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Gulberti A, Schneider TR, Galindo-Leon EE, Heise M, Pino A, Westphal M, Hamel W, Buhmann C, Zittel S, Gerloff C, Pötter-Nerger M, Engel AK, Moll CKE. Premotor cortical beta synchronization and the network neuromodulation of externally paced finger tapping in Parkinson's disease. Neurobiol Dis 2024; 197:106529. [PMID: 38740349 DOI: 10.1016/j.nbd.2024.106529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Revised: 04/30/2024] [Accepted: 05/10/2024] [Indexed: 05/16/2024] Open
Abstract
Parkinson's disease (PD) is characterized by the disruption of repetitive, concurrent and sequential motor actions due to compromised timing-functions principally located in cortex-basal ganglia (BG) circuits. Increasing evidence suggests that motor impairments in untreated PD patients are linked to an excessive synchronization of cortex-BG activity at beta frequencies (13-30 Hz). Levodopa and subthalamic nucleus deep brain stimulation (STN-DBS) suppress pathological beta-band reverberation and improve the motor symptoms in PD. Yet a dynamic tuning of beta oscillations in BG-cortical loops is fundamental for movement-timing and synchronization, and the impact of PD therapies on sensorimotor functions relying on neural transmission in the beta frequency-range remains controversial. Here, we set out to determine the differential effects of network neuromodulation through dopaminergic medication (ON and OFF levodopa) and STN-DBS (ON-DBS, OFF-DBS) on tapping synchronization and accompanying cortical activities. To this end, we conducted a rhythmic finger-tapping study with high-density EEG-recordings in 12 PD patients before and after surgery for STN-DBS and in 12 healthy controls. STN-DBS significantly ameliorated tapping parameters as frequency, amplitude and synchrony to the given auditory rhythms. Aberrant neurophysiologic signatures of sensorimotor feedback in the beta-range were found in PD patients: their neural modulation was weaker, temporally sluggish and less distributed over the right cortex in comparison to controls. Levodopa and STN-DBS boosted the dynamics of beta-band modulation over the right hemisphere, hinting to an improved timing of movements relying on tactile feedback. The strength of the post-event beta rebound over the supplementary motor area correlated significantly with the tapping asynchrony in patients, thus indexing the sensorimotor match between the external auditory pacing signals and the performed taps. PD patients showed an excessive interhemispheric coherence in the beta-frequency range during the finger-tapping task, while under DBS-ON the cortico-cortical connectivity in the beta-band was normalized. Ultimately, therapeutic DBS significantly ameliorated the auditory-motor coupling of PD patients, enhancing the electrophysiological processing of sensorimotor feedback-information related to beta-band activity, and thus allowing a more precise cued-tapping performance.
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Affiliation(s)
- Alessandro Gulberti
- Department of Neurophysiology and Pathophysiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
| | - Till R Schneider
- Department of Neurophysiology and Pathophysiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Edgar E Galindo-Leon
- Department of Neurophysiology and Pathophysiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Miriam Heise
- Department of Neurosurgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Alessandro Pino
- Department of Aerospace Science and Technology, Politecnico di Milano, Milan, Italy
| | - Manfred Westphal
- Department of Neurosurgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Wolfgang Hamel
- Department of Neurosurgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Carsten Buhmann
- Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Simone Zittel
- Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Christian Gerloff
- Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Monika Pötter-Nerger
- Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Andreas K Engel
- Department of Neurophysiology and Pathophysiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Christian K E Moll
- Department of Neurophysiology and Pathophysiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
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2
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Sauerbier A, Herberg J, Stopic V, Loehrer PA, Ashkan K, Rizos A, Jost ST, Petry-Schmelzer JN, Gronostay A, Schneider C, Visser-Vandewalle V, Evans J, Nimsky C, Fink GR, Antonini A, Martinez-Martin P, Silverdale M, Weintraub D, Schrag A, Ray Chaudhuri K, Timmermann L, Dafsari HS. Predictors of short-term anxiety outcome in subthalamic stimulation for Parkinson's disease. NPJ Parkinsons Dis 2024; 10:114. [PMID: 38851717 PMCID: PMC11162430 DOI: 10.1038/s41531-024-00701-6] [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: 09/21/2023] [Accepted: 04/02/2024] [Indexed: 06/10/2024] Open
Abstract
The effects of subthalamic nucleus deep brain stimulation (STN-DBS) on anxiety in Parkinson's disease (PD) are understudied. We identified clinical predictors of STN-DBS effects on anxiety in this study. In this prospective, open-label, multicentre study, we assessed patients with anxiety undergoing STN-DBS for PD preoperatively and at 6-month follow-up postoperatively. We assessed the Hospital Anxiety and Depression Scale (HADS-anxiety and depression subscales), Unified PD Rating Scale-motor examination, Scales for Outcomes in PD-motor (SCOPA-M)-activities of daily living (ADL) and -motor complications, Non-Motor Symptom Scale (NMSS), PDQuestionnaire-8 (PDQ-8), and levodopa-equivalent daily dose. We tested changes at follow-up with Wilcoxon signed-rank test and corrected for multiple comparisons (Bonferroni method). We identified patients with a clinically relevant anxiety improvement of anxiety based on a designated threshold of ½ standard deviation of baseline HADS-anxiety. Moreover, we investigated predictors of HADS-anxiety changes with correlations and linear regressions. We included 50 patients with clinically relevant baseline anxiety (i.e., HADS-anxiety ≥ 8) aged 63.1 years ± 8.3 with 10.4 years ± 4.5 PD duration. HADS-anxiety improved significantly at 6-month follow-up as 80% of our cohort experienced clinically relevant anxiety improvement. In predictor analyses, worse baseline SCOPA-ADL and NMSS-urinary domain were associated with greater HADS-anxiety improvements. HADS-anxiety and PDQ-8 changes correlated moderately. Worse preoperative ADL and urinary symptoms predicted favourable postoperative anxiety outcome, which in turn was directly proportionate to greater QoL improvement. This study highlights the importance of detailed anxiety assessments alongside other non-motor and motor symptoms when advising and monitoring patients undergoing STN-DBS for PD.
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Affiliation(s)
- Anna Sauerbier
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Neurology, Cologne, Germany.
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
| | - Johanna Herberg
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Neurology, Cologne, Germany
| | - Vasilija Stopic
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Neurology, Cologne, Germany
| | - Philipp A Loehrer
- Department of Neurology, University Hospital Giessen and Marburg, Campus Marburg, Marburg, Germany
| | - Keyoumars Ashkan
- Parkinson Foundation International Centre of Excellence, King's College Hospital, London, UK
| | - Alexandra Rizos
- Parkinson Foundation International Centre of Excellence, King's College Hospital, London, UK
| | - Stefanie T Jost
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Neurology, Cologne, Germany
| | - Jan Niklas Petry-Schmelzer
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Neurology, Cologne, Germany
| | - Alexandra Gronostay
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Neurology, Cologne, Germany
| | - Christian Schneider
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Neurology, Cologne, Germany
| | - Veerle Visser-Vandewalle
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Stereotactic and Functional Neurosurgery, Cologne, Germany
| | - Julian Evans
- Department of Neurology and Neurosurgery, Salford Royal NHS Foundation Trust, Manchester Academic Health Science Centre, Greater Manchester, UK
| | - Christopher Nimsky
- Department of Neurosurgery, University Hospital Giessen and Marburg, Campus Marburg, Marburg, Germany
| | - Gereon R Fink
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Neurology, Cologne, Germany
- Cognitive Neuroscience, Institute of Neuroscience and Medicine (INM-3), Research Centre Jülich, Jülich, Germany
| | - Angelo Antonini
- Parkinson and Movement Disorders Unit, Department of Neurosciences (DNS), University of Padua, Padova, Italy
| | - Pablo Martinez-Martin
- Center for Networked Biomedical Research in Neurodegenerative Diseases (CIBERNED), Carlos III Institute of Health, Madrid, Spain
| | - Monty Silverdale
- Department of Neurology and Neurosurgery, Salford Royal NHS Foundation Trust, Manchester Academic Health Science Centre, Greater Manchester, UK
| | - Daniel Weintraub
- Departments of Psychiatry and Neurology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, 19104-2676, USA
| | - Anette Schrag
- Department of Clinical and Movement Neurosciences, UCL Institute of Neurology, University College London, London, UK
| | - K Ray Chaudhuri
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- Parkinson Foundation International Centre of Excellence, King's College Hospital, London, UK
| | - Lars Timmermann
- Department of Neurology, University Hospital Giessen and Marburg, Campus Marburg, Marburg, Germany
| | - Haidar S Dafsari
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Neurology, Cologne, Germany.
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3
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Lazcano-Ocampo C, van Wamelen D, Samuel M, Silverdale M, Rizos A, Sauerbier A, Koch J, Podlewska A, Leta V, Dafsari HS, Timmermann L, Ashkan K, Ray Chaudhuri K. Evaluation of the effect of bilateral subthalamic nucleus deep brain stimulation on fatigue in Parkinson's Disease as measured by the non-motor symptoms scale. Br J Neurosurg 2024; 38:712-715. [PMID: 34357840 DOI: 10.1080/02688697.2021.1961681] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2020] [Revised: 07/06/2021] [Accepted: 07/23/2021] [Indexed: 02/06/2023]
Abstract
BACKGROUND Fatigue is a common and disabling non-motor symptom (NMS) in Parkinson's disease (PD) patients. However, the effect of subthalamic nucleus (STN) deep brain stimulation (DBS) on fatigue has not been widely studied. OBJECTIVE To determine the effect of STN DBS on fatigue in PD patients, measured by the Non-motor symptoms scale (NMSS). METHODS Cross-sectional analysis of 50 patients with PD who underwent STN DBS at King's College Hospital and Salford Royal Hospital with fatigue scores (measured by question number 4 from domain 2 (sleep/fatigue) of the NMSS as the primary outcome measure. Secondary outcome measures included the PD Sleep Scale (PDSS), Scales for Outcome in PD (SCOPA)-motor examination, activities of daily living, motor complications, Hoehn and Yahr (HY) stage and changes in Levodopa Equivalent Daily Dose (LEDD). RESULTS 50 patients with a mean follow-up period of 1.98 ± 1.36 years were studied. Significant improvement in median fatigue scores (4.00 (0.75-9.00) to 1.00 (0.00-4.50); p = .001) was observed. In addition, improvements in question 5 (sleep maintenance and fragmentation; 8.00 (4.00-12.00) to 0.00 (0.00-4.00); p < .001) and in domain 2 total score (sleep/fatigue; 20.00 (8.75-27.25) to 6.00 (0.75-16.00); p < .001) were also significant, together with improvements in NMSS total score, SCOPA scores and HY stage (p ≤ .02). Moreover, LEDD but especially dopamine agonists LEDD was significantly reduced after DBS (310.00 (0.00-480.00) to 150.00 (0.00-300.00); p < .020). CONCLUSIONS Even though open label and not using a validated fatigue scale, this observational analysis suggest that fatigue improves significantly after STN DBS with persisting benefits at two years follow-up.
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Affiliation(s)
- Claudia Lazcano-Ocampo
- King's College London, Department of Neurosciences, Institute of Psychiatry, Psychology & Neuroscience, London, UK
- Parkinson's Foundation Centre of Excellence, King's College Hospital, London, UK
| | - Daniel van Wamelen
- King's College London, Department of Neurosciences, Institute of Psychiatry, Psychology & Neuroscience, London, UK
- Parkinson's Foundation Centre of Excellence, King's College Hospital, London, UK
| | - Michael Samuel
- Parkinson's Foundation Centre of Excellence, King's College Hospital, London, UK
- Department of Neurology, King's College Hospital, London, UK
| | - Monty Silverdale
- Salford Royal NHS Foundation Trust, Department of Neurology, Salford, UK
| | - Alexandra Rizos
- King's College London, Department of Neurosciences, Institute of Psychiatry, Psychology & Neuroscience, London, UK
- Parkinson's Foundation Centre of Excellence, King's College Hospital, London, UK
| | - Anna Sauerbier
- Department of Neurology, University Hospital Cologne, Cologne, Germany
| | - Julia Koch
- King's College London, Department of Neurosciences, Institute of Psychiatry, Psychology & Neuroscience, London, UK
- Parkinson's Foundation Centre of Excellence, King's College Hospital, London, UK
| | - Aleksandra Podlewska
- King's College London, Department of Neurosciences, Institute of Psychiatry, Psychology & Neuroscience, London, UK
- Parkinson's Foundation Centre of Excellence, King's College Hospital, London, UK
| | - Valentina Leta
- King's College London, Department of Neurosciences, Institute of Psychiatry, Psychology & Neuroscience, London, UK
- Parkinson's Foundation Centre of Excellence, King's College Hospital, London, UK
| | - Haidar S Dafsari
- Department of Neurology, University Hospital Cologne, Cologne, Germany
| | - Lars Timmermann
- Department of Neurology, University Hospital Cologne, Cologne, Germany
| | - Keyoumars Ashkan
- King's College London, Department of Neurosciences, Institute of Psychiatry, Psychology & Neuroscience, London, UK
- Parkinson's Foundation Centre of Excellence, King's College Hospital, London, UK
- Department of Neurosurgery, King's College Hospital, London, UK
| | - K Ray Chaudhuri
- King's College London, Department of Neurosciences, Institute of Psychiatry, Psychology & Neuroscience, London, UK
- Parkinson's Foundation Centre of Excellence, King's College Hospital, London, UK
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Aiello G, Ledergerber D, Dubcek T, Stieglitz L, Baumann C, Polanìa R, Imbach L. Functional network dynamics between the anterior thalamus and the cortex in deep brain stimulation for epilepsy. Brain 2023; 146:4717-4735. [PMID: 37343140 DOI: 10.1093/brain/awad211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 05/10/2023] [Accepted: 06/08/2023] [Indexed: 06/23/2023] Open
Abstract
Owing to its unique connectivity profile with cortical brain regions, and its suggested role in the subcortical propagation of seizures, the anterior nucleus of the thalamus (ANT) has been proposed as a key deep brain stimulation (DBS) target in drug-resistant epilepsy. However, the spatio-temporal interaction dynamics of this brain structure, and the functional mechanisms underlying ANT DBS in epilepsy remain unknown. Here, we study how the ANT interacts with the neocortex in vivo in humans and provide a detailed neurofunctional characterization of mechanisms underlying the effectiveness of ANT DBS, aiming at defining intraoperative neural biomarkers of responsiveness to therapy, assessed at 6 months post-implantation as the reduction in seizure frequency. A cohort of 15 patients with drug-resistant epilepsy (n = 6 males, age = 41.6 ± 13.79 years) underwent bilateral ANT DBS implantation. Using intraoperative cortical and ANT simultaneous electrophysiological recordings, we found that the ANT is characterized by high amplitude θ (4-8 Hz) oscillations, mostly in its superior part. The strongest functional connectivity between the ANT and the scalp EEG was also found in the θ band in ipsilateral centro-frontal regions. Upon intraoperative stimulation in the ANT, we found a decrease in higher EEG frequencies (20-70 Hz) and a generalized increase in scalp-to-scalp connectivity. Crucially, we observed that responders to ANT DBS treatment were characterized by higher EEG θ oscillations, higher θ power in the ANT, and stronger ANT-to-scalp θ connectivity, highlighting the crucial role of θ oscillations in the dynamical network characterization of these structures. Our study provides a comprehensive characterization of the interaction dynamic between the ANT and the cortex, delivering crucial information to optimize and predict clinical DBS response in patients with drug-resistant epilepsy.
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Affiliation(s)
- Giovanna Aiello
- Decision Neuroscience Lab, Department of Health Sciences and Technology, ETH Zurich, 8092 Zurich, Switzerland
- Swiss Epilepsy Center (Klinik Lengg), 8008 Zurich, Switzerland
- Neuroscience Center Zurich, University of Zurich and ETH Zurich, 8057 Zurich, Switzerland
| | - Debora Ledergerber
- Swiss Epilepsy Center (Klinik Lengg), 8008 Zurich, Switzerland
- Neuroscience Center Zurich, University of Zurich and ETH Zurich, 8057 Zurich, Switzerland
| | - Tena Dubcek
- Decision Neuroscience Lab, Department of Health Sciences and Technology, ETH Zurich, 8092 Zurich, Switzerland
- Swiss Epilepsy Center (Klinik Lengg), 8008 Zurich, Switzerland
- Neuroscience Center Zurich, University of Zurich and ETH Zurich, 8057 Zurich, Switzerland
| | - Lennart Stieglitz
- Department of Neurosurgery, University Hospital Zurich, 8091 Zurich, Switzerland
| | - Christian Baumann
- Department of Neurology, University Hospital Zurich, 8091 Zurich, Switzerland
| | - Rafael Polanìa
- Decision Neuroscience Lab, Department of Health Sciences and Technology, ETH Zurich, 8092 Zurich, Switzerland
- Neuroscience Center Zurich, University of Zurich and ETH Zurich, 8057 Zurich, Switzerland
| | - Lukas Imbach
- Swiss Epilepsy Center (Klinik Lengg), 8008 Zurich, Switzerland
- Neuroscience Center Zurich, University of Zurich and ETH Zurich, 8057 Zurich, Switzerland
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Boëx C, Awadhi AA, Tyrand R, Corniola MV, Kibleur A, Fleury V, Burkhard PR, Momjian S. Validation of Lead-DBS β-Oscillation Localization with Directional Electrodes. Bioengineering (Basel) 2023; 10:898. [PMID: 37627782 PMCID: PMC10451384 DOI: 10.3390/bioengineering10080898] [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: 06/21/2023] [Revised: 07/17/2023] [Accepted: 07/21/2023] [Indexed: 08/27/2023] Open
Abstract
In deep brain stimulation (DBS) studies in patients with Parkinson's disease, the Lead-DBS toolbox allows the reconstruction of the location of β-oscillations in the subthalamic nucleus (STN) using Vercise Cartesia directional electrodes (Boston Scientific). The objective was to compare these probabilistic locations with those of intraoperative monopolar β-oscillations computed from local field potentials (0.5-3 kHz) recorded by using shielded single wires and an extracranial shielded reference electrode. For each electrode contact, power spectral densities of the β-band (13-31 Hz) were compared with those of all eight electrode contacts on the directional electrodes. The DBS Intrinsic Template AtLas (DISTAL), electrophysiological, and DBS target atlases of the Lead-DBS toolbox were applied to the reconstructed electrodes from preoperative MRI and postoperative CT. Thirty-six electrodes (20 patients: 7 females, 13 males; both STN electrodes for 16 of 20 patients; one single STN electrode for 4 of 20 patients) were analyzed. Stimulation sites both dorsal and/or lateral to the sensorimotor STN were the most efficient. In 33 out of 36 electrodes, at least one contact was measured with stronger β-oscillations, including 23 electrodes running through or touching the ventral subpart of the β-oscillations' probabilistic volume, while 10 did not touch it but were adjacent to this volume; in 3 out of 36 electrodes, no contact was found with β-oscillations and all 3 were distant from this volume. Monopolar local field potentials confirmed the ventral subpart of the probabilistic β-oscillations.
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Affiliation(s)
- Colette Boëx
- Department of Neurosurgery, University Hospitals of Geneva, CH-1205 Geneva, Switzerland (S.M.)
- Faculty of Medicine, University of Geneva, 1206 Geneva, Switzerland (P.R.B.)
| | - Abdullah Al Awadhi
- Department of Neurosurgery, University Hospitals of Geneva, CH-1205 Geneva, Switzerland (S.M.)
| | - Rémi Tyrand
- Department of Neurosurgery, University Hospitals of Geneva, CH-1205 Geneva, Switzerland (S.M.)
- Faculty of Medicine, University of Geneva, 1206 Geneva, Switzerland (P.R.B.)
| | - Marco V. Corniola
- Department of Neurosurgery, Pontchaillou Hospitals, CEDEX 9, F-35033 Rennes, France
| | - Astrid Kibleur
- Centre Hospitalier Universitaire Caen Normandie, F-14000 Caen, France
| | - Vanessa Fleury
- Faculty of Medicine, University of Geneva, 1206 Geneva, Switzerland (P.R.B.)
- Department of Neurosurgery, Pontchaillou Hospitals, CEDEX 9, F-35033 Rennes, France
| | - Pierre R. Burkhard
- Faculty of Medicine, University of Geneva, 1206 Geneva, Switzerland (P.R.B.)
| | - Shahan Momjian
- Department of Neurosurgery, University Hospitals of Geneva, CH-1205 Geneva, Switzerland (S.M.)
- Faculty of Medicine, University of Geneva, 1206 Geneva, Switzerland (P.R.B.)
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6
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Bangel KA, Bais M, Eijsker N, Schuurman PR, van den Munckhof P, Figee M, Smit DJA, Denys D. Acute effects of deep brain stimulation on brain function in obsessive-compulsive disorder. Clin Neurophysiol 2023; 148:109-117. [PMID: 36774324 DOI: 10.1016/j.clinph.2022.12.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 12/08/2022] [Accepted: 12/24/2022] [Indexed: 01/24/2023]
Abstract
OBJECTIVE Deep brain stimulation (DBS) is an effective treatment for refractory obsessive-compulsive disorder (OCD) yet neural markers of optimized stimulation parameters are largely unknown. We aimed to describe (sub-)cortical electrophysiological responses to acute DBS at various voltages in OCD. METHODS We explored how DBS doses between 3-5 V delivered to the ventral anterior limb of the internal capsule of five OCD patients affected electroencephalograms and intracranial local field potentials (LFPs). We focused on theta power/ phase-stability, given their previously established role in DBS for OCD. RESULTS Cortical theta power and theta phase-stability did not increase significantly with DBS voltage. DBS-induced theta power peaks were seen at the previously defined individualized therapeutic voltage. Although LFP power generally increased with DBS voltages, this occurred mostly in frequency peaks that overlapped with stimulation artifacts limiting its interpretability. Though highly idiosyncratic, three subjects showed significant acute DBS effects on electroencephalogram theta power and four subjects showed significant carry-over effects (pre-vs post DBS, unstimulated) on LFP and electroencephalogram theta power. CONCLUSIONS Our findings challenge the presence of a consistent dose-response relationship between stimulation voltage and brain activity. SIGNIFICANCE Theta power may be investigated further as a neurophysiological marker to aid personalized DBS voltage optimization in OCD.
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Affiliation(s)
- Katrin A Bangel
- Amsterdam University Medical Centers, University of Amsterdam, Department of Psychiatry, Amsterdam Neuroscience, Amsterdam, the Netherlands; Institute of Neuroscience, The Medical School, Newcastle University, NE2 4HH, UK; Department of Medical Physics and Clinical Engineering, Royal Victoria Infirmary, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne NE1 4LP, UK; Amsterdam Brain and Cognition, University of Amsterdam, Amsterdam, the Netherlands
| | - Melisse Bais
- Amsterdam University Medical Centers, University of Amsterdam, Department of Psychiatry, Amsterdam Neuroscience, Amsterdam, the Netherlands
| | - Nadine Eijsker
- Amsterdam University Medical Centers, University of Amsterdam, Department of Psychiatry, Amsterdam Neuroscience, Amsterdam, the Netherlands; Amsterdam Brain and Cognition, University of Amsterdam, Amsterdam, the Netherlands
| | - P Richard Schuurman
- Amsterdam University Medical Centers, University of Amsterdam, Department of Neurosurgery, Amsterdam Neuroscience, Amsterdam, the Netherlands
| | - Pepijn van den Munckhof
- Amsterdam University Medical Centers, University of Amsterdam, Department of Neurosurgery, Amsterdam Neuroscience, Amsterdam, the Netherlands
| | - Martijn Figee
- Amsterdam University Medical Centers, University of Amsterdam, Department of Psychiatry, Amsterdam Neuroscience, Amsterdam, the Netherlands; Amsterdam Brain and Cognition, University of Amsterdam, Amsterdam, the Netherlands; Department of Psychiatry, Icahn School of Medicine at Mount Sinai, NY, USA
| | - Dirk J A Smit
- Amsterdam University Medical Centers, University of Amsterdam, Department of Psychiatry, Amsterdam Neuroscience, Amsterdam, the Netherlands; Amsterdam Brain and Cognition, University of Amsterdam, Amsterdam, the Netherlands.
| | - Damiaan Denys
- Amsterdam University Medical Centers, University of Amsterdam, Department of Psychiatry, Amsterdam Neuroscience, Amsterdam, the Netherlands; Amsterdam Brain and Cognition, University of Amsterdam, Amsterdam, the Netherlands; The Netherlands Institute for Neuroscience, Amsterdam, the Netherlands
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7
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Valkonen K, Mäkelä JP, Airaksinen K, Nurminen J, Kivisaari R, Renvall H, Pekkonen E. Deep brain stimulation of subthalamic nucleus modulates cortical auditory processing in advanced Parkinson’s Disease. PLoS One 2022; 17:e0264333. [PMID: 35202426 PMCID: PMC8870490 DOI: 10.1371/journal.pone.0264333] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Accepted: 02/08/2022] [Indexed: 12/02/2022] Open
Abstract
Deep brain stimulation (DBS) has proven its clinical efficacy in Parkinson’s disease (PD), but its exact mechanisms and cortical effects continue to be unclear. Subthalamic (STN) DBS acutely modifies auditory evoked responses, but its long-term effect on auditory cortical processing remains ambiguous. We studied with magnetoencephalography the effect of long-term STN DBS on auditory processing in patients with advanced PD. DBS resulted in significantly increased contra-ipsilateral auditory response latency difference at ~100 ms after stimulus onset compared with preoperative state. The effect is likely due to normalization of neuronal asynchrony in the auditory pathways. The present results indicate that STN DBS in advanced PD patients has long-lasting effects on cortical areas outside those confined to motor processing. Whole-head magnetoencephalography provides a feasible tool to study motor and non-motor neural networks in PD, and to track possible changes related to cortical reorganization or plasticity induced by DBS.
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Affiliation(s)
- Kati Valkonen
- Department of Neurology, Helsinki University Hospital, Finland and Department of Clinical Neurosciences (Neurology), University of Helsinki, Helsinki, Finland
- BioMag Laboratory, Helsinki University Hospital Medical Imaging Center, Helsinki University Hospital, Helsinki University and Aalto University School of Science, Helsinki, Finland
| | - Jyrki P. Mäkelä
- BioMag Laboratory, Helsinki University Hospital Medical Imaging Center, Helsinki University Hospital, Helsinki University and Aalto University School of Science, Helsinki, Finland
| | - Katja Airaksinen
- Department of Neurology, Helsinki University Hospital, Finland and Department of Clinical Neurosciences (Neurology), University of Helsinki, Helsinki, Finland
| | - Jussi Nurminen
- BioMag Laboratory, Helsinki University Hospital Medical Imaging Center, Helsinki University Hospital, Helsinki University and Aalto University School of Science, Helsinki, Finland
| | - Riku Kivisaari
- Department of Neurosurgery, Helsinki University Hospital, Helsinki, Finland
| | - Hanna Renvall
- BioMag Laboratory, Helsinki University Hospital Medical Imaging Center, Helsinki University Hospital, Helsinki University and Aalto University School of Science, Helsinki, Finland
- Department of Neuroscience and Biomedical Engineering, Aalto University, Espoo, Finland
- * E-mail:
| | - Eero Pekkonen
- Department of Neurology, Helsinki University Hospital, Finland and Department of Clinical Neurosciences (Neurology), University of Helsinki, Helsinki, Finland
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8
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De Groote E, Eqlimi E, Bockstael A, Botteldooren D, Santens P, De Letter M. Parkinson's disease affects the neural alpha oscillations associated with speech-in-noise processing. Eur J Neurosci 2021; 54:7355-7376. [PMID: 34617350 DOI: 10.1111/ejn.15477] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 09/03/2021] [Accepted: 09/21/2021] [Indexed: 11/29/2022]
Abstract
Parkinson's disease (PD) has increasingly been associated with auditory dysfunction, including alterations regarding the control of auditory information processing. Although these alterations may interfere with the processing of speech in degraded listening conditions, behavioural studies have generally found preserved speech-in-noise recognition in PD. However, behavioural speech audiometry does not capture the neurophysiological mechanisms supporting speech-in-noise processing. Therefore, the aim of this study was to investigate the neural oscillatory mechanisms associated with speech-in-noise processing in PD. Twelve persons with PD and 12 age- and gender-matched healthy controls (HCs) were included in this study. Persons with PD were studied in the medication off condition. All subjects underwent an audiometric screening and performed a sentence-in-noise recognition task under simultaneous electroencephalography (EEG) recording. Behavioural speech recognition scores and self-reported ratings of effort, performance, and motivation were collected. Time-frequency analysis of EEG data revealed no significant difference between persons with PD and HCs regarding delta-theta (2-8 Hz) inter-trial phase coherence to noise and sentence onset. In contrast, significantly increased alpha (8-12 Hz) power was found in persons with PD compared with HCs during the sentence-in-noise recognition task. Behaviourally, persons with PD demonstrated significantly decreased speech recognition scores, whereas no significant differences were found regarding effort, performance, and motivation ratings. These results suggest that persons with PD allocate more cognitive resources to support speech-in-noise processing. The interpretation of this finding is discussed in the context of a top-down mediated compensation mechanism for inefficient filtering and degradation of auditory input in PD.
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Affiliation(s)
- Evelien De Groote
- Department of Rehabilitation Sciences, BrainComm Research Group, Ghent University, Ghent, Belgium
| | - Ehsan Eqlimi
- Department of Information Technology, WAVES Research Group, Ghent University, Ghent, Belgium
| | - Annelies Bockstael
- Department of Information Technology, WAVES Research Group, Ghent University, Ghent, Belgium
| | - Dick Botteldooren
- Department of Information Technology, WAVES Research Group, Ghent University, Ghent, Belgium
| | - Patrick Santens
- Department of Neurology, Ghent University Hospital, Ghent, Belgium
| | - Miet De Letter
- Department of Rehabilitation Sciences, BrainComm Research Group, Ghent University, Ghent, Belgium
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9
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Kearney J, Brittain JS. Sensory Attenuation in Sport and Rehabilitation: Perspective from Research in Parkinson's Disease. Brain Sci 2021; 11:580. [PMID: 33946218 PMCID: PMC8145846 DOI: 10.3390/brainsci11050580] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2021] [Revised: 04/27/2021] [Accepted: 04/29/2021] [Indexed: 11/16/2022] Open
Abstract
People with Parkinson's disease (PD) experience motor symptoms that are affected by sensory information in the environment. Sensory attenuation describes the modulation of sensory input caused by motor intent. This appears to be altered in PD and may index important sensorimotor processes underpinning PD symptoms. We review recent findings investigating sensory attenuation and reconcile seemingly disparate results with an emphasis on task-relevance in the modulation of sensory input. Sensory attenuation paradigms, across different sensory modalities, capture how two identical stimuli can elicit markedly different perceptual experiences depending on our predictions of the event, but also the context in which the event occurs. In particular, it appears as though contextual information may be used to suppress or facilitate a response to a stimulus on the basis of task-relevance. We support this viewpoint by considering the role of the basal ganglia in task-relevant sensory filtering and the use of contextual signals in complex environments to shape action and perception. This perspective highlights the dual effect of basal ganglia dysfunction in PD, whereby a reduced capacity to filter task-relevant signals harms the ability to integrate contextual cues, just when such cues are required to effectively navigate and interact with our environment. Finally, we suggest how this framework might be used to establish principles for effective rehabilitation in the treatment of PD.
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Affiliation(s)
- Joshua Kearney
- School of Psychology, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK
| | - John-Stuart Brittain
- Centre for Human Brain Health, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK;
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10
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De Groote E, Bockstael A, Botteldooren D, Santens P, De Letter M. Evaluation of multi-feature auditory deviance detection in Parkinson's disease: a mismatch negativity study. J Neural Transm (Vienna) 2021; 128:645-657. [PMID: 33895941 DOI: 10.1007/s00702-021-02341-z] [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: 03/26/2021] [Accepted: 04/19/2021] [Indexed: 12/13/2022]
Abstract
Behavioral studies on auditory deviance detection in patients with Parkinson's disease (PD) have reported contradictory results. The primary aim of this study was to investigate auditory deviance detection of multiple auditory features in patients with PD by means of objective and reliable electroencephalographic (EEG) measurements. Twelve patients with early-stage PD and twelve age- and gender-matched healthy controls (HCs) were included in this study. Patients with PD participated without their regular dopaminergic medication. All subjects underwent an audiometric screening and performed a passive multi-feature mismatch negativity (MMN) paradigm. Repeated-measures analysis of variance (ANOVA) demonstrated no significant differences between patients with PD and HCs regarding MMN mean amplitude and latency for frequency, duration and gap deviants. Nevertheless, a trend towards increased MMN mean amplitude and latency was found in response to intensity deviants in patients with PD compared to HCs. Increased intensity MMN amplitude may indicate that more neural resources are allocated to the processing of intensity deviances in patients with PD compared to HCs. The interpretation of this intensity-specific MMN alteration is further discussed in the context of a compensatory mechanism for auditory intensity processing and involuntary attention switching in PD.
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Affiliation(s)
- Evelien De Groote
- Department of Rehabilitation Sciences, Faculty of Medicine and Health Sciences, Ghent University, C. Heymanslaan 10, 9000, Ghent, Belgium.
| | - Annelies Bockstael
- Department of Information Technology, WAVES Research Group, Ghent University, Technologiepark Zwijnaarde 126, 9052, Ghent, Belgium
| | - Dick Botteldooren
- Department of Information Technology, WAVES Research Group, Ghent University, Technologiepark Zwijnaarde 126, 9052, Ghent, Belgium
| | - Patrick Santens
- Department of Neurology, Ghent University Hospital, C. Heymanslaan 10, 9000, Ghent, Belgium
| | - Miet De Letter
- Department of Rehabilitation Sciences, Faculty of Medicine and Health Sciences, Ghent University, C. Heymanslaan 10, 9000, Ghent, Belgium
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11
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Jost ST, Ray Chaudhuri K, Ashkan K, Loehrer PA, Silverdale M, Rizos A, Evans J, Petry-Schmelzer JN, Barbe MT, Sauerbier A, Fink GR, Visser-Vandewalle V, Antonini A, Martinez-Martin P, Timmermann L, Dafsari HS. Subthalamic Stimulation Improves Quality of Sleep in Parkinson Disease: A 36-Month Controlled Study. JOURNAL OF PARKINSONS DISEASE 2021; 11:323-335. [PMID: 33074192 DOI: 10.3233/jpd-202278] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND Sleep disturbances and neuropsychiatric symptoms are some of the most common nonmotor symptoms in Parkinson's disease (PD). The effect of subthalamic stimulation (STN-DBS) on these symptoms beyond a short-term follow-up is unclear. OBJECTIVE To examine 36-month effects of bilateral STN-DBS on quality of sleep, depression, anxiety, and quality of life (QoL) compared to standard-of-care medical therapy (MED) in PD. METHODS In this prospective, controlled, observational, propensity score matched, international multicenter study, we assessed sleep disturbances using the PDSleep Scale-1 (PDSS), QoL employing the PDQuestionnaire-8 (PDQ-8), motor disorder with the Scales for Outcomes in PD (SCOPA), anxiety and depression with the Hospital Anxiety and Depression Scale (HADS), and dopaminergic medication requirements (LEDD). Within-group longitudinal outcome changes were tested using Wilcoxon signed-rank and between-group longitudinal differences of change scores with Mann-Whitney U tests. Spearman correlations analyzed the relationships of outcome parameter changes at follow-up. RESULTS Propensity score matching applied on 159 patients (STN-DBS n = 75, MED n = 84) resulted in 40 patients in each treatment group. At 36-month follow-up, STN-DBS led to significantly better PDSS and PDQ-8 change scores, which were significantly correlated. We observed no significant effects for HADS and no significant correlations between change scores in PDSS, HADS, and LEDD. CONCLUSIONS We report Class IIb evidence of beneficial effects of STN-DBS on quality of sleep at 36-month follow-up, which were associated with QoL improvement independent of depression and dopaminergic medication. Our study highlights the importance of sleep for assessments of DBS outcomes.
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Affiliation(s)
- Stefanie T Jost
- Department of Neurology, University Hospital of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - K Ray Chaudhuri
- Parkinson Foundation International Centre of Excellence, King's College Hospital, London, UK.,Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Keyoumars Ashkan
- Parkinson Foundation International Centre of Excellence, King's College Hospital, London, UK
| | - Philipp A Loehrer
- Department of Neurology, University Hospital Giessen and Marburg, Campus Marburg, Marburg, Germany
| | - Monty Silverdale
- Department of Neurology and Neurosurgery, Salford Royal NHS Foundation Trust, Manchester Academic Health Science Centre, University of Manchester, Greater Manchester, UK
| | - Alexandra Rizos
- Parkinson Foundation International Centre of Excellence, King's College Hospital, London, UK
| | - Julian Evans
- Department of Neurology and Neurosurgery, Salford Royal NHS Foundation Trust, Manchester Academic Health Science Centre, University of Manchester, Greater Manchester, UK
| | - Jan Niklas Petry-Schmelzer
- Department of Neurology, University Hospital of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Michael T Barbe
- Department of Neurology, University Hospital of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Anna Sauerbier
- Department of Neurology, University Hospital of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany.,Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Gereon R Fink
- Department of Neurology, University Hospital of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany.,Cognitive Neuroscience, Institute of Neuroscience and Medicine (INM-3), Research Centre Jülich, Jülich, Germany
| | - Veerle Visser-Vandewalle
- Department of Stereotaxy and Functional Neurosurgery, University Hospital of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Angelo Antonini
- Department of Neurosciences (DNS), Padova University, Padova, Italy
| | - Pablo Martinez-Martin
- Center for Networked Biomedical Research in Neurodegenerative Diseases (CIBERNED), Carlos III Institute of Health, Madrid, Spain
| | - Lars Timmermann
- Department of Neurology, University Hospital Giessen and Marburg, Campus Marburg, Marburg, Germany
| | - Haidar S Dafsari
- Department of Neurology, University Hospital of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
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12
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De Keyser K, De Letter M, Santens P, Talsma D, Botteldooren D, Bockstael A. Neurophysiological investigation of auditory intensity dependence in patients with Parkinson's disease. J Neural Transm (Vienna) 2021; 128:345-356. [PMID: 33515333 DOI: 10.1007/s00702-021-02305-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Accepted: 01/12/2021] [Indexed: 02/07/2023]
Abstract
There is accumulating evidence for auditory dysfunctions in patients with Parkinson's disease (PD). Moreover, a possible relationship has been suggested between altered auditory intensity processing and the hypophonic speech characteristics in PD. Nonetheless, further insight into the neurophysiological correlates of auditory intensity processing in patients with PD is needed primarily. In the present study, high-density EEG recordings were used to investigate intensity dependence of auditory evoked potentials (IDAEPs) in 14 patients with PD and 14 age- and gender-matched healthy control participants (HCs). Patients with PD were evaluated in both the on- and off-medication states. HCs were also evaluated twice. Significantly increased IDAEP of the N1/P2 was demonstrated in patients with PD evaluated in the on-medication state compared to HCs. Distinctive results were found for the N1 and P2 component. Regarding the N1 component, no differences in latency or amplitude were shown between patients with PD and HCs regardless of the medication state. In contrast, increased P2 amplitude was demonstrated in patients with PD evaluated in the on-medication state compared to the off-medication state and HCs. In addition to a dopaminergic deficiency, deficits in serotonergic neurotransmission in PD were shown based on increased IDAEP. Due to specific alterations of the N1-P2 complex, the current results suggest deficiencies in early-attentive inhibitory processing of auditory input in PD. This interpretation is consistent with the involvement of the basal ganglia and the role of dopaminergic and serotonergic neurotransmission in auditory gating.
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Affiliation(s)
- Kim De Keyser
- Department of Rehabilitation Sciences, Faculty of Medicine and Health Sciences, Ghent University, Corneel Heymanslaan 10, 9000, Ghent, Belgium
| | - Miet De Letter
- Department of Rehabilitation Sciences, Faculty of Medicine and Health Sciences, Ghent University, Corneel Heymanslaan 10, 9000, Ghent, Belgium.
| | - Patrick Santens
- Department of Neurology, Ghent University Hospital, Corneel Heymanslaan 10, 9000, Ghent, Belgium
| | - Durk Talsma
- Department of Experimental Psychology, Ghent University, Henri Dunantlaan 2, 9000, Ghent, Belgium
| | - Dick Botteldooren
- Department of Information Technology (INTEC), Acoustics Research Group, Ghent University, Technologiepark-Zwijnaarde 15, 9052, Ghent, Belgium
| | - Annelies Bockstael
- Department of Information Technology (INTEC), Acoustics Research Group, Ghent University, Technologiepark-Zwijnaarde 15, 9052, Ghent, Belgium
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13
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Buril J, Burilova P, Pokorna A, Balaz M. Use of high-density EEG in patients with Parkinson's disease treated with deep brain stimulation. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub 2020; 164:366-370. [DOI: 10.5507/bp.2020.042] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Accepted: 09/15/2020] [Indexed: 12/17/2022] Open
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14
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Petry-Schmelzer JN, Krause M, Dembek TA, Horn A, Evans J, Ashkan K, Rizos A, Silverdale M, Schumacher W, Sack C, Loehrer PA, Fink GR, Fonoff ET, Martinez-Martin P, Antonini A, Barbe MT, Visser-Vandewalle V, Ray-Chaudhuri K, Timmermann L, Dafsari HS. Non-motor outcomes depend on location of neurostimulation in Parkinson's disease. Brain 2020; 142:3592-3604. [PMID: 31553039 DOI: 10.1093/brain/awz285] [Citation(s) in RCA: 85] [Impact Index Per Article: 21.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Revised: 06/11/2019] [Accepted: 07/15/2019] [Indexed: 01/29/2023] Open
Abstract
Deep brain stimulation of the subthalamic nucleus is an effective and established therapy for patients with advanced Parkinson's disease improving quality of life, motor symptoms and non-motor symptoms. However, there is a considerable degree of interindividual variability for these outcomes, likely due to variability in electrode placement and stimulation settings. Here, we present probabilistic mapping data from a prospective, open-label, multicentre, international study to investigate the influence of the location of subthalamic nucleus deep brain stimulation on non-motor symptoms in patients with Parkinson's disease. A total of 91 Parkinson's disease patients undergoing bilateral deep brain stimulation of the subthalamic nucleus were included, and we investigated NMSScale, NMSQuestionnaire, Scales for Outcomes in Parkinson's disease-motor examination, -activities of daily living, and -motor complications, and Parkinson's disease Questionnaire-8 preoperatively and at 6-month follow-up after surgery. Leads were localized in standard space using the Lead-DBS toolbox and individual volumes of tissue activated were calculated based on clinical stimulation settings. Probabilistic stimulation maps and non-parametric permutation statistics were applied to identify voxels with significant above or below average improvement for each scale and analysed using the DISTAL atlas. All outcomes improved significantly at follow-up. Significant spatial distribution patterns of neurostimulation were observed for NMSScale total score and its mood/apathy and attention/memory domains. For both domains, voxels associated with below average improvement were mainly located dorsal to the subthalamic nucleus. In contrast, above average improvement for mood/apathy was observed in the ventral border region of the subthalamic nucleus and in its sensorimotor subregion and for attention/memory in the associative subregion. A trend was observed for NMSScale sleep domain showing voxels with above average improvement located ventral to the subthalamic nucleus. Our study provides evidence that the interindividual variability of mood/apathy, attention/memory, and sleep outcomes after subthalamic nucleus deep brain stimulation depends on the location of neurostimulation. This study highlights the importance of holistic assessments of motor and non-motor aspects of Parkinson's disease to tailor surgical targeting and stimulation parameter settings to patients' personal profiles.
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Affiliation(s)
- Jan Niklas Petry-Schmelzer
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Neurology, Cologne, Germany
| | - Max Krause
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Neurology, Cologne, Germany
| | - Till A Dembek
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Neurology, Cologne, Germany
| | - Andreas Horn
- Department of Neurology, Charité - University Medicine Berlin, Berlin, Germany
| | - Julian Evans
- Department of Neurology and Neurosurgery, Salford Royal Foundation Thrust, Greater Manchester, UK
| | - Keyoumars Ashkan
- National Parkinson Foundation Centre of Excellence, King's College Hospital, London, UK
| | - Alexandra Rizos
- National Parkinson Foundation Centre of Excellence, King's College Hospital, London, UK
| | - Monty Silverdale
- Department of Neurology and Neurosurgery, Salford Royal Foundation Thrust, Greater Manchester, UK
| | - Wibke Schumacher
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Neurology, Cologne, Germany
| | - Carolin Sack
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Neurology, Cologne, Germany
| | - Philipp A Loehrer
- Department of Neurology, University Hospital Giessen and Marburg, Campus Marburg, Marburg, Germany
| | - Gereon R Fink
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Neurology, Cologne, Germany.,Cognitive Neuroscience, Institute of Neuroscience and Medicine (INM-3), Research Center Jülich, Jülich, Germany
| | - Erich T Fonoff
- Division of Functional Neurosurgery of Institute of Psychiatry, Department of Neurology, University of São Paulo Medical School, São Paulo, Brazil
| | - Pablo Martinez-Martin
- National Center of Epidemiology and CIBERNED, Carlos III Institute of Health, Madrid, Spain
| | - Angelo Antonini
- Department of Neuroscience, University of Padua, Padua, Italy
| | - Michael T Barbe
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Neurology, Cologne, Germany
| | - Veerle Visser-Vandewalle
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Stereotaxy and Functional Neurosurgery, Cologne, Germany
| | - K Ray-Chaudhuri
- National Parkinson Foundation Centre of Excellence, King's College Hospital, London, UK.,The Maurice Wohl Clinical Neuroscience Institute, King's College London, London, UK
| | - Lars Timmermann
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Neurology, Cologne, Germany.,Department of Neurology, University Hospital Giessen and Marburg, Campus Marburg, Marburg, Germany
| | - Haidar S Dafsari
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Neurology, Cologne, Germany.,National Parkinson Foundation Centre of Excellence, King's College Hospital, London, UK
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15
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De Groote E, De Keyser K, Bockstael A, Botteldooren D, Santens P, De Letter M. Central auditory processing in parkinsonian disorders: A systematic review. Neurosci Biobehav Rev 2020; 113:111-132. [PMID: 32145223 DOI: 10.1016/j.neubiorev.2020.03.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Revised: 02/23/2020] [Accepted: 03/02/2020] [Indexed: 10/24/2022]
Abstract
Altered auditory processing has been increasingly recognized as a non-motor feature in parkinsonian disorders. This systematic review provides an overview of behavioral and electrophysiological literature on central auditory processing in patients with Parkinson's disease (PD), multiple system atrophy (MSA) and progressive supranuclear palsy (PSP). A systematic database search was conducted and yielded 88 studies that met the intelligibility criteria. The collected data revealed distinct impairments in a range of central auditory processes in PD, including altered deviance detection of basic auditory features, auditory brainstem processing, auditory gating and selective auditory attention. In contrast to PD, literature on central auditory processing in atypical parkinsonian disorders was relatively scarce, but provided some evidence for impaired central auditory processing in MSA and PSP. The interpretation of these findings is discussed and suggestions for further research are offered.
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Affiliation(s)
- Evelien De Groote
- Department of Rehabilitation Sciences, Ghent University, C. Heymanslaan 10, B-9000, Ghent, Belgium.
| | - Kim De Keyser
- Department of Rehabilitation Sciences, Ghent University, C. Heymanslaan 10, B-9000, Ghent, Belgium
| | - Annelies Bockstael
- INTEC, Acoustic Research Group, Ghent University, Technologiepark Zwijnaarde 15, B-9052, Ghent, Belgium
| | - Dick Botteldooren
- INTEC, Acoustic Research Group, Ghent University, Technologiepark Zwijnaarde 15, B-9052, Ghent, Belgium
| | - Patrick Santens
- Department of Neurology, Ghent University Hospital, C. Heymanslaan 10, B-9000, Ghent, Belgium
| | - Miet De Letter
- Department of Rehabilitation Sciences, Ghent University, C. Heymanslaan 10, B-9000, Ghent, Belgium
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16
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Habelt B, Arvaneh M, Bernhardt N, Minev I. Biomarkers and neuromodulation techniques in substance use disorders. Bioelectron Med 2020; 6:4. [PMID: 32232112 PMCID: PMC7098236 DOI: 10.1186/s42234-020-0040-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Accepted: 01/29/2020] [Indexed: 01/10/2023] Open
Abstract
Addictive disorders are a severe health concern. Conventional therapies have just moderate success and the probability of relapse after treatment remains high. Brain stimulation techniques, such as transcranial Direct Current Stimulation (tDCS) and Deep Brain Stimulation (DBS), have been shown to be effective in reducing subjectively rated substance craving. However, there are few objective and measurable parameters that reflect neural mechanisms of addictive disorders and relapse. Key electrophysiological features that characterize substance related changes in neural processing are Event-Related Potentials (ERP). These high temporal resolution measurements of brain activity are able to identify neurocognitive correlates of addictive behaviours. Moreover, ERP have shown utility as biomarkers to predict treatment outcome and relapse probability. A future direction for the treatment of addiction might include neural interfaces able to detect addiction-related neurophysiological parameters and deploy neuromodulation adapted to the identified pathological features in a closed-loop fashion. Such systems may go beyond electrical recording and stimulation to employ sensing and neuromodulation in the pharmacological domain as well as advanced signal analysis and machine learning algorithms. In this review, we describe the state-of-the-art in the treatment of addictive disorders with electrical brain stimulation and its effect on addiction-related neurophysiological markers. We discuss advanced signal processing approaches and multi-modal neural interfaces as building blocks in future bioelectronics systems for treatment of addictive disorders.
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Affiliation(s)
- Bettina Habelt
- Department of Psychiatry and Psychotherapy, Medical Faculty Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Mahnaz Arvaneh
- Department of Automatic Control and Systems Engineering, University of Sheffield, Sheffield, UK
| | - Nadine Bernhardt
- Department of Psychiatry and Psychotherapy, Medical Faculty Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Ivan Minev
- Department of Automatic Control and Systems Engineering, University of Sheffield, Sheffield, UK
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17
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Gault JM, Thompson JA, Maharajh K, Hosokawa P, Stevens KE, Olincy A, Liedtke EI, Ojemann A, Ojemann S, Abosch A. Striatal and Thalamic Auditory Response During Deep Brain Stimulation for Essential Tremor: Implications for Psychosis. Neuromodulation 2020; 23:478-488. [PMID: 32022409 DOI: 10.1111/ner.13101] [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: 05/15/2019] [Revised: 12/04/2019] [Accepted: 01/02/2020] [Indexed: 12/20/2022]
Abstract
INTRODUCTION The P50, a positive auditory-evoked potential occurring 50 msec after an auditory click, has been characterized extensively with electroencephalography (EEG) to detect aberrant auditory electrophysiology in disorders like schizophrenia (SZ) where 61-74% have an auditory gating deficit. The P50 response occurs in primary auditory cortex and several thalamocortical regions. In rodents, the gated P50 response has been identified in the reticular thalamic nucleus (RT)-a deep brain structure traversed during deep brain stimulation (DBS) targeting of the ventral intermediate nucleus (VIM) of the thalamus to treat essential tremor (ET) allowing for interspecies comparison. The goal was to utilize the unique opportunity provided by DBS surgery for ET to map the P50 response in multiple deep brain structures in order to determine the utility of intraoperative P50 detection for facilitating DBS targeting of auditory responsive subterritories. MATERIALS AND METHODS We developed a method to assess P50 response intraoperatively with local field potentials (LFP) using microelectrode recording during routine clinical electrophysiologic mapping for awake DBS surgery in seven ET patients. Recording sites were mapped into a common stereotactic space. RESULTS Forty significant P50 responses of 155 recordings mapped to the ventral thalamus, RT and CN head/body interface at similar rates of 22.7-26.7%. P50 response exhibited anatomic specificity based on distinct positions of centroids of positive and negative responses within brain regions and the fact that P50 response was not identified in the recordings from either the internal capsule or the dorsal thalamus. CONCLUSIONS Detection of P50 response intraoperatively may guide DBS targeting RT and subterritories within CN head/body interface-DBS targets with the potential to treat psychosis and shown to modulate schizophrenia-like aberrancies in mouse models.
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Affiliation(s)
- Judith M Gault
- Department of Neurosurgery, University of Colorado Denver Anschutz Medical Campus, Aurora, CO, USA.,Department of Psychiatry, University of Colorado Denver Anschutz Medical Campus, Aurora, CO, USA
| | - John A Thompson
- Department of Neurosurgery, University of Colorado Denver Anschutz Medical Campus, Aurora, CO, USA
| | - Keeran Maharajh
- Department of Psychiatry, University of Colorado Denver Anschutz Medical Campus, Aurora, CO, USA.,Department of Neurology, University of Colorado Denver, Anschutz Medical Campus, Aurora, CO, USA
| | - Patrick Hosokawa
- Department of Neurosurgery, University of Colorado Denver Anschutz Medical Campus, Aurora, CO, USA
| | - Karen E Stevens
- Department of Psychiatry, University of Colorado Denver Anschutz Medical Campus, Aurora, CO, USA
| | - Ann Olincy
- Department of Psychiatry, University of Colorado Denver Anschutz Medical Campus, Aurora, CO, USA
| | - Erin I Liedtke
- Department of Neurosurgery, University of Colorado Denver Anschutz Medical Campus, Aurora, CO, USA
| | - Alex Ojemann
- Department of Neurosurgery, University of Colorado Denver Anschutz Medical Campus, Aurora, CO, USA
| | - Steven Ojemann
- Department of Neurosurgery, University of Colorado Denver Anschutz Medical Campus, Aurora, CO, USA
| | - Aviva Abosch
- Department of Neurosurgery, University of Colorado Denver Anschutz Medical Campus, Aurora, CO, USA.,Department of Neurology, University of Colorado Denver, Anschutz Medical Campus, Aurora, CO, USA
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18
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Lio G, Thobois S, Ballanger B, Lau B, Boulinguez P. Removing deep brain stimulation artifacts from the electroencephalogram: Issues, recommendations and an open-source toolbox. Clin Neurophysiol 2018; 129:2170-2185. [PMID: 30144660 DOI: 10.1016/j.clinph.2018.07.023] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2014] [Revised: 07/23/2018] [Accepted: 07/28/2018] [Indexed: 12/30/2022]
Abstract
A major question for deep brain stimulation (DBS) research is understanding how DBS of one target area modulates activity in different parts of the brain. EEG gives privileged access to brain dynamics, but its use with implanted patients is limited since DBS adds significant high-amplitude electrical artifacts that can completely obscure neural activity measured using EEG. Here, we systematically review and discuss the methods available for removing DBS artifacts. These include simple techniques such as oversampling, antialiasing analog filtering and digital low-pass filtering, which are necessary but typically not sufficient to fully remove DBS artifacts when each is used in isolation. We also cover more advanced methods, including techniques tracking outliers in the frequency-domain, which can be effective, but are rarely used. The reason for that is twofold: First, it requires advanced skills in signal processing since no user friendly tool for removing DBS artifacts is currently available. Second, it involves fine-tuning to avoid over-aggressive filtering. We highlight an open-source toolbox incorporating most artifact removal methods, allowing users to combine different strategies.
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Affiliation(s)
- Guillaume Lio
- Université de Lyon, F-69622 Lyon, France; Université Lyon 1, Villeurbanne, France; CNRS, Centre de Neuroscience Cognitive, Bron, France
| | - Stéphane Thobois
- Université de Lyon, F-69622 Lyon, France; Université Lyon 1, Villeurbanne, France; CNRS, Centre de Neuroscience Cognitive, Bron, France; Hospices civils de Lyon, hôpital neurologique Pierre Wertheimer, Bron, France
| | - Bénédicte Ballanger
- Université de Lyon, F-69622 Lyon, France; Université Lyon 1, Villeurbanne, France; INSERM U1028, CNRS UMR5292, Centre de Recherche en Neurosciences de Lyon, Lyon, France
| | - Brian Lau
- Sorbonne Universités, UPMC Univ Paris 06, UMR S 1127, CNRS UMR 7225, Institut du Cerveau et de la Moelle épinière, F-75013 Paris, France
| | - Philippe Boulinguez
- Université de Lyon, F-69622 Lyon, France; Université Lyon 1, Villeurbanne, France; INSERM U1028, CNRS UMR5292, Centre de Recherche en Neurosciences de Lyon, Lyon, France.
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Electroencephalographic read-outs of the modulation of cortical network activity by deep brain stimulation. Bioelectron Med 2018; 4:2. [PMID: 32232078 PMCID: PMC7098231 DOI: 10.1186/s42234-018-0003-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2018] [Accepted: 02/15/2018] [Indexed: 12/24/2022] Open
Abstract
Deep brain stimulation (DBS), a reversible and adjustable treatment for neurological and psychiatric refractory disorders, consists in delivering electrical currents to neuronal populations located in subcortical structures. The targets of DBS are spatially restricted, but connect to many parts of the brain, including the cortex, which might explain the observed clinical benefits in terms of symptomatology. The DBS mechanisms of action at a large scale are however poorly understood, which has motivated several groups to recently conduct many research programs to monitor cortical responses to DBS. Here we review the knowledge gathered from the use of electroencephalography (EEG) in patients treated by DBS. We first focus on the methodology to record and process EEG signals concurrently to DBS. In the second part of the review, we address the clinical and scientific benefits brought by EEG/DBS studies so far.
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Dafsari HS, Weiß L, Silverdale M, Rizos A, Reddy P, Ashkan K, Evans J, Reker P, Petry-Schmelzer JN, Samuel M, Visser-Vandewalle V, Antonini A, Martinez-Martin P, Ray-Chaudhuri K, Timmermann L. Short-term quality of life after subthalamic stimulation depends on non-motor symptoms in Parkinson's disease. Brain Stimul 2018; 11:867-874. [PMID: 29655587 DOI: 10.1016/j.brs.2018.02.015] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2017] [Revised: 02/06/2018] [Accepted: 02/22/2018] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND Subthalamic nucleus (STN) deep brain stimulation (DBS) improves quality of life (QoL), motor, and non-motor symptoms (NMS) in advanced Parkinson's disease (PD). However, considerable inter-individual variability has been observed for QoL outcome. HYPOTHESIS We hypothesized that demographic and preoperative NMS characteristics can predict postoperative QoL outcome. METHODS In this ongoing, prospective, multicenter study (Cologne, Manchester, London) including 88 patients, we collected the following scales preoperatively and on follow-up 6 months postoperatively: PDQuestionnaire-8 (PDQ-8), NMSScale (NMSS), NMSQuestionnaire (NMSQ), Scales for Outcomes in PD (SCOPA)-motor examination, -complications, and -activities of daily living, levodopa equivalent daily dose. We dichotomized patients into "QoL responders"/"non-responders" and screened for factors associated with QoL improvement with (1) Spearman-correlations between baseline test scores and QoL improvement, (2) step-wise linear regressions with baseline test scores as independent and QoL improvement as dependent variables, (3) logistic regressions using aforementioned "responders/non-responders" as dependent variable. RESULTS All outcomes improved significantly on follow-up. However, approximately 44% of patients were categorized as "QoL non-responders". Spearman-correlations, linear and logistic regression analyses were significant for NMSS and NMSQ but not for SCOPA-motor examination. Post-hoc, we identified specific NMS (flat moods, difficulties experiencing pleasure, pain, bladder voiding) as significant contributors to QoL outcome. CONCLUSIONS Our results provide evidence that QoL improvement after STN-DBS depends on preoperative NMS characteristics. These findings are important in the advising and selection of individuals for DBS therapy. Future studies investigating motor and non-motor PD clusters may enable stratifying QoL outcomes and help predict patients' individual prospects of benefiting from DBS.
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Affiliation(s)
- Haidar Salimi Dafsari
- Department of Neurology, University Hospital Cologne, Cologne, Germany; National Parkinson Foundation International Centre of Excellence, King's College Hospital, London, United Kingdom.
| | - Luisa Weiß
- Department of Neurology, University Hospital Cologne, Cologne, Germany
| | - Monty Silverdale
- Department of Neurology and Neurosurgery, Salford Royal NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, United Kingdom
| | - Alexandra Rizos
- National Parkinson Foundation International Centre of Excellence, King's College Hospital, London, United Kingdom
| | - Prashanth Reddy
- National Parkinson Foundation International Centre of Excellence, King's College Hospital, London, United Kingdom
| | - Keyoumars Ashkan
- National Parkinson Foundation International Centre of Excellence, King's College Hospital, London, United Kingdom
| | - Julian Evans
- Department of Neurology and Neurosurgery, Salford Royal NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, United Kingdom
| | - Paul Reker
- Department of Neurology, University Hospital Cologne, Cologne, Germany
| | | | - Michael Samuel
- National Parkinson Foundation International Centre of Excellence, King's College Hospital, London, United Kingdom
| | - Veerle Visser-Vandewalle
- Department of Stereotaxy and Functional Neurosurgery, University Hospital Cologne, Cologne, Germany
| | | | - Pablo Martinez-Martin
- National Center of Epidemiology and CIBERNED, Carlos III Institute of Health, Madrid, Spain
| | - K Ray-Chaudhuri
- National Parkinson Foundation International Centre of Excellence, King's College Hospital, London, United Kingdom; Department of Basic and Clinical Neurosciences, King's College, London, United Kingdom
| | - Lars Timmermann
- Department of Neurology, University Hospital Giessen and Marburg, Campus Marburg, Germany
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De Keyser K, Santens P, Bockstael A, Botteldooren D, Talsma D, De Vos S, Van Cauwenberghe M, Verheugen F, Corthals P, De Letter M. The Relationship Between Speech Production and Speech Perception Deficits in Parkinson's Disease. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2016; 59:915-931. [PMID: 27617884 DOI: 10.1044/2016_jslhr-s-15-0197] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/03/2015] [Accepted: 01/17/2016] [Indexed: 06/06/2023]
Abstract
PURPOSE This study investigated the possible relationship between hypokinetic speech production and speech intensity perception in patients with Parkinson's disease (PD). METHOD Participants included 14 patients with idiopathic PD and 14 matched healthy controls (HCs) with normal hearing and cognition. First, speech production was objectified through a standardized speech intelligibility assessment, acoustic analysis, and speech intensity measurements. Second, an overall estimation task and an intensity estimation task were addressed to evaluate overall speech perception and speech intensity perception, respectively. Finally, correlation analysis was performed between the speech characteristics of the overall estimation task and the corresponding acoustic analysis. The interaction between speech production and speech intensity perception was investigated by an intensity imitation task. RESULTS Acoustic analysis and speech intensity measurements demonstrated significant differences in speech production between patients with PD and the HCs. A different pattern in the auditory perception of speech and speech intensity was found in the PD group. CONCLUSIONS Auditory perceptual deficits may influence speech production in patients with PD. The present results suggest a disturbed auditory perception related to an automatic monitoring deficit in PD.
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Affiliation(s)
- Kim De Keyser
- Department of Neurology, Ghent University Hospital, BelgiumDepartment of Speech, Language, and Hearing Sciences, Ghent University, BelgiumParkinson Zorgwijzer Vlaanderen, Ghent University Hospital, Belgium
| | | | | | | | - Durk Talsma
- Department of Experimental Psychology, Ghent University, Belgium
| | - Stefanie De Vos
- Parkinson Zorgwijzer Vlaanderen, Ghent University Hospital, Belgium
| | | | - Femke Verheugen
- Parkinson Zorgwijzer Vlaanderen, Ghent University Hospital, Belgium
| | - Paul Corthals
- Department of Speech, Language, and Hearing Sciences, Ghent University, Belgium
| | - Miet De Letter
- Department of Neurology, Ghent University Hospital, BelgiumDepartment of Speech, Language, and Hearing Sciences, Ghent University, BelgiumParkinson Zorgwijzer Vlaanderen, Ghent University Hospital, Belgium
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Gulberti A, Moll CKE, Hamel W, Buhmann C, Koeppen JA, Boelmans K, Zittel S, Gerloff C, Westphal M, Schneider TR, Engel AK. Predictive timing functions of cortical beta oscillations are impaired in Parkinson's disease and influenced by L-DOPA and deep brain stimulation of the subthalamic nucleus. NEUROIMAGE-CLINICAL 2015; 9:436-49. [PMID: 26594626 PMCID: PMC4596926 DOI: 10.1016/j.nicl.2015.09.013] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/23/2015] [Revised: 09/11/2015] [Accepted: 09/15/2015] [Indexed: 01/08/2023]
Abstract
Cortex-basal ganglia circuits participate in motor timing and temporal perception, and are important for the dynamic configuration of sensorimotor networks in response to exogenous demands. In Parkinson's disease (PD) patients, rhythmic auditory stimulation (RAS) induces motor performance benefits. Hitherto, little is known concerning contributions of the basal ganglia to sensory facilitation and cortical responses to RAS in PD. Therefore, we conducted an EEG study in 12 PD patients before and after surgery for subthalamic nucleus deep brain stimulation (STN-DBS) and in 12 age-matched controls. Here we investigated the effects of levodopa and STN-DBS on resting-state EEG and on the cortical-response profile to slow and fast RAS in a passive-listening paradigm focusing on beta-band oscillations, which are important for auditory–motor coupling. The beta-modulation profile to RAS in healthy participants was characterized by local peaks preceding and following auditory stimuli. In PD patients RAS failed to induce pre-stimulus beta increases. The absence of pre-stimulus beta-band modulation may contribute to impaired rhythm perception in PD. Moreover, post-stimulus beta-band responses were highly abnormal during fast RAS in PD patients. Treatment with levodopa and STN-DBS reinstated a post-stimulus beta-modulation profile similar to controls, while STN-DBS reduced beta-band power in the resting-state. The treatment-sensitivity of beta oscillations suggests that STN-DBS may specifically improve timekeeping functions of cortical beta oscillations during fast auditory pacing. High density EEG investigation in patients with PD before and after STN-DBS surgery Resting state EEG: altered spectral composition following STN-DBS Rhythmic auditory stimulation (RAS): absence of pre-stimulus beta activity in PD Fast RAS: normalization of beta (13–30 Hz) activities by L-DOPA and STN-DBS Altered beta modulation profile may contribute to timekeeping deficits in PD.
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Affiliation(s)
- A Gulberti
- Department of Neurophysiology and Pathophysiology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, Hamburg 20246, Germany
| | - C K E Moll
- Department of Neurophysiology and Pathophysiology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, Hamburg 20246, Germany
| | - W Hamel
- Department of Neurosurgery, University Medical Center Hamburg-Eppendorf, Martinistr. 52, Hamburg 20246, Germany
| | - C Buhmann
- Department of Neurology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, Hamburg 20246, Germany
| | - J A Koeppen
- Department of Neurosurgery, University Medical Center Hamburg-Eppendorf, Martinistr. 52, Hamburg 20246, Germany
| | - K Boelmans
- Department of Neurology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, Hamburg 20246, Germany ; Department of Neurology, University Hospital of Würzburg, Josef-Schneider-Strasse 11, Würzburg 97080, Germany
| | - S Zittel
- Department of Neurology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, Hamburg 20246, Germany ; Department of Paediatric and Adult Movement Disorders and Neuropsychiatry, Institute of Neurogenetics, University of Lübeck, Maria-Goeppert-Strasse 1, 23562 Lübeck, Germany
| | - C Gerloff
- Department of Neurology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, Hamburg 20246, Germany
| | - M Westphal
- Department of Neurosurgery, University Medical Center Hamburg-Eppendorf, Martinistr. 52, Hamburg 20246, Germany
| | - T R Schneider
- Department of Neurophysiology and Pathophysiology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, Hamburg 20246, Germany
| | - A K Engel
- Department of Neurophysiology and Pathophysiology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, Hamburg 20246, Germany
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23
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Alhourani A, McDowell MM, Randazzo MJ, Wozny TA, Kondylis ED, Lipski WJ, Beck S, Karp JF, Ghuman AS, Richardson RM. Network effects of deep brain stimulation. J Neurophysiol 2015; 114:2105-17. [PMID: 26269552 DOI: 10.1152/jn.00275.2015] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2015] [Accepted: 08/10/2015] [Indexed: 11/22/2022] Open
Abstract
The ability to differentially alter specific brain functions via deep brain stimulation (DBS) represents a monumental advance in clinical neuroscience, as well as within medicine as a whole. Despite the efficacy of DBS in the treatment of movement disorders, for which it is often the gold-standard therapy when medical management becomes inadequate, the mechanisms through which DBS in various brain targets produces therapeutic effects is still not well understood. This limited knowledge is a barrier to improving efficacy and reducing side effects in clinical brain stimulation. A field of study related to assessing the network effects of DBS is gradually emerging that promises to reveal aspects of the underlying pathophysiology of various brain disorders and their response to DBS that will be critical to advancing the field. This review summarizes the nascent literature related to network effects of DBS measured by cerebral blood flow and metabolic imaging, functional imaging, and electrophysiology (scalp and intracranial electroencephalography and magnetoencephalography) in order to establish a framework for future studies.
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Affiliation(s)
- Ahmad Alhourani
- Department of Neurosurgery, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Michael M McDowell
- Department of Neurosurgery, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Michael J Randazzo
- Department of Neurosurgery, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Thomas A Wozny
- Department of Neurosurgery, University of Pittsburgh, Pittsburgh, Pennsylvania
| | | | - Witold J Lipski
- Department of Neurosurgery, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Sarah Beck
- Department of Neurosurgery, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Jordan F Karp
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania; and
| | - Avniel S Ghuman
- Department of Neurosurgery, University of Pittsburgh, Pittsburgh, Pennsylvania; Center for the Neural Basis of Cognition, Pittsburgh, Pennsylvania
| | - R Mark Richardson
- Department of Neurosurgery, University of Pittsburgh, Pittsburgh, Pennsylvania; Center for the Neural Basis of Cognition, Pittsburgh, Pennsylvania
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