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Wang P, Dai W, Liu H, Liu H, Xu Y. Fenobam modulates distinct electrophysiological mechanisms for regulating excessive gamma oscillations in the striatum of dyskinetic rats. Exp Neurol 2024; 378:114833. [PMID: 38782350 DOI: 10.1016/j.expneurol.2024.114833] [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: 01/22/2024] [Revised: 04/28/2024] [Accepted: 05/20/2024] [Indexed: 05/25/2024]
Abstract
Gamma oscillations have been frequently observed in levodopa-induced dyskinesia (LID), manifest as broadband (60-120 Hz) and narrowband (80-110 Hz) gamma activity in cortico-striatal projection. We investigated the electrophysiological mechanisms and correlation of gamma oscillations with dyskinesia severity, while assessing the administration of fenobam, a selective metabotropic glutamate receptor 5 (mGluR5) antagonist, in regulating dyskinesia-associated gamma activity. We conducted simultaneous electrophysiological recordings in Striatum (Str) and primary motor cortex (M1), together with Abnormal Involuntary Movement Scale scoring (AIMs). Phase-amplitude coupling (PAC), power, coherence, and Granger causality analyses were conducted for electrophysiological data. The findings demonstrated increased beta oscillations with directionality from M1 to Str in parkinsonian state. During on-state dyskinesia, elevated broadband gamma activity was modulated by the phase of theta activity in Str, while M1 → Str gamma causality mediated narrowband gamma oscillations in Str. Striatal gamma power (both periodic and aperiodic power), periodic power, peak frequency, and PAC at 80 min (corresponding to the peak dyskinesia) after repeated levodopa injections across recording days (day 30, 33, 36, 39, and 42) increased progressively, correlating with total AIMs. Additionally, a time-dependent parabolic trend of PAC, peak frequency and gamma power was observed after levodopa injection on day 42 from 20 to 120 min, which also correlated with corresponding AIMs. Fenobam effectively alleviates dyskinesia, suppresses enhanced gamma oscillations in the M1-Str directionality, and reduces PAC in Str. The temporal characteristics of gamma oscillations provide parameters for classifying LID severity. Antagonizing striatal mGluR5, a promising therapeutic target for dyskinesia, exerts its effects by modulating gamma activity.
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Affiliation(s)
- Pengfei Wang
- Department of Otology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Weina Dai
- School of Basic Medical Science, Sanquan College of Xinxiang Medical University, Henan Province, China
| | - Hongbin Liu
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China; NHC Key Laboratory of Prevention and treatment of Cerebrovascular Disease, Henan Key Laboratory of Cerebrovascular Diseases of Zhengzhou University, Zhengzhou, China
| | - Han Liu
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China; NHC Key Laboratory of Prevention and treatment of Cerebrovascular Disease, Henan Key Laboratory of Cerebrovascular Diseases of Zhengzhou University, Zhengzhou, China
| | - Yuming Xu
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China; NHC Key Laboratory of Prevention and treatment of Cerebrovascular Disease, Henan Key Laboratory of Cerebrovascular Diseases of Zhengzhou University, Zhengzhou, China.
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2
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Yin Z, Yu H, Yuan T, Smyth C, Anjum MF, Zhu G, Ma R, Xu Y, An Q, Gan Y, Merk T, Qin G, Xie H, Zhang N, Wang C, Jiang Y, Meng F, Yang A, Neumann WJ, Starr P, Little S, Li L, Zhang J. Generalized sleep decoding with basal ganglia signals in multiple movement disorders. NPJ Digit Med 2024; 7:122. [PMID: 38729977 PMCID: PMC11087561 DOI: 10.1038/s41746-024-01115-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2023] [Accepted: 04/23/2024] [Indexed: 05/12/2024] Open
Abstract
Sleep disturbances profoundly affect the quality of life in individuals with neurological disorders. Closed-loop deep brain stimulation (DBS) holds promise for alleviating sleep symptoms, however, this technique necessitates automated sleep stage decoding from intracranial signals. We leveraged overnight data from 121 patients with movement disorders (Parkinson's disease, Essential Tremor, Dystonia, Essential Tremor, Huntington's disease, and Tourette's syndrome) in whom synchronized polysomnograms and basal ganglia local field potentials were recorded, to develop a generalized, multi-class, sleep specific decoder - BGOOSE. This generalized model achieved 85% average accuracy across patients and across disease conditions, even in the presence of recordings from different basal ganglia targets. Furthermore, we also investigated the role of electrocorticography on decoding performances and proposed an optimal decoding map, which was shown to facilitate channel selection for optimal model performances. BGOOSE emerges as a powerful tool for generalized sleep decoding, offering exciting potentials for the precision stimulation delivery of DBS and better management of sleep disturbances in movement disorders.
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Affiliation(s)
- Zixiao Yin
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
- Movement Disorder and Neuromodulation Unit, Department of Neurology, Charité-Campus Mitte, Charite-Universitatsmedizin Berlin, Chariteplatz 1, 10117, Berlin, Germany.
| | - Huiling Yu
- National Engineering Research Center of Neuromodulation, School of Aerospace Engineering, Tsinghua University, 100084, Beijing, China
| | - Tianshuo Yuan
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Clay Smyth
- Department of Bioengineering, University of California, San Francisco, UCSF Byers Hall Box 2520, 1700 Fourth St Ste 203, San Francisco, CA, 94143, USA
| | - Md Fahim Anjum
- Department of Neurology, University of California, San Francisco, 1651 4th Street, San Francisco, CA, 94158, USA
| | - Guanyu Zhu
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- Movement Disorder and Neuromodulation Unit, Department of Neurology, Charité-Campus Mitte, Charite-Universitatsmedizin Berlin, Chariteplatz 1, 10117, Berlin, Germany
| | - Ruoyu Ma
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Yichen Xu
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Qi An
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Yifei Gan
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Timon Merk
- Movement Disorder and Neuromodulation Unit, Department of Neurology, Charité-Campus Mitte, Charite-Universitatsmedizin Berlin, Chariteplatz 1, 10117, Berlin, Germany
| | - Guofan Qin
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Hutao Xie
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Ning Zhang
- Department of Neuropsychiatry, Behavioral Neurology and Sleep Center, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Chunxue Wang
- Department of Neuropsychiatry, Behavioral Neurology and Sleep Center, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Yin Jiang
- Department of Functional Neurosurgery, Beijing Neurosurgical Institute, Capital Medical University, Beijing, China
| | - Fangang Meng
- Department of Functional Neurosurgery, Beijing Neurosurgical Institute, Capital Medical University, Beijing, China
| | - Anchao Yang
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Wolf-Julian Neumann
- Movement Disorder and Neuromodulation Unit, Department of Neurology, Charité-Campus Mitte, Charite-Universitatsmedizin Berlin, Chariteplatz 1, 10117, Berlin, Germany
| | - Philip Starr
- Department of Neurosurgery, University of California, San Francisco, Eighth Floor, 400 Parnassus Ave, San Francisco, CA, 94143, USA
| | - Simon Little
- Department of Neurology, University of California, San Francisco, 1651 4th Street, San Francisco, CA, 94158, USA.
| | - Luming Li
- National Engineering Research Center of Neuromodulation, School of Aerospace Engineering, Tsinghua University, 100084, Beijing, China
- IDG/McGovern Institute for Brain Research, Tsinghua University, 100084, Beijing, China
| | - Jianguo Zhang
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
- Department of Functional Neurosurgery, Beijing Neurosurgical Institute, Capital Medical University, Beijing, China.
- Beijing Key Laboratory of Neurostimulation, Beijing, China.
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3
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Brown G, De Jesus S. Bridging the Gap: Local Field Potentials Offer a Peek Into the Brain of a Person With Parkinson Disease. Neurology 2024; 102:e209283. [PMID: 38513164 DOI: 10.1212/wnl.0000000000209283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Accepted: 01/20/2024] [Indexed: 03/23/2024] Open
Abstract
Clinically available deep brain recordings in patients with Parkinson disease (PD) offer insights into disease mechanisms and create a pathway for personalized treatment strategies. This case illustrates the transformative potential of recordings of neuronal firing in the form of local field potentials (LFPs) by detailing a patient's clinical trajectory for 6 months after deep brain stimulation (DBS) surgery to treat their PD symptoms. LFPs, obtained easily in clinic with a tablet interface to measure and track brain rhythms across the disease course, enriched the patient's clinical picture. Specifically, strong beta peaks were captured at initial programming, and, as the beta peaks diminished over the course of optimizing settings, symptoms improved. These signals may also reveal insights into the neural dynamics of PD such as hypersynchrony in basal ganglia circuitry. Furthermore, the ability to record chronically may unlock new understanding of neuronal dysfunction in PD, possibly enabling future adaptive DBS. In conclusion, identification, tracking, and modulation of LFPs correlated with subjective and objective clinical improvement in the case presented. The use of neurophysiologic signals in the future may lead to therapeutic innovations for our patients with PD.
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Affiliation(s)
- Gregory Brown
- From the Department of Neurology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey, PA
| | - Sol De Jesus
- From the Department of Neurology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey, PA
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4
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Jiang X, Yang J, Wang Z, Jia J, Wang G. Functional interaction of abnormal beta and gamma oscillations on bradykinesia in parkinsonian rats. Brain Res Bull 2024; 209:110911. [PMID: 38432496 DOI: 10.1016/j.brainresbull.2024.110911] [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: 11/30/2023] [Revised: 02/21/2024] [Accepted: 02/26/2024] [Indexed: 03/05/2024]
Abstract
Bradykinesia, a debilitating symptom characterized by impaired movement initiation and reduced speed in Parkinson's disease (PD), is associated with abnormal oscillatory activity in the motor cortex-basal ganglia circuit. We investigated the interplay between abnormal beta and gamma oscillations in relation to bradykinesia in parkinsonian rats. Our findings showed reduced movement activities in parkinsonian rats, accompanied by enhanced high beta oscillations in the motor cortex, which are closely associated with movement transitional difficulties. Additionally, gamma oscillations correlated with movement velocity in control rats but not in parkinsonian rats. We observed selective coupling between high beta oscillation phase and gamma oscillation amplitude in PD, as well as cortical high beta-broadband gamma phase-amplitude coupling (PAC) negatively influencing locomotor activities in control and PD rats. These findings suggest a collaborative role of cortical beta and gamma oscillations in facilitating movement execution, with beta oscillations being linked to movement initiation and gamma oscillations associated with movement speed. Importantly, the aberrant alterations of these oscillations are closely related to the development of bradykinesia. Furthermore, PAC hold promise as a biomarker for comprehensive assessment of movement performance in PD.
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Affiliation(s)
- Xinxin Jiang
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing 100088, China; Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing 100069, China; Department of physiology and pathophysiology, School of Basic Medical Science, Capital Medical University, Beijing 100069, China
| | - Jian Yang
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing 100088, China; Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing 100069, China
| | - Zirui Wang
- Department of physiology and pathophysiology, School of Basic Medical Science, Capital Medical University, Beijing 100069, China
| | - Jun Jia
- Department of physiology and pathophysiology, School of Basic Medical Science, Capital Medical University, Beijing 100069, China.
| | - Gang Wang
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing 100088, China; Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing 100069, China.
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5
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Farokhniaee A, Palmisano C, Del Vecchio Del Vecchio J, Pezzoli G, Volkmann J, Isaias IU. Gait-related beta-gamma phase amplitude coupling in the subthalamic nucleus of parkinsonian patients. Sci Rep 2024; 14:6674. [PMID: 38509158 PMCID: PMC10954750 DOI: 10.1038/s41598-024-57252-2] [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: 06/15/2023] [Accepted: 03/15/2024] [Indexed: 03/22/2024] Open
Abstract
Analysis of coupling between the phases and amplitudes of neural oscillations has gained increasing attention as an important mechanism for large-scale brain network dynamics. In Parkinson's disease (PD), preliminary evidence indicates abnormal beta-phase coupling to gamma-amplitude in different brain areas, including the subthalamic nucleus (STN). We analyzed bilateral STN local field potentials (LFPs) in eight subjects with PD chronically implanted with deep brain stimulation electrodes during upright quiet standing and unperturbed walking. Phase-amplitude coupling (PAC) was computed using the Kullback-Liebler method, based on the modulation index. Neurophysiological recordings were correlated with clinical and kinematic measurements and individual molecular brain imaging studies ([123I]FP-CIT and single-photon emission computed tomography). We showed a dopamine-related increase in subthalamic beta-gamma PAC from standing to walking. Patients with poor PAC modulation and low PAC during walking spent significantly more time in the stance and double support phase of the gait cycle. Our results provide new insights into the subthalamic contribution to human gait and suggest cross-frequency coupling as a gateway mechanism to convey patient-specific information of motor control for human locomotion.
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Affiliation(s)
- AmirAli Farokhniaee
- Fondazione Grigioni Per Il Morbo Di Parkinson, Via Gianfranco Zuretti 35, 20125, Milano, Italy.
- Parkinson Institute Milan, ASST G. Pini CTO, Via Bignami 1, 20126, Milano, Italy.
| | - Chiara Palmisano
- Department of Neurology, University Hospital of Würzburg, and Julius Maximilian University of Würzburg, Josef-Schneider-Straße 11, 97080, Würzburg, Germany
| | - Jasmin Del Vecchio Del Vecchio
- Department of Neurology, University Hospital of Würzburg, and Julius Maximilian University of Würzburg, Josef-Schneider-Straße 11, 97080, Würzburg, Germany
| | - Gianni Pezzoli
- Fondazione Grigioni Per Il Morbo Di Parkinson, Via Gianfranco Zuretti 35, 20125, Milano, Italy
- Parkinson Institute Milan, ASST G. Pini CTO, Via Bignami 1, 20126, Milano, Italy
| | - Jens Volkmann
- Department of Neurology, University Hospital of Würzburg, and Julius Maximilian University of Würzburg, Josef-Schneider-Straße 11, 97080, Würzburg, Germany
| | - Ioannis U Isaias
- Parkinson Institute Milan, ASST G. Pini CTO, Via Bignami 1, 20126, Milano, Italy
- Department of Neurology, University Hospital of Würzburg, and Julius Maximilian University of Würzburg, Josef-Schneider-Straße 11, 97080, Würzburg, Germany
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6
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Chen Y, Zhu G, Yuan T, Ma R, Zhang X, Meng F, Yang A, Du T, Zhang J. Subthalamic nucleus deep brain stimulation alleviates oxidative stress via mitophagy in Parkinson's disease. NPJ Parkinsons Dis 2024; 10:52. [PMID: 38448431 PMCID: PMC10917786 DOI: 10.1038/s41531-024-00668-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 02/23/2024] [Indexed: 03/08/2024] Open
Abstract
Subthalamic nucleus deep brain stimulation (STN-DBS) has the potential to delay Parkinson's disease (PD) progression. Whether oxidative stress participates in the neuroprotective effects of DBS and related signaling pathways remains unknown. To address this, we applied STN-DBS to mice and monkey models of PD and collected brain tissue to evaluate mitophagy, oxidative stress, and related pathway. To confirm findings in animal experiments, a cohort of PD patients was recruited and oxidative stress was evaluated in cerebrospinal fluid. When PD mice received STN stimulation, the mTOR pathway was suppressed, accompanied by elevated LC3 II expression, increased mitophagosomes, and a decrease in p62 expression. The increase in mitophagy and balance of mitochondrial fission/fusion dynamics in the substantia nigra caused a marked enhancement of the antioxidant enzymes superoxide dismutase and glutathione levels. Subsequently, fewer mitochondrial apoptogenic factors were released to the cytoplasm, which resulted in a suppression of caspase activation and reservation of dopaminergic neurons. While interfaced with an mTOR activator, oxidative stress was no longer regulated by STN-DBS, with no neuroprotective effect. Similar results to those found in the rodent experiments were obtained in monkeys treated with chronic STN stimulation. Moreover, antioxidant enzymes in PD patients were increased after the operation, however, there was no relation between changes in antioxidant enzymes and motor impairment. Collectively, our study found that STN-DBS was able to increase mitophagy via an mTOR-dependent pathway, and oxidative stress was suppressed due to removal of damaged mitochondria, which was attributed to the dopaminergic neuroprotection of STN-DBS in PD.
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Affiliation(s)
- Yingchuan Chen
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, 100070, Beijing, China
- Beijing Key Laboratory of Neurostimulation, 100070, Beijing, China
| | - Guanyu Zhu
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, 100070, Beijing, China
- Beijing Key Laboratory of Neurostimulation, 100070, Beijing, China
| | - Tianshuo Yuan
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, 100070, Beijing, China
- Beijing Key Laboratory of Neurostimulation, 100070, Beijing, China
| | - Ruoyu Ma
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, 100070, Beijing, China
- Beijing Key Laboratory of Neurostimulation, 100070, Beijing, China
| | - Xin Zhang
- Beijing Key Laboratory of Neurostimulation, 100070, Beijing, China
- Department of Functional Neurosurgery, Beijing Neurosurgical Institute, Capital Medical University, 100070, Beijing, China
| | - Fangang Meng
- Beijing Key Laboratory of Neurostimulation, 100070, Beijing, China
- Department of Functional Neurosurgery, Beijing Neurosurgical Institute, Capital Medical University, 100070, Beijing, China
| | - Anchao Yang
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, 100070, Beijing, China
- Beijing Key Laboratory of Neurostimulation, 100070, Beijing, China
| | - Tingting Du
- Beijing Key Laboratory of Neurostimulation, 100070, Beijing, China.
- Department of Functional Neurosurgery, Beijing Neurosurgical Institute, Capital Medical University, 100070, Beijing, China.
| | - Jianguo Zhang
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, 100070, Beijing, China.
- Beijing Key Laboratory of Neurostimulation, 100070, Beijing, China.
- Department of Functional Neurosurgery, Beijing Neurosurgical Institute, Capital Medical University, 100070, Beijing, China.
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7
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Kamble N, Pal PK. Frequency of Stimulation: The Most Important DBS Parameter in Improvement of Freezing of Gait in Parkinson's Disease. Ann Indian Acad Neurol 2024; 27:120-121. [PMID: 38751920 PMCID: PMC11093155 DOI: 10.4103/aian.aian_580_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2023] [Revised: 07/04/2023] [Accepted: 07/04/2023] [Indexed: 05/18/2024] Open
Affiliation(s)
- Nitish Kamble
- Department of Neurology, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bengaluru, Karnataka, India
| | - Pramod K. Pal
- Department of Neurology, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bengaluru, Karnataka, India
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8
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Nie JZ, Flint RD, Prakash P, Hsieh JK, Mugler EM, Tate MC, Rosenow JM, Slutzky MW. High-Gamma Activity Is Coupled to Low-Gamma Oscillations in Precentral Cortices and Modulates with Movement and Speech. eNeuro 2024; 11:ENEURO.0163-23.2023. [PMID: 38242691 PMCID: PMC10867721 DOI: 10.1523/eneuro.0163-23.2023] [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: 05/16/2023] [Revised: 10/26/2023] [Accepted: 12/06/2023] [Indexed: 01/21/2024] Open
Abstract
Planning and executing motor behaviors requires coordinated neural activity among multiple cortical and subcortical regions of the brain. Phase-amplitude coupling between the high-gamma band amplitude and the phase of low frequency oscillations (theta, alpha, beta) has been proposed to reflect neural communication, as has synchronization of low-gamma oscillations. However, coupling between low-gamma and high-gamma bands has not been investigated. Here, we measured phase-amplitude coupling between low- and high-gamma in monkeys performing a reaching task and in humans either performing finger-flexion or word-reading tasks. We found significant coupling between low-gamma phase and high-gamma amplitude in multiple sensorimotor and premotor cortices of both species during all tasks. This coupling modulated with the onset of movement. These findings suggest that interactions between the low and high gamma bands are markers of network dynamics related to movement and speech generation.
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Affiliation(s)
- Jeffrey Z Nie
- Southern Illinois University School of Medicine, Springfield 62794, Illinois
- Departments of Neurology, Northwestern University, Chicago 60611, Illinois
| | - Robert D Flint
- Departments of Neurology, Northwestern University, Chicago 60611, Illinois
| | - Prashanth Prakash
- Departments of Neurology, Northwestern University, Chicago 60611, Illinois
| | - Jason K Hsieh
- Departments of Neurology, Northwestern University, Chicago 60611, Illinois
- Neurological Surgery, Northwestern University, Chicago 60611, Illinois
- Department of Neurosurgery, Neurological Institute, Cleveland Clinic Foundation, Cleveland, Ohio
| | - Emily M Mugler
- Departments of Neurology, Northwestern University, Chicago 60611, Illinois
| | - Matthew C Tate
- Departments of Neurology, Northwestern University, Chicago 60611, Illinois
- Neurological Surgery, Northwestern University, Chicago 60611, Illinois
| | - Joshua M Rosenow
- Departments of Neurology, Northwestern University, Chicago 60611, Illinois
- Neurological Surgery, Northwestern University, Chicago 60611, Illinois
- Physical Medicine & Rehabilitation, Northwestern University, Chicago 60611, Illinois
- Shirley Ryan AbilityLab, Chicago 60611, Illinois
| | - Marc W Slutzky
- Departments of Neurology, Northwestern University, Chicago 60611, Illinois
- Physical Medicine & Rehabilitation, Northwestern University, Chicago 60611, Illinois
- Neuroscience, Northwestern University, Chicago 60611, Illinois
- Shirley Ryan AbilityLab, Chicago 60611, Illinois
- Department of Biomedical Engineering, Northwestern University, Evanston 60201, Illinois
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9
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Marano M, Anzini G, Saltarocchi L, Ricciuti R, Capone F, Tan H, Torrecillos F, Lanzone J, Lazzaro VD. Left Vagus Stimulation Modulates Contralateral Subthalamic β Power Improving the Gait in Parkinson's Disease. Mov Disord 2024; 39:424-428. [PMID: 38111224 PMCID: PMC7615838 DOI: 10.1002/mds.29690] [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: 08/02/2023] [Revised: 11/09/2023] [Accepted: 11/28/2023] [Indexed: 12/20/2023] Open
Abstract
BACKGROUND Transcutaneous vagus nerve stimulation (VNS) showed early evidence of efficacy for the gait treatment of Parkinson's disease (PD). OBJECTIVES Providing data on neurophysiological and clinical effects of transauricular VNS (taVNS). METHODS Ten patients with recording deep brain stimulation (DBS) have been enrolled in a within participant design pilot study, double-blind crossover sham-controlled trial of taVNS. Subthalamic local field potentials (β band power), Unified Parkinson's Disease Rating Scales (UPDRS), and a digital timed-up-and-go test (TUG) were measured and compared with real versus sham taVNS during medication-off/DBS-OFF condition. RESULTS The left taVNS induced a reduction of the total β power in the contralateral (ie, right) subthalamic nucleus and an improvement of TUG time, speed, and variability. The taVNS-induced β reduction correlated with the improvement of gait speed. No major clinical changes were observed at UPDRS. CONCLUSIONS taVNS is a promising strategy for the management of PD gait, deserving prospective trials of chronic neuromodulation. © 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)
- Massimo Marano
- Unit of Neurology, Neurophysiology, Neurobiology and Psychiatry, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Roma, Italy
- Fondazione Policlinico Universitario Campus Bio-Medico, Roma, Italy
| | - Gaia Anzini
- Unit of Neurology, Neurophysiology, Neurobiology and Psychiatry, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Roma, Italy
- Fondazione Policlinico Universitario Campus Bio-Medico, Roma, Italy
| | - Luca Saltarocchi
- Unit of Neurology, Neurophysiology, Neurobiology and Psychiatry, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Roma, Italy
| | - Riccardo Ricciuti
- Neurosurgery Unit, Ospedale Belcolle, ASL di Viterbo, Viterbo, Italy
| | - Fioravante Capone
- Unit of Neurology, Neurophysiology, Neurobiology and Psychiatry, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Roma, Italy
- Fondazione Policlinico Universitario Campus Bio-Medico, Roma, Italy
| | - Huiling Tan
- Medical Research Council Brain Network Dynamics Unit, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom
| | - Flavie Torrecillos
- Medical Research Council Brain Network Dynamics Unit, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom
| | - Jacopo Lanzone
- Department of the Neurorehabilitation, Istituti Clinici Scientifici Maugeri IRCCS, Milano Institute, Milan, Italy
| | - Vincenzo Di Lazzaro
- Unit of Neurology, Neurophysiology, Neurobiology and Psychiatry, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Roma, Italy
- Fondazione Policlinico Universitario Campus Bio-Medico, Roma, Italy
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10
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Fan H, Guo Z, Jiang Y, Xue T, Yin Z, Xie H, Diao Y, Hu T, Zhao B, Wu D, An Q, Xu Y, Gao Y, Bai Y, Zhang J. Optimal subthalamic stimulation sites and related networks for freezing of gait in Parkinson's disease. Brain Commun 2023; 5:fcad238. [PMID: 37701817 PMCID: PMC10493641 DOI: 10.1093/braincomms/fcad238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 07/10/2023] [Accepted: 09/02/2023] [Indexed: 09/14/2023] Open
Abstract
Freezing of gait is a common and debilitating symptom in Parkinson's disease. Although high-frequency subthalamic deep brain stimulation is an effective treatment for Parkinson's disease, post-operative freezing of gait severity has been reported to alleviate, deteriorate or remain constant. We conducted this study to explore the optimal stimulation sites and related connectivity networks for high-frequency subthalamic deep brain stimulation treating freezing of gait in Parkinson's disease. A total of 76 Parkinson's disease patients with freezing of gait who underwent bilateral high-frequency subthalamic stimulation were retrospectively included. The volumes of tissue activated were estimated based on individual electrode reconstruction. The optimal and sour stimulation sites were calculated at coordinate/voxel/mapping level and mapped to anatomical space based on patient-specific images and stimulation settings. The structural and functional predictive connectivity networks for the change of the post-operative Freezing of Gait-Questionnaire were also identified based on normative connectomes derived from the Parkinson's Progression Marker Initiative database. Leave-one-out cross-validation model validated the above results, and the model remained significant after including covariates. The dorsolateral two-thirds of the subthalamic nucleus was identified as the optimal stimulation site, while the ventrocentral portion of the right subthalamic nucleus and internal capsule surrounding the left central subthalamic nucleus were considered as the sour stimulation sites. Modulation of the fibre tracts connecting to the supplementary motor area, pre-supplementary motor area and pedunculopontine nucleus accounted for the alleviation of freezing of gait, whereas tracts connecting to medial and ventrolateral prefrontal cortices contributed to the deterioration of freezing of gait. The optimal/sour stimulation sites and structural/functional predictive connectivity networks for high-frequency subthalamic deep brain stimulation treating freezing of gait are identified and validated through sizable Parkinson's disease patients in this study. With the growing understanding of stimulation sites and related networks, individualized deep brain stimulation treatment with directional leads will become an optimal choice for Parkinson's disease patients with freezing of gait in the future.
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Affiliation(s)
- Houyou Fan
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, 100070 Beijing, China
- Department of Functional Neurosurgery, Beijing Neurosurgical Institute, Capital Medical University, 100070 Beijing, China
| | - Zijian Guo
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, 100070 Beijing, China
- School of Biomedical Engineering, Capital Medical University, 100069 Beijing, China
| | - Yin Jiang
- Department of Functional Neurosurgery, Beijing Neurosurgical Institute, Capital Medical University, 100070 Beijing, China
- Beijing Key Laboratory of Neurostimulation, 100070 Beijing, China
| | - Tao Xue
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, 100070 Beijing, China
- Department of Functional Neurosurgery, Beijing Neurosurgical Institute, Capital Medical University, 100070 Beijing, China
| | - Zixiao Yin
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, 100070 Beijing, China
- Department of Functional Neurosurgery, Beijing Neurosurgical Institute, Capital Medical University, 100070 Beijing, China
| | - Hutao Xie
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, 100070 Beijing, China
- Department of Functional Neurosurgery, Beijing Neurosurgical Institute, Capital Medical University, 100070 Beijing, China
| | - Yu Diao
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, 100070 Beijing, China
- Department of Functional Neurosurgery, Beijing Neurosurgical Institute, Capital Medical University, 100070 Beijing, China
| | - Tianqi Hu
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, 100070 Beijing, China
- Department of Functional Neurosurgery, Beijing Neurosurgical Institute, Capital Medical University, 100070 Beijing, China
| | - Baotian Zhao
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, 100070 Beijing, China
- Department of Functional Neurosurgery, Beijing Neurosurgical Institute, Capital Medical University, 100070 Beijing, China
- Beijing Key Laboratory of Neurostimulation, 100070 Beijing, China
| | - Delong Wu
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, 100070 Beijing, China
- Department of Functional Neurosurgery, Beijing Neurosurgical Institute, Capital Medical University, 100070 Beijing, China
| | - Qi An
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, 100070 Beijing, China
- Department of Functional Neurosurgery, Beijing Neurosurgical Institute, Capital Medical University, 100070 Beijing, China
| | - Yichen Xu
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, 100070 Beijing, China
- Department of Functional Neurosurgery, Beijing Neurosurgical Institute, Capital Medical University, 100070 Beijing, China
| | - Yuan Gao
- Department of Functional Neurosurgery, Beijing Neurosurgical Institute, Capital Medical University, 100070 Beijing, China
- Beijing Key Laboratory of Neurostimulation, 100070 Beijing, China
| | - Yutong Bai
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, 100070 Beijing, China
- Department of Functional Neurosurgery, Beijing Neurosurgical Institute, Capital Medical University, 100070 Beijing, China
| | - Jianguo Zhang
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, 100070 Beijing, China
- Department of Functional Neurosurgery, Beijing Neurosurgical Institute, Capital Medical University, 100070 Beijing, China
- Beijing Key Laboratory of Neurostimulation, 100070 Beijing, China
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Starkweather CK, Morrison MA, Yaroshinsky M, Louie K, Balakid J, Presbrey K, Starr PA, Wang DD. Human upper extremity motor cortex activity shows distinct oscillatory signatures for stereotyped arm and leg movements. Front Hum Neurosci 2023; 17:1212963. [PMID: 37635808 PMCID: PMC10449648 DOI: 10.3389/fnhum.2023.1212963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Accepted: 07/25/2023] [Indexed: 08/29/2023] Open
Abstract
Introduction Stepping and arm swing are stereotyped movements that require coordination across multiple muscle groups. It is not known whether the encoding of these stereotyped movements in the human primary motor cortex is confined to the limbs' respective somatotopy. Methods We recorded subdural electrocorticography activities from the hand/arm area in the primary motor cortex of 6 subjects undergoing deep brain stimulation surgery for essential tremor and Parkinson's disease who performed stepping (all patients) and arm swing (n = 3 patients) tasks. Results We show stepping-related low frequency oscillations over the arm area. Furthermore, we show that this oscillatory activity is separable, both in frequency and spatial domains, from gamma band activity changes that occur during arm swing. Discussion Our study contributes to the growing body of evidence that lower extremity movement may be more broadly represented in the motor cortex, and suggest that it may represent a way to coordinate stereotyped movements across the upper and lower extremities.
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Affiliation(s)
- Clara Kwon Starkweather
- Department of Neurological Surgery, University of California, San Francisco, San Francisco, CA, United States
| | - Melanie A. Morrison
- Department of Radiology, University of California, San Francisco, San Francisco, CA, United States
| | - Maria Yaroshinsky
- Department of Neurological Surgery, University of California, San Francisco, San Francisco, CA, United States
| | - Kenneth Louie
- Department of Neurological Surgery, University of California, San Francisco, San Francisco, CA, United States
| | - Jannine Balakid
- Department of Neurological Surgery, University of California, San Francisco, San Francisco, CA, United States
| | - Kara Presbrey
- Department of Neurological Surgery, University of California, San Francisco, San Francisco, CA, United States
| | - Philip A. Starr
- Department of Neurological Surgery, University of California, San Francisco, San Francisco, CA, United States
| | - Doris D. Wang
- Department of Neurological Surgery, University of California, San Francisco, San Francisco, CA, United States
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12
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Yeh CH, Zhang C, Shi W, Lo MT, Tinkhauser G, Oswal A. Cross-Frequency Coupling and Intelligent Neuromodulation. CYBORG AND BIONIC SYSTEMS 2023; 4:0034. [PMID: 37266026 PMCID: PMC10231647 DOI: 10.34133/cbsystems.0034] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Accepted: 05/02/2023] [Indexed: 06/03/2023] Open
Abstract
Cross-frequency coupling (CFC) reflects (nonlinear) interactions between signals of different frequencies. Evidence from both patient and healthy participant studies suggests that CFC plays an essential role in neuronal computation, interregional interaction, and disease pathophysiology. The present review discusses methodological advances and challenges in the computation of CFC with particular emphasis on potential solutions to spurious coupling, inferring intrinsic rhythms in a targeted frequency band, and causal interferences. We specifically focus on the literature exploring CFC in the context of cognition/memory tasks, sleep, and neurological disorders, such as Alzheimer's disease, epilepsy, and Parkinson's disease. Furthermore, we highlight the implication of CFC in the context and for the optimization of invasive and noninvasive neuromodulation and rehabilitation. Mainly, CFC could support advancing the understanding of the neurophysiology of cognition and motor control, serve as a biomarker for disease symptoms, and leverage the optimization of therapeutic interventions, e.g., closed-loop brain stimulation. Despite the evident advantages of CFC as an investigative and translational tool in neuroscience, further methodological improvements are required to facilitate practical and correct use in cyborg and bionic systems in the field.
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Affiliation(s)
- Chien-Hung Yeh
- School of Information and Electronics,
Beijing Institute of Technology, Beijing, China
| | - Chuting Zhang
- School of Information and Electronics,
Beijing Institute of Technology, Beijing, China
| | - Wenbin Shi
- School of Information and Electronics,
Beijing Institute of Technology, Beijing, China
| | - Men-Tzung Lo
- Department of Biomedical Sciences and Engineering,
National Central University, Taoyuan, Taiwan
| | - Gerd Tinkhauser
- Department of Neurology,
Bern University Hospital and University of Bern, Bern, Switzerland
| | - Ashwini Oswal
- MRC Brain Network Dynamics Unit,
University of Oxford, Oxford, UK
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13
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Wang S, Zhu G, Shi L, Zhang C, Wu B, Yang A, Meng F, Jiang Y, Zhang J. Closed-Loop Adaptive Deep Brain Stimulation in Parkinson's Disease: Procedures to Achieve It and Future Perspectives. JOURNAL OF PARKINSON'S DISEASE 2023:JPD225053. [PMID: 37182899 DOI: 10.3233/jpd-225053] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
Parkinson's disease (PD) is a neurodegenerative disease with a heavy burden on patients, families, and society. Deep brain stimulation (DBS) can improve the symptoms of PD patients for whom medication is insufficient. However, current open-loop uninterrupted conventional DBS (cDBS) has inherent limitations, such as adverse effects, rapid battery consumption, and a need for frequent parameter adjustment. To overcome these shortcomings, adaptive DBS (aDBS) was proposed to provide responsive optimized stimulation for PD. This topic has attracted scientific interest, and a growing body of preclinical and clinical evidence has shown its benefits. However, both achievements and challenges have emerged in this novel field. To date, only limited reviews comprehensively analyzed the full framework and procedures for aDBS implementation. Herein, we review current preclinical and clinical data on aDBS for PD to discuss the full procedures for its achievement and to provide future perspectives on this treatment.
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Affiliation(s)
- Shu Wang
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Guanyu Zhu
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Lin Shi
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Chunkui Zhang
- Center of Cognition and Brain Science, Beijing Institute of Basic Medical Sciences, Beijing, China
| | - Bing Wu
- Center of Cognition and Brain Science, Beijing Institute of Basic Medical Sciences, Beijing, China
| | - Anchao Yang
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Fangang Meng
- Department of Functional Neurosurgery, Beijing Neurosurgical Institute, Capital Medical University, Beijing, China
- Beijing Key Laboratory of Neurostimulation, Beijing, China
| | - Yin Jiang
- Department of Functional Neurosurgery, Beijing Neurosurgical Institute, Capital Medical University, Beijing, China
- Beijing Key Laboratory of Neurostimulation, Beijing, China
| | - Jianguo Zhang
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- Department of Functional Neurosurgery, Beijing Neurosurgical Institute, Capital Medical University, Beijing, China
- Beijing Key Laboratory of Neurostimulation, Beijing, China
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14
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Neumann WJ, Horn A, Kühn AA. Insights and opportunities for deep brain stimulation as a brain circuit intervention. Trends Neurosci 2023; 46:472-487. [PMID: 37105806 DOI: 10.1016/j.tins.2023.03.009] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 03/13/2023] [Accepted: 03/17/2023] [Indexed: 04/29/2023]
Abstract
Deep brain stimulation (DBS) is an effective treatment and has provided unique insights into the dynamic circuit architecture of brain disorders. This Review illustrates our current understanding of the pathophysiology of movement disorders and their underlying brain circuits that are modulated with DBS. It proposes principles of pathological network synchronization patterns like beta activity (13-35 Hz) in Parkinson's disease. We describe alterations from microscale including local synaptic activity via modulation of mesoscale hypersynchronization to changes in whole-brain macroscale connectivity. Finally, an outlook on advances for clinical innovations in next-generation neurotechnology is provided: from preoperative connectomic targeting to feedback controlled closed-loop adaptive DBS as individualized network-specific brain circuit interventions.
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Affiliation(s)
- Wolf-Julian Neumann
- Movement Disorders and Neuromodulation Unit, Department of Neurology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany; Einstein Center for Neurosciences Berlin, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany; Bernstein Center for Computational Neuroscience, Humboldt Universität zu Berlin, Berlin, Germany
| | - Andreas Horn
- Movement Disorders and Neuromodulation Unit, Department of Neurology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany; Einstein Center for Neurosciences Berlin, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany; Bernstein Center for Computational Neuroscience, Humboldt Universität zu Berlin, Berlin, Germany; Center for Brain Circuit Therapeutics, Department of Neurology, Brigham & Women's Hospital, Harvard Medical School, Boston, MA, USA; MGH Neurosurgery & Center for Neurotechnology and Neurorecovery at MGH Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Andrea A Kühn
- Movement Disorders and Neuromodulation Unit, Department of Neurology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany; Einstein Center for Neurosciences Berlin, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany; Bernstein Center for Computational Neuroscience, Humboldt Universität zu Berlin, Berlin, Germany; NeuroCure Clinical Research Centre, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany; Berlin School of Mind and Brain, Humboldt-Universität zu Berlin, Berlin, Germany; DZNE, German Center for Degenerative Diseases, Berlin, Germany.
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15
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Bosch TJ, Cole RC, Bezchlibnyk Y, Flouty O, Singh A. Effects of Very Low- and High-Frequency Subthalamic Stimulation on Motor Cortical Oscillations During Rhythmic Lower-Limb Movements in Parkinson's Disease Patients. JOURNAL OF PARKINSON'S DISEASE 2023:JPD225113. [PMID: 37092236 DOI: 10.3233/jpd-225113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/25/2023]
Abstract
BACKGROUND Standard high-frequency deep brain stimulation (HF-DBS) at the subthalamic nucleus (STN) is less effective for lower-limb motor dysfunctions in Parkinson's disease (PD) patients. However, the effects of very low frequency (VLF; 4 Hz)-DBS on lower-limb movement and motor cortical oscillations have not been compared. OBJECTIVE To compare the effects of VLF-DBS and HF-DBS at the STN on a lower-limb pedaling motor task and motor cortical oscillations in patients with PD and with and without freezing of gait (FOG). METHODS Thirteen PD patients with bilateral STN-DBS performed a cue-triggered lower-limb pedaling motor task with electroencephalography (EEG) in OFF-DBS, VLF-DBS (4 Hz), and HF-DBS (120-175 Hz) states. We performed spectral analysis on the preparatory signals and compared GO-cue-triggered theta and movement-related beta oscillations over motor cortical regions across DBS conditions in PD patients and subgroups (PDFOG-and PDFOG+). RESULTS Both VLF-DBS and HF-DBS decreased the linear speed of the pedaling task in PD, and HF-DBS decreased speed in both PDFOG-and PDFOG+. Preparatory theta and beta activities were increased with both stimulation frequencies. Both DBS frequencies increased motor cortical theta activity during pedaling movement in PD patients, but this increase was only observed in PDFOG + group. Beta activity was not significantly different from OFF-DBS at either frequency regardless of FOG status. CONCLUSION Results suggest that VL and HF DBS may induce similar effects on lower-limb kinematics by impairing movement speed and modulating motor cortical oscillations in the lower frequency band.
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Affiliation(s)
- Taylor J Bosch
- Center for Brain and Behavior Research, University of South Dakota, Vermillion, SD, USA
- Division of Basic Biomedical Sciences, Sanford School of Medicine, University of South Dakota, Vermillion, SD, USA
| | - Rachel C Cole
- Department of Neurology, University of Iowa, Iowa City, IA, USA
| | - Yarema Bezchlibnyk
- Department of Neurosurgery and Brain Repair, University of South Florida, Tampa, FL, USA
| | - Oliver Flouty
- Department of Neurosurgery and Brain Repair, University of South Florida, Tampa, FL, USA
| | - Arun Singh
- Center for Brain and Behavior Research, University of South Dakota, Vermillion, SD, USA
- Division of Basic Biomedical Sciences, Sanford School of Medicine, University of South Dakota, Vermillion, SD, USA
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16
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Wu D, Zhao B, Xie H, Xu Y, Yin Z, Bai Y, Fan H, Zhang Q, Liu D, Hu T, Jiang Y, An Q, Zhang X, Yang A, Zhang J. Profiling the low-beta characteristics of the subthalamic nucleus in early- and late-onset Parkinson's disease. Front Aging Neurosci 2023; 15:1114466. [PMID: 36875708 PMCID: PMC9978704 DOI: 10.3389/fnagi.2023.1114466] [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: 12/02/2022] [Accepted: 01/30/2023] [Indexed: 02/18/2023] Open
Abstract
Objectives Low-beta oscillation (13-20 Hz) has rarely been studied in patients with early-onset Parkinson's disease (EOPD, age of onset ≤50 years). We aimed to explore the characteristics of low-beta oscillation in the subthalamic nucleus (STN) of patients with EOPD and investigate the differences between EOPD and late-onset Parkinson's disease (LOPD). Methods We enrolled 31 EOPD and 31 LOPD patients, who were matched using propensity score matching. Patients underwent bilateral STN deep brain stimulation (DBS). Local field potentials were recorded using intraoperative microelectrode recording. We analyzed the low-beta band parameters, including aperiodic/periodic components, beta burst, and phase-amplitude coupling. We compared low-beta band activity between EOPD and LOPD. Correlation analyses were performed between the low-beta parameters and clinical assessment results for each group. Results We found that the EOPD group had lower aperiodic parameters, including offset (p = 0.010) and exponent (p = 0.047). Low-beta burst analysis showed that EOPD patients had significantly higher average burst amplitude (p = 0.016) and longer average burst duration (p = 0.011). Furthermore, EOPD had higher proportion of long burst (500-650 ms, p = 0.008), while LOPD had higher proportion of short burst (200-350 ms, p = 0.007). There was a significant difference in phase-amplitude coupling values between low-beta phase and fast high frequency oscillation (300-460 Hz) amplitude (p = 0.019). Conclusion We found that low-beta activity in the STN of patients with EOPD had characteristics that varied when compared with LOPD, and provided electrophysiological evidence for different pathological mechanisms between the two types of PD. These differences need to be considered when applying adaptive DBS on patients of different ages.
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Affiliation(s)
- Delong Wu
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Baotian Zhao
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Hutao Xie
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Yichen Xu
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Zixiao Yin
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Yutong Bai
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,Beijing Key Laboratory of Neurostimulation, Beijing, China.,Department of Functional Neurosurgery, Beijing Neurosurgical Institute, Capital Medical University, Beijing, China
| | - Houyou Fan
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Quan Zhang
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Defeng Liu
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Tianqi Hu
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Yin Jiang
- Beijing Key Laboratory of Neurostimulation, Beijing, China.,Department of Functional Neurosurgery, Beijing Neurosurgical Institute, Capital Medical University, Beijing, China
| | - Qi An
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Xin Zhang
- Beijing Key Laboratory of Neurostimulation, Beijing, China.,Department of Functional Neurosurgery, Beijing Neurosurgical Institute, Capital Medical University, Beijing, China
| | - Anchao Yang
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,Beijing Key Laboratory of Neurostimulation, Beijing, China.,Department of Functional Neurosurgery, Beijing Neurosurgical Institute, Capital Medical University, Beijing, China
| | - Jianguo Zhang
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,Beijing Key Laboratory of Neurostimulation, Beijing, China.,Department of Functional Neurosurgery, Beijing Neurosurgical Institute, Capital Medical University, Beijing, China
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17
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Karimi F, Almeida Q, Jiang N. Large-scale frontoparietal theta, alpha, and beta phase synchronization: A set of EEG differential characteristics for freezing of gait in Parkinson's disease? Front Aging Neurosci 2022; 14:988037. [PMID: 36389071 PMCID: PMC9643859 DOI: 10.3389/fnagi.2022.988037] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Accepted: 10/03/2022] [Indexed: 08/18/2023] Open
Abstract
Freezing of gait (FOG) is a complex gait disturbance in Parkinson's disease (PD), during which the patient is not able to effectively initiate gait or continue walking. The mystery of the FOG phenomenon is still unsolved. Recent studies have revealed abnormalities in cortical activities associated with FOG, which highlights the importance of cortical and cortical-subcortical network dysfunction in PD patients with FOG. In this paper, phase-locking value (PLV) of eight frequency sub-bands between 0.05 Hz and 35 Hz over frontal, motor, and parietal areas [during an ankle dorsiflexion (ADF) task] is used to investigate EEG phase synchronization. PLV was investigated over both superficial and deeper networks by analyzing EEG signals preprocessed with and without Surface Laplacian (SL) spatial filter. Four groups of participants were included: PD patients with severe FOG (N = 5, 5 males), PD patients with mild FOG (N = 7, 6 males), PD patients without FOG (N = 14, 13 males), and healthy age-matched controls (N = 13, 10 males). Fifteen trials were recorded from each participant. At superficial layers, frontoparietal theta phase synchrony was a unique feature present in PD with FOG groups. At deeper networks, significant dominance of interhemispheric frontoparietal alpha phase synchrony in PD with FOG, in contrast to beta phase synchrony in PD without FOG, was identified. Alpha phase synchrony was more distributed in PD with severe FOG, with higher levels of frontoparietal alpha phase synchrony. In addition to FOG-related abnormalities in PLV analysis, phase-amplitude coupling (PAC) analysis was also performed on frequency bands with PLV abnormalities. PAC analysis revealed abnormal coupling between theta and low beta frequency bands in PD with severe FOG at the superficial layers over frontal areas. At deeper networks, theta and alpha frequency bands show high PAC over parietal areas in PD with severe FOG. Alpha and low beta also presented PAC over frontal areas in PD groups with FOG. The results introduced significant phase synchrony differences between PD with and without FOG and provided important insight into a possible unified underlying mechanism for FOG. These results thus suggest that PLV and PAC can potentially be used as EEG-based biomarkers for FOG.
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Affiliation(s)
- Fatemeh Karimi
- Department of Systems Design Engineering, University of Waterloo, Waterloo, ON, Canada
| | - Quincy Almeida
- Movement Disorders Research and Rehabilitation Consortium, Department of Kinesiology and Physical Education, Wilfrid Laurier University, Waterloo, ON, Canada
| | - Ning Jiang
- National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China
- Med-X Center for Manufacturing, Sichuan University, Chengdu, China
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18
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Sui Y, Yu H, Zhang C, Chen Y, Jiang C, Li L. Deep brain-machine interfaces: sensing and modulating the human deep brain. Natl Sci Rev 2022; 9:nwac212. [PMID: 36644311 PMCID: PMC9834907 DOI: 10.1093/nsr/nwac212] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 10/02/2022] [Accepted: 10/04/2022] [Indexed: 01/18/2023] Open
Abstract
Different from conventional brain-machine interfaces that focus more on decoding the cerebral cortex, deep brain-machine interfaces enable interactions between external machines and deep brain structures. They sense and modulate deep brain neural activities, aiming at function restoration, device control and therapeutic improvements. In this article, we provide an overview of multiple deep brain recording and stimulation techniques that can serve as deep brain-machine interfaces. We highlight two widely used interface technologies, namely deep brain stimulation and stereotactic electroencephalography, for technical trends, clinical applications and brain connectivity research. We discuss the potential to develop closed-loop deep brain-machine interfaces and achieve more effective and applicable systems for the treatment of neurological and psychiatric disorders.
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Affiliation(s)
- Yanan Sui
- National Engineering Research Center of Neuromodulation, Tsinghua University, Beijing 100084, China
| | - Huiling Yu
- National Engineering Research Center of Neuromodulation, Tsinghua University, Beijing 100084, China
| | - Chen Zhang
- National Engineering Research Center of Neuromodulation, Tsinghua University, Beijing 100084, China
| | - Yue Chen
- National Engineering Research Center of Neuromodulation, Tsinghua University, Beijing 100084, China
| | - Changqing Jiang
- National Engineering Research Center of Neuromodulation, Tsinghua University, Beijing 100084, China
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19
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Nwogo RO, Kammermeier S, Singh A. Abnormal neural oscillations during gait and dual-task in Parkinson’s disease. Front Syst Neurosci 2022; 16:995375. [PMID: 36185822 PMCID: PMC9522469 DOI: 10.3389/fnsys.2022.995375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Accepted: 08/23/2022] [Indexed: 12/03/2022] Open
Abstract
Gait dysfunctions are debilitating motor symptoms of Parkinson’s disease (PD) and may result in frequent falling with health complications. The contribution of the motor-cognitive network to gait disturbance can be studied more thoroughly by challenging motor-cognitive dual-task gait performances. Gait is a complex motor task that requires an appropriate contribution from motor and cognitive networks, reflected in frequency modulations among several cortical and subcortical networks. Electrophysiological recordings by scalp electroencephalography and implanted deep brain stimulation (DBS) electrodes have unveiled modulations of specific oscillatory patterns in the cortical-subcortical circuits in PD. In this review, we summarize oscillatory contributions of the cortical, basal ganglia, mesencephalic locomotor, and cerebellar regions during gait and dual-task activities in PD. We detail the involvement of the cognitive network in dual-task settings and compare how abnormal oscillations in the specific frequency bands in the cortical and subcortical regions correlate with gait deficits in PD, particularly freezing of gait (FOG). We suggest that altered neural oscillations in different frequencies can cause derangements in broader brain networks, so neuromodulation and pharmacological therapies should be considered to normalize those network oscillations to improve challenged gait and dual-task motor functions in PD. Specifically, the theta and beta bands in premotor cortical areas, subthalamic nucleus, as well as alpha band activity in the brainstem prepontine nucleus, modulate under clinically effective levodopa and DBS therapies, improving gait and dual-task performance in PD with FOG, compared to PD without FOG and age-matched healthy control groups.
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Affiliation(s)
- Rachel O. Nwogo
- Division of Basic Biomedical Sciences, Sanford School of Medicine, University of South Dakota, Vermillion, SD, United States
| | | | - Arun Singh
- Division of Basic Biomedical Sciences, Sanford School of Medicine, University of South Dakota, Vermillion, SD, United States
- *Correspondence: Arun Singh,
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