A model of pathological oscillations in the basal ganglia and deep brain stimulation in Parkinson's disease

Effects of antidromic and orthodromic activation of STN afferent axons during DBS in Parkinson's disease: a simulation study

Recent studies suggest that subthalamic nucleus (STN)-Deep Brain Stimulation (DBS) may exert at least part of its therapeutic effect through the antidromic suppression of pathological oscillations in the cortex in 6-OHDA treated rats and in parkinsonian patients. STN-DBS may also activate STN neurons by initiating action potential propagation in the orthodromic direction, similarly resulting in suppression of pathological oscillations in the STN. While experimental studies have provided strong evidence in support of antidromic stimulation of cortical neurons, it is difficult to separate relative contributions of antidromic and orthodromic effects of STN-DBS. The aim of this computational study was to examine the effects of antidromic and orthodromic activation on neural firing patterns and beta-band (13-30 Hz) oscillations in the STN and cortex during DBS of STN afferent axons projecting from the cortex. High frequency antidromic stimulation alone effectively suppressed simulated beta activity in both the cortex and STN-globus pallidus externa (GPe) network. High frequency orthodromic stimulation similarly suppressed beta activity within the STN and GPe through the direct stimulation of STN neurons driven by DBS at the same frequency as the stimulus. The combined effect of both antidromic and orthodromic stimulation modulated cortical activity antidromically while simultaneously orthodromically driving STN neurons. While high frequency DBS reduced STN beta-band power, low frequency stimulation resulted in resonant effects, increasing beta-band activity, consistent with previous experimental observations. The simulation results indicate effective suppression of simulated oscillatory activity through both antidromic stimulation of cortical neurons and direct orthodromic stimulation of STN neurons. The results of the study agree with experimental recordings of STN and cortical neurons in rats and support the therapeutic potential of stimulation of cortical neurons.

200-300Hz movement modulated oscillations in the internal globus pallidus of patients with Parkinson's Disease

Symptoms in Parkinson's Disease (PD) have been linked to oscillatory activity within the basal ganglia. In humans, such activity has been detected mainly in the local field potentials (LFPs) recorded from electrode contacts used for deep brain stimulation. Although most studies have focused on activity within the subthalamic nucleus (STN), the internal part of the globus pallidus (GPi) is considered an equally efficacious site for therapeutic neuromodulation. Moreover, while most investigations have evaluated changes in oscillatory activity in the beta (12-35Hz) and gamma (35-100Hz) bands, our preliminary spectral analysis of LFP signals in the GPi suggested distinct activity at higher frequencies as well. We hypothesized there is a unique LFP signature in the GPi that consists of movement modulated spectral power increases above 100Hz. Using invasive recordings from the GPi of patients undergoing DBS, in addition to confirming increased beta band activity within the GPi of patients with PD, we have identified and characterized a previously undescribed peak between 200 and 300Hz centered at approximately 235Hz, whose height and width but not center frequency are movement modulated. An increase in peak height is not transient, but rather persists for the duration of movement. The 200-300Hz rhythms in the GPi could have a functional role in the basal ganglia reentrant circuits by encoding output information entering the thalamo-cortical network or by organizing downstream activity for the successful execution of tasks.