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Nucci L, Miraglia F, Pappalettera C, Rossini PM, Vecchio F. Exploring the complexity of EEG patterns in Parkinson's disease. GeroScience 2024:10.1007/s11357-024-01277-y. [PMID: 38997574 DOI: 10.1007/s11357-024-01277-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Accepted: 07/02/2024] [Indexed: 07/14/2024] Open
Abstract
Parkinson's disease (PD) is a progressive neurodegenerative disorder primarily associated with motor dysfunctions. By the time of definitive diagnosis, about 60% of dopaminergic neurons have already been lost; moreover, even if dopaminergic drugs are highly effective in symptoms control, they only help maintaining a near-healthy condition when started as soon as possible. Therefore, interest in identifying early biomarkers of PD has grown in recent years, especially using neurophysiological techniques such as electroencephalography (EEG). This study aims to investigate brain complexity differences in PD patients compared to healthy controls, focusing on the beta band using approximate entropy (ApEn) analysis of resting-state EEG recordings. Sixty participants were recruited, including 25 PD patients and 35 healthy elderly subjects, matched for age and gender. EEG were recorded for each participant and ApEn values were computed in the beta 1 (13-20 Hz) and beta 2 (20-30 Hz) frequency bands for each EEG-channel and for ROIs. PD patients showed statistically lower ApEn values compared to controls in both beta 1 and beta 2 bands. Regarding electrodes analysis, beta 1 band alterations were found in frontocentral areas, while beta 2 band alterations were observed in centroparietal and frontocentral areas. Considering ROIs, statistically lower ApEn values for PD patients has been reported in central and parietal ROIs in the beta 2 band. Complexity reduction in these areas may underlie beta oscillatory activity dysfunction, reflecting impaired cortical mechanisms associated with motor dysfunction in PD. The results suggest that ApEn analysis of resting EEG activity may serve as a potential tool for early PD detection. Further studies are necessary to validate this approach in PD diagnosis and rehabilitation planning.
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Affiliation(s)
- Lorenzo Nucci
- Brain Connectivity Laboratory, Department of Neuroscience and Neurorehabilitation, IRCCS San Raffaele Roma, Rome, 00166, Italy
| | - Francesca Miraglia
- Brain Connectivity Laboratory, Department of Neuroscience and Neurorehabilitation, IRCCS San Raffaele Roma, Rome, 00166, Italy.
- Department of Theoretical and Applied Sciences, eCampus University, Novedrate, Como, Italy.
| | - Chiara Pappalettera
- Brain Connectivity Laboratory, Department of Neuroscience and Neurorehabilitation, IRCCS San Raffaele Roma, Rome, 00166, Italy
- Department of Theoretical and Applied Sciences, eCampus University, Novedrate, Como, Italy
| | - Paolo Maria Rossini
- Brain Connectivity Laboratory, Department of Neuroscience and Neurorehabilitation, IRCCS San Raffaele Roma, Rome, 00166, Italy
| | - Fabrizio Vecchio
- Brain Connectivity Laboratory, Department of Neuroscience and Neurorehabilitation, IRCCS San Raffaele Roma, Rome, 00166, Italy
- Department of Theoretical and Applied Sciences, eCampus University, Novedrate, Como, Italy
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2
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Bayman E, Chee K, Mendlen M, Denman DJ, Tien RN, Ojemann S, Kramer DR, Thompson JA. Subthalamic nucleus synchronization between beta band local field potential and single-unit activity in Parkinson's disease. Physiol Rep 2024; 12:e16001. [PMID: 38697943 PMCID: PMC11065686 DOI: 10.14814/phy2.16001] [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: 08/24/2023] [Revised: 12/24/2023] [Accepted: 03/26/2024] [Indexed: 05/05/2024] Open
Abstract
Local field potential (LFP) oscillations in the beta band (13-30 Hz) in the subthalamic nucleus (STN) of Parkinson's disease patients have been implicated in disease severity and treatment response. The relationship between single-neuron activity in the STN and regional beta power changes remains unclear. We used spike-triggered average (STA) to assess beta synchronization in STN. Beta power and STA magnitude at the beta frequency range were compared in three conditions: STN versus other subcortical structures, dorsal versus ventral STN, and high versus low beta power STN recordings. Magnitude of STA-LFP was greater within the STN compared to extra-STN structures along the trajectory path, despite no difference in percentage of the total power. Within the STN, there was a higher percent beta power in dorsal compared to ventral STN but no difference in STA-LFP magnitude. Further refining the comparison to high versus low beta peak power recordings inside the STN to evaluate if single-unit activity synchronized more strongly with beta band activity in areas of high beta power resulted in a significantly higher STA magnitude for areas of high beta power. Overall, these results suggest that STN single units strongly synchronize to beta activity, particularly units in areas of high beta power.
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Affiliation(s)
- Eric Bayman
- Department of NeurosurgeryUniversity of Colorado Anschutz Medical CampusAuroraColoradoUSA
| | - Keanu Chee
- Department of NeurosurgeryUniversity of Colorado Anschutz Medical CampusAuroraColoradoUSA
| | - Madelyn Mendlen
- Department of NeurosurgeryUniversity of Colorado Anschutz Medical CampusAuroraColoradoUSA
| | - Daniel J. Denman
- Department of Neurophysiology and BiophysicsUniversity of Colorado Anschutz Medical CampusAuroraColoradoUSA
| | - Rex N. Tien
- Department of NeurosurgeryUniversity of Colorado Anschutz Medical CampusAuroraColoradoUSA
| | - Steven Ojemann
- Department of NeurosurgeryUniversity of Colorado Anschutz Medical CampusAuroraColoradoUSA
| | - Daniel R. Kramer
- Department of NeurosurgeryUniversity of Colorado Anschutz Medical CampusAuroraColoradoUSA
| | - John A. Thompson
- Department of NeurosurgeryUniversity of Colorado Anschutz Medical CampusAuroraColoradoUSA
- Department of NeurologyUniversity of Colorado Anschutz Medical CampusAuroraColoradoUSA
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3
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Davidson B, Milosevic L, Kondrataviciute L, Kalia LV, Kalia SK. Neuroscience fundamentals relevant to neuromodulation: Neurobiology of deep brain stimulation in Parkinson's disease. Neurotherapeutics 2024; 21:e00348. [PMID: 38579455 PMCID: PMC11000190 DOI: 10.1016/j.neurot.2024.e00348] [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: 11/15/2023] [Revised: 03/05/2024] [Accepted: 03/14/2024] [Indexed: 04/07/2024] Open
Abstract
Deep Brain Stimulation (DBS) has become a pivotal therapeutic approach for Parkinson's Disease (PD) and various neuropsychiatric conditions, impacting over 200,000 patients. Despite its widespread application, the intricate mechanisms behind DBS remain a subject of ongoing investigation. This article provides an overview of the current knowledge surrounding the local, circuit, and neurobiochemical effects of DBS, focusing on the subthalamic nucleus (STN) as a key target in PD management. The local effects of DBS, once thought to mimic a reversible lesion, now reveal a more nuanced interplay with myelinated axons, neurotransmitter release, and the surrounding microenvironment. Circuit effects illuminate the modulation of oscillatory activities within the basal ganglia and emphasize communication between the STN and the primary motor cortex. Neurobiochemical effects, encompassing changes in dopamine levels and epigenetic modifications, add further complexity to the DBS landscape. Finally, within the context of understanding the mechanisms of DBS in PD, the article highlights the controversial question of whether DBS exerts disease-modifying effects in PD. While preclinical evidence suggests neuroprotective potential, clinical trials such as EARLYSTIM face challenges in assessing long-term disease modification due to enrollment timing and methodology limitations. The discussion underscores the need for robust biomarkers and large-scale prospective trials to conclusively determine DBS's potential as a disease-modifying therapy in PD.
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Affiliation(s)
- Benjamin Davidson
- Division of Neurosurgery, Department of Surgery, University of Toronto, Canada.
| | - Luka Milosevic
- KITE, Toronto, Canada; CRANIA, Toronto, Canada; Krembil Research Institute, University Health Network Toronto, Canada; Institute of Biomedical Engineering, University of Toronto, Canada
| | - Laura Kondrataviciute
- CRANIA, Toronto, Canada; Krembil Research Institute, University Health Network Toronto, Canada; Institute of Biomedical Engineering, University of Toronto, Canada
| | - Lorraine V Kalia
- CRANIA, Toronto, Canada; Krembil Research Institute, University Health Network Toronto, Canada; Division of Neurology, Department of Medicine, University of Toronto, Canada
| | - Suneil K Kalia
- Division of Neurosurgery, Department of Surgery, University of Toronto, Canada; KITE, Toronto, Canada; CRANIA, Toronto, Canada; Krembil Research Institute, University Health Network Toronto, Canada
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Abdulbaki A, Doll T, Helgers S, Heissler HE, Voges J, Krauss JK, Schwabe K, Alam M. Subthalamic Nucleus Deep Brain Stimulation Restores Motor and Sensorimotor Cortical Neuronal Oscillatory Activity in the Free-Moving 6-Hydroxydopamine Lesion Rat Parkinson Model. Neuromodulation 2024; 27:489-499. [PMID: 37002052 DOI: 10.1016/j.neurom.2023.01.014] [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: 08/10/2022] [Revised: 12/28/2022] [Accepted: 01/04/2023] [Indexed: 03/31/2023]
Abstract
OBJECTIVES Enhanced beta oscillations in cortical-basal ganglia (BG) thalamic circuitries have been linked to clinical symptoms of Parkinson's disease. Deep brain stimulation (DBS) of the subthalamic nucleus (STN) reduces beta band activity in BG regions, whereas little is known about activity in cortical regions. In this study, we investigated the effect of STN DBS on the spectral power of oscillatory activity in the motor cortex (MCtx) and sensorimotor cortex (SMCtx) by recording via an electrocorticogram (ECoG) array in free-moving 6-hydroxydopamine (6-OHDA) lesioned rats and sham-lesioned controls. MATERIALS AND METHODS Male Sprague-Dawley rats (250-350 g) were injected either with 6-OHDA or with saline in the right medial forebrain bundle, under general anesthesia. A stimulation electrode was then implanted in the ipsilateral STN, and an ECoG array was placed subdurally above the MCtx and SMCtx areas. Six days after the second surgery, the free-moving rats were individually recorded in three conditions: 1) basal activity, 2) during STN DBS, and 3) directly after STN DBS. RESULTS In 6-OHDA-lesioned rats (N = 8), the relative power of theta band activity was reduced, whereas activity of broad-range beta band (12-30 Hz) along with two different subbeta bands, that is, low (12-30 Hz) and high (20-30 Hz) beta band and gamma band, was higher in MCtx and SMCtx than in sham-lesioned controls (N = 7). This was, to some extent, reverted toward control level by STN DBS during and after stimulation. No major differences were found between contacts of the electrode grid or between MCtx and SMCtx. CONCLUSION Loss of nigrostriatal dopamine leads to abnormal oscillatory activity in both MCtx and SMCtx, which is compensated by STN stimulation, suggesting that parkinsonism-related oscillations in the cortex and BG are linked through their anatomic connections.
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Affiliation(s)
- Arif Abdulbaki
- Hannover Medical School, Department of Neurosurgery, Hannover, Germany.
| | - Theodor Doll
- Fraunhofer Institute for Toxicology and Experimental Medicine, Hannover, Germany
| | - Simeon Helgers
- Hannover Medical School, Department of Neurosurgery, Hannover, Germany
| | - Hans E Heissler
- Hannover Medical School, Department of Neurosurgery, Hannover, Germany
| | - Jürgen Voges
- Department of Stereotactic Neurosurgery, University Hospital Magdeburg, Magdeburg, Germany
| | - Joachim K Krauss
- Hannover Medical School, Department of Neurosurgery, Hannover, Germany
| | - Kerstin Schwabe
- Hannover Medical School, Department of Neurosurgery, Hannover, Germany
| | - Mesbah Alam
- Hannover Medical School, Department of Neurosurgery, Hannover, Germany
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Pardo-Valencia J, Fernández-García C, Alonso-Frech F, Foffani G. Oscillatory vs. non-oscillatory subthalamic beta activity in Parkinson's disease. J Physiol 2024; 602:373-395. [PMID: 38084073 DOI: 10.1113/jp284768] [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: 04/02/2023] [Accepted: 11/13/2023] [Indexed: 01/16/2024] Open
Abstract
Parkinson's disease is characterized by exaggerated beta activity (13-35 Hz) in cortico-basal ganglia motor loops. Beta activity includes both periodic fluctuations (i.e. oscillatory activity) and aperiodic fluctuations reflecting spiking activity and excitation/inhibition balance (i.e. non-oscillatory activity). However, the relative contribution, dopamine dependency and clinical correlations of oscillatory vs. non-oscillatory beta activity remain unclear. We recorded, modelled and analysed subthalamic local field potentials in parkinsonian patients at rest while off or on medication. Autoregressive modelling with additive 1/f noise clarified the relationships between measures of beta activity in the time domain (i.e. amplitude and duration of beta bursts) or in the frequency domain (i.e. power and sharpness of the spectral peak) and oscillatory vs. non-oscillatory activity: burst duration and spectral sharpness are specifically sensitive to oscillatory activity, whereas burst amplitude and spectral power are ambiguously sensitive to both oscillatory and non-oscillatory activity. Our experimental data confirmed the model predictions and assumptions. We subsequently analysed the effect of levodopa, obtaining strong-to-extreme Bayesian evidence that oscillatory beta activity is reduced in patients on vs. off medication, with moderate evidence for absence of modulation of the non-oscillatory component. Finally, specifically the oscillatory component of beta activity correlated with the rate of motor progression of the disease. Methodologically, these results provide an integrative understanding of beta-based biomarkers relevant for adaptive deep brain stimulation. Biologically, they suggest that primarily the oscillatory component of subthalamic beta activity is dopamine dependent and may play a role not only in the pathophysiology but also in the progression of Parkinson's disease. KEY POINTS: Beta activity in Parkinson's disease includes both true periodic fluctuations (i.e. oscillatory activity) and aperiodic fluctuations reflecting spiking activity and synaptic balance (i.e. non-oscillatory activity). The relative contribution, dopamine dependency and clinical correlations of oscillatory vs. non-oscillatory beta activity remain unclear. Burst duration and spectral sharpness are specifically sensitive to oscillatory activity, while burst amplitude and spectral power are ambiguously sensitive to both oscillatory and non-oscillatory activity. Only the oscillatory component of subthalamic beta activity is dopamine-dependent. Stronger beta oscillatory activity correlates with faster motor progression of the disease.
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Affiliation(s)
- Jesús Pardo-Valencia
- HM CINAC (Centro Integral de Neurociencias Abarca Campal), Hospital Universitario HM Puerta del Sur, HM Hospitales, Madrid, Spain
- Escuela Técnica Superior de Ingenieros de Telecomunicación, Universidad Politécnica de Madrid, Madrid, Spain
| | - Carla Fernández-García
- HM CINAC (Centro Integral de Neurociencias Abarca Campal), Hospital Universitario HM Puerta del Sur, HM Hospitales, Madrid, Spain
| | - Fernando Alonso-Frech
- HM CINAC (Centro Integral de Neurociencias Abarca Campal), Hospital Universitario HM Puerta del Sur, HM Hospitales, Madrid, Spain
- Department of Neurology, San Carlos Research Health Intitute (IdISSC), Hospital Clínico San Carlos, Madrid, Spain
| | - Guglielmo Foffani
- HM CINAC (Centro Integral de Neurociencias Abarca Campal), Hospital Universitario HM Puerta del Sur, HM Hospitales, Madrid, Spain
- Hospital Nacional de Parapléjicos, SESCAM, Toledo, Spain
- Instituto de Salud Carlos III, CIBERNED, Madrid, Spain
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6
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Conti M, Guerra A, Pierantozzi M, Bovenzi R, D'Onofrio V, Simonetta C, Cerroni R, Liguori C, Placidi F, Mercuri NB, Di Giuliano F, Schirinzi T, Stefani A. Band-Specific Altered Cortical Connectivity in Early Parkinson's Disease and its Clinical Correlates. Mov Disord 2023; 38:2197-2208. [PMID: 37860930 DOI: 10.1002/mds.29615] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Revised: 08/25/2023] [Accepted: 09/11/2023] [Indexed: 10/21/2023] Open
Abstract
BACKGROUND Functional connectivity (FC) has shown promising results in assessing the pathophysiology and identifying early biomarkers of neurodegenerative disorders, such as Parkinson's disease (PD). OBJECTIVES In this study, we aimed to assess possible resting-state FC abnormalities in early-stage PD patients using high-density electroencephalography (EEG) and to detect their clinical relationship with motor and non-motor PD symptoms. METHODS We enrolled 26 early-stage levodopa naïve PD patients and a group of 20 healthy controls (HC). Data were recorded with 64-channels EEG system and a source-reconstruction method was used to identify brain-region activity. FC was calculated using the weighted phase-lag index in θ, α, and β bands. Additionally, we quantified the unbalancing between β and lower frequencies through a novel index (β-functional ratio [FR]). Statistical analysis was conducted using a network-based statistical approach. RESULTS PD patients showed hypoconnected networks in θ and α band, involving prefrontal-limbic-temporal and frontoparietal areas, respectively, and a hyperconnected network in the β frequency band, involving sensorimotor-frontal areas. The θ FC network was negatively related to Non-Motor Symptoms Scale scores and α FC to the Movement Disorder Society-Sponsored Revision of the Unified Parkinson's Disease Rating Scale part III gait subscore, whereas β FC and β-FR network were positively linked to the bradykinesia subscore. Changes in θ FC and β-FR showed substantial reliability and high accuracy, precision, sensitivity, and specificity in discriminating PD and HC. CONCLUSIONS Frequency-specific FC changes in PD likely reflect the dysfunction of distinct cortical networks, which occur from the early stage of the disease. These abnormalities are involved in the pathophysiology of specific motor and non-motor PD symptoms, including gait, bradykinesia, mood, and cognition. © 2023 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Matteo Conti
- Parkinson Centre, Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy
| | - Andrea Guerra
- Parkinson and Movement Disorders Unit, Study Centre on Neurodegeneration (CESNE), Department of Neuroscience, University of Padova, Padua, Italy
| | - Mariangela Pierantozzi
- Parkinson Centre, Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy
- Neurology Unit, Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy
| | - Roberta Bovenzi
- Parkinson Centre, Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy
| | - Valentina D'Onofrio
- Parkinson and Movement Disorders Unit, Study Centre on Neurodegeneration (CESNE), Department of Neuroscience, University of Padova, Padua, Italy
| | - Clara Simonetta
- Neurology Unit, Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy
| | - Rocco Cerroni
- Parkinson Centre, Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy
| | - Claudio Liguori
- Neurology Unit, Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy
| | - Fabio Placidi
- Neurology Unit, Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy
| | - Nicola Biagio Mercuri
- Neurology Unit, Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy
| | - Francesca Di Giuliano
- Neuroradiology Unit, Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy
| | - Tommaso Schirinzi
- Neurology Unit, Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy
| | - Alessandro Stefani
- Parkinson Centre, Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy
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Sil T, Hanafi I, Eldebakey H, Palmisano C, Volkmann J, Muthuraman M, Reich MM, Peach R. Wavelet-Based Bracketing, Time-Frequency Beta Burst Detection: New Insights in Parkinson's Disease. Neurotherapeutics 2023; 20:1767-1778. [PMID: 37819489 PMCID: PMC10684463 DOI: 10.1007/s13311-023-01447-4] [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] [Accepted: 09/25/2023] [Indexed: 10/13/2023] Open
Abstract
Studies have shown that beta band activity is not tonically elevated but comprises exaggerated phasic bursts of varying durations and magnitudes, for Parkinson's disease (PD) patients. Current methods for detecting beta bursts target a single frequency peak in beta band, potentially ignoring bursts in the wider beta band. In this study, we propose a new robust framework for beta burst identification across wide frequency ranges. Chronic local field potential at-rest recordings were obtained from seven PD patients implanted with Medtronic SenSight™ deep brain stimulation (DBS) electrodes. The proposed method uses wavelet decomposition to compute the time-frequency spectrum and identifies bursts spanning multiple frequency bins by thresholding, offering an additional burst measure, ∆f, that captures the width of a burst in the frequency domain. Analysis included calculating burst duration, magnitude, and ∆f and evaluating the distribution and likelihood of bursts between the low beta (13-20 Hz) and high beta (21-35 Hz). Finally, the results of the analysis were correlated to motor impairment (MDS-UPDRS III) med off scores. We found that low beta bursts with longer durations and larger width in the frequency domain (∆f) were positively correlated, while high beta bursts with longer durations and larger ∆f were negatively correlated with motor impairment. The proposed method, finding clear differences between bursting behavior in high and low beta bands, has clearly demonstrated the importance of considering wide frequency bands for beta burst behavior with implications for closed-loop DBS paradigms.
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Affiliation(s)
- Tanmoy Sil
- Department of Neurology, University Hospital Würzburg (UKW), Josef-Schneider-Str. 11, 97080, Würzburg, Germany
| | - Ibrahem Hanafi
- Department of Neurology, University Hospital Würzburg (UKW), Josef-Schneider-Str. 11, 97080, Würzburg, Germany
| | - Hazem Eldebakey
- Department of Neurology, University Hospital Würzburg (UKW), Josef-Schneider-Str. 11, 97080, Würzburg, Germany
| | - Chiara Palmisano
- Department of Neurology, University Hospital Würzburg (UKW), Josef-Schneider-Str. 11, 97080, Würzburg, Germany
| | - Jens Volkmann
- Department of Neurology, University Hospital Würzburg (UKW), Josef-Schneider-Str. 11, 97080, Würzburg, Germany
| | - Muthuraman Muthuraman
- Department of Neurology, University Hospital Würzburg (UKW), Josef-Schneider-Str. 11, 97080, Würzburg, Germany.
| | - Martin M Reich
- Department of Neurology, University Hospital Würzburg (UKW), Josef-Schneider-Str. 11, 97080, Würzburg, Germany
| | - Robert Peach
- Department of Neurology, University Hospital Würzburg (UKW), Josef-Schneider-Str. 11, 97080, Würzburg, Germany
- Department of Brain Sciences, Imperial College London, London, UK
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Ricciardi L, Apps M, Little S. Uncovering the neurophysiology of mood, motivation and behavioral symptoms in Parkinson's disease through intracranial recordings. NPJ Parkinsons Dis 2023; 9:136. [PMID: 37735477 PMCID: PMC10514046 DOI: 10.1038/s41531-023-00567-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Accepted: 08/07/2023] [Indexed: 09/23/2023] Open
Abstract
Neuropsychiatric mood and motivation symptoms (depression, anxiety, apathy, impulse control disorders) in Parkinson's disease (PD) are highly disabling, difficult to treat and exacerbated by current medications and deep brain stimulation therapies. High-resolution intracranial recording techniques have the potential to undercover the network dysfunction and cognitive processes that drive these symptoms, towards a principled re-tuning of circuits. We highlight intracranial recording as a valuable tool for mapping and desegregating neural networks and their contribution to mood, motivation and behavioral symptoms, via the ability to dissect multiplexed overlapping spatial and temporal neural components. This technique can be powerfully combined with behavioral paradigms and emerging computational techniques to model underlying latent behavioral states. We review the literature of intracranial recording studies investigating mood, motivation and behavioral symptomatology with reference to 1) emotional processing, 2) executive control 3) subjective valuation (reward & cost evaluation) 4) motor control and 5) learning and updating. This reveals associations between different frequency specific network activities and underlying cognitive processes of reward decision making and action control. If validated, these signals represent potential computational biomarkers of motivational and behavioural states and could lead to principled therapy development for mood, motivation and behavioral symptoms in PD.
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Affiliation(s)
- Lucia Ricciardi
- Neurosciences Research Centre, Molecular and Clinical Sciences Research Institute, St George's University of London, London, UK.
| | - Matthew Apps
- Centre for Human Brain Health, School of Psychology, University of Birmingham, Birmingham, UK
| | - Simon Little
- Movement Disorders and Neuromodulation Centre, University of California San Francisco, San Francisco, CA, USA
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Alva L, Bernasconi E, Torrecillos F, Fischer P, Averna A, Bange M, Mostofi A, Pogosyan A, Ashkan K, Muthuraman M, Groppa S, Pereira EA, Tan H, Tinkhauser G. Clinical neurophysiological interrogation of motor slowing: A critical step towards tuning adaptive deep brain stimulation. Clin Neurophysiol 2023; 152:43-56. [PMID: 37285747 PMCID: PMC7615935 DOI: 10.1016/j.clinph.2023.04.013] [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: 08/23/2022] [Revised: 03/07/2023] [Accepted: 04/18/2023] [Indexed: 06/09/2023]
Abstract
OBJECTIVE Subthalamic nucleus (STN) beta activity (13-30 Hz) is the most accepted biomarker for adaptive deep brain stimulation (aDBS) for Parkinson's disease (PD). We hypothesize that different frequencies within the beta range may exhibit distinct temporal dynamics and, as a consequence, different relationships to motor slowing and adaptive stimulation patterns. We aim to highlight the need for an objective method to determine the aDBS feedback signal. METHODS STN LFPs were recorded in 15 PD patients at rest and while performing a cued motor task. The impact of beta bursts on motor performance was assessed for different beta candidate frequencies: the individual frequency strongest associated with motor slowing, the individual beta peak frequency, the frequency most modulated by movement execution, as well as the entire-, low- and high beta band. How these candidate frequencies differed in their bursting dynamics and theoretical aDBS stimulation patterns was further investigated. RESULTS The individual motor slowing frequency often differs from the individual beta peak or beta-related movement-modulation frequency. Minimal deviations from a selected target frequency as feedback signal for aDBS leads to a substantial drop in the burst overlapping and in the alignment of the theoretical onset of stimulation triggers (to ∼ 75% for 1 Hz, to ∼ 40% for 3 Hz deviation). CONCLUSIONS Clinical-temporal dynamics within the beta frequency range are highly diverse and deviating from a reference biomarker frequency can result in altered adaptive stimulation patterns. SIGNIFICANCE A clinical-neurophysiological interrogation could be helpful to determine the patient-specific feedback signal for aDBS.
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Affiliation(s)
- Laura Alva
- Department of Neurology, Bern University Hospital and University of Bern, Bern, Switzerland
| | - Elena Bernasconi
- Department of Neurology, Bern University Hospital and University of Bern, Bern, Switzerland
| | - Flavie Torrecillos
- MRC Brain Network Dynamics Unit, University of Oxford, Oxford, United Kingdom; Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom
| | - Petra Fischer
- School of Physiology, Pharmacology & Neuroscience, University of Bristol, University Walk, BS8 1TD Bristol, United Kingdom
| | - Alberto Averna
- Department of Neurology, Bern University Hospital and University of Bern, Bern, Switzerland
| | - Manuel Bange
- Movement Disorders and Neurostimulation, Department of Neurology, University Medical Center of the Johannes Gutenberg University Mainz, 55131 Mainz, Germany
| | - Abteen Mostofi
- Neurosciences Research Centre, Molecular and Clinical Sciences Research Institute, St George's, University of London, London SW17 0RE, United Kingdom
| | - Alek Pogosyan
- MRC Brain Network Dynamics Unit, University of Oxford, Oxford, United Kingdom; Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom
| | - Keyoumars Ashkan
- Department of Neurosurgery, King's College Hospital, King's College London, SE59RS, United Kingdom
| | - Muthuraman Muthuraman
- Movement Disorders and Neurostimulation, Department of Neurology, University Medical Center of the Johannes Gutenberg University Mainz, 55131 Mainz, Germany
| | - Sergiu Groppa
- Movement Disorders and Neurostimulation, Department of Neurology, University Medical Center of the Johannes Gutenberg University Mainz, 55131 Mainz, Germany
| | - Erlick A Pereira
- Neurosciences Research Centre, Molecular and Clinical Sciences Research Institute, St George's, University of London, London SW17 0RE, United Kingdom
| | - Huiling Tan
- MRC Brain Network Dynamics Unit, University of Oxford, Oxford, United Kingdom; Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom
| | - Gerd Tinkhauser
- Department of Neurology, Bern University Hospital and University of Bern, Bern, Switzerland.
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10
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Qin Y, Qiu S, Liu X, Xu S, Wang X, Guo X, Tang Y, Li H. Lesions causing post-stroke spasticity localize to a common brain network. Front Aging Neurosci 2022; 14:1011812. [PMID: 36389077 PMCID: PMC9642815 DOI: 10.3389/fnagi.2022.1011812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Accepted: 10/07/2022] [Indexed: 11/25/2022] Open
Abstract
Objective The efficacy of clinical interventions for post-stroke spasticity (PSS) has been consistently unsatisfactory, probably because lesions causing PSS may occur at different locations in the brain, leaving the neuroanatomical substrates of spasticity unclear. Here, we investigated whether heterogeneous lesions causing PSS were localized to a common brain network and then identified the key nodes in this network. Methods We used 32 cases of PSS and the Human Connectome dataset (n = 1,000), using a lesion network mapping method to identify the brain regions that were associated with each lesion in patients with PSS. Functional connectivity maps of all lesions were overlaid to identify common connectivity. Furthermore, a split-half replication method was used to evaluate reproducibility. Then, the lesion network mapping results were compared with those of patients with post-stroke non-spastic motor dysfunction (n = 29) to assess the specificity. Next, both sensitive and specific regions associated with PSS were identified using conjunction analyses, and the correlation between these regions and PSS was further explored by correlation analysis. Results The lesions in all patients with PSS were located in different cortical and subcortical locations. However, at least 93% of these lesions (29/32) had functional connectivity with the bilateral putamen and globus pallidus. These connections were highly repeatable and specific, as compared to those in non-spastic patients. In addition, the functional connectivity between lesions and bilateral putamen and globus pallidus in patients with PSS was positively correlated with the degree of spasticity. Conclusion We identified that lesions causing PSS were localized to a common functional connectivity network defined by connectivity to the bilateral putamen and globus pallidus. This network may best cover the locations of lesions causing PSS. The putamen and globus pallidus may be potential key regions in PSS. Our findings complement previous neuroimaging studies on PSS, contributing to identifying patients with stroke at high risk for spasticity at an early stage, and may point to PSS-specific brain stimulation targets.
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Affiliation(s)
- Yin Qin
- Department of Rehabilitation Medicine, The 900th Hospital of Joint Logistic Support Force, People’s Liberation Army (PLA), Fuzhou, China
- Department of Rehabilitation Medicine, Fuzong Clinical Medical College of Fujian Medical University, Fuzhou, China
- *Correspondence: Yin Qin,
| | - Shuting Qiu
- Department of Rehabilitation Medicine, The 900th Hospital of Joint Logistic Support Force, People’s Liberation Army (PLA), Fuzhou, China
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Xiaoying Liu
- Department of Rehabilitation Medicine, The 900th Hospital of Joint Logistic Support Force, People’s Liberation Army (PLA), Fuzhou, China
- Department of Rehabilitation Medicine, Fuzong Clinical Medical College of Fujian Medical University, Fuzhou, China
| | - Shangwen Xu
- Department of Radiology, The 900th Hospital of Joint Logistic Support Force, People’s Liberation Army (PLA), Fuzhou, China
| | - Xiaoyang Wang
- Department of Radiology, The 900th Hospital of Joint Logistic Support Force, People’s Liberation Army (PLA), Fuzhou, China
| | - Xiaoping Guo
- Department of Rehabilitation Medicine, The 900th Hospital of Joint Logistic Support Force, People’s Liberation Army (PLA), Fuzhou, China
- Department of Rehabilitation Medicine, Fuzong Clinical Medical College of Fujian Medical University, Fuzhou, China
| | - Yuting Tang
- Department of Rehabilitation Medicine, The 900th Hospital of Joint Logistic Support Force, People’s Liberation Army (PLA), Fuzhou, China
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Hui Li
- Department of Radiology, The 900th Hospital of Joint Logistic Support Force, People’s Liberation Army (PLA), Fuzhou, China
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11
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Fim Neto A, de Luccas JB, Bianqueti BL, da Silva LR, Almeida TP, Takahata AK, Teixeira MJ, Figueiredo EG, Nasuto SJ, Rocha MSG, Soriano DC, Godinho F. Subthalamic low beta bursts differ in Parkinson's disease phenotypes. Clin Neurophysiol 2022; 140:45-58. [PMID: 35728405 DOI: 10.1016/j.clinph.2022.05.013] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 05/20/2022] [Accepted: 05/26/2022] [Indexed: 11/24/2022]
Abstract
OBJECTIVE Parkinson's disease (PD) patients may be categorized into tremor-dominant (TD) and postural-instability and gait disorder (PIGD) motor phenotypes, but the dynamical aspects of subthalamic nucleus local field potentials (STN-LFP) and the neural correlates of this phenotypical classification remain unclear. METHODS 35 STN-LFP (20 PIGD and 15 TD) were investigated through continuous wavelet transform and machine-learning-based methods. The beta oscillation - the main band associated with motor impairment in PD - dynamics was characterized through beta burst parameters across phenotypes and burst intervals under specific proposed criteria for optimal burst threshold definition. RESULTS Low-frequency (13-22 Hz) beta burst probability was the best predictor for PD phenotypes (75% accuracy). PIGD patients presented higher average burst duration (p = 0.018), while TD patients exhibited higher burst probability (p = 0.014). Categorization into shorter and longer than 400 ms bursts led to significant interaction between burst length categories and the phenotypes (p < 0.050) as revealed by mixed-effects models. Long burst durations and short bursts probability positively correlated, respectively, with rigidity-bradykinesia (p = 0.029) and tremor (p = 0.038) scores. CONCLUSIONS Subthalamic low-frequency beta bursts differed between TD and PIGD phenotypes and correlated with motor symptoms. SIGNIFICANCE These findings improve the PD phenotypes' electrophysiological characterization and may define new criteria for adaptive deep brain stimulation.
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Affiliation(s)
- Arnaldo Fim Neto
- Center for Engineering, Modeling and Applied Social Sciences, Federal University of ABC, São Bernardo do Campo, Brazil; Brazilian Institute of Neuroscience and Neurotechnology, Campinas, São Paulo, Brazil; Department of Cosmic Rays and Chronology, Institute of Physics, University of Campinas, Campinas, Brazil.
| | - Julia Baldi de Luccas
- Center for Engineering, Modeling and Applied Social Sciences, Federal University of ABC, São Bernardo do Campo, Brazil; Brazilian Institute of Neuroscience and Neurotechnology, Campinas, São Paulo, Brazil
| | - Bruno Leonardo Bianqueti
- Center for Engineering, Modeling and Applied Social Sciences, Federal University of ABC, São Bernardo do Campo, Brazil; Brazilian Institute of Neuroscience and Neurotechnology, Campinas, São Paulo, Brazil
| | - Luiz Ricardo da Silva
- Center for Engineering, Modeling and Applied Social Sciences, Federal University of ABC, São Bernardo do Campo, Brazil
| | - Tiago Paggi Almeida
- Department of Cardiovascular Sciences, University of Leicester, Leicester, UK
| | - André Kazuo Takahata
- Center for Engineering, Modeling and Applied Social Sciences, Federal University of ABC, São Bernardo do Campo, Brazil; Brazilian Institute of Neuroscience and Neurotechnology, Campinas, São Paulo, Brazil
| | | | | | | | | | - Diogo Coutinho Soriano
- Center for Engineering, Modeling and Applied Social Sciences, Federal University of ABC, São Bernardo do Campo, Brazil; Brazilian Institute of Neuroscience and Neurotechnology, Campinas, São Paulo, Brazil
| | - Fabio Godinho
- Center for Engineering, Modeling and Applied Social Sciences, Federal University of ABC, São Bernardo do Campo, Brazil; Department of Functional Neurosurgery, Santa Marcelina Hospital, São Paulo, São Paulo, Brazil; Division of Functional Neurosurgery of Institute of Psychiatry, Department of Neurology, Medical School, University of São Paulo, São Paulo, São Paulo, Brazil
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12
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Bore JC, Toth C, Campbell BA, Cho H, Pucci F, Hogue O, Machado AG, Baker KB. Consistent Changes in Cortico-Subthalamic Directed Connectivity Are Associated With the Induction of Parkinsonism in a Chronically Recorded Non-human Primate Model. Front Neurosci 2022; 16:831055. [PMID: 35310095 PMCID: PMC8930827 DOI: 10.3389/fnins.2022.831055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Accepted: 01/31/2022] [Indexed: 11/23/2022] Open
Abstract
Parkinson’s disease is a neurological disease with cardinal motor signs including bradykinesia and tremor. Although beta-band hypersynchrony in the cortico-basal ganglia network is thought to contribute to disease manifestation, the resulting effects on network connectivity are unclear. We examined local field potentials from a non-human primate across the naïve, mild, and moderate disease states (model was asymmetric, left-hemispheric dominant) and probed power spectral density as well as cortico-cortical and cortico-subthalamic connectivity using both coherence and Granger causality, which measure undirected and directed effective connectivity, respectively. Our network included the left subthalamic nucleus (L-STN), bilateral primary motor cortices (L-M1, R-M1), and bilateral premotor cortices (L-PMC, R-PMC). Results showed two distinct peaks (Peak A at 5–20 Hz, Peak B at 25–45 Hz) across all analyses. Power and coherence analyses showed widespread increases in power and connectivity in both the Peak A and Peak B bands with disease progression. For Granger causality, increases in Peak B connectivity and decreases in Peak A connectivity were associated with the disease. Induction of mild disease was associated with several changes in connectivity: (1) the cortico-subthalamic connectivity in the descending direction (L-PMC to L-STN) decreased in the Peak A range while the reciprocal, ascending connectivity (L-STN to L-PMC) increased in the Peak B range; this may play a role in generating beta-band hypersynchrony in the cortex, (2) both L-M1 to L-PMC and R-M1 to R-PMC causalities increased, which may either be compensatory or a pathologic effect of disease, and (3) a decrease in connectivity occurred from the R-PMC to R-M1. The only significant change seen between mild and moderate disease was increased right cortical connectivity, which may reflect compensation for the left-hemispheric dominant moderate disease state.
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Affiliation(s)
- Joyce Chelangat Bore
- Department of Neurosciences, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, United States
| | - Carmen Toth
- Department of Neurosciences, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, United States
| | - Brett A. Campbell
- Department of Neurosciences, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, United States
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH, United States
| | - Hanbin Cho
- Department of Neurosciences, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, United States
| | - Francesco Pucci
- Center for Neurological Restoration, Cleveland Clinic, Neurological Institute, Cleveland, OH, United States
- Department of Neurosurgery, Cleveland Clinic, Neurological Institute, Cleveland, OH, United States
| | - Olivia Hogue
- Center for Neurological Restoration, Cleveland Clinic, Neurological Institute, Cleveland, OH, United States
| | - Andre G. Machado
- Department of Neurosciences, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, United States
- Center for Neurological Restoration, Cleveland Clinic, Neurological Institute, Cleveland, OH, United States
- Department of Neurosurgery, Cleveland Clinic, Neurological Institute, Cleveland, OH, United States
| | - Kenneth B. Baker
- Department of Neurosciences, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, United States
- Center for Neurological Restoration, Cleveland Clinic, Neurological Institute, Cleveland, OH, United States
- *Correspondence: Kenneth B. Baker,
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13
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Pozzi NG, Isaias IU. Adaptive deep brain stimulation: Retuning Parkinson's disease. HANDBOOK OF CLINICAL NEUROLOGY 2022; 184:273-284. [PMID: 35034741 DOI: 10.1016/b978-0-12-819410-2.00015-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
A brain-machine interface represents a promising therapeutic avenue for the treatment of many neurologic conditions. Deep brain stimulation (DBS) is an invasive, neuro-modulatory tool that can improve different neurologic disorders by delivering electric stimulation to selected brain areas. DBS is particularly successful in advanced Parkinson's disease (PD), where it allows sustained improvement of motor symptoms. However, this approach is still poorly standardized, with variable clinical outcomes. To achieve an optimal therapeutic effect, novel adaptive DBS (aDBS) systems are being developed. These devices operate by adapting stimulation parameters in response to an input signal that can represent symptoms, motor activity, or other behavioral features. Emerging evidence suggests greater efficacy with fewer adverse effects during aDBS compared with conventional DBS. We address this topic by discussing the basics principles of aDBS, reviewing current evidence, and tackling the many challenges posed by aDBS for PD.
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Affiliation(s)
- Nicoló G Pozzi
- Department of Neurology, University Hospital Würzburg and Julius Maximilian University Würzburg, Würzburg, Germany
| | - Ioannis U Isaias
- Department of Neurology, University Hospital Würzburg and Julius Maximilian University Würzburg, Würzburg, Germany.
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14
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A Systematic Review of Neurofeedback for the Management of Motor Symptoms in Parkinson's Disease. Brain Sci 2021; 11:brainsci11101292. [PMID: 34679358 PMCID: PMC8534214 DOI: 10.3390/brainsci11101292] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Accepted: 09/27/2021] [Indexed: 12/04/2022] Open
Abstract
Background: Neurofeedback has been proposed as a treatment for Parkinson’s disease (PD) motor symptoms by changing the neural network activity directly linked with movement. However, the effectiveness of neurofeedback as a treatment for PD motor symptoms is unclear. Aim: To systematically review the literature to identify the effects of neurofeedback in people with idiopathic PD; as defined by measurement of brain activity; motor function; and performance. Design: A systematic review. Included Sources and Articles: PubMed; MEDLINE; Cinhal; PsychoInfo; Prospero; Cochrane; ClinicalTrials.gov; EMBASE; Web of Science; PEDro; OpenGrey; Conference Paper Index; Google Scholar; and eThos; searched using the Population-Intervention-Comparison-Outcome (PICO) framework. Primary studies with the following designs were included: randomized controlled trials (RCTs), non-RCTs; quasi-experimental; pre/post studies; and case studies. Results: This review included 11 studies out of 6197 studies that were identified from the literature search. Neuroimaging methods used were fMRI; scalp EEG; surface brain EEG; and deep brain EEG; where 10–15 Hz and the supplementary motor area were the most commonly targeted signatures for EEG and fMRI, respectively. Success rates for changing one’s brain activity ranged from 47% to 100%; however, both sample sizes and success criteria differed considerably between studies. While six studies included a clinical outcome; a lack of consistent assessments prevented a reliable conclusion on neurofeedback’s effectiveness. Narratively, fMRI neurofeedback has the greatest potential to improve PD motor symptoms. Two main limitations were found in the studies that contributed to the lack of a confident conclusion: (1) insufficient clinical information and perspectives (e.g., no reporting of adverse events), and (2) limitations in numerical data reporting (e.g., lack of explicit statistics) that prevented a meta-analysis. Conclusions: While fMRI neurofeedback was narratively the most effective treatment; the omission of clinical outcome measures in studies using other neurofeedback approaches limits comparison. Therefore, no single neurofeedback type can currently be identified as an optimal treatment for PD motor symptoms. This systematic review highlights the need to improve the inclusion of clinical information and more robust reporting of numerical data in future work. Neurofeedback appears to hold great potential as a treatment for PD motor symptoms. However, this field is still in its infancy and needs high quality RCTs to establish its effectiveness. Review Registration: PROSPERO (ID: CRD42020191097)
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15
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Oswal A, Cao C, Yeh CH, Neumann WJ, Gratwicke J, Akram H, Horn A, Li D, Zhan S, Zhang C, Wang Q, Zrinzo L, Foltynie T, Limousin P, Bogacz R, Sun B, Husain M, Brown P, Litvak V. Neural signatures of hyperdirect pathway activity in Parkinson's disease. Nat Commun 2021; 12:5185. [PMID: 34465771 PMCID: PMC8408177 DOI: 10.1038/s41467-021-25366-0] [Citation(s) in RCA: 57] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2020] [Accepted: 08/02/2021] [Indexed: 11/25/2022] Open
Abstract
Parkinson's disease (PD) is characterised by the emergence of beta frequency oscillatory synchronisation across the cortico-basal-ganglia circuit. The relationship between the anatomy of this circuit and oscillatory synchronisation within it remains unclear. We address this by combining recordings from human subthalamic nucleus (STN) and internal globus pallidus (GPi) with magnetoencephalography, tractography and computational modelling. Coherence between supplementary motor area and STN within the high (21-30 Hz) but not low (13-21 Hz) beta frequency range correlated with 'hyperdirect pathway' fibre densities between these structures. Furthermore, supplementary motor area activity drove STN activity selectively at high beta frequencies suggesting that high beta frequencies propagate from the cortex to the basal ganglia via the hyperdirect pathway. Computational modelling revealed that exaggerated high beta hyperdirect pathway activity can provoke the generation of widespread pathological synchrony at lower beta frequencies. These findings suggest a spectral signature and a pathophysiological role for the hyperdirect pathway in PD.
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Affiliation(s)
- Ashwini Oswal
- MRC Brain Network Dynamics Unit, University of Oxford, Oxford, UK.
- Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK.
- The Wellcome Centre for Human Neuroimaging, University College London, London, UK.
| | - Chunyan Cao
- Department of Neurosurgery, Affiliated Ruijin Hospital, School of Medicine, Shanghai JiaoTong University, Shanghai, China
| | - Chien-Hung Yeh
- MRC Brain Network Dynamics Unit, University of Oxford, Oxford, UK
- Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
- School of Information and Electronics Engineering, Beijing Institute of Technology, Beijing, China
| | | | - James Gratwicke
- Department of Clinical and Movement Neurosciences, University College London, London, UK
| | - Harith Akram
- Department of Clinical and Movement Neurosciences, University College London, London, UK
| | - Andreas Horn
- Department of Neurology, Charité University, Berlin, Germany
| | - Dianyou Li
- Department of Neurosurgery, Affiliated Ruijin Hospital, School of Medicine, Shanghai JiaoTong University, Shanghai, China
| | - Shikun Zhan
- Department of Neurosurgery, Affiliated Ruijin Hospital, School of Medicine, Shanghai JiaoTong University, Shanghai, China
| | - Chao Zhang
- Department of Neurosurgery, Affiliated Ruijin Hospital, School of Medicine, Shanghai JiaoTong University, Shanghai, China
| | - Qiang Wang
- Department of Neurology, Charité University, Berlin, Germany
| | - Ludvic Zrinzo
- Department of Clinical and Movement Neurosciences, University College London, London, UK
| | - Tom Foltynie
- Department of Clinical and Movement Neurosciences, University College London, London, UK
| | - Patricia Limousin
- Department of Clinical and Movement Neurosciences, University College London, London, UK
| | - Rafal Bogacz
- MRC Brain Network Dynamics Unit, University of Oxford, Oxford, UK
- Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | - Bomin Sun
- Department of Neurosurgery, Affiliated Ruijin Hospital, School of Medicine, Shanghai JiaoTong University, Shanghai, China
| | - Masud Husain
- Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | - Peter Brown
- MRC Brain Network Dynamics Unit, University of Oxford, Oxford, UK.
- Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK.
| | - Vladimir Litvak
- The Wellcome Centre for Human Neuroimaging, University College London, London, UK.
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16
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Alhourani A, Korzeniewska A, Wozny TA, Lipski WJ, Kondylis ED, Ghuman AS, Crone NE, Crammond DJ, Turner RS, Richardson RM. Subthalamic Nucleus Activity Influences Sensory and Motor Cortex during Force Transduction. Cereb Cortex 2021; 30:2615-2626. [PMID: 31989165 DOI: 10.1093/cercor/bhz264] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Revised: 08/23/2019] [Accepted: 09/17/2019] [Indexed: 12/12/2022] Open
Abstract
The subthalamic nucleus (STN) is proposed to participate in pausing, or alternately, in dynamic scaling of behavioral responses, roles that have conflicting implications for understanding STN function in the context of deep brain stimulation (DBS) therapy. To examine the nature of event-related STN activity and subthalamic-cortical dynamics, we performed primary motor and somatosensory electrocorticography while subjects (n = 10) performed a grip force task during DBS implantation surgery. Phase-locking analyses demonstrated periods of STN-cortical coherence that bracketed force transduction, in both beta and gamma ranges. Event-related causality measures demonstrated that both STN beta and gamma activity predicted motor cortical beta and gamma activity not only during force generation but also prior to movement onset. These findings are consistent with the idea that the STN participates in motor planning, in addition to the modulation of ongoing movement. We also demonstrated bidirectional information flow between the STN and somatosensory cortex in both beta and gamma range frequencies, suggesting robust STN participation in somatosensory integration. In fact, interactions in beta activity between the STN and somatosensory cortex, and not between STN and motor cortex, predicted PD symptom severity. Thus, the STN contributes to multiple aspects of sensorimotor behavior dynamically across time.
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Affiliation(s)
- Ahmad Alhourani
- Department of Neurological Surgery, University of Louisville, Louisville, KY 40292, USA
| | - Anna Korzeniewska
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
| | - Thomas A Wozny
- Department of Neurological Surgery, University of Pittsburgh, Pittsburgh, PA 15213, USA
| | - Witold J Lipski
- Department of Neurological Surgery, University of Pittsburgh, Pittsburgh, PA 15213, USA
| | - Efstathios D Kondylis
- Department of Neurological Surgery, University of Pittsburgh, Pittsburgh, PA 15213, USA
| | - Avniel S Ghuman
- Department of Neurological Surgery, University of Pittsburgh, Pittsburgh, PA 15213, USA.,Brain Institute, University of Pittsburgh, Pittsburgh, PA 15260, USA
| | - Nathan E Crone
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
| | - Donald J Crammond
- Department of Neurological Surgery, University of Pittsburgh, Pittsburgh, PA 15213, USA
| | - Robert S Turner
- Brain Institute, University of Pittsburgh, Pittsburgh, PA 15260, USA.,Department of Neurobiology, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA
| | - R Mark Richardson
- Department of Neurosurgery, Massachusetts General Hospital, Boston, MA 02114, USA.,Harvard Medical School, Boston, MA 02115, USA
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17
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Altered directed connectivity during processing of implicit versus explicit predictive stimuli in Parkinson's disease patients. Brain Cogn 2021; 152:105773. [PMID: 34225173 DOI: 10.1016/j.bandc.2021.105773] [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: 02/18/2021] [Revised: 05/06/2021] [Accepted: 06/25/2021] [Indexed: 11/22/2022]
Abstract
The study investigated the role of top-down versus bottom-up connectivity, during the processing of implicit or explicit predictive information, in Parkinson's disease (PD). EEG was recorded during the performance of a task, which evaluated the ability to utilize either implicit or explicit predictive contextual information in order to facilitate the detection of predictable versus random targets. Thus, subjects performed an implicit and explicit session, where subjects were either unaware or made aware of a predictive sequence that signals the presentation of a subsequent target, respectively. We evaluated EEG event-related directed connectivity, in PD patients compared with healthy age-matched controls, using phase transfer entropy. PD patients showed increased top-down frontal-parietal connectivity, compared to control subjects, during the processing of the last (most informative) stimulus of the predictive sequence and of random standards, in the implicit and explicit session, respectively. These findings suggest that PD is associated with compensatory top-down connectivity, specifically during the processing of implicit predictive stimuli. During the explicit session, PD patients seem to allocate more attentional resources to non-informative standard stimuli, compared to controls. These connectivity changes shed further light on the cognitive deficits, associated with the processing of predictive contextual information, that are observed in PD patients.
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18
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Subthalamic deep brain stimulation induces finely-tuned gamma oscillations in the absence of levodopa. Neurobiol Dis 2021; 152:105287. [PMID: 33549721 PMCID: PMC7116781 DOI: 10.1016/j.nbd.2021.105287] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 01/20/2021] [Accepted: 02/03/2021] [Indexed: 11/20/2022] Open
Abstract
Finely-tuned gamma (FTG) oscillations can be recorded from cortex or the subthalamic nucleus (STN) in patients with Parkinson's disease (PD) on dopaminergic medication, and have been associated with dyskinesias. When recorded during deep brain stimulation (DBS) on medication the FTG is entrained to half the stimulation frequency. We investigated whether these characteristics are shared off medication by recording local field potentials (LFP) from the STN from externalised DBS leads in 14 PD patients after overnight withdrawal of medication. FTG was induced de-novo by DBS in the absence of dyskinesias in a third of our cohort. The FTG could outlast stimulation or arise only after DBS ceased. FTG frequencies decreased during and across consecutive DBS blocks, but did not shift with changing stimulation frequency off medication. Together with the sustained after-effects this argues against simple entrainment by DBS in the off medication state. We also found significant coherence between STN-LFP and electroencephalogram (EEG) signals at FTG frequencies. We conclude that FTG is a network phenomenon that behaves differently in the off medication state, when it is neither associated with dyskinesias nor susceptible to entrainment.
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19
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Damborská A, Lamoš M, Brunet D, Vulliemoz S, Bočková M, Deutschová B, Baláž M, Rektor I. Resting-State Phase-Amplitude Coupling Between the Human Subthalamic Nucleus and Cortical Activity: A Simultaneous Intracranial and Scalp EEG Study. Brain Topogr 2021; 34:272-282. [PMID: 33515171 DOI: 10.1007/s10548-021-00822-8] [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: 11/19/2020] [Accepted: 01/18/2021] [Indexed: 10/22/2022]
Abstract
It has been suggested that slow oscillations in the subthalamic nucleus (STN) reflect top-down inputs from the medial prefrontal cortex, thus implementing behavior control. It is unclear, however, whether the STN oscillations are related to cortical activity in a bottom-up manner. To assess resting-state subcortico-cortical interactions, we recorded simultaneous scalp electroencephalographic activity and local field potentials in the STN (LFP-STN) in 11 patients with Parkinson's disease implanted with deep brain stimulation electrodes in the on-medication state during rest. We assessed the cross-structural phase-amplitude coupling (PAC) between the STN and cortical activity within a wide frequency range of 1 to 100 Hz. The PAC was dominant between the δ/θ STN phase and β/γ cortical amplitude in most investigated scalp regions and between the δ cortical phase and θ/α STN amplitude in the frontal and temporal regions. The cross-frequency linkage between the slow oscillations of the LFP-STN activity and the amplitude of the scalp-recorded cortical activity at rest was demonstrated, and similar involvement of the left and right STNs in the coupling was observed. Our results suggest that the STN plays a role in both bottom-up and top-down processes within the subcortico-cortical circuitries of the human brain during the resting state. A relative left-right symmetry in the STN-cortex functional linkage was suggested. Practical treatment studies would be necessary to assess whether unilateral stimulation of the STN might be sufficient for treatment of Parkinson's disease.
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Affiliation(s)
- Alena Damborská
- CEITEC - Central European Institute of Technology, Masaryk University, Brno, Czech Republic. .,Functional Brain Mapping Lab, University of Geneva, Geneva, Switzerland. .,CEITEC - Central European Institute of Technology, Brain and Mind Research Program, Masaryk University, Kamenice 753/5, 625 00, Brno, Czech Republic.
| | - Martin Lamoš
- CEITEC - Central European Institute of Technology, Masaryk University, Brno, Czech Republic
| | - Denis Brunet
- Functional Brain Mapping Lab, University of Geneva, Geneva, Switzerland.,CIBM - Center for Biomedical Imaging, Geneva, Switzerland
| | - Serge Vulliemoz
- CIBM - Center for Biomedical Imaging, Geneva, Switzerland.,EEG and Epilepsy Unit, Neurology, University Hospital and Faculty of Medicine, Geneva, Switzerland
| | - Martina Bočková
- CEITEC - Central European Institute of Technology, Masaryk University, Brno, Czech Republic.,First Department of Neurology, St. Anne's University Hospital, Masaryk University, Brno, Czech Republic
| | - Barbora Deutschová
- CEITEC - Central European Institute of Technology, Masaryk University, Brno, Czech Republic.,First Department of Neurology, St. Anne's University Hospital, Masaryk University, Brno, Czech Republic
| | - Marek Baláž
- First Department of Neurology, St. Anne's University Hospital, Masaryk University, Brno, Czech Republic
| | - Ivan Rektor
- CEITEC - Central European Institute of Technology, Masaryk University, Brno, Czech Republic.,First Department of Neurology, St. Anne's University Hospital, Masaryk University, Brno, Czech Republic
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Litvak V, Florin E, Tamás G, Groppa S, Muthuraman M. EEG and MEG primers for tracking DBS network effects. Neuroimage 2020; 224:117447. [PMID: 33059051 DOI: 10.1016/j.neuroimage.2020.117447] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 10/08/2020] [Accepted: 10/08/2020] [Indexed: 10/23/2022] Open
Abstract
Deep brain stimulation (DBS) is an effective treatment method for a range of neurological and psychiatric disorders. It involves implantation of stimulating electrodes in a precisely guided fashion into subcortical structures and, at a later stage, chronic stimulation of these structures with an implantable pulse generator. While the DBS surgery makes it possible to both record brain activity and stimulate parts of the brain that are difficult to reach with non-invasive techniques, electroencephalography (EEG) and magnetoencephalography (MEG) provide complementary information from other brain areas, which can be used to characterize brain networks targeted through DBS. This requires, however, the careful consideration of different types of artifacts in the data acquisition and the subsequent analyses. Here, we review both the technical issues associated with EEG/MEG recordings in DBS patients and the experimental findings to date. One major line of research is simultaneous recording of local field potentials (LFPs) from DBS targets and EEG/MEG. These studies revealed a set of cortico-subcortical coherent networks functioning at distinguishable physiological frequencies. Specific network responses were linked to clinical state, task or stimulation parameters. Another experimental approach is mapping of DBS-targeted networks in chronically implanted patients by recording EEG/MEG responses during stimulation. One can track responses evoked by single stimulation pulses or bursts as well as brain state shifts caused by DBS. These studies have the potential to provide biomarkers for network responses that can be adapted to guide stereotactic implantation or optimization of stimulation parameters. This is especially important for diseases where the clinical effect of DBS is delayed or develops slowly over time. The same biomarkers could also potentially be utilized for the online control of DBS network effects in the new generation of closed-loop stimulators that are currently entering clinical use. Through future studies, the use of network biomarkers may facilitate the integration of circuit physiology into clinical decision making.
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Affiliation(s)
- Vladimir Litvak
- The Wellcome Centre for Human Neuroimaging, UCL Queen Square Institute of Neurology, London, UK
| | - Esther Florin
- Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty, Heinrich-Heine University Düsseldorf, Düsseldorf, Germany
| | - Gertrúd Tamás
- Department of Neurology, Semmelweis University, Budapest, Hungary
| | - Sergiu Groppa
- Movement disorders and Neurostimulation, Biomedical Statistics and Multimodal Signal Processing Unit, Department of Neurology, University Medical Center of the Johannes Gutenberg University, Langenbeckstrasse 1, 55131 Mainz, Germany
| | - Muthuraman Muthuraman
- Movement disorders and Neurostimulation, Biomedical Statistics and Multimodal Signal Processing Unit, Department of Neurology, University Medical Center of the Johannes Gutenberg University, Langenbeckstrasse 1, 55131 Mainz, Germany.
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21
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Baaske MK, Kormann E, Holt AB, Gulberti A, McNamara CG, Pötter-Nerger M, Westphal M, Engel AK, Hamel W, Brown P, Moll CKE, Sharott A. Parkinson's disease uncovers an underlying sensitivity of subthalamic nucleus neurons to beta-frequency cortical input in vivo. Neurobiol Dis 2020; 146:105119. [PMID: 32991998 PMCID: PMC7710979 DOI: 10.1016/j.nbd.2020.105119] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2020] [Revised: 09/13/2020] [Accepted: 09/24/2020] [Indexed: 11/26/2022] Open
Abstract
Abnormally sustained beta-frequency synchronisation between the motor cortex and subthalamic nucleus (STN) is associated with motor symptoms in Parkinson's disease (PD). It is currently unclear whether STN neurons have a preference for beta-frequency input (12-35 Hz), rather than cortical input at other frequencies, and how such a preference would arise following dopamine depletion. To address this question, we combined analysis of cortical and STN recordings from awake human PD patients undergoing deep brain stimulation surgery with recordings of identified STN neurons in anaesthetised rats. In these patients, we demonstrate that a subset of putative STN neurons is strongly and selectively sensitive to magnitude fluctuations of cortical beta oscillations over time, linearly increasing their phase-locking strength with respect to the full range of instantaneous amplitude in the beta-frequency range. In rats, we probed the frequency response of STN neurons in the cortico-basal-ganglia-network more precisely, by recording spikes evoked by short bursts of cortical stimulation with variable frequency (4-40 Hz) and constant amplitude. In both healthy and dopamine-depleted rats, only beta-frequency stimulation led to a progressive reduction in the variability of spike timing through the stimulation train. This suggests, that the interval of beta-frequency input provides an optimal window for eliciting the next spike with high fidelity. We hypothesize, that abnormal activation of the indirect pathway, via dopamine depletion and/or cortical stimulation, could trigger an underlying sensitivity of the STN microcircuit to beta-frequency input. STN-neurons are selectively entrained to cortical beta oscillations in PD patients. Phase-locking of STN-neurons is linearly dependent on oscillation magnitude. Beta bursts in LFP/EEG are accompanied by transient synchronisation of STN spiking. STN neurons are selectively entrained to cortical beta stimulation in rats. Beta-selectivity of STN neurons is present in control and dopamine-depleted rats.
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Affiliation(s)
- Magdalena K Baaske
- Medical Research Council Brain Network Dynamics Unit, Nuffield Department of Clinical Neurosciences, University of Oxford, Mansfield Road, Oxford OX1 3TH, UK; Department of Neurology, University of Lübeck, 23538 Lübeck, Germany; Institute of Neurogenetics, University of Lübeck, 23538 Lübeck, Germany
| | - Eszter Kormann
- Medical Research Council Brain Network Dynamics Unit, Nuffield Department of Clinical Neurosciences, University of Oxford, Mansfield Road, Oxford OX1 3TH, UK
| | - Abbey B Holt
- Medical Research Council Brain Network Dynamics Unit, Nuffield Department of Clinical Neurosciences, University of Oxford, Mansfield Road, Oxford OX1 3TH, UK
| | - Alessandro Gulberti
- Department of Neurophysiology and Pathophysiology, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany
| | - Colin G McNamara
- Medical Research Council Brain Network Dynamics Unit, Nuffield Department of Clinical Neurosciences, University of Oxford, Mansfield Road, Oxford OX1 3TH, UK
| | - Monika Pötter-Nerger
- Department of Neurology, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany
| | - Manfred Westphal
- Department of Neurosurgery, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany
| | - Andreas K Engel
- Department of Neurophysiology and Pathophysiology, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany
| | - Wolfgang Hamel
- Department of Neurosurgery, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany
| | - Peter Brown
- Medical Research Council Brain Network Dynamics Unit, Nuffield Department of Clinical Neurosciences, University of Oxford, Mansfield Road, Oxford OX1 3TH, UK; Department of Neurology, University of Lübeck, 23538 Lübeck, Germany
| | - Christian K E Moll
- Department of Neurophysiology and Pathophysiology, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany
| | - Andrew Sharott
- Medical Research Council Brain Network Dynamics Unit, Nuffield Department of Clinical Neurosciences, University of Oxford, Mansfield Road, Oxford OX1 3TH, UK.
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22
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Ahn M, Lee S, Lauro PM, Schaeffer EL, Akbar U, Asaad WF. Rapid motor fluctuations reveal short-timescale neurophysiological biomarkers of Parkinson's disease. J Neural Eng 2020; 17:046042. [PMID: 32756018 PMCID: PMC8140652 DOI: 10.1088/1741-2552/abaca3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Objective. Identifying neural activity biomarkers of brain disease is essential to provide objective estimates of disease burden, obtain reliable feedback regarding therapeutic efficacy, and potentially to serve as a source of control for closed-loop neuromodulation. In Parkinson’s disease (PD), microelectrode recordings (MER) are routinely performed in the basal ganglia to guide electrode implantation for deep brain stimulation (DBS). While pathologically-excessive oscillatory activity has been observed and linked to PD motor dysfunction broadly, the extent to which these signals provide quantitative information about disease expression and fluctuations, particularly at short timescales, is unknown. Furthermore, the degree to which informative signal features are similar or different across patients has not been rigorously investigated. We sought to determine the extent to which motor error in PD across patients can be decoded on a rapid timescale using spectral features of neural activity. Approach. Here, we recorded neural activity from the subthalamic nucleus (STN) of subjects with PD undergoing awake DBS surgery while they performed an objective, continuous behavioral assessment that synthesized heterogenous PD motor manifestations to generate a scalar measure of motor dysfunction at short timescales. We then leveraged natural motor performance variations as a ‘ground truth’ to identify corresponding neurophysiological biomarkers. Main results. Support vector machines using multi-spectral decoding of neural signals from the STN succeeded in tracking the degree of motor impairment at short timescales (as short as one second). Spectral power across a wide range of frequencies, beyond the classic ‘β’ oscillations, contributed to this decoding, and multi-spectral models consistently outperformed those generated using more isolated frequency bands. While generalized decoding models derived across subjects were able to estimate motor impairment, patient-specific models typically performed better. Significance. These results demonstrate that quantitative information about short-timescale PD motor dysfunction is available in STN neural activity, distributed across various patient-specific spectral components, such that an individualized approach will be critical to fully harness this information for optimal disease tracking and closed-loop neuromodulation.
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Affiliation(s)
- Minkyu Ahn
- Department of Neuroscience, Brown University, Providence, RI 02912, United States of America. Robert J. and Nancy D. Carney Institute for Brain Science, Brown University, Providence, RI 02912, United States of America
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23
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Khawaldeh S, Tinkhauser G, Shah SA, Peterman K, Debove I, Nguyen TAK, Nowacki A, Lachenmayer ML, Schuepbach M, Pollo C, Krack P, Woolrich M, Brown P. Subthalamic nucleus activity dynamics and limb movement prediction in Parkinson's disease. Brain 2020; 143:582-596. [PMID: 32040563 PMCID: PMC7009471 DOI: 10.1093/brain/awz417] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Revised: 10/21/2019] [Accepted: 11/19/2019] [Indexed: 02/01/2023] Open
Abstract
Whilst exaggerated bursts of beta frequency band oscillatory synchronization in the subthalamic nucleus have been associated with motor impairment in Parkinson's disease, a plausible mechanism linking the two phenomena has been lacking. Here we test the hypothesis that increased synchronization denoted by beta bursting might compromise information coding capacity in basal ganglia networks. To this end we recorded local field potential activity in the subthalamic nucleus of 18 patients with Parkinson's disease as they executed cued upper and lower limb movements. We used the accuracy of local field potential-based classification of the limb to be moved on each trial as an index of the information held by the system with respect to intended action. Machine learning using the naïve Bayes conditional probability model was used for classification. Local field potential dynamics allowed accurate prediction of intended movements well ahead of their execution, with an area under the receiver operator characteristic curve of 0.80 ± 0.04 before imperative cues when the demanded action was known ahead of time. The presence of bursts of local field potential activity in the alpha, and even more so, in the beta frequency band significantly compromised the prediction of the limb to be moved. We conclude that low frequency bursts, particularly those in the beta band, restrict the capacity of the basal ganglia system to encode physiologically relevant information about intended actions. The current findings are also important as they suggest that local subthalamic activity may potentially be decoded to enable effector selection, in addition to force control in restorative brain-machine interface applications.
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Affiliation(s)
- Saed Khawaldeh
- MRC Brain Network Dynamics Unit, University of Oxford, UK.,Nuffield Department of Clinical Neurosciences, University of Oxford, UK.,Oxford Centre for Human Brain Activity, Wellcome Centre for Integrative Neuroimaging, University of Oxford, UK
| | - Gerd Tinkhauser
- MRC Brain Network Dynamics Unit, University of Oxford, UK.,Nuffield Department of Clinical Neurosciences, University of Oxford, UK.,Department of Neurology, Bern University Hospital and University of Bern, Switzerland
| | - Syed Ahmar Shah
- MRC Brain Network Dynamics Unit, University of Oxford, UK.,Nuffield Department of Clinical Neurosciences, University of Oxford, UK.,Usher Institute of Population Health Sciences and Informatics, Edinburgh Medical School, The University of Edinburgh, Edinburgh, UK
| | - Katrin Peterman
- Department of Neurology, Bern University Hospital and University of Bern, Switzerland
| | - Ines Debove
- Department of Neurology, Bern University Hospital and University of Bern, Switzerland
| | - T A Khoa Nguyen
- Department of Neurosurgery, Bern University Hospital and University of Bern, Switzerland
| | - Andreas Nowacki
- Department of Neurosurgery, Bern University Hospital and University of Bern, Switzerland
| | - M Lenard Lachenmayer
- Department of Neurology, Bern University Hospital and University of Bern, Switzerland
| | - Michael Schuepbach
- Department of Neurology, Bern University Hospital and University of Bern, Switzerland
| | - Claudio Pollo
- Department of Neurosurgery, Bern University Hospital and University of Bern, Switzerland
| | - Paul Krack
- Department of Neurology, Bern University Hospital and University of Bern, Switzerland
| | - Mark Woolrich
- Nuffield Department of Clinical Neurosciences, University of Oxford, UK.,Oxford Centre for Human Brain Activity, Wellcome Centre for Integrative Neuroimaging, University of Oxford, UK
| | - Peter Brown
- MRC Brain Network Dynamics Unit, University of Oxford, UK.,Nuffield Department of Clinical Neurosciences, University of Oxford, UK
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24
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Yeh CH, Al-Fatly B, Kühn AA, Meidahl AC, Tinkhauser G, Tan H, Brown P. Waveform changes with the evolution of beta bursts in the human subthalamic nucleus. Clin Neurophysiol 2020; 131:2086-2099. [PMID: 32682236 DOI: 10.1016/j.clinph.2020.05.035] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2019] [Revised: 05/19/2020] [Accepted: 05/26/2020] [Indexed: 01/11/2023]
Abstract
OBJECTIVE Phasic bursts of beta band synchronisation have been linked to motor impairment in Parkinson's disease (PD). However, little is known about what terminates bursts. METHODS We used the Hilbert-Huang transform to investigate beta bursts in the local field potential recorded from the subthalamic nucleus in nine patients with PD on and off levodopa. RESULTS The sharpness of the beta waveform extrema fell as burst amplitude dropped. Conversely, an index of phase slips between waveform extrema, and the power of concurrent theta activity increased as burst amplitude fell. Theta activity was also increased on levodopa when beta bursts were attenuated. These phenomena were associated with reduction in coupling between beta phase and high gamma activity amplitude. We discuss how these findings may suggest that beta burst termination is associated with relative desynchronization of the beta drive, increase in competing theta activity and increased phase slips in the beta activity. CONCLUSIONS We characterise the dynamical nature of beta bursts, thereby permitting inferences about underlying activities and, in particular, about why bursts terminate. SIGNIFICANCE Understanding the dynamical nature of beta bursts may help point to interventions that can cause their termination and potentially treat motor impairment in PD.
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Affiliation(s)
- Chien-Hung Yeh
- MRC Brain Network Dynamics Unit, University of Oxford, Oxford OX1 3TH, United Kingdom; Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford OX3 9DU, United Kingdom; School of Information and Electronics, Beijing Institute of Technology, Beijing 100081, China.
| | - Bassam Al-Fatly
- Department of Neurology, Charitè-Universitätsmedizin Berlin, 10177 Berlin, Germany
| | - Andrea A Kühn
- Department of Neurology, Charitè-Universitätsmedizin Berlin, 10177 Berlin, Germany
| | - Anders C Meidahl
- MRC Brain Network Dynamics Unit, University of Oxford, Oxford OX1 3TH, United Kingdom; Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford OX3 9DU, United Kingdom
| | - Gerd Tinkhauser
- MRC Brain Network Dynamics Unit, University of Oxford, Oxford OX1 3TH, United Kingdom; Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford OX3 9DU, United Kingdom; Department of Neurology, Bern University Hospital and University of Bern, 3010 Bern, Switzerland
| | - Huiling Tan
- MRC Brain Network Dynamics Unit, University of Oxford, Oxford OX1 3TH, United Kingdom; Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford OX3 9DU, United Kingdom
| | - Peter Brown
- MRC Brain Network Dynamics Unit, University of Oxford, Oxford OX1 3TH, United Kingdom; Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford OX3 9DU, United Kingdom
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25
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Emmi A, Antonini A, Macchi V, Porzionato A, De Caro R. Anatomy and Connectivity of the Subthalamic Nucleus in Humans and Non-human Primates. Front Neuroanat 2020; 14:13. [PMID: 32390807 PMCID: PMC7189217 DOI: 10.3389/fnana.2020.00013] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2019] [Accepted: 03/13/2020] [Indexed: 02/02/2023] Open
Abstract
The Subthalamic Nucleus (STh) is an oval-shaped diencephalic structure located ventrally to the thalamus, playing a fundamental role in the circuitry of the basal ganglia. In addition to being involved in the pathophysiology of several neurodegenerative disorders, such as Huntington’s and Parkinson’s disease, the STh is one of the target nuclei for deep brain stimulation. However, most of the anatomical evidence available derives from non-human primate studies. In this review, we will present the topographical and morphological organization of the nucleus and its connections to structurally and functionally related regions of the basal ganglia circuitry. We will also highlight the importance of additional research in humans focused on validating STh connectivity, cytoarchitectural organization, and its functional subdivision.
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Affiliation(s)
- Aron Emmi
- Institute of Human Anatomy, Department of Neuroscience, University of Padua, Padua, Italy
| | - Angelo Antonini
- Parkinson and Movement Disorders Unit, Neurology Clinic, Department of Neuroscience, University of Padua, Padua, Italy
| | - Veronica Macchi
- Institute of Human Anatomy, Department of Neuroscience, University of Padua, Padua, Italy
| | - Andrea Porzionato
- Institute of Human Anatomy, Department of Neuroscience, University of Padua, Padua, Italy
| | - Raffaele De Caro
- Institute of Human Anatomy, Department of Neuroscience, University of Padua, Padua, Italy
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26
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The globus pallidus orchestrates abnormal network dynamics in a model of Parkinsonism. Nat Commun 2020; 11:1570. [PMID: 32218441 PMCID: PMC7099038 DOI: 10.1038/s41467-020-15352-3] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Accepted: 02/28/2020] [Indexed: 11/29/2022] Open
Abstract
The dynamical properties of cortico-basal ganglia (CBG) circuits are dramatically altered following the loss of dopamine in Parkinson’s disease (PD). The neural circuit dysfunctions associated with PD include spike-rate alteration concomitant with excessive oscillatory spike-synchronization in the beta frequency range (12–30 Hz). Which neuronal circuits orchestrate and propagate these abnormal neural dynamics in CBG remains unknown. In this work, we combine in vivo electrophysiological recordings with advanced optogenetic manipulations in normal and 6-OHDA rats to shed light on the mechanistic principle underlying circuit dysfunction in PD. Our results show that abnormal neural dynamics present in a rat model of PD do not rely on cortical or subthalamic nucleus activity but critically dependent on globus pallidus (GP) integrity. Our findings highlight the pivotal role played by the GP which operates as a hub nucleus capable of orchestrating firing rate and synchronization changes across CBG circuits both in normal and pathological conditions. Oscillatory changes between basal ganglia nuclei occur in Parkinson’s disease. Here the authors determine that the globus pallidus is the source of beta oscillation generation in a rodent model of the disease.
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27
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Darbin O, Hatanaka N, Takara S, Kaneko N, Chiken S, Naritoku D, Martino A, Nambu A. Parkinsonism Differently Affects the Single Neuronal Activity in the Primary and Supplementary Motor Areas in Monkeys: An Investigation in Linear and Nonlinear Domains. Int J Neural Syst 2020; 30:2050010. [PMID: 32019380 DOI: 10.1142/s0129065720500100] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The changes in neuronal firing activity in the primary motor cortex (M1) and supplementary motor area (SMA) were compared in monkeys rendered parkinsonian by treatment with 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine. The neuronal dynamic was characterized using mathematical tools defined in different frameworks (rate, oscillations or complex patterns). Then, and for each cortical area, multivariate and discriminate analyses were further performed on these features to identify those important to differentiate between the normal and the pathological neuronal activity. Our results show a different order in the importance of the features to discriminate the pathological state in each cortical area which suggests that the M1 and the SMA exhibit dissimilarities in their neuronal alterations induced by parkinsonism. Our findings highlight the need for multiple mathematical frameworks to best characterize the pathological neuronal activity related to parkinsonism. Future translational studies are warranted to investigate the causal relationships between cortical region-specificities, dominant pathological hallmarks and symptoms.
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Affiliation(s)
- Olivier Darbin
- Department of Neurology, University South Alabama, 307 University Blvd, Mobile, AL 36688, USA
| | - Nobuhiko Hatanaka
- Division of System Neurophysiology, National Institute for Physiological Sciences and Department of Physiological Sciences, SOKENDAI (Graduate University for Advanced Studies), Okazaki, Aichi 444-8585, Japan
| | - Sayuki Takara
- Division of System Neurophysiology, National Institute for Physiological Sciences and Department of Physiological Sciences, SOKENDAI (Graduate University for Advanced Studies), Okazaki, Aichi 444-8585, Japan
| | - Nobuya Kaneko
- Division of System Neurophysiology, National Institute for Physiological Sciences and Department of Physiological Sciences, SOKENDAI (Graduate University for Advanced Studies), Okazaki, Aichi 444-8585, Japan
| | - Satomi Chiken
- Division of System Neurophysiology, National Institute for Physiological Sciences and Department of Physiological Sciences, SOKENDAI (Graduate University for Advanced Studies), Okazaki, Aichi 444-8585, Japan
| | - Dean Naritoku
- Department of Neurology, University South Alabama, 307 University Blvd, Mobile, AL 36688, USA
| | - Anthony Martino
- Department of Neurology, University South Alabama, 307 University Blvd, Mobile, AL 36688, USA
| | - Atsushi Nambu
- Division of System Neurophysiology, National Institute for Physiological Sciences and Department of Physiological Sciences, SOKENDAI (Graduate University for Advanced Studies), Okazaki, Aichi 444-8585, Japan
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28
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Darbin O, Hatanaka N, Takara S, Kaneko M, Chiken S, Naritoku D, Martino A, Nambu A. Local field potential dynamics in the primate cortex in relation to parkinsonism reveled by machine learning: A comparison between the primary motor cortex and the supplementary area. Neurosci Res 2020; 156:66-79. [PMID: 31991205 DOI: 10.1016/j.neures.2020.01.012] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2019] [Revised: 11/09/2019] [Accepted: 11/29/2019] [Indexed: 12/20/2022]
Abstract
The present study compares the cortical local field potentials (LFPs) in the primary motor cortex (M1) and the supplementary motor area (SMA) of non-human primates rendered Parkinsonian with administration of dopaminergic neurotoxin, 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine. The dynamic of the LFPs was investigated under several mathematical frameworks and machine learning was used to discriminate the recordings based on these features between healthy, parkinsonian with off-medication and parkinsonian with on-medication states. The importance of each feature in the discrimination process was further investigated. The dynamic of the LFPs in M1 and SMA was affected regarding its variability (time domain analysis), oscillatory activities (frequency domain analysis) and complex patterns (non-linear domain analysis). Machine learning algorithms achieved accuracy near 0.90 for comparisons between conditions. The TreeBagger algorithm provided best accuracy. The relative importance of these features differed with the cortical location, condition and treatment. Overall, the most important features included beta oscillation, fractal dimension, gamma oscillation, entropy and asymmetry of amplitude fluctuation. The importance of features in discriminating between normal and pathological states, and on- or off-medication states depends on the pair-comparison and it is region-specific. These findings are discussed regarding the refinement of current models for movement disorders and the development of on-demand therapies.
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Affiliation(s)
- Olivier Darbin
- Division of System Neurophysiology, National Institute for Physiological Sciences, Okazaki, Aichi 444-8585, Japan; Department of Neurology, University South Alabama, 307 University Blvd, Mobile, AL 36688, USA.
| | - Nobuhiko Hatanaka
- Division of System Neurophysiology, National Institute for Physiological Sciences, Okazaki, Aichi 444-8585, Japan; Department of Physiological Sciences, SOKENDAI (Graduate University for Advanced Studies), Okazaki, Aichi 444-8585, Japan
| | - Sayuki Takara
- Division of System Neurophysiology, National Institute for Physiological Sciences, Okazaki, Aichi 444-8585, Japan; Department of Physiological Sciences, SOKENDAI (Graduate University for Advanced Studies), Okazaki, Aichi 444-8585, Japan
| | - Masaya Kaneko
- Division of System Neurophysiology, National Institute for Physiological Sciences, Okazaki, Aichi 444-8585, Japan; Department of Physiological Sciences, SOKENDAI (Graduate University for Advanced Studies), Okazaki, Aichi 444-8585, Japan
| | - Satomi Chiken
- Division of System Neurophysiology, National Institute for Physiological Sciences, Okazaki, Aichi 444-8585, Japan; Department of Physiological Sciences, SOKENDAI (Graduate University for Advanced Studies), Okazaki, Aichi 444-8585, Japan
| | - Dean Naritoku
- Department of Neurology, University South Alabama, 307 University Blvd, Mobile, AL 36688, USA
| | - Anthony Martino
- Department of Neurosurgery, University South Alabama, 307 University Blvd., Mobile, AL 36688, USA
| | - Atsushi Nambu
- Division of System Neurophysiology, National Institute for Physiological Sciences, Okazaki, Aichi 444-8585, Japan; Department of Physiological Sciences, SOKENDAI (Graduate University for Advanced Studies), Okazaki, Aichi 444-8585, Japan
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29
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Aristieta A, Ruiz-Ortega J, Morera-Herreras T, Miguelez C, Ugedo L. Acute L-DOPA administration reverses changes in firing pattern and low frequency oscillatory activity in the entopeduncular nucleus from long term L-DOPA treated 6-OHDA-lesioned rats. Exp Neurol 2019; 322:113036. [DOI: 10.1016/j.expneurol.2019.113036] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Revised: 08/12/2019] [Accepted: 08/14/2019] [Indexed: 01/06/2023]
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30
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Temporal evolution of beta bursts in the parkinsonian cortical and basal ganglia network. Proc Natl Acad Sci U S A 2019; 116:16095-16104. [PMID: 31341079 PMCID: PMC6690030 DOI: 10.1073/pnas.1819975116] [Citation(s) in RCA: 72] [Impact Index Per Article: 14.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
Prevalence and temporal dynamics of transient oscillations in the beta frequency band (15 to 35 Hz), referred to as β bursts, are correlated with motor performance. Disturbance of these activities is a candidate mechanism for motor impairment in Parkinson’s disease (PD), where the excessively long bursts correlate with symptom severity and are reduced by pharmacological and surgical treatments. Here we describe the changes in action potential firing that take place across multiple nodes of the cortical and basal ganglia circuit as these transient oscillations evolve. These analyses provide fresh insights into the network dynamics of β bursts that can guide novel strategies to interfere with their generation and maintenance in PD. Beta frequency oscillations (15 to 35 Hz) in cortical and basal ganglia circuits become abnormally synchronized in Parkinson’s disease (PD). How excessive beta oscillations emerge in these circuits is unclear. We addressed this issue by defining the firing properties of basal ganglia neurons around the emergence of cortical beta bursts (β bursts), transient (50 to 350 ms) increases in the beta amplitude of cortical signals. In PD patients, the phase locking of background spiking activity in the subthalamic nucleus (STN) to frontal electroencephalograms preceded the onset and followed the temporal profile of cortical β bursts, with conditions of synchronization consistent within and across bursts. Neuronal ensemble recordings in multiple basal ganglia structures of parkinsonian rats revealed that these dynamics were recapitulated in STN, but also in external globus pallidus and striatum. The onset of consistent phase-locking conditions was preceded by abrupt phase slips between cortical and basal ganglia ensemble signals. Single-unit recordings demonstrated that ensemble-level properties of synchronization were not underlain by changes in firing rate but, rather, by the timing of action potentials in relation to cortical oscillation phase. Notably, the preferred angle of phase-locked action potential firing in each basal ganglia structure was shifted during burst initiation, then maintained stable phase relations during the burst. Subthalamic, pallidal, and striatal neurons engaged and disengaged with cortical β bursts to different extents and timings. The temporal evolution of cortical and basal ganglia synchronization is cell type-selective, which could be key for the generation/ maintenance of excessive beta oscillations in parkinsonism.
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Ramirez Pasos UE, Steigerwald F, Reich MM, Matthies C, Volkmann J, Reese R. Levodopa Modulates Functional Connectivity in the Upper Beta Band Between Subthalamic Nucleus and Muscle Activity in Tonic and Phasic Motor Activity Patterns in Parkinson's Disease. Front Hum Neurosci 2019; 13:223. [PMID: 31312129 PMCID: PMC6614179 DOI: 10.3389/fnhum.2019.00223] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Accepted: 06/18/2019] [Indexed: 01/10/2023] Open
Abstract
Introduction: Striatal dopamine depletion disrupts basal ganglia function and causes Parkinson's disease (PD). The pathophysiology of the dopamine-dependent relationship between basal ganglia signaling and motor control, however, is not fully understood. We obtained simultaneous recordings of local field potentials (LFPs) from the subthalamic nucleus (STN) and electromyograms (EMGs) in patients with PD to investigate the impact of dopaminergic state and movement on long-range beta functional connectivity between basal ganglia and lower motor neurons. Methods: Eight PD patients were investigated 3 months after implantation of a deep brain stimulation (DBS)-system capable of recording LFPs via chronically-implanted leads (Medtronic, ACTIVA PC+S®). We analyzed STN spectral power and its coherence with EMG in the context of two different movement paradigms (tonic wrist extension vs. alternating wrist extension and flexion) and the effect of levodopa (L-Dopa) intake using an unbiased data-driven approach to determine regions of interest (ROI). Results: Two ROIs capturing prominent coherence within a grand average coherogram were identified. A trend of a dopamine effect was observed for the first ROI (50-150 ms after movement start) with higher STN-EMG coherence in medicated patients. Concerning the second ROI (300-500 ms after movement start), an interaction effect of L-Dopa medication and movement task was observed with higher coherence in the isometric contraction task compared to alternating movements in the medication ON state, a pattern which was reversed in L-Dopa OFF. Discussion: L-Dopa medication may normalize functional connectivity between remote structures of the motor system with increased upper beta coherence reflecting a physiological restriction of the amount of information conveyed between remote structures. This may be necessary to maintain simple movements like isometric contraction. Our study adds dynamic properties to the complex interplay between STN spectral beta power and the nucleus' functional connectivity to remote structures of the motor system as a function of movement and dopaminergic state. This may help to identify markers of neuronal activity relevant for more individualized programming of DBS therapy.
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Affiliation(s)
| | - Frank Steigerwald
- Department of Neurology, University Hospital Würzburg, Würzburg, Germany
| | - Martin M Reich
- Department of Neurology, University Hospital Würzburg, Würzburg, Germany
| | - Cordula Matthies
- Department of Neurosurgery, University Hospital Würzburg, Würzburg, Germany
| | - Jens Volkmann
- Department of Neurology, University Hospital Würzburg, Würzburg, Germany
| | - René Reese
- Department of Neurology, University Hospital Würzburg, Würzburg, Germany.,Department of Neurology, University of Rostock, Rostock, Germany
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Sushkova OS, Morozov AA, Gabova AV, Karabanov AV. [Application of brain electrical activity burst analysis method for detection of EEG characteristics in the early stage of Parkinson's disease]. Zh Nevrol Psikhiatr Im S S Korsakova 2019; 118:45-48. [PMID: 30132456 DOI: 10.17116/jnevro20181187145] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
AIM To develop a mathematical method of analysis and visualization of EEG based on the ROC analysis of burst electrical activity in the cerebral cortex. MATERIAL AND METHODS Using a new method of analysis of EEG burst activity, the frequency parameters of brain electrical activity have been investigated in patients in the first stage of Parkinson's disease (PD) defined by the Hoehn and Yahr scale. Patients were right-handed, with disease onset in either the right or the left side. The burst term is used in neurophysiology for the description of wave activity in EEG signals. Bursts are reflected in the local peaks of wavelet spectrograms, some of the parameters of which have been analyzed. Electrical activity of the left and right central cortex areas was investigated. The results were compared with those obtained from healthy volunteers. RESULTS In PD patients, burst activity was changed in alpha- and beta bands. Compared to healthy volunteers, it was higher in alpha band 8-9 Hz and lower in upper alpha band 11-13 Hz and beta band 18-24 Hz. With regard to asymmetry of the brain in PD patients, there was the change in burst activity in both brain hemispheres. Diagrams of burst activity showed the difference between the patients with tremor onset in the left hand and tremor onset in the right hand. CONCLUSION This suggests differences in brain electrical activity changes in patients with left-sided and right-sided disease onset. The initial results of the study demonstrate that the method of analysis and visualization based on the evaluation of certain parameters of EEG bursts is promising for the analysis of EEG features in PD patients.
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Affiliation(s)
- O S Sushkova
- Kotel'nikov Institute of Radio Engineering and Electronics of RAS, Moscow, Russia
| | - A A Morozov
- Kotel'nikov Institute of Radio Engineering and Electronics of RAS, Moscow, Russia
| | - A V Gabova
- Institute of Higher Nervous Activity and Neurophysiology of RAS, Moscow, Russia
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Tinkhauser G, Shah SA, Fischer P, Peterman K, Debove I, Nygyuen K, Nowacki A, Torrecillos F, Khawaldeh S, Tan H, Pogosyan A, Schuepbach M, Pollo C, Brown P. Electrophysiological differences between upper and lower limb movements in the human subthalamic nucleus. Clin Neurophysiol 2019; 130:727-738. [PMID: 30903826 PMCID: PMC6487671 DOI: 10.1016/j.clinph.2019.02.011] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2018] [Revised: 01/26/2019] [Accepted: 02/18/2019] [Indexed: 11/21/2022]
Abstract
OBJECTIVE Functional processes in the brain are segregated in both the spatial and spectral domain. Motivated by findings reported at the cortical level in healthy participants we test the hypothesis in the basal ganglia of Parkinson's disease patients that lower frequency beta band activity relates to motor circuits associated with the upper limb and higher beta frequencies with lower limb movements. METHODS We recorded local field potentials (LFPs) from the subthalamic nucleus using segmented "directional" DBS leads, during which patients performed repetitive upper and lower limb movements. Movement-related spectral changes in the beta and gamma frequency-ranges and their spatial distributions were compared between limbs. RESULTS We found that the beta desynchronization during leg movements is characterised by a strikingly greater involvement of higher beta frequencies (24-31 Hz), regardless of whether this was contralateral or ipsilateral to the limb moved. The spatial distribution of limb-specific movement-related changes was evident at higher gamma frequencies. CONCLUSION Limb processing in the basal ganglia is differentially organised in the spectral and spatial domain and can be captured by directional DBS leads. SIGNIFICANCE These findings may help to refine the use of the subthalamic LFPs as a control signal for adaptive DBS and neuroprosthetic devices.
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Affiliation(s)
- Gerd Tinkhauser
- Department of Neurology, Bern University Hospital and University of Bern, Bern, Switzerland; MRC Brain Network Dynamics Unit at the University of Oxford, Oxford, United Kingdom; Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom.
| | - Syed Ahmar Shah
- MRC Brain Network Dynamics Unit at the University of Oxford, Oxford, United Kingdom; Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom
| | - Petra Fischer
- MRC Brain Network Dynamics Unit at the University of Oxford, Oxford, United Kingdom; Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom
| | - Katrin Peterman
- Department of Neurology, Bern University Hospital and University of Bern, Bern, Switzerland
| | - Ines Debove
- Department of Neurology, Bern University Hospital and University of Bern, Bern, Switzerland
| | - Khoa Nygyuen
- Department of Neurosurgery, Bern University Hospital and University of Bern, Bern, Switzerland
| | - Andreas Nowacki
- Department of Neurosurgery, Bern University Hospital and University of Bern, Bern, Switzerland; Department of Neurosurgery, John Radcliffe Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom
| | - Flavie Torrecillos
- MRC Brain Network Dynamics Unit at the University of Oxford, Oxford, United Kingdom; Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom
| | - Saed Khawaldeh
- MRC Brain Network Dynamics Unit at the University of Oxford, Oxford, United Kingdom; Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom
| | - Huiling Tan
- MRC Brain Network Dynamics Unit at the University of Oxford, Oxford, United Kingdom; Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom
| | - Alek Pogosyan
- MRC Brain Network Dynamics Unit at the University of Oxford, Oxford, United Kingdom; Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom
| | - Michael Schuepbach
- Department of Neurology, Bern University Hospital and University of Bern, Bern, Switzerland
| | - Claudio Pollo
- Department of Neurosurgery, Bern University Hospital and University of Bern, Bern, Switzerland
| | - Peter Brown
- MRC Brain Network Dynamics Unit at the University of Oxford, Oxford, United Kingdom; Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom
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Dopamine substitution alters effective connectivity of cortical prefrontal, premotor, and motor regions during complex bimanual finger movements in Parkinson's disease. Neuroimage 2019; 190:118-132. [DOI: 10.1016/j.neuroimage.2018.04.030] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2018] [Revised: 03/23/2018] [Accepted: 04/12/2018] [Indexed: 01/31/2023] Open
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Müller EJ, Robinson PA. Suppression of Parkinsonian Beta Oscillations by Deep Brain Stimulation: Determination of Effective Protocols. Front Comput Neurosci 2018; 12:98. [PMID: 30618692 PMCID: PMC6297248 DOI: 10.3389/fncom.2018.00098] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2018] [Accepted: 11/26/2018] [Indexed: 01/05/2023] Open
Abstract
A neural field model of the corticothalamic-basal ganglia system is developed that describes enhanced beta activity within subthalamic and pallidal circuits in Parkinson's disease (PD) via system resonances. A model of deep brain stimulation (DBS) of typical clinical targets, the subthalamic nucleus (STN) and globus pallidus internus (GPi), is added and studied for several distinct stimulation protocols that are used for treatment of the motor symptoms of PD and that reduce pathological beta band activity (13-30 Hz) in the corticothalamic-basal ganglia network. The resulting impact of DBS on enhanced beta activity in the STN and GPi, as well as cortico-subthalamic and cortico-pallidal coherence, are studied. Both STN-DBS and GPi-DBS are found to be effective for suppressing peak STN and GPi power in the beta band, with GPi-DBS being slightly more effective in both the STN and the GPi for all stimulus protocols tested. The largest decrease in cortico-STN coherence is observed during STN-DBS, whereas GPi-DBS is most effective for reducing cortico-GPi coherence. A reduction of the pathologically large STN connection strengths that define the parkinsonian state results in enhanced 6 Hz activity and could thus represent a compensatory mechanism that has the side effect of driving parkinsonian tremor-like oscillations. This model provides a method for systematically testing effective DBS protocols that agrees with experimental and clinical findings. Furthermore, the model suggests GPi-DBS and STN-DBS have distinct impacts on elevated synchronization between the basal ganglia and motor cortex in PD.
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Affiliation(s)
- Eli J Müller
- School of Physics, The University of Sydney, Sydney, NSW, Australia.,Center for Integrative Brain Function, The University of Sydney, Sydney, NSW, Australia
| | - Peter A Robinson
- School of Physics, The University of Sydney, Sydney, NSW, Australia.,Center for Integrative Brain Function, The University of Sydney, Sydney, NSW, Australia
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Muthuraman M, Koirala N, Ciolac D, Pintea B, Glaser M, Groppa S, Tamás G, Groppa S. Deep Brain Stimulation and L-DOPA Therapy: Concepts of Action and Clinical Applications in Parkinson's Disease. Front Neurol 2018; 9:711. [PMID: 30210436 PMCID: PMC6119713 DOI: 10.3389/fneur.2018.00711] [Citation(s) in RCA: 49] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2018] [Accepted: 08/06/2018] [Indexed: 12/15/2022] Open
Abstract
L-DOPA is still the most effective pharmacological therapy for the treatment of motor symptoms in Parkinson's disease (PD) almost four decades after it was first used. Deep brain stimulation (DBS) is a safe and highly effective treatment option in patients with PD. Even though a clear understanding of the mechanisms of both treatment methods is yet to be obtained, the combination of both treatments is the most effective standard evidenced-based therapy to date. Recent studies have demonstrated that DBS is a therapy option even in the early course of the disease, when first complications arise despite a rigorous adjustment of the pharmacological treatment. The unique feature of this therapeutic approach is the ability to preferentially modulate specific brain networks through the choice of stimulation site. The clinical effects have been unequivocally confirmed in recent studies; however, the impact of DBS and the supplementary effect of L-DOPA on the neuronal network are not yet fully understood. In this review, we present emerging data on the presumable mechanisms of DBS in patients with PD and discuss the pathophysiological similarities and differences in the effects of DBS in comparison to dopaminergic medication. Targeted, selective modulation of brain networks by DBS and pharmacodynamic effects of L-DOPA therapy on the central nervous system are presented. Moreover, we outline the perioperative algorithms for PD patients before and directly after the implantation of DBS electrodes and strategies for the reduction of side effects and optimization of motor and non-motor symptoms.
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Affiliation(s)
- Muthuraman Muthuraman
- Movement Disorders and Neurostimulation, Biomedical Statistics and Multimodal Signal Processing Unit, Department of Neurology, University Medical Center of the Johannes Gutenberg University, Mainz, Germany
| | - Nabin Koirala
- Movement Disorders and Neurostimulation, Biomedical Statistics and Multimodal Signal Processing Unit, Department of Neurology, University Medical Center of the Johannes Gutenberg University, Mainz, Germany
| | - Dumitru Ciolac
- Department of Neurology, Institute of Emergency Medicine, Chisinau, Moldova.,Laboratory of Neurobiology and Medical Genetics, Nicolae Testemiţanu State University of Medicine and Pharmacy, Chisinau, Moldova
| | - Bogdan Pintea
- Department of Neurosurgery, University Hospital of Bonn, Bonn, Germany
| | - Martin Glaser
- Department of Neurosurgery, University Medical Center of the Johannes Gutenberg University, Mainz, Germany
| | - Stanislav Groppa
- Department of Neurology, Institute of Emergency Medicine, Chisinau, Moldova.,Laboratory of Neurobiology and Medical Genetics, Nicolae Testemiţanu State University of Medicine and Pharmacy, Chisinau, Moldova
| | - Gertrúd Tamás
- Department of Neurology, Semmelweis University, Budapest, Hungary
| | - Sergiu Groppa
- Movement Disorders and Neurostimulation, Biomedical Statistics and Multimodal Signal Processing Unit, Department of Neurology, University Medical Center of the Johannes Gutenberg University, Mainz, Germany
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Generic dynamic causal modelling: An illustrative application to Parkinson's disease. Neuroimage 2018; 181:818-830. [PMID: 30130648 PMCID: PMC7343527 DOI: 10.1016/j.neuroimage.2018.08.039] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2018] [Revised: 08/15/2018] [Accepted: 08/16/2018] [Indexed: 12/26/2022] Open
Abstract
We present a technical development in the dynamic causal modelling of
electrophysiological responses that combines qualitatively different neural mass
models within a single network. This affords the option to couple various
cortical and subcortical nodes that differ in their form and dynamics. Moreover,
it enables users to implement new neural mass models in a straightforward and
standardized way. This generic framework hence supports flexibility and
facilitates the exploration of increasingly plausible models. We illustrate this
by coupling a basal ganglia-thalamus model to a (previously validated) cortical
model developed specifically for motor cortex. The ensuing DCM is used to infer
pathways that contribute to the suppression of beta oscillations induced by
dopaminergic medication in patients with Parkinson's disease.
Experimental recordings were obtained from deep brain stimulation electrodes
(implanted in the subthalamic nucleus) and simultaneous magnetoencephalography.
In line with previous studies, our results indicate a reduction of synaptic
efficacy within the circuit between the subthalamic nucleus and external
pallidum, as well as reduced efficacy in connections of the hyperdirect and
indirect pathway leading to this circuit. This work forms the foundation for a
range of modelling studies of the synaptic mechanisms (and pathophysiology)
underlying event-related potentials and cross-spectral densities.
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38
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Luoma J, Pekkonen E, Airaksinen K, Helle L, Nurminen J, Taulu S, Mäkelä JP. Spontaneous sensorimotor cortical activity is suppressed by deep brain stimulation in patients with advanced Parkinson's disease. Neurosci Lett 2018; 683:48-53. [PMID: 29940326 DOI: 10.1016/j.neulet.2018.06.041] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2018] [Revised: 06/20/2018] [Accepted: 06/21/2018] [Indexed: 11/17/2022]
Abstract
Advanced Parkinson's disease (PD) is characterized by an excessive oscillatory beta band activity in the subthalamic nucleus (STN). Deep brain stimulation (DBS) of STN alleviates motor symptoms in PD and suppresses the STN beta band activity. The effect of DBS on cortical sensorimotor activity is more ambiguous; both increases and decreases of beta band activity have been reported. Non-invasive studies with simultaneous DBS are problematic due to DBS-induced artifacts. We recorded magnetoencephalography (MEG) from 16 advanced PD patients with and without STN DBS during rest and wrist extension. The strong magnetic artifacts related to stimulation were removed by temporal signal space separation. MEG oscillatory activity at 5-25 Hz was suppressed during DBS in a widespread frontoparietal region, including the sensorimotor cortex identified by the cortico-muscular coherence. The strength of suppression did not correlate with clinical improvement. Our results indicate that alpha and beta band oscillations are suppressed at the frontoparietal cortex by STN DBS in PD.
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Affiliation(s)
- Jarkko Luoma
- BioMag Laboratory, HUS Medical Imaging Center, University of Helsinki and Helsinki University Hospital, Finland
| | - Eero Pekkonen
- Department of Neurology, Helsinki University Hospital and Department of Clinical Neurosciences (Neurology), University of Helsinki, Helsinki, Finland
| | - Katja Airaksinen
- BioMag Laboratory, HUS Medical Imaging Center, University of Helsinki and Helsinki University Hospital, Finland; Department of Neurology, Helsinki University Hospital and Department of Clinical Neurosciences (Neurology), University of Helsinki, Helsinki, Finland
| | - Liisa Helle
- Elekta Oy, Helsinki, Finland; Department of Neuroscience and Biomedical Engineering, Aalto University School of Science, Espoo, Finland
| | - Jussi Nurminen
- BioMag Laboratory, HUS Medical Imaging Center, University of Helsinki and Helsinki University Hospital, Finland
| | - Samu Taulu
- Institute for Learning & Brain Sciences, University of Washington, Seattle, USA; Department of Physics, University of Washington, Seattle, USA
| | - Jyrki P Mäkelä
- BioMag Laboratory, HUS Medical Imaging Center, University of Helsinki and Helsinki University Hospital, Finland.
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Alternating Modulation of Subthalamic Nucleus Beta Oscillations during Stepping. J Neurosci 2018; 38:5111-5121. [PMID: 29760182 PMCID: PMC5977446 DOI: 10.1523/jneurosci.3596-17.2018] [Citation(s) in RCA: 52] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2017] [Revised: 03/02/2018] [Accepted: 04/24/2018] [Indexed: 01/05/2023] Open
Abstract
Gait disturbances in Parkinson's disease are commonly refractory to current treatment options and majorly impair patient's quality of life. Auditory cues facilitate gait and prevent motor blocks. We investigated how neural dynamics in the human subthalamic nucleus of Parkinsons's disease patients (14 male, 2 female) vary during stepping and whether rhythmic auditory cues enhance the observed modulation. Oscillations in the beta band were suppressed after ipsilateral heel strikes, when the contralateral foot had to be raised, and reappeared after contralateral heel strikes, when the contralateral foot rested on the floor. The timing of this 20–30 Hz beta modulation was clearly distinct between the left and right subthalamic nucleus, and was alternating within each stepping cycle. This modulation was similar, whether stepping movements were made while sitting, standing, or during gait, confirming the utility of the stepping in place paradigm. During stepping in place, beta modulation increased with auditory cues that assisted patients in timing their steps more regularly. Our results suggest a link between the degree of power modulation within high beta frequency bands and stepping performance. These findings raise the possibility that alternating deep brain stimulation patterns may be superior to constant stimulation for improving parkinsonian gait. SIGNIFICANCE STATEMENT Gait disturbances in Parkinson's disease majorly reduce patients' quality of life and are often refractory to current treatment options. We investigated how neural activity in the subthalamic nucleus of patients who received deep brain stimulation surgery covaries with the stepping cycle. 20–30 Hz beta activity was modulated relative to each step, alternating between the left and right STN. The stepping performance of patients improved when auditory cues were provided, which went along with enhanced beta modulation. This raises the possibility that alternating stimulation patterns may also enhance beta modulation and may be more beneficial for gait control than continuous stimulation, which needs to be tested in future studies.
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40
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Intra-operative characterisation of subthalamic oscillations in Parkinson's disease. Clin Neurophysiol 2018; 129:1001-1010. [PMID: 29567582 DOI: 10.1016/j.clinph.2018.01.075] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2017] [Revised: 12/21/2017] [Accepted: 01/31/2018] [Indexed: 12/12/2022]
Abstract
OBJECTIVE This study aims to use the activities recorded directly from the deep brain stimulation (DBS) electrode to address the focality and distinct nature of the local field potential (LFP) activities of different frequency. METHODS Pre-operative and intra-operative magnetic resonance imaging (MRI) were acquired from patients with Parkinson's disease (PD) who underwent DBS in the subthalamic nucleus and intra-operative LFP recording at rest and during cued movements. Images were reconstructed and 3-D visualized using Lead-DBS® toolbox to determine the coordinates of contact. The resting spectral power and movement-related power modulation of LFP oscillations were estimated. RESULTS Both subthalamic LFP activity recorded at rest and its modulation by movement had focal maxima in the alpha, beta and gamma bands. The spatial distribution of alpha band activity and its modulation was significantly different to that in the beta band. Moreover, there were significant differences in the scale and timing of movement related modulation across the frequency bands. CONCLUSION Subthalamic LFP activities within specific frequency bands can be distinguished by spatial topography and pattern of movement related modulation. SIGNIFICANCE Assessment of the frequency, focality and pattern of movement related modulation of subthalamic LFPs reveals a heterogeneity of neural population activity in this region. This could potentially be leveraged to finesse intra-operative targeting and post-operative contact selection.
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Beaton LE, Azma S, Marinkovic K. When the brain changes its mind: Oscillatory dynamics of conflict processing and response switching in a flanker task during alcohol challenge. PLoS One 2018; 13:e0191200. [PMID: 29329355 PMCID: PMC5766228 DOI: 10.1371/journal.pone.0191200] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2017] [Accepted: 12/30/2017] [Indexed: 01/22/2023] Open
Abstract
Despite the subjective experience of being in full and deliberate control of our actions, our daily routines rely on a continuous and interactive engagement of sensory evaluation and response preparation streams. They unfold automatically and unconsciously and are seamlessly integrated with cognitive control which is mobilized by stimuli that evoke ambiguity or response conflict. Methods with high spatio-temporal sensitivity are needed to provide insight into the interplay between automatic and controlled processing. This study used anatomically-constrained MEG to examine the underlying neural dynamics in a flanker task that manipulated S-R incongruity at the stimulus (SI) and response levels (RI). Though irrelevant, flankers evoked automatic preparation of motor plans which had to be suppressed and reversed following the target presentation on RI trials. Event-related source power estimates in beta (15–25 Hz) frequency band in the sensorimotor cortex tracked motor preparation and response in real time and revealed switching from the incorrectly-primed to the correctly-responding hemisphere. In contrast, theta oscillations (4–7 Hz) were sensitive to the levels of incongruity as the medial and ventrolateral frontal cortices were especially activated by response conflict. These two areas are key to cognitive control and their integrated contributions to response inhibition and switching were revealed by phase-locked co-oscillations. These processes were pharmacologically manipulated with a moderate alcohol beverage or a placebo administered to healthy social drinkers. Alcohol selectively decreased accuracy to response conflict. It strongly attenuated theta oscillations during decision making and partly re-sculpted relative contributions of the frontal network without affecting the motor switching process subserved by beta band. Our results indicate that motor preparation is initiated automatically even when counterproductive but that it is monitored and regulated by the prefrontal cognitive control processes under conflict. They further confirm that the regulative top-down functions are particularly vulnerable to alcohol intoxication.
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Affiliation(s)
- Lauren E. Beaton
- Department of Psychology, San Diego State University, San Diego, California, United States of America
| | - Sheeva Azma
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, Massachusetts, United States of America
| | - Ksenija Marinkovic
- Department of Psychology, San Diego State University, San Diego, California, United States of America
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, Massachusetts, United States of America
- Department of Radiology, University of California, San Diego, La Jolla, California, United States of America
- * E-mail:
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Harmsen IE, Rowland NC, Wennberg RA, Lozano AM. Characterizing the effects of deep brain stimulation with magnetoencephalography: A review. Brain Stimul 2018; 11:481-491. [PMID: 29331287 DOI: 10.1016/j.brs.2017.12.016] [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: 05/28/2017] [Revised: 12/26/2017] [Accepted: 12/28/2017] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Deep brain stimulation (DBS) is an important form of neuromodulation that is being applied to patients with motor, mood, or cognitive circuit disorders. Despite the efficacy and widespread use of DBS, the precise mechanisms by which it works remain unknown. Over the last decade, magnetoencephalography (MEG) has become an important functional neuroimaging technique used to study DBS. OBJECTIVE This review summarizes the literature related to the use of MEG to characterize the effects of DBS. METHODS Peer reviewed literature on DBS-MEG was obtained by searching the publicly accessible literature databases available on PubMed. The abstracts of all reports were scanned and publications which combined DBS-MEG in human subjects were selected for review. RESULTS A total of 32 publications met the selection criteria, and included studies which applied DBS for Parkinson's disease, dystonia, chronic pain, phantom limb pain, cluster headache, and epilepsy. DBS-MEG studies provided valuable insights into network connectivity, pathological coupling, and the modulatory effects of DBS. CONCLUSIONS As DBS-MEG research continues to develop, we can expect to gain a better understanding of diverse pathophysiological networks and their response to DBS. This knowledge will improve treatment efficacy, reduce side-effects, reveal optimal surgical targets, and advance the development of closed-loop neuromodulation.
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Affiliation(s)
- Irene E Harmsen
- Division of Neurosurgery, Department of Surgery, University of Toronto, Toronto, Ontario, Canada; Toronto Western Research Institute, Krembil Discovery Tower, University Health Network, Toronto, Ontario, Canada.
| | - Nathan C Rowland
- Department of Neurosurgery, Medical University of South Carolina, Charleston, SC, USA
| | - Richard A Wennberg
- Mitchell Goldhar Magnetoencephalography Unit, Krembil Neuroscience Centre, Toronto Western Hospital, Toronto, Ontario, Canada; Division of Neurology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Andres M Lozano
- Division of Neurosurgery, Department of Surgery, University of Toronto, Toronto, Ontario, Canada; Toronto Western Research Institute, Krembil Discovery Tower, University Health Network, Toronto, Ontario, Canada
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Spatio-temporal dynamics of cortical drive to human subthalamic nucleus neurons in Parkinson's disease. Neurobiol Dis 2018; 112:49-62. [PMID: 29307661 PMCID: PMC5821899 DOI: 10.1016/j.nbd.2018.01.001] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2017] [Revised: 11/30/2017] [Accepted: 01/03/2018] [Indexed: 11/24/2022] Open
Abstract
Pathological synchronisation of beta frequency (12–35 Hz) oscillations between the subthalamic nucleus (STN) and cerebral cortex is thought to contribute to motor impairment in Parkinson's disease (PD). For this cortico-subthalamic oscillatory drive to be mechanistically important, it must influence the firing of STN neurons and, consequently, their downstream targets. Here, we examined the dynamics of synchronisation between STN LFPs and units with multiple cortical areas, measured using frontal ECoG, midline EEG and lateral EEG, during rest and movement. STN neurons lagged cortical signals recorded over midline (over premotor cortices) and frontal (over prefrontal cortices) with stable time delays, consistent with strong corticosubthalamic drive, and many neurons maintained these dynamics during movement. In contrast, most STN neurons desynchronised from lateral EEG signals (over primary motor cortices) during movement and those that did not had altered phase relations to the cortical signals. The strength of synchronisation between STN units and midline EEG in the high beta range (25–35 Hz) correlated positively with the severity of akinetic-rigid motor symptoms across patients. Together, these results suggest that sustained synchronisation of STN neurons to premotor-cortical beta oscillations play an important role in disrupting the normal coding of movement in PD. Multi-channel EEG with coincident STN single unit and local field potential recordings Variable time delays between beta oscillations in different cortical areas and STN neurons. Frontal/premotor cortical areas have most stable oscillatory synchronisation with STN neurons. Correlation between cortico-subthalamic beta-frequency synchronisation and clinical scores in PD.
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Processing of implicit versus explicit predictive contextual information in Parkinson's disease. Neuropsychologia 2018; 109:39-51. [DOI: 10.1016/j.neuropsychologia.2017.12.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2017] [Revised: 11/30/2017] [Accepted: 12/02/2017] [Indexed: 12/24/2022]
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Foldes ST, Weber DJ, Collinger JL. Altered modulation of sensorimotor rhythms with chronic paralysis. J Neurophysiol 2017; 118:2412-2420. [PMID: 28768745 DOI: 10.1152/jn.00878.2016] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2016] [Revised: 07/28/2017] [Accepted: 07/28/2017] [Indexed: 02/06/2023] Open
Abstract
After paralysis, the disconnection between the cortex and its peripheral targets leads to neuroplasticity throughout the nervous system. However, it is unclear how chronic paralysis specifically impacts cortical oscillations associated with attempted movement of impaired limbs. We hypothesized that μ- (8-13 Hz) and β- (15-30 Hz) event-related desynchronization (ERD) would be less modulated for individuals with hand paralysis due to cervical spinal cord injury (SCI). To test this, we compared the modulation of ERD from magnetoencephalography (MEG) during attempted and imagined grasping performed by participants with cervical SCI (n = 12) and able-bodied controls (n = 13). Seven participants with tetraplegia were able to generate some electromyography (EMG) activity during attempted grasping, whereas the other five were not. The peak and area of ERD were significantly decreased for individuals without volitional muscle activity when they attempted to grasp compared with able-bodied subjects and participants with SCI,with some residual EMG activity. However, no significant differences were found between subject groups during mentally simulated tasks (i.e., motor imagery) where no muscle activity or somatosensory consequences were expected. These findings suggest that individuals who are unable to produce muscle activity are capable of generating ERD when attempting to move, but the characteristics of this ERD are altered. However, for people who maintain volitional muscle activity after SCI, there are no significant differences in ERD characteristics compared with able-bodied controls. These results provide evidence that ERD is dependent on the level of intact muscle activity after SCI.NEW & NOTEWORTHY Source space MEG was used to investigate sensorimotor cortical oscillations in individuals with SCI. This study provides evidence that individuals with cervical SCI exhibit decreased ERD when they attempt to grasp if they are incapable of generating muscle activity. However, there were no significant differences in ERD between paralyzed and able-bodied participants during motor imagery. These results have important implications for the design and evaluation of new therapies, such as motor imagery and neurofeedback interventions.
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Affiliation(s)
- Stephen T Foldes
- Veterans Affairs Pittsburgh Healthcare System, Department of Veterans Affairs, Pittsburgh, Pennsylvania.,Department of Physical Medicine and Rehabilitation, University of Pittsburgh, Pittsburgh, Pennsylvania.,Center for the Neural Basis of Cognition, Carnegie Mellon University, Pittsburgh, Pennsylvania.,Barrow Neurological Institute at Phoenix Children's Hospital, Phoenix, Arizona; and
| | - Douglas J Weber
- Department of Physical Medicine and Rehabilitation, University of Pittsburgh, Pittsburgh, Pennsylvania.,Center for the Neural Basis of Cognition, Carnegie Mellon University, Pittsburgh, Pennsylvania.,Department of Bioengineering, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Jennifer L Collinger
- Veterans Affairs Pittsburgh Healthcare System, Department of Veterans Affairs, Pittsburgh, Pennsylvania; .,Department of Physical Medicine and Rehabilitation, University of Pittsburgh, Pittsburgh, Pennsylvania.,Center for the Neural Basis of Cognition, Carnegie Mellon University, Pittsburgh, Pennsylvania.,Department of Bioengineering, University of Pittsburgh, Pittsburgh, Pennsylvania
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Lozano AM, Hutchison WD, Kalia SK. What Have We Learned About Movement Disorders from Functional Neurosurgery? Annu Rev Neurosci 2017; 40:453-477. [DOI: 10.1146/annurev-neuro-070815-013906] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Andres M. Lozano
- Division of Neurosurgery, Department of Surgery, University of Toronto, Toronto, Ontario M5T 2S8, Canada;, ,
- Krembil Research Institute, Toronto Western Hospital, Toronto, Ontario M5T 2S8, Canada
| | - William D. Hutchison
- Division of Neurosurgery, Department of Surgery, University of Toronto, Toronto, Ontario M5T 2S8, Canada;, ,
- Krembil Research Institute, Toronto Western Hospital, Toronto, Ontario M5T 2S8, Canada
| | - Suneil K. Kalia
- Division of Neurosurgery, Department of Surgery, University of Toronto, Toronto, Ontario M5T 2S8, Canada;, ,
- Krembil Research Institute, Toronto Western Hospital, Toronto, Ontario M5T 2S8, Canada
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Frontosubthalamic Circuits for Control of Action and Cognition. J Neurosci 2017; 36:11489-11495. [PMID: 27911752 DOI: 10.1523/jneurosci.2348-16.2016] [Citation(s) in RCA: 166] [Impact Index Per Article: 23.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2016] [Revised: 08/12/2016] [Accepted: 08/14/2016] [Indexed: 12/20/2022] Open
Abstract
The subthalamic nucleus (STN) of the basal ganglia appears to have a potent role in action and cognition. Anatomical and imaging studies show that different frontal cortical areas directly project to the STN via so-called hyperdirect pathways. This review reports some of the latest findings about such circuits, including simultaneous recordings from cortex and the STN in humans, single-unit recordings in humans, high-resolution fMRI, and neurocomputational modeling. We argue that a major function of the STN is to broadly pause behavior and cognition when stop signals, conflict signals, or surprise signals occur, and that the fronto-STN circuits for doing this, at least for stopping and conflict, are dissociable anatomically and in terms of their spectral reactivity. We also highlight recent evidence for synchronization of oscillations between prefrontal cortex and the STN, which may provide a preferential "window in time" for single neuron communication via long-range connections.
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Kolb R, Abosch A, Felsen G, Thompson JA. Use of intraoperative local field potential spectral analysis to differentiate basal ganglia structures in Parkinson's disease patients. Physiol Rep 2017; 5:e13322. [PMID: 28642341 PMCID: PMC5492209 DOI: 10.14814/phy2.13322] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2017] [Accepted: 05/24/2017] [Indexed: 01/06/2023] Open
Abstract
Identification of brain structures traversed during implantation of deep brain-stimulating (DBS) electrodes into the subthalamic nucleus (STN-DBS) for the treatment of Parkinson's disease (PD) frequently relies on subjective correspondence between kinesthetic response and multiunit activity. However, recent work suggests that local field potentials (LFP) could be used as a more robust signal to objectively differentiate subcortical structures. The goal of this study was to analyze the spectral properties of LFP collected during STN-DBS in order to objectively identify commonly traversed brain regions and improve our understanding of aberrant oscillations in the PD-related pathophysiological cortico-basal ganglia network. In 21 PD patients, LFP were collected and analyzed during STN-DBS implantation surgery. Spectral power for delta-, theta-, alpha-, low-beta-, and high-beta-frequency bands was assessed at multiple depths throughout the subcortical structures traversed on the trajectory to the ventral border of STN. Similar to previous findings, beta-band oscillations had an increased magnitude within the borders of the motor-related area of STN, however, across several subjects, we also observed increased high-beta magnitude within the borders of thalamus. Comparing across all patients using relative power, we observed a gradual increase in the magnitude of both low- and high-beta-frequency bands as the electrode descended from striatum to STN. These results were also compared with frequency bands below beta, and similar trends were observed. Our results suggest that LFP signals recorded during the implantation of a DBS electrode evince distinct oscillatory signatures that distinguish subcortical structures.
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Affiliation(s)
- Rachel Kolb
- Department of Bioengineering, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Aviva Abosch
- Department of Neurosurgery, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Gidon Felsen
- Department of Physiology and Biophysics, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - John A Thompson
- Department of Neurosurgery, University of Colorado School of Medicine, Aurora, Colorado, USA
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Hohlefeld F, Ewald A, Ehlen F, Tiedt H, Horn A, Kühn A, Curio G, Klostermann F, Nikulin V. Neural correlates of lexical decisions in Parkinson’s disease revealed with multivariate extraction of cortico-subthalamic interactions. Clin Neurophysiol 2017; 128:538-548. [DOI: 10.1016/j.clinph.2016.12.026] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2016] [Revised: 11/28/2016] [Accepted: 12/23/2016] [Indexed: 10/20/2022]
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He X, Zhang Y, Chen J, Xie C, Gan R, Yang R, Wang L, Nie K, Wang L. The patterns of EEG changes in early-onset Parkinson's disease patients. Int J Neurosci 2017; 127:1028-1035. [PMID: 28281852 DOI: 10.1080/00207454.2017.1304393] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Xuetao He
- Department of Neurology, Guangdong Neuroscience Institute, Guangdong General Hospital and Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Yuhu Zhang
- Department of Neurology, Guangdong Neuroscience Institute, Guangdong General Hospital and Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Jieling Chen
- Department of Neurology, Guangdong Neuroscience Institute, Guangdong General Hospital and Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Chunge Xie
- Department of Neurology, Guangdong Neuroscience Institute, Guangdong General Hospital and Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Rong Gan
- Department of Neurology, Guangdong Neuroscience Institute, Guangdong General Hospital and Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Rong Yang
- Department of Neurology, Guangdong Neuroscience Institute, Guangdong General Hospital and Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Limin Wang
- Department of Neurology, Guangdong Neuroscience Institute, Guangdong General Hospital and Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Kun Nie
- Department of Neurology, Guangdong Neuroscience Institute, Guangdong General Hospital and Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Lijuan Wang
- Department of Neurology, Guangdong Neuroscience Institute, Guangdong General Hospital and Guangdong Academy of Medical Sciences, Guangzhou, China
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