA
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Jin X, Schwabe K, Krauss JK, Alam M. The anterior and posterior pedunculopontine tegmental nucleus are involved in behavior and neuronal activity of the cuneiform and entopeduncular nuclei. Neuroscience 2016; 322:39-53. [PMID: 26880033 DOI: 10.1016/j.neuroscience.2016.02.016] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2015] [Revised: 01/13/2016] [Accepted: 02/06/2016] [Indexed: 10/22/2022]
Abstract
Loss of cholinergic neurons in the mesencephalic locomotor region, comprising the pedunculopontine nucleus (PPN) and the cuneiform nucleus (CnF), is related to gait disturbances in late stage Parkinson's disease (PD). We investigate the effect of anterior or posterior cholinergic lesions of the PPN on gait-related motor behavior, and on neuronal network activity of the PPN area and basal ganglia (BG) motor loop in rats. Anterior PPN lesions, posterior PPN lesions or sham lesions were induced by stereotaxic microinjection of the cholinergic toxin AF64-A or vehicle in male Sprague-Dawley rats. First, locomotor activity (open field), postural disturbances (Rotarod) and gait asymmetry (treadmill test) were assessed. Thereafter, single-unit and oscillatory activities were measured in the non-lesioned area of the PPN, the CnF and the entopeduncular nucleus (EPN), the BG output region, with microelectrodes under urethane anesthesia. Additionally, ECoG was recorded in the motor cortex. Injection of AF64-A into the anterior and posterior PPN decreased cholinergic cell counts as compared to naive controls (P<0.001) but also destroyed non-cholinergic cells. Only anterior PPN lesions decreased the front limb swing time of gait in the treadmill test, while not affecting other gait-related parameters tested. Main electrophysiological findings were that anterior PPN lesions increased the firing activity in the CnF (P<0.001). Further, lesions of either PPN region decreased the coherence of alpha (8-12 Hz) band between CnF and motor cortex (MCx), and increased the beta (12-30 Hz) oscillatory synchronization between EPN and the MCx. Lesions of the PPN in rats had complex effects on oscillatory neuronal activity of the CnF and the BG network, which may contribute to the understanding of the pathophysiology of gait disturbance in PD.
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Affiliation(s)
- X Jin
- Department of Neurosurgery, Hannover Medical School, Hannover, Germany
| | - K Schwabe
- Department of Neurosurgery, Hannover Medical School, Hannover, Germany
| | - J K Krauss
- Department of Neurosurgery, Hannover Medical School, Hannover, Germany
| | - M Alam
- Department of Neurosurgery, Hannover Medical School, Hannover, Germany.
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Coherence of neuronal firing of the entopeduncular nucleus with motor cortex oscillatory activity in the 6-OHDA rat model of Parkinson’s disease with levodopa-induced dyskinesias. Exp Brain Res 2016; 234:1105-18. [DOI: 10.1007/s00221-015-4532-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2015] [Accepted: 12/13/2015] [Indexed: 10/22/2022]
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Alam M, Sanghera MK, Schwabe K, Lütjens G, Jin X, Song J, von Wrangel C, Stewart RM, Jankovic J, Grossman RG, Darbin O, Krauss JK. Globus pallidus internus neuronal activity: a comparative study of linear and non-linear features in patients with dystonia or Parkinson’s disease. J Neural Transm (Vienna) 2015; 123:231-40. [DOI: 10.1007/s00702-015-1484-3] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2015] [Accepted: 11/08/2015] [Indexed: 10/22/2022]
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Advanced target identification in STN-DBS with beta power of combined local field potentials and spiking activity. J Neurosci Methods 2015; 253:116-25. [DOI: 10.1016/j.jneumeth.2015.06.006] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2014] [Revised: 06/05/2015] [Accepted: 06/08/2015] [Indexed: 01/04/2023]
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Krishna V, Elias G, Sammartino F, Basha D, King NKK, Fasano A, Munhoz R, Kalia SK, Hodaie M, Venkatraghavan L, Lozano AM, Hutchison WD. The effect of dexmedetomidine on the firing properties of STN neurons in Parkinson's disease. Eur J Neurosci 2015; 42:2070-7. [DOI: 10.1111/ejn.13004] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2015] [Revised: 06/10/2015] [Accepted: 06/18/2015] [Indexed: 11/30/2022]
Affiliation(s)
- Vibhor Krishna
- Division of Neurosurgery; Toronto Western Hospital; University of Toronto; 399 Bathurst Street Toronto ON M5T2S8 Canada
| | - Gavin Elias
- Division of Neurosurgery; Toronto Western Hospital; University of Toronto; 399 Bathurst Street Toronto ON M5T2S8 Canada
| | - Francesco Sammartino
- Division of Neurosurgery; Toronto Western Hospital; University of Toronto; 399 Bathurst Street Toronto ON M5T2S8 Canada
| | - Diellor Basha
- Department of Physiology; Toronto Western Hospital; University of Toronto; Toronto ON Canada
| | - Nicolas K. K. King
- Division of Neurosurgery; Toronto Western Hospital; University of Toronto; 399 Bathurst Street Toronto ON M5T2S8 Canada
| | - Alfonso Fasano
- Morton and Gloria Shulman Movement Disorders Centre and the Edmond J. Safra Program in Parkinson's Disease; Toronto Western Hospital; Toronto ON Canada
| | - Renato Munhoz
- Morton and Gloria Shulman Movement Disorders Centre and the Edmond J. Safra Program in Parkinson's Disease; Toronto Western Hospital; Toronto ON Canada
| | - Suneil K. Kalia
- Division of Neurosurgery; Toronto Western Hospital; University of Toronto; 399 Bathurst Street Toronto ON M5T2S8 Canada
| | - Mojgan Hodaie
- Division of Neurosurgery; Toronto Western Hospital; University of Toronto; 399 Bathurst Street Toronto ON M5T2S8 Canada
| | - Lashmi Venkatraghavan
- Department of Anesthesiology; Toronto Western Hospital; University of Toronto; Toronto ON Canada
| | - Andres M. Lozano
- Division of Neurosurgery; Toronto Western Hospital; University of Toronto; 399 Bathurst Street Toronto ON M5T2S8 Canada
| | - William D. Hutchison
- Department of Physiology; Toronto Western Hospital; University of Toronto; Toronto ON Canada
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Hohlefeld FU, Ehlen F, Tiedt HO, Krugel LK, Horn A, Kühn AA, Curio G, Klostermann F, Nikulin VV. Correlation between cortical and subcortical neural dynamics on multiple time scales in Parkinson's disease. Neuroscience 2015; 298:145-60. [PMID: 25881724 DOI: 10.1016/j.neuroscience.2015.04.013] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2015] [Revised: 03/16/2015] [Accepted: 04/07/2015] [Indexed: 10/23/2022]
Abstract
Complex amplitude dynamics of dominant alpha oscillations (8-13 Hz) in the cortex can be captured with long-range temporal correlations (LRTC) in healthy subjects and in various diseases. In patients with Parkinson's disease (PD), intra-nuclear coherence was demonstrated in dominant beta rhythms (10-30 Hz) in the basal ganglia. However, so far the relation between cortical LRTC (across tens of seconds) and subcortical coherence (millisecond scale) is unknown. We addressed these "multiscale interactions" by simultaneous recordings of surface electroencephalography (EEG) and deep local field potentials (LFP) from the bilateral subthalamic nucleus (STN) in eight patients with severe PD eligible for deep brain stimulation, who performed a lexical decision task on medication. In the continuous data set LRTC up to 20s were calculated in the amplitude envelope of 8-13-Hz EEG oscillations (across whole scalp), and subcortical coherence was assessed with measures being insensitive to volume conduction artifacts (imaginary part of coherency; iCOH) in 10-20 and 21-30-Hz oscillations in STN-LFP. We showed a significant positive correlation across patients between cortical LRTC (8-13Hz) and subcortical iCOH selectively in 10-20-Hz oscillations in the left STN. Our results suggest a relation between neural dynamics in the most dominant rhythms in the cortex and basal ganglia in PD, extending across multiple time scales (milliseconds vs. tens of seconds). Furthermore, the investigation of multiscale interactions might contribute to our understanding of cortical-subcortical neural coupling in PD.
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Affiliation(s)
- F U Hohlefeld
- Neurophysics Group, Department of Neurology, Charité - Universitätsmedizin Berlin, Campus Benjamin Franklin, Berlin, Germany.
| | - F Ehlen
- Motor and Cognition Group, Department of Neurology, Charité - Universitätsmedizin Berlin, Campus Benjamin Franklin, Berlin, Germany
| | - H O Tiedt
- Motor and Cognition Group, Department of Neurology, Charité - Universitätsmedizin Berlin, Campus Benjamin Franklin, Berlin, Germany
| | - L K Krugel
- Motor and Cognition Group, Department of Neurology, Charité - Universitätsmedizin Berlin, Campus Benjamin Franklin, Berlin, Germany
| | - A Horn
- Motor Neuroscience Group, Department of Neurology, Charité - Universitätsmedizin Berlin, Campus Virchow, Berlin, Germany
| | - A A Kühn
- Motor Neuroscience Group, Department of Neurology, Charité - Universitätsmedizin Berlin, Campus Virchow, Berlin, Germany
| | - G Curio
- Neurophysics Group, Department of Neurology, Charité - Universitätsmedizin Berlin, Campus Benjamin Franklin, Berlin, Germany; Bernstein Center for Computational Neuroscience, Berlin, Germany
| | - F Klostermann
- Motor and Cognition Group, Department of Neurology, Charité - Universitätsmedizin Berlin, Campus Benjamin Franklin, Berlin, Germany
| | - V V Nikulin
- Neurophysics Group, Department of Neurology, Charité - Universitätsmedizin Berlin, Campus Benjamin Franklin, Berlin, Germany; Bernstein Center for Computational Neuroscience, Berlin, Germany
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Bour LJ, Lourens MAJ, Verhagen R, de Bie RMA, van den Munckhof P, Schuurman PR, Contarino MF. Directional Recording of Subthalamic Spectral Power Densities in Parkinson's Disease and the Effect of Steering Deep Brain Stimulation. Brain Stimul 2015; 8:730-41. [PMID: 25753176 DOI: 10.1016/j.brs.2015.02.002] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2014] [Revised: 02/03/2015] [Accepted: 02/06/2015] [Indexed: 10/24/2022] Open
Abstract
BACKGROUND A new 32-contacts deep brain stimulation (DBS) lead, capable of directionally steering stimulation, was tested intraoperatively. OBJECTIVE The aim of this pilot study was to perform recordings from the multidirectional contacts and to investigate the effect of directional current steering on the local field potentials (LFPs). METHODS In eight patients with Parkinson's disease, after standard microelectrode recording and clinical testing, the new lead was temporarily implanted. The 32-channel LFP recordings were measured simultaneously at different depths and directions before and after directional stimulation. RESULTS The spatial distribution of LFPs power spectral densities across the contact array at baseline marked the borders of the subthalamic nucleus (STN) with a significant increase in beta power and with a mean accuracy of approximately 0.6 mm in four patients.The power in the 18.5-30 Hz frequency band varied across different directions in all patients. In the three cases that showed improvement of rigidity, this was higher when current was steered toward the direction with the highest LFP power in the beta band. Subthalamic LFPs in six patients showed a differential frequency-dependent suppression/enhancement of the oscillatory activity in the 10-45 Hz frequency band after four different 'steering' modes as compared to ring mode, suggesting a higher specificity. CONCLUSIONS Through a new 32-contact DBS lead it is possible to record simultaneous subthalamic LFPs at different depths and directions, providing confirmation of adequate lead placement and multidirectional spatial-temporal information potentially related to pathological subthalamic electrical activity and to the effect of stimulation. Although further research is needed, this may improve the efficiency of steering stimulation.
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Affiliation(s)
- L J Bour
- Department of Neurology and Clinical Neurophysiology, Academic Medical Center, University of Amsterdam, the Netherlands.
| | - M A J Lourens
- Department of Neurology and Clinical Neurophysiology, Academic Medical Center, University of Amsterdam, the Netherlands
| | - R Verhagen
- Department of Neurology and Clinical Neurophysiology, Academic Medical Center, University of Amsterdam, the Netherlands
| | - R M A de Bie
- Department of Neurology and Clinical Neurophysiology, Academic Medical Center, University of Amsterdam, the Netherlands
| | - P van den Munckhof
- Department of Neurosurgery, Academic Medical Center, University of Amsterdam, the Netherlands
| | - P R Schuurman
- Department of Neurosurgery, Academic Medical Center, University of Amsterdam, the Netherlands
| | - M F Contarino
- Department of Neurology and Clinical Neurophysiology, Academic Medical Center, University of Amsterdam, the Netherlands; Department of Neurology, Haga Teaching Hospital, the Hague, the Netherlands.
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Deffains M, Holland P, Moshel S, de Noriega FR, Bergman H, Israel Z. Higher neuronal discharge rate in the motor area of the subthalamic nucleus of Parkinsonian patients. J Neurophysiol 2014; 112:1409-20. [DOI: 10.1152/jn.00170.2014] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
In Parkinson's disease, pathological synchronous oscillations divide the subthalamic nucleus (STN) of patients into a dorsolateral oscillatory region and ventromedial nonoscillatory region. This bipartite division reflects the motor vs. the nonmotor (associative/limbic) subthalamic areas, respectively. However, significant topographic differences in the neuronal discharge rate between these two STN subregions in Parkinsonian patients is still controversial. In this study, 119 STN microelectrode trajectories (STN length > 2 mm, mean = 5.32 mm) with discernible oscillatory and nonoscillatory regions were carried on 60 patients undergoing deep brain stimulation surgery for Parkinson's disease. 2,137 and 2,152 multiunit stable signals were recorded (recording duration > 10 s, mean = 21.25 s) within the oscillatory and nonoscillatory STN regions, respectively. Spike detection and sorting were applied offline on every multiunit stable signal using an automatic method with systematic quantification of the isolation quality (range = 0–1) of the identified units. In all, 3,094 and 3,130 units were identified in the oscillatory and nonoscillatory regions, respectively. On average, the discharge rate of better-isolated neurons (isolation score > 0.70) was higher in the oscillatory region than the nonoscillatory region (44.55 ± 0.87 vs. 39.97 ± 0.77 spikes/s, N = 665 and 761, respectively). The discharge rate of the STN neurons was positively correlated to the strength of their own and their surrounding 13- to 30-Hz beta oscillatory activity. Therefore, in the Parkinsonian STN, beta oscillations and higher neuronal discharge rate are correlated and coexist in the motor area of the STN compared with its associative/limbic area.
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Affiliation(s)
- Marc Deffains
- Department of Medical Neurobiology, The Hebrew University-Hadassah Medical School, Jerusalem, Israel
- The Edmond and Lily Safra Center for Brain Sciences, The Hebrew University, Jerusalem, Israel
| | | | - Shay Moshel
- Department of Medical Neurobiology, The Hebrew University-Hadassah Medical School, Jerusalem, Israel
- The Edmond and Lily Safra Center for Brain Sciences, The Hebrew University, Jerusalem, Israel
- The Research Laboratory of Brain Imaging and Stimulation, The Jerusalem Mental Health Center, Kfar-Shaul Etanim, The Hebrew University-Hadassah Medical School, Jerusalem, Israel; and
| | - Fernando Ramirez de Noriega
- Center for Functional and Restorative Neurosurgery, Department of Neurosurgery, Hadassah University Hospital, Jerusalem, Israel
| | - Hagai Bergman
- Department of Medical Neurobiology, The Hebrew University-Hadassah Medical School, Jerusalem, Israel
- The Edmond and Lily Safra Center for Brain Sciences, The Hebrew University, Jerusalem, Israel
| | - Zvi Israel
- Center for Functional and Restorative Neurosurgery, Department of Neurosurgery, Hadassah University Hospital, Jerusalem, Israel
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Moshel S, Shamir RR, Raz A, de Noriega FR, Eitan R, Bergman H, Israel Z. Subthalamic nucleus long-range synchronization-an independent hallmark of human Parkinson's disease. Front Syst Neurosci 2013; 7:79. [PMID: 24312018 PMCID: PMC3832794 DOI: 10.3389/fnsys.2013.00079] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2013] [Accepted: 10/18/2013] [Indexed: 12/04/2022] Open
Abstract
Beta-band synchronous oscillations in the dorsolateral region of the subthalamic nucleus (STN) of human patients with Parkinson's disease (PD) have been frequently reported. However, the correlation between STN oscillations and synchronization has not been thoroughly explored. The simultaneous recordings of 2390 multi-unit pairs recorded by two parallel microelectrodes (separated by fixed distance of 2 mm, n = 72 trajectories with two electrode tracks >4 mm STN span) in 57 PD patients undergoing STN deep brain stimulation surgery were analyzed. Automatic procedures were utilized to divide the STN into dorsolateral oscillatory and ventromedial non-oscillatory regions, and to quantify the intensity of STN oscillations and synchronicity. Finally, the synchronicity of simultaneously vs. non-simultaneously recorded pairs were compared using a shuffling procedure. Synchronization was observed predominately in the beta range and only between multi-unit pairs in the dorsolateral oscillatory region (n = 615). In paired recordings between sites in the dorsolateral and ventromedial (n = 548) and ventromedial-ventromedial region pairs (n = 1227), no synchronization was observed. Oscillation and synchronicity intensity decline along the STN dorsolateral-ventromedial axis suggesting a fuzzy border between the STN regions. Synchronization strength was significantly correlated to the oscillation power, but synchronization was no longer observed following shuffling. We conclude that STN long-range beta oscillatory synchronization is due to increased neuronal coupling in the Parkinsonian brain and does not merely reflect the outcome of oscillations at similar frequency. The neural synchronization in the dorsolateral (probably the motor domain) STN probably augments the pathological changes in firing rate and patterns of subthalamic neurons in PD patients.
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Affiliation(s)
- Shay Moshel
- Department of Medical Neurobiology, IMRIC, The Hebrew University-Hadassah Medical School Jerusalem, Israel ; The Interdisciplinary Center for Neural Computation, The Hebrew University Jerusalem, Israel ; The Edmond and Lily Safra Center for Brain Sciences, The Hebrew University Jerusalem, Israel ; The Research Laboratory of Brain Imaging and Stimulation, The Jerusalem Mental Health Center, Kfar-Shaul Etanim, Hebrew University-Hadassah Medical School Jerusalem, Israel
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Hohlefeld FU, Huchzermeyer C, Huebl J, Schneider GH, Nolte G, Brücke C, Schönecker T, Kühn AA, Curio G, Nikulin VV. Functional and effective connectivity in subthalamic local field potential recordings of patients with Parkinson's disease. Neuroscience 2013; 250:320-32. [PMID: 23876322 DOI: 10.1016/j.neuroscience.2013.07.028] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2013] [Revised: 06/24/2013] [Accepted: 07/11/2013] [Indexed: 01/16/2023]
Abstract
In Parkinson's disease (PD) levodopa-associated changes in the power and long-range temporal correlations of beta oscillations have been demonstrated, yet the presence and modulation of genuine connectivity in local field potentials (LFP) recorded from the subthalamic nucleus (STN) remains an open question. The present study investigated LFP recorded bilaterally from the STN at wakeful rest in ten patients with PD after overnight withdrawal of levodopa (OFF) and after a single dose levodopa administration (ON). We utilized connectivity measures being insensitive to volume conduction (functional connectivity: non-zero imaginary part of coherency; effective connectivity: phase-slope index). We demonstrated the presence of neuronal interactions in the frequency range of 10-30 Hz in STN-LFP without a preferential directionality of interactions between different contacts along the electrode tracks. While the direction of neuronal interactions per se was preserved after levodopa administration, functional connectivity and the ventral-dorsal information flow were modulated by medication. The OFF-ON differences in functional connectivity were correlated with the levodopa-induced improvement in clinical Unified Parkinson's Disease Rating Scale scores. We hypothesize that regional neuronal interactions, as reflected in STN-LFP connectivity, might represent a basis for the intra-nuclear spatial specificity of deep brain stimulation. Moreover, our results suggest the potential use of volume conduction-insensitive measures of connectivity in STN-LFP as a marker of clinical motor symptoms in PD.
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Affiliation(s)
- F U Hohlefeld
- Neurophysics Group, Department of Neurology, Charité - Universitätsmedizin Berlin, Campus Benjamin Franklin, Berlin, Germany.
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