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Boon LI, Hillebrand A, Potters WV, de Bie RMA, Prent N, Bot M, Schuurman PR, Stam CJ, van Rootselaar AF, Berendse HW. Motor effects of deep brain stimulation correlate with increased functional connectivity in Parkinson's disease: An MEG study. Neuroimage Clin 2020; 26:102225. [PMID: 32120294 PMCID: PMC7049661 DOI: 10.1016/j.nicl.2020.102225] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Revised: 01/27/2020] [Accepted: 02/20/2020] [Indexed: 11/06/2022]
Abstract
Deep brain stimulation (DBS) of the subthalamic nucleus (STN) is an established symptomatic treatment in Parkinson's disease, yet its mechanism of action is not fully understood. Locally in the STN, stimulation lowers beta band power, in parallel with symptom relief. Therefore, beta band oscillations are sometimes referred to as "anti-kinetic". However, in recent studies functional interactions have been observed beyond the STN, which we hypothesized to reflect clinical effects of DBS. Resting-state, whole-brain magnetoencephalography (MEG) recordings and assessments on motor function were obtained in 18 Parkinson's disease patients with bilateral STN-DBS, on and off stimulation. For each brain region, we estimated source-space spectral power and functional connectivity with the rest of the brain. Stimulation led to an increase in average peak frequency and a suppression of absolute band power (delta to low-beta band) in the sensorimotor cortices. Significant changes (decreases and increases) in low-beta band functional connectivity were observed upon stimulation. Improvement in bradykinesia/rigidity was significantly related to increases in alpha2 and low-beta band functional connectivity (of sensorimotor regions, the cortex as a whole, and subcortical regions). By contrast, tremor improvement did not correlate with changes in functional connectivity. Our results highlight the distributed effects of DBS on the resting-state brain and suggest that DBS-related improvements in rigidity and bradykinesia, but not tremor, may be mediated by an increase in alpha2 and low-beta functional connectivity. Beyond the local effects of DBS in and around the STN, functional connectivity changes in these frequency bands might therefore be considered as "pro-kinetic".
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Affiliation(s)
- Lennard I Boon
- Amsterdam UMC, Vrije Universiteit Amsterdam, Neurology, Amsterdam Neuroscience, De Boelelaan 1117, Amsterdam, the Netherlands; Amsterdam UMC, Vrije Universiteit Amsterdam, Clinical Neurophysiology and Magnetoencephalography Centre, Amsterdam Neuroscience, De Boelelaan 1117, Amsterdam, the Netherlands.
| | - Arjan Hillebrand
- Amsterdam UMC, Vrije Universiteit Amsterdam, Clinical Neurophysiology and Magnetoencephalography Centre, Amsterdam Neuroscience, De Boelelaan 1117, Amsterdam, the Netherlands
| | - Wouter V Potters
- Amsterdam UMC, University of Amsterdam, Neurology and Clinical Neurophysiology, Amsterdam Neuroscience, Meibergdreef 9, Amsterdam, the Netherlands
| | - Rob M A de Bie
- Amsterdam UMC, University of Amsterdam, Neurology and Clinical Neurophysiology, Amsterdam Neuroscience, Meibergdreef 9, Amsterdam, the Netherlands
| | - Naomi Prent
- Amsterdam UMC, University of Amsterdam, Neurology and Clinical Neurophysiology, Amsterdam Neuroscience, Meibergdreef 9, Amsterdam, the Netherlands
| | - Maarten Bot
- Amsterdam UMC, University of Amsterdam, Neurosurgery, Amsterdam Neuroscience, Meibergdreef 9, Amsterdam, the Netherlands
| | - P Richard Schuurman
- Amsterdam UMC, University of Amsterdam, Neurosurgery, Amsterdam Neuroscience, Meibergdreef 9, Amsterdam, the Netherlands
| | - Cornelis J Stam
- Amsterdam UMC, Vrije Universiteit Amsterdam, Clinical Neurophysiology and Magnetoencephalography Centre, Amsterdam Neuroscience, De Boelelaan 1117, Amsterdam, the Netherlands
| | - Anne-Fleur van Rootselaar
- Amsterdam UMC, University of Amsterdam, Neurology and Clinical Neurophysiology, Amsterdam Neuroscience, Meibergdreef 9, Amsterdam, the Netherlands
| | - Henk W Berendse
- Amsterdam UMC, Vrije Universiteit Amsterdam, Neurology, Amsterdam Neuroscience, De Boelelaan 1117, Amsterdam, the Netherlands
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Boon LI, Geraedts VJ, Hillebrand A, Tannemaat MR, Contarino MF, Stam CJ, Berendse HW. A systematic review of MEG-based studies in Parkinson's disease: The motor system and beyond. Hum Brain Mapp 2019; 40:2827-2848. [PMID: 30843285 PMCID: PMC6594068 DOI: 10.1002/hbm.24562] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2018] [Revised: 01/27/2019] [Accepted: 02/13/2019] [Indexed: 01/29/2023] Open
Abstract
Parkinson's disease (PD) is accompanied by functional changes throughout the brain, including changes in the electromagnetic activity recorded with magnetoencephalography (MEG). An integrated overview of these changes, its relationship with clinical symptoms, and the influence of treatment is currently missing. Therefore, we systematically reviewed the MEG studies that have examined oscillatory activity and functional connectivity in the PD‐affected brain. The available articles could be separated into motor network‐focused and whole‐brain focused studies. Motor network studies revealed PD‐related changes in beta band (13–30 Hz) neurophysiological activity within and between several of its components, although it remains elusive to what extent these changes underlie clinical motor symptoms. In whole‐brain studies PD‐related oscillatory slowing and decrease in functional connectivity correlated with cognitive decline and less strongly with other markers of disease progression. Both approaches offer a different perspective on PD‐specific disease mechanisms and could therefore complement each other. Combining the merits of both approaches will improve the setup and interpretation of future studies, which is essential for a better understanding of the disease process itself and the pathophysiological mechanisms underlying specific PD symptoms, as well as for the potential to use MEG in clinical care.
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Affiliation(s)
- Lennard I Boon
- Amsterdam UMC, location VUmc, Department of Neurology, Amsterdam Neuroscience, Amsterdam, the Netherlands.,Amsterdam UMC, location VUmc, Department of Clinical Neurophysiology and Magnetoencephalography Center, Amsterdam Neuroscience, Amsterdam, the Netherlands
| | - Victor J Geraedts
- Amsterdam UMC, location VUmc, Department of Clinical Neurophysiology and Magnetoencephalography Center, Amsterdam Neuroscience, Amsterdam, the Netherlands.,Department of Neurology, Leiden University Medical Center, Leiden, the Netherlands
| | - Arjan Hillebrand
- Amsterdam UMC, location VUmc, Department of Clinical Neurophysiology and Magnetoencephalography Center, Amsterdam Neuroscience, Amsterdam, the Netherlands
| | - Martijn R Tannemaat
- Department of Neurology, Leiden University Medical Center, Leiden, the Netherlands
| | - Maria Fiorella Contarino
- Department of Neurology, Leiden University Medical Center, Leiden, the Netherlands.,Department of Neurology, Haga Teaching Hospital, The Hague, The Netherlands
| | - Cornelis J Stam
- Amsterdam UMC, location VUmc, Department of Clinical Neurophysiology and Magnetoencephalography Center, Amsterdam Neuroscience, Amsterdam, the Netherlands
| | - Henk W Berendse
- Amsterdam UMC, location VUmc, Department of Neurology, Amsterdam Neuroscience, Amsterdam, the Netherlands
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