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Langer A, Hansen C, Roth D, Santer A, Flotz A, Gruber J, Wizany L, Hasenauer S, Pokan R, Dabnichki P, Treven M, Zimmel S, Schmoeger M, Willinger U, Gassner L, Brücke C, Maetzler W, Zach H. Vertical locomotion improves horizontal locomotion: effects of climbing on gait and other mobility aspects in Parkinson's disease. A secondary analysis from a randomized controlled trial. J Neuroeng Rehabil 2024; 21:63. [PMID: 38678241 PMCID: PMC11055236 DOI: 10.1186/s12984-024-01363-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2023] [Accepted: 04/22/2024] [Indexed: 04/29/2024] Open
Abstract
BACKGROUND In the Climb Up! Head Up! trial, we showed that sport climbing reduces bradykinesia, tremor, and rigidity in mildly to moderately affected participants with Parkinson's disease. This secondary analysis aimed to evaluate the effects of sport climbing on gait and functional mobility in this cohort. METHODS Climb Up! Head Up! was a 1:1 randomized controlled trial. Forty-eight PD participants (Hoehn and Yahr stage 2-3) either participated in a 12-week, 90-min-per-week sport climbing course (intervention group) or were engaged in regular unsupervised physical activity (control group). Relevant outcome measures for this analysis were extracted from six inertial measurement units placed on the extremities, chest, and lower back, that were worn during supervised gait and functional mobility assessments before and after the intervention. Assessments included normal and fast walking, dual-tasking walking, Timed Up and Go test, Instrumented Stand and Walk test, and Five Times Sit to Stand test. RESULTS Compared to baseline, climbing improved gait speed during normal walking by 0.09 m/s (p = 0.005) and during fast walking by 0.1 m/s. Climbing also reduced the time spent in the stance phase during fast walking by 0.03 s. Climbing improved the walking speed in the 7-m- Timed Up and Go test by 0.1 m/s (p < 0.001) and the turning speed by 0.39 s (p = 0.052), the speed in the Instrumented Stand and Walk test by 0.1 m/s (p < 0.001), and the speed in the Five Times Sit to Stand test by 2.5 s (p = 0.014). There was no effect of sport climbing on gait speed or gait variables during dual-task walking. CONCLUSIONS Sport climbing improves gait speed during normal and fast walking, as well as functional mobility in people with Parkinson's disease. Trial registration This study was registered within the U.S. National Library of Medicine (No: NCT04569981, date of registration September 30th, 2020).
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Affiliation(s)
- Agnes Langer
- Department of Neurology, Medical University of Vienna, Waehringerstrasse 18-21, 1090, Vienna, Austria
| | - Clint Hansen
- Department of Neurology, University Hospital Schleswig-Holstein and Kiel University, 24105, Kiel, Germany
| | - Dominik Roth
- Department of Emergency Medicine, Medical University of Vienna, 1090, Vienna, Austria
| | - Agnes Santer
- Department of Neurology, Medical University of Vienna, Waehringerstrasse 18-21, 1090, Vienna, Austria
| | - Anna Flotz
- Department of Neurology, Medical University of Vienna, Waehringerstrasse 18-21, 1090, Vienna, Austria
| | - Jakob Gruber
- Department of Neurology, Medical University of Vienna, Waehringerstrasse 18-21, 1090, Vienna, Austria
| | - Laurenz Wizany
- Department of Neurology, Medical University of Vienna, Waehringerstrasse 18-21, 1090, Vienna, Austria
| | - Sebastian Hasenauer
- Department of Neurology, Medical University of Vienna, Waehringerstrasse 18-21, 1090, Vienna, Austria
| | - Rochus Pokan
- Department of Sport Physiology, Institute of Sports Sciences, University of Vienna, 1090, Vienna, Austria
| | - Peter Dabnichki
- School of Engineering, RMIT University, 3000, Melbourne, VIC, Australia
| | - Marco Treven
- Department of Neurology, Medical University of Vienna, Waehringerstrasse 18-21, 1090, Vienna, Austria
| | - Sarah Zimmel
- Department of Neurology, Medical University of Vienna, Waehringerstrasse 18-21, 1090, Vienna, Austria
| | - Michaela Schmoeger
- Department of Neurology, Medical University of Vienna, Waehringerstrasse 18-21, 1090, Vienna, Austria
| | - Ulrike Willinger
- Department of Neurology, Medical University of Vienna, Waehringerstrasse 18-21, 1090, Vienna, Austria
| | - Lucia Gassner
- Department of Sport Physiology, Institute of Sports Sciences, University of Vienna, 1090, Vienna, Austria
- School of Engineering, RMIT University, 3000, Melbourne, VIC, Australia
| | - Christof Brücke
- Department of Neurology, Medical University of Vienna, Waehringerstrasse 18-21, 1090, Vienna, Austria
| | - Walter Maetzler
- Department of Neurology, University Hospital Schleswig-Holstein and Kiel University, 24105, Kiel, Germany
| | - Heidemarie Zach
- Department of Neurology, Medical University of Vienna, Waehringerstrasse 18-21, 1090, Vienna, Austria.
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Krenn M, Wagner M, Zulehner G, Weng R, Jäger F, Keritam O, Sener M, Brücke C, Milenkovic I, Langer A, Buchinger D, Habersam R, Mayerhanser K, Brugger M, Brunet T, Jacob M, Graf E, Berutti R, Cetin H, Hoefele J, Winkelmann J, Zimprich F, Rath J. Next-generation sequencing and comprehensive data reassessment in 263 adult patients with neuromuscular disorders: insights into the gray zone of molecular diagnoses. J Neurol 2024; 271:1937-1946. [PMID: 38127101 PMCID: PMC10972933 DOI: 10.1007/s00415-023-12101-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 11/03/2023] [Accepted: 11/04/2023] [Indexed: 12/23/2023]
Abstract
BACKGROUND Neuromuscular disorders (NMDs) are heterogeneous conditions with a considerable fraction attributed to monogenic defects. Despite the advancements in genomic medicine, many patients remain without a diagnosis. Here, we investigate whether a comprehensive reassessment strategy improves the diagnostic outcomes. METHODS We analyzed 263 patients with NMD phenotypes that underwent diagnostic exome or genome sequencing at our tertiary referral center between 2015 and 2023. We applied a comprehensive reassessment encompassing variant reclassification, re-phenotyping and NGS data reanalysis. Multivariable logistic regression was performed to identify predictive factors associated with a molecular diagnosis. RESULTS Initially, a molecular diagnosis was identified in 53 cases (20%), while an additional 23 (9%) had findings of uncertain significance. Following comprehensive reassessment, the diagnostic yield increased to 23%, revealing 44 distinct monogenic etiologies. Reasons for newly obtained molecular diagnoses were variant reclassifications in 7 and NGS data reanalysis in 3 cases including one recently described disease-gene association (DNAJB4). Male sex reduced the odds of receiving a molecular diagnosis (OR 0.42; 95%CI 0.21-0.82), while a positive family history (OR 5.46; 95%CI 2.60-11.76) and a myopathy phenotype (OR 2.72; 95%CI 1.11-7.14) increased the likelihood. 7% were resolved through targeted genetic testing or classified as acquired etiologies. CONCLUSION Our findings reinforce the use of NGS in NMDs of suspected monogenic origin. We show that a comprehensive reassessment enhances diagnostic accuracy. However, one needs to be aware that genetic diagnoses are often made with uncertainty and can even be downgraded based on new evidence.
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Affiliation(s)
- Martin Krenn
- Department of Neurology, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
- Comprehensive Center for Clinical Neurosciences and Mental Health, Medical University of Vienna, Vienna, Austria
| | - Matias Wagner
- Institute of Human Genetics, Klinikum Rechts Der Isar, School of Medicine, Technical University of Munich, Munich, Germany
- Institute of Neurogenomics, Helmholtz Zentrum München, Munich, Germany
| | - Gudrun Zulehner
- Department of Neurology, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
- Comprehensive Center for Clinical Neurosciences and Mental Health, Medical University of Vienna, Vienna, Austria
| | - Rosa Weng
- Department of Neurology, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
- Comprehensive Center for Clinical Neurosciences and Mental Health, Medical University of Vienna, Vienna, Austria
| | - Fiona Jäger
- Department of Neurology, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
- Comprehensive Center for Clinical Neurosciences and Mental Health, Medical University of Vienna, Vienna, Austria
| | - Omar Keritam
- Department of Neurology, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
- Comprehensive Center for Clinical Neurosciences and Mental Health, Medical University of Vienna, Vienna, Austria
| | - Merve Sener
- Department of Neurology, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
- Comprehensive Center for Clinical Neurosciences and Mental Health, Medical University of Vienna, Vienna, Austria
| | - Christof Brücke
- Department of Neurology, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
- Comprehensive Center for Clinical Neurosciences and Mental Health, Medical University of Vienna, Vienna, Austria
| | - Ivan Milenkovic
- Department of Neurology, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
- Comprehensive Center for Clinical Neurosciences and Mental Health, Medical University of Vienna, Vienna, Austria
| | - Agnes Langer
- Department of Neurology, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
- Comprehensive Center for Clinical Neurosciences and Mental Health, Medical University of Vienna, Vienna, Austria
| | - Dominic Buchinger
- Department of Neurology, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
- Comprehensive Center for Clinical Neurosciences and Mental Health, Medical University of Vienna, Vienna, Austria
| | - Richard Habersam
- Department of Neurology, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
- Comprehensive Center for Clinical Neurosciences and Mental Health, Medical University of Vienna, Vienna, Austria
| | - Katharina Mayerhanser
- Institute of Human Genetics, Klinikum Rechts Der Isar, School of Medicine, Technical University of Munich, Munich, Germany
| | - Melanie Brugger
- Institute of Human Genetics, Klinikum Rechts Der Isar, School of Medicine, Technical University of Munich, Munich, Germany
| | - Theresa Brunet
- Institute of Human Genetics, Klinikum Rechts Der Isar, School of Medicine, Technical University of Munich, Munich, Germany
- Department of Pediatric Neurology, Developmental Medicine and Social Pediatrics, Dr. Von Hauner's Children's Hospital, University of Munich, Munich, Germany
| | - Maureen Jacob
- Institute of Human Genetics, Klinikum Rechts Der Isar, School of Medicine, Technical University of Munich, Munich, Germany
| | - Elisabeth Graf
- Institute of Human Genetics, Klinikum Rechts Der Isar, School of Medicine, Technical University of Munich, Munich, Germany
| | - Riccardo Berutti
- Institute of Human Genetics, Klinikum Rechts Der Isar, School of Medicine, Technical University of Munich, Munich, Germany
- Institute of Neurogenomics, Helmholtz Zentrum München, Munich, Germany
| | - Hakan Cetin
- Department of Neurology, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
- Comprehensive Center for Clinical Neurosciences and Mental Health, Medical University of Vienna, Vienna, Austria
| | - Julia Hoefele
- Institute of Human Genetics, Klinikum Rechts Der Isar, School of Medicine, Technical University of Munich, Munich, Germany
| | - Juliane Winkelmann
- Institute of Human Genetics, Klinikum Rechts Der Isar, School of Medicine, Technical University of Munich, Munich, Germany
- Institute of Neurogenomics, Helmholtz Zentrum München, Munich, Germany
| | - Fritz Zimprich
- Department of Neurology, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
- Comprehensive Center for Clinical Neurosciences and Mental Health, Medical University of Vienna, Vienna, Austria
| | - Jakob Rath
- Department of Neurology, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria.
- Comprehensive Center for Clinical Neurosciences and Mental Health, Medical University of Vienna, Vienna, Austria.
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Spee BTM, Sladky R, Fingerhut J, Laciny A, Kraus C, Carls-Diamante S, Brücke C, Pelowski M, Treven M. Repeating patterns: Predictive processing suggests an aesthetic learning role of the basal ganglia in repetitive stereotyped behaviors. Front Psychol 2022; 13:930293. [PMID: 36160532 PMCID: PMC9497189 DOI: 10.3389/fpsyg.2022.930293] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Accepted: 07/21/2022] [Indexed: 11/13/2022] Open
Abstract
Recurrent, unvarying, and seemingly purposeless patterns of action and cognition are part of normal development, but also feature prominently in several neuropsychiatric conditions. Repetitive stereotyped behaviors (RSBs) can be viewed as exaggerated forms of learned habits and frequently correlate with alterations in motor, limbic, and associative basal ganglia circuits. However, it is still unclear how altered basal ganglia feedback signals actually relate to the phenomenological variability of RSBs. Why do behaviorally overlapping phenomena sometimes require different treatment approaches−for example, sensory shielding strategies versus exposure therapy for autism and obsessive-compulsive disorder, respectively? Certain clues may be found in recent models of basal ganglia function that extend well beyond action selection and motivational control, and have implications for sensorimotor integration, prediction, learning under uncertainty, as well as aesthetic learning. In this paper, we systematically compare three exemplary conditions with basal ganglia involvement, obsessive-compulsive disorder, Parkinson’s disease, and autism spectrum conditions, to gain a new understanding of RSBs. We integrate clinical observations and neuroanatomical and neurophysiological alterations with accounts employing the predictive processing framework. Based on this review, we suggest that basal ganglia feedback plays a central role in preconditioning cortical networks to anticipate self-generated, movement-related perception. In this way, basal ganglia feedback appears ideally situated to adjust the salience of sensory signals through precision weighting of (external) new sensory information, relative to the precision of (internal) predictions based on prior generated models. Accordingly, behavioral policies may preferentially rely on new data versus existing knowledge, in a spectrum spanning between novelty and stability. RSBs may then represent compensatory or reactive responses, respectively, at the opposite ends of this spectrum. This view places an important role of aesthetic learning on basal ganglia feedback, may account for observed changes in creativity and aesthetic experience in basal ganglia disorders, is empirically testable, and may inform creative art therapies in conditions characterized by stereotyped behaviors.
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Affiliation(s)
- Blanca T. M. Spee
- Vienna Cognitive Science Hub, University of Vienna, Vienna, Austria
- Department of Neurology, Center of Expertise for Parkinson and Movement Disorders, Radboud University Medical Center, Nijmegen, Netherlands
| | - Ronald Sladky
- Social, Cognitive and Affective Neuroscience Unit, Department of Cognition, Emotion, and Methods in Psychology, University of Vienna, Vienna, Austria
| | - Joerg Fingerhut
- Berlin School of Mind and Brain, Department of Philosophy, Humboldt-Universität zu Berlin, Berlin, Germany
- Faculty of Philosophy, Philosophy of Science and Religious Studies, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Alice Laciny
- Konrad Lorenz Institute for Evolution and Cognition Research, Klosterneuburg, Austria
| | - Christoph Kraus
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
- Medical Neuroscience Cluster, Medical University of Vienna, Vienna, Austria
| | | | - Christof Brücke
- Medical Neuroscience Cluster, Medical University of Vienna, Vienna, Austria
- Department of Neurology, Medical University of Vienna, Vienna, Austria
| | - Matthew Pelowski
- Vienna Cognitive Science Hub, University of Vienna, Vienna, Austria
- Department of Cognition, Emotion, and Methods in Psychology, Faculty of Psychology, University of Vienna, Vienna, Austria
| | - Marco Treven
- Konrad Lorenz Institute for Evolution and Cognition Research, Klosterneuburg, Austria
- Medical Neuroscience Cluster, Medical University of Vienna, Vienna, Austria
- Department of Neurology, Medical University of Vienna, Vienna, Austria
- *Correspondence: Marco Treven,
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4
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Darcy N, Lofredi R, Al-Fatly B, Neumann WJ, Hübl J, Brücke C, Krause P, Schneider GH, Kühn A. Spectral and spatial distribution of subthalamic beta peak activity in Parkinson's disease patients. Exp Neurol 2022; 356:114150. [PMID: 35732220 DOI: 10.1016/j.expneurol.2022.114150] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 05/27/2022] [Accepted: 06/15/2022] [Indexed: 11/17/2022]
Abstract
Current efforts to optimize subthalamic deep brain stimulation in Parkinson's disease patients aim to harness local oscillatory activity in the beta frequency range (13-35 Hz) as a feedback-signal for demand-based adaptive stimulation paradigms. A high prevalence of beta peak activity is prerequisite for this approach to become routine clinical practice. In a large dataset of postoperative rest recordings from 106 patients we quantified occurrence and identified determinants of spectral peaks in the alpha, low and high beta bands. At least one peak in beta band occurred in 92% of patients and 84% of hemispheres off medication, irrespective of demographic parameters, clinical subtype or motor symptom severity. Distance to previously described clinical sweet spot was significantly related both to beta peak occurrence and to spectral power (rho -0.21, p 0.006), particularly in the high beta band. Electrophysiological landscapes of our cohort's dataset in normalised space showed divergent heatmaps for alpha and beta but found similar regions for low and high beta frequency bands. We discuss potential ramifications for clinicians' programming decisions. In summary, this report provides robust evidence that spectral peaks in beta frequency range can be detected in the vast majority of Parkinsonian subthalamic nuclei, increasing confidence in the broad applicability of beta-guided deep brain stimulation.
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Affiliation(s)
- Natasha Darcy
- Department of Neurology, Charité - Universitätsmedizin Berlin, Berlin, Germany; Berlin Institute of Health (BIH), Berlin, Germany.
| | - Roxanne Lofredi
- Department of Neurology, Charité - Universitätsmedizin Berlin, Berlin, Germany; Berlin Institute of Health (BIH), Berlin, Germany
| | - Bassam Al-Fatly
- Department of Neurology, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Wolf-Julian Neumann
- Department of Neurology, Charité - Universitätsmedizin Berlin, Berlin, Germany; Bernstein Center for Computational Neuroscience, Humboldt-Universität, Berlin, Germany
| | - Julius Hübl
- Department of Neurology, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Christof Brücke
- Department of Neurology, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Patricia Krause
- Department of Neurology, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Gerd-Helge Schneider
- Department of Neurosurgery, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Andrea Kühn
- Department of Neurology, Charité - Universitätsmedizin Berlin, Berlin, Germany; Bernstein Center for Computational Neuroscience, Humboldt-Universität, Berlin, Germany; NeuroCure, Exzellenzcluster, Charité - Universitätsmedizin Berlin, Berlin, Germany; DZNE, German center for neurodegenerative diseases, Berlin, Germany; Berlin School of Mind and Brain, Humboldt-Universität zu Berlin, Germany
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5
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Brücke T, Brücke C. Dopamine transporter (DAT) imaging in Parkinson's disease and related disorders. J Neural Transm (Vienna) 2021; 129:581-594. [PMID: 34910248 DOI: 10.1007/s00702-021-02452-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Accepted: 11/30/2021] [Indexed: 11/27/2022]
Abstract
This review gives an insight into the beginnings of dopamine transporter (DAT) imaging in the early 1990s, focussing on single photon emission tomography (SPECT). The development of the method and its consolidation as a now widely used clinical tool is described. The role of DAT-SPECT in the diagnosis and differential diagnosis of PD, atypical parkinsonian syndromes and several other different neurological disorders is reviewed. Finally the clinical research using DAT-SPECT as a biomarker for the progression of PD, for the detection of a preclinical dopaminergic lesion and its correlation with neuropathological findings is outlined.
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Affiliation(s)
- Thomas Brücke
- Ottakring Clinic, Neurological Department, Verein zur Förderung der Wissenschaftlichen Forschung am Wilhelminenspital (FWFW), Montleartstrasse 37, 1160, Vienna, Austria.
- , Linke Wienzeile 12, 1060, Vienna, Austria.
| | - Christof Brücke
- Department for Neurology, Medical University Vienna, Währingergürtel 18-20, 1090, Vienna, Austria
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Siegert S, Mindler GT, Brücke C, Kranzl A, Patsch J, Ritter M, Janecke AR, Vodopiutz J. Expanding the Phenotype of the FAM149B1-Related Ciliopathy and Identification of Three Neurogenetic Disorders in a Single Family. Genes (Basel) 2021; 12:genes12111648. [PMID: 34828254 PMCID: PMC8622907 DOI: 10.3390/genes12111648] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2021] [Revised: 10/10/2021] [Accepted: 10/15/2021] [Indexed: 12/02/2022] Open
Abstract
Biallelic truncating FAM149B1 variants result in cilia dysfunction and have been reported in four infants with Joubert syndrome and orofaciodigital syndrome type VI, respectively. We report here on three adult siblings, 18 to 40 years of age, homozygous for the known FAM149B1 c.354_357delinsCACTC (p.Gln118Hisfs*20) variant. Detailed clinical examinations were performed including ocular and gait analyses, skeletal- and neuroimaging. All three patients presented with neurological and oculomotor symptoms since birth and mild skeletal dysplasia in infancy resulting in characteristic gait abnormalities. We document mild skeletal dysplasia, abnormal gait with increased hip rotation and increased external foot rotation, ataxia, variable polydactyly, ocular Duane syndrome, progressive ophthalmoplegia, nystagmus, situs inversus of the retinal vessels, olfactory bulb aplasia, and corpus callosal dysgenesis as novel features in FAM149B1-ciliopathy. We show that intellectual disability is mild to moderate and retinal, renal and liver function is normal in these affected adults. Our study thus expands the FAM149B1-related Joubert syndrome to a mainly neurological and skeletal ciliopathy phenotype with predominant oculomotor dysfunction but otherwise stable outcome in adults. Diagnosis of FAM149B1-related disorder was impeded by segregation of multiple neurogenetic disorders in the same family, highlighting the importance of extended clinical and genetic studies in families with complex phenotypes.
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Affiliation(s)
- Sandy Siegert
- Department of Pediatrics and Adolescent Medicine, Division of Pediatric Pulmonology, Allergology and Endocrinology, Comprehensive Center for Pediatrics, Medical University of Vienna, 1090 Vienna, Austria;
| | - Gabriel T. Mindler
- Department of Pediatric Orthopaedics, Orthopaedic Hospital Speising, 1130 Vienna, Austria; (G.T.M.); (A.K.)
- Vienna Bone and Growth Center, 1090 Vienna, Austria;
| | - Christof Brücke
- Department of Neurology, Medical University of Vienna, 1090 Vienna, Austria;
| | - Andreas Kranzl
- Department of Pediatric Orthopaedics, Orthopaedic Hospital Speising, 1130 Vienna, Austria; (G.T.M.); (A.K.)
- Vienna Bone and Growth Center, 1090 Vienna, Austria;
- Laboratory for Gait and Movement Analysis, Orthopaedic Hospital Speising, 1130 Vienna, Austria
| | - Janina Patsch
- Vienna Bone and Growth Center, 1090 Vienna, Austria;
- Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, 1090 Vienna, Austria
| | - Markus Ritter
- Department of Ophthalmology, Medical University of Vienna, 1090 Vienna, Austria;
| | - Andreas R. Janecke
- Department of Pediatrics I, Medical University of Innsbruck, 6020 Innsbruck, Austria;
- Division of Human Genetics, Medical University of Innsbruck, 6020 Innsbruck, Austria
| | - Julia Vodopiutz
- Department of Pediatrics and Adolescent Medicine, Division of Pediatric Pulmonology, Allergology and Endocrinology, Comprehensive Center for Pediatrics, Medical University of Vienna, 1090 Vienna, Austria;
- Vienna Bone and Growth Center, 1090 Vienna, Austria;
- Correspondence: ; Tel.: +43-1-40400-31880
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Wenzel GR, Roediger J, Brücke C, Marcelino ALDA, Gülke E, Pötter-Nerger M, Scholtes H, Wynants K, Juárez Paz LM, Kühn AA. CLOVER-DBS: Algorithm-Guided Deep Brain Stimulation-Programming Based on External Sensor Feedback Evaluated in a Prospective, Randomized, Crossover, Double-Blind, Two-Center Study. J Parkinsons Dis 2021; 11:1887-1899. [PMID: 34151855 DOI: 10.3233/jpd-202480] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Recent technological advances in deep brain stimulation (DBS) (e.g., directional leads, multiple independent current sources) lead to increasing DBS-optimization burden. Techniques to streamline and facilitate programming could leverage these innovations. OBJECTIVE We evaluated clinical effectiveness of algorithm-guided DBS-programming based on wearable-sensor-feedback compared to standard-of-care DBS-settings in a prospective, randomized, crossover, double-blind study in two German DBS centers. METHODS For 23 Parkinson's disease patients with clinically effective DBS, new algorithm-guided DBS-settings were determined and compared to previously established standard-of-care DBS-settings using UPDRS-III and motion-sensor-assessment. Clinical and imaging data with lead-localizations were analyzed to evaluate characteristics of algorithm-derived programming compared to standard-of-care. Six different versions of the algorithm were evaluated during the study and 10 subjects programmed with uniform algorithm-version were analyzed as a subgroup. RESULTS Algorithm-guided and standard-of-care DBS-settings effectively reduced motor symptoms compared to off-stimulation-state. UPDRS-III scores were reduced significantly more with standard-of-care settings as compared to algorithm-guided programming with heterogenous algorithm versions in the entire cohort. A subgroup with the latest algorithm version showed no significant differences in UPDRS-III achieved by the two programming-methods. Comparing active contacts in standard-of-care and algorithm-guided DBS-settings, contacts in the latter had larger location variability and were farther away from a literature-based optimal stimulation target. CONCLUSION Algorithm-guided programming may be a reasonable approach to replace monopolar review, enable less trained health-professionals to achieve satisfactory DBS-programming results, or potentially reduce time needed for programming. Larger studies and further improvements of algorithm-guided programming are needed to confirm these results.
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Affiliation(s)
- Gregor R Wenzel
- Department of Neurology, Movement disorders & Neuromodulation section, Charité -University Medicine Berlin, Germany
| | - Jan Roediger
- Department of Neurology, Movement disorders & Neuromodulation section, Charité -University Medicine Berlin, Germany.,Einstein Center for Neurosciences Berlin, Charité -University Medicine Berlin, Germany
| | - Christof Brücke
- Department of Neurology, Movement disorders & Neuromodulation section, Charité -University Medicine Berlin, Germany
| | - Ana Luísa de A Marcelino
- Department of Neurology, Movement disorders & Neuromodulation section, Charité -University Medicine Berlin, Germany
| | - Eileen Gülke
- Department of Neurology, Universitätsklinikum Hamburg-Eppendorf, Germany
| | | | | | | | | | - Andrea A Kühn
- Department of Neurology, Movement disorders & Neuromodulation section, Charité -University Medicine Berlin, Germany
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Huebl J, Poshtiban A, Brücke C, Siegert S, Bock A, Koziara H, Kmiec T, Rola R, Mandat T, Kühn AA. Subthalamic and pallidal oscillatory activity in patients with Neurodegeneration with Brain Iron Accumulation type I (NBIA-I). Clin Neurophysiol 2019; 130:469-473. [DOI: 10.1016/j.clinph.2018.12.012] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2016] [Revised: 12/11/2018] [Accepted: 12/23/2018] [Indexed: 01/24/2023]
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9
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Lofredi R, Neumann W, Brücke C, Huebl J, Krauss JK, Schneider G, Kühn AA. Pallidal beta bursts in Parkinson's disease and dystonia. Mov Disord 2018; 34:420-424. [DOI: 10.1002/mds.27524] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2018] [Revised: 09/05/2018] [Accepted: 09/16/2018] [Indexed: 01/04/2023] Open
Affiliation(s)
- Roxanne Lofredi
- Movement Disorders and Neuromodulation Unit, Department of NeurologyCharité–Universitätsmedizin Berlin Berlin Germany
| | - Wolf‐Julian Neumann
- Movement Disorders and Neuromodulation Unit, Department of NeurologyCharité–Universitätsmedizin Berlin Berlin Germany
| | - Christof Brücke
- Movement Disorders and Neuromodulation Unit, Department of NeurologyCharité–Universitätsmedizin Berlin Berlin Germany
| | - Julius Huebl
- Movement Disorders and Neuromodulation Unit, Department of NeurologyCharité–Universitätsmedizin Berlin Berlin Germany
| | | | | | - Andrea A. Kühn
- Movement Disorders and Neuromodulation Unit, Department of NeurologyCharité–Universitätsmedizin Berlin Berlin Germany
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10
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Neumann WJ, Huebl J, Brücke C, Lofredi R, Horn A, Saryyeva A, Müller-Vahl K, Krauss JK, Kühn AA. Pallidal and thalamic neural oscillatory patterns in tourette's syndrome. Ann Neurol 2018; 84:505-514. [PMID: 30112767 DOI: 10.1002/ana.25311] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2018] [Revised: 06/08/2018] [Accepted: 07/08/2018] [Indexed: 01/03/2023]
Abstract
OBJECTIVE Aberrant oscillatory activity has been hypothesized to play a role in the pathophysiology of Tourette's syndrome (TS). Deep brain stimulation (DBS) has recently been established as an effective treatment for severe TS. Modulation of symptom-specific oscillations may underlie the mechanism of action of DBS and could be used for adaptive neuromodulation to improve therapeutic efficacy. The objective of this study was to demonstrate a pathophysiological association of pallidal and thalamic local field potentials (LFPs) with TS. METHODS Nine medication-refractory TS patients were included in the study. Intracerebral LFPs were recorded simultaneously from bilateral pallidal and thalamic DBS electrodes. Spectral and temporal dynamics of pallidal and thalamic oscillations were characterized and correlated with preoperative Yale Global Tic Severity Scale (YGTSS) scores. RESULTS Peaks of activity in the theta (3-12Hz) and beta (13-35Hz) were present in pallidal and thalamic recordings from all patients (3 women/6 men; mean age, 29.8 years) and coupled through coherence across targets. Presence of prolonged theta bursts in both targets was associated with preoperative motor tic severity. Total preoperative YGTSS scores (mean, 38.1) were correlated with pallidal and thalamic LFP activity using multivariable linear regression (R² = 0.96; p = 0.02). INTERPRETATION Our findings suggest that pallidothalamic oscillations may be implicated in the pathophysiology of TS. Furthermore, our results highlight the utility of multisite and -spectral oscillatory features in severely affected patients for future identification and clinical use of oscillatory physiomarkers for adaptive stimulation in TS. Ann Neurol 2018;84:505-514.
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Affiliation(s)
- Wolf-Julian Neumann
- Department of Neurology, Movement Disorders and Neuromodulation Unit, Campus Charite Mitte, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Julius Huebl
- Department of Neurology, Movement Disorders and Neuromodulation Unit, Campus Charite Mitte, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Christof Brücke
- Department of Neurology, Movement Disorders and Neuromodulation Unit, Campus Charite Mitte, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Roxanne Lofredi
- Department of Neurology, Movement Disorders and Neuromodulation Unit, Campus Charite Mitte, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Andreas Horn
- Department of Neurology, Movement Disorders and Neuromodulation Unit, Campus Charite Mitte, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Assel Saryyeva
- Department of Neurosurgery, Hannover Medical School, Hannover, Germany
| | - Kirsten Müller-Vahl
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Hannover, Germany
| | - Joachim K Krauss
- Department of Neurosurgery, Hannover Medical School, Hannover, Germany
| | - Andrea A Kühn
- Department of Neurology, Movement Disorders and Neuromodulation Unit, Campus Charite Mitte, Charité-Universitätsmedizin Berlin, Berlin, Germany
- Berlin School of Mind and Brain, Charité-Universitätsmedizin Berlin, Berlin, Germany
- NeuroCure, Charité-Universitätsmedizin Berlin, Berlin, Germany
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11
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Neumann W, Horn A, Ewert S, Huebl J, Brücke C, Slentz C, Schneider G, Kühn AA. A localized pallidal physiomarker in cervical dystonia. Ann Neurol 2017; 82:912-924. [DOI: 10.1002/ana.25095] [Citation(s) in RCA: 93] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2017] [Revised: 10/06/2017] [Accepted: 11/05/2017] [Indexed: 12/18/2022]
Affiliation(s)
- Wolf‐Julian Neumann
- Department of Neurology, Movement Disorders and Neuromodulation Unit, Campus Charite MittéCharité–Universitätsmedizin Berlin
| | - Andreas Horn
- Department of Neurology, Movement Disorders and Neuromodulation Unit, Campus Charite MittéCharité–Universitätsmedizin Berlin
| | - Siobhan Ewert
- Department of Neurology, Movement Disorders and Neuromodulation Unit, Campus Charite MittéCharité–Universitätsmedizin Berlin
| | - Julius Huebl
- Department of Neurology, Movement Disorders and Neuromodulation Unit, Campus Charite MittéCharité–Universitätsmedizin Berlin
| | - Christof Brücke
- Department of Neurology, Movement Disorders and Neuromodulation Unit, Campus Charite MittéCharité–Universitätsmedizin Berlin
| | - Colleen Slentz
- Department of Neurology, Movement Disorders and Neuromodulation Unit, Campus Charite MittéCharité–Universitätsmedizin Berlin
| | - Gerd‐Helge Schneider
- Department of Neurosurgery, Campus Charite MittéCharité–Universitätsmedizin Berlin
| | - Andrea A. Kühn
- Department of Neurology, Movement Disorders and Neuromodulation Unit, Campus Charite MittéCharité–Universitätsmedizin Berlin
- Berlin School of Mind and BrainCharité–Universitätsmedizin Berlin
- NeuroCureCharité–Universitätsmedizin BerlinBerlin Germany
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12
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Irmen F, Huebl J, Schroll H, Brücke C, Schneider GH, Hamker FH, Kühn AA. Subthalamic nucleus stimulation impairs emotional conflict adaptation in Parkinson's disease. Soc Cogn Affect Neurosci 2017; 12:1594-1604. [PMID: 28985419 PMCID: PMC5647801 DOI: 10.1093/scan/nsx090] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2016] [Revised: 06/23/2017] [Accepted: 06/30/2017] [Indexed: 11/18/2022] Open
Abstract
The subthalamic nucleus (STN) occupies a strategic position in the motor network, slowing down responses in situations with conflicting perceptual input. Recent evidence suggests a role of the STN in emotion processing through strong connections with emotion recognition structures. As deep brain stimulation (DBS) of the STN in patients with Parkinson's disease (PD) inhibits monitoring of perceptual and value-based conflict, STN DBS may also interfere with emotional conflict processing. To assess a possible interference of STN DBS with emotional conflict processing, we used an emotional Stroop paradigm. Subjects categorized face stimuli according to their emotional expression while ignoring emotionally congruent or incongruent superimposed word labels. Eleven PD patients ON and OFF STN DBS and eleven age-matched healthy subjects conducted the task. We found conflict-induced response slowing in healthy controls and PD patients OFF DBS, but not ON DBS, suggesting STN DBS to decrease adaptation to within-trial conflict. OFF DBS, patients showed more conflict-induced slowing for negative conflict stimuli, which was diminished by STN DBS. Computational modelling of STN influence on conflict adaptation disclosed DBS to interfere via increased baseline activity.
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Affiliation(s)
- Friederike Irmen
- Berlin School of Mind and Brain, Humboldt-Universität zu Berlin, Berlin 10117 Germany
- Department of Neurology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin 10117, Germany
| | - Julius Huebl
- Department of Neurology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin 10117, Germany
| | - Henning Schroll
- Department of Neurology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin 10117, Germany
- Department of Neurosurgery, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin 10117, Germany
| | - Christof Brücke
- Department of Neurology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin 10117, Germany
| | - Gerd-Helge Schneider
- Department of Computer Science, Chemnitz University of Technology, 09111 Chemnitz, Germany
| | - Fred H Hamker
- Department of Neurosurgery, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin 10117, Germany
| | - Andrea A Kühn
- Berlin School of Mind and Brain, Humboldt-Universität zu Berlin, Berlin 10117 Germany
- Department of Neurology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin 10117, Germany
- NeuroCure Cluster of Excellence, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin 10117, Germany
- Deutsches Zentrum für Neurodegenerative Erkrankungen, 10117 Berlin, Germany
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13
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Neumann WJ, Huebl J, Brücke C, Slentz C, Schneider GH, Kühn A. SP 2. Pallidal low frequency activity correlates with dystonic symptoms in patients with cervical dystonia. Clin Neurophysiol 2016. [DOI: 10.1016/j.clinph.2016.05.188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Neumann WJ, Degen K, Schneider GH, Brücke C, Huebl J, Brown P, Kühn AA. Subthalamic synchronized oscillatory activity correlates with motor impairment in patients with Parkinson's disease. Mov Disord 2016; 31:1748-1751. [PMID: 27548068 DOI: 10.1002/mds.26759] [Citation(s) in RCA: 169] [Impact Index Per Article: 21.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2016] [Revised: 07/26/2016] [Accepted: 07/31/2016] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVE Beta band oscillations in the subthalamic nucleus (STN) have been proposed as a pathophysiological signature in patients with Parkinson's disease (PD). The aim of this study was to investigate the potential association between oscillatory activity in the STN and symptom severity in PD. METHODS Subthalamic local field potentials were recorded from 63 PD patients in a dopaminergic OFF state. Power-spectra were analyzed for the frequency range from 5 to 95 Hz and correlated with individual UPDRS-III motor scores in the OFF state. RESULTS A correlation between total UPDRS-III scores and 8 to 35 Hz activity was revealed across all patients (ρ = 0.44, P < .0001). When correlating each frequency bin, a narrow range from 10 to 15 Hz remained significant for the correlation (false discovery rate corrected P < .05). CONCLUSION Our results show a correlation between local STN 8 to 35 Hz power and impairment in PD, further supporting the role of subthalamic oscillatory activity as a potential biomarker for PD.
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Affiliation(s)
- Wolf-Julian Neumann
- Department of Neurology, Campus Virchow Klinikum, Charité-University Medicine Berlin, Berlin, Germany
| | - Katharina Degen
- Department of Neurology, Campus Virchow Klinikum, Charité-University Medicine Berlin, Berlin, Germany
| | - Gerd-Helge Schneider
- Department of Neurosurgery, Campus Virchow Klinikum, Charité-University Medicine Berlin, Berlin, Germany
| | - Christof Brücke
- Department of Neurology, Campus Virchow Klinikum, Charité-University Medicine Berlin, Berlin, Germany
| | - Julius Huebl
- Department of Neurology, Campus Virchow Klinikum, Charité-University Medicine Berlin, Berlin, Germany
| | - Peter Brown
- Nuffield Department of Clinical Neurosciences and Medical Research Council Brain Network Dynamics Unit, University of Oxford, Oxford, UK
| | - Andrea A Kühn
- Department of Neurology, Campus Virchow Klinikum, Charité-University Medicine Berlin, Berlin, Germany.,Berlin School of Mind and Brain, Charité-University Medicine Berlin, Berlin, Germany.,NeuroCure, Charité-University Medicine Berlin, Berlin, Germany.,Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE), Berlin, Germany
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15
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Huebl J, Brücke C, Merkl A, Bajbouj M, Schneider GH, Kühn AA. Processing of emotional stimuli is reflected by modulations of beta band activity in the subgenual anterior cingulate cortex in patients with treatment resistant depression. Soc Cogn Affect Neurosci 2016; 11:1290-8. [PMID: 27013105 DOI: 10.1093/scan/nsw038] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2015] [Accepted: 03/17/2016] [Indexed: 01/09/2023] Open
Abstract
Deep brain stimulation (DBS) of the subgenual anterior cingulate cortex (sgACC) has emerged as a new therapeutic option in patients with treatment resistant depression (TRD). At the same time, DBS offers a unique opportunity as an innovative research tool to study brain function in vivo Indirect measures of brain function such as positron-emission-tomography imaging findings have revealed a hypermetabolism in the sgACC area in patients with TRD that normalizes in parallel with treatment response to DBS. We used direct intracranial recordings via implanted DBS electrodes to study the neuronal oscillatory activity in the sgACC area during a picture viewing task including emotional and neutral stimuli in eight patients with TRD who underwent DBS.We found a stimulus-induced decrease in beta-band and increase in gamma-band activity, with a main effect of valence for event-related desynchronisation in the beta-frequency range (14-30 Hz). Unpleasant stimuli induced the strongest and most sustained beta-power decrease. The degree of beta-band modulation upon emotional stimuli correlated with the patients' rating of stimulus valence. Our findings confirm the involvement of the sgACC area in emotional processing that was more enhanced for unpleasant stimuli. Moreover, stimulus evaluation may be encoded by modulations of beta-band activity.
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Affiliation(s)
| | | | - Angela Merkl
- Department of Neurology Department of Psychiatry and Psychotherapy
| | | | | | - Andrea A Kühn
- Department of Neurology Mind & Brain School NeuroCure, Cluster of Excellence, Charité - University Medicine Berlin, Germany
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16
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Schroll H, Horn A, Gröschel C, Brücke C, Lütjens G, Schneider GH, Krauss JK, Kühn AA, Hamker FH. Differential contributions of the globus pallidus and ventral thalamus to stimulus-response learning in humans. Neuroimage 2015. [PMID: 26220740 DOI: 10.1016/j.neuroimage.2015.07.061] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
The ability to learn associations between stimuli, responses and rewards is a prerequisite for survival. Models of reinforcement learning suggest that the striatum, a basal ganglia input nucleus, vitally contributes to these learning processes. Our recently presented computational model predicts, first, that not only the striatum, but also the globus pallidus contributes to the learning (i.e., exploration) of stimulus-response associations based on rewards. Secondly, it predicts that the stable execution (i.e., exploitation) of well-learned associations involves further learning in the thalamus. To test these predictions, we postoperatively recorded local field potentials (LFPs) from patients that had undergone surgery for deep brain stimulation to treat severe movement disorders. Macroelectrodes were placed either in the globus pallidus or in the ventral thalamus. During recordings, patients performed a reward-based stimulus-response learning task that comprised periods of exploration and exploitation. We analyzed correlations between patients' LFP amplitudes and model-based estimates of their reward expectations and reward prediction errors. In line with our first prediction, pallidal LFP amplitudes during the presentation of rewards and reward omissions correlated with patients' reward prediction errors, suggesting pallidal access to reward-based teaching signals. Unexpectedly, the same was true for the thalamus. In further support of this prediction, pallidal LFP amplitudes during stimulus presentation correlated with patients' reward expectations during phases of low reward certainty - suggesting pallidal participation in the learning of stimulus-response associations. In line with our second prediction, correlations between thalamic stimulus-related LFP amplitudes and patients' reward expectations were significant within phases of already high reward certainty, suggesting thalamic participation in exploitation.
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Affiliation(s)
- Henning Schroll
- Neurology, Charité - Universitätsmedizin Berlin, 13353 Berlin, Germany; Bernstein Center for Computational Neuroscience, Charité - Universitätsmedizin Berlin, 10115 Berlin, Germany; Psychology, Humboldt Universität zu Berlin, 10099 Berlin, Germany; Computer Science, Chemnitz University of Technology, Chemnitz 09111, Germany.
| | - Andreas Horn
- Neurology, Charité - Universitätsmedizin Berlin, 13353 Berlin, Germany
| | | | - Christof Brücke
- Neurology, Charité - Universitätsmedizin Berlin, 13353 Berlin, Germany
| | - Götz Lütjens
- Neurosurgery, Medical University Hanover, 30625 Hanover, Germany
| | | | - Joachim K Krauss
- Neurosurgery, Medical University Hanover, 30625 Hanover, Germany
| | - Andrea A Kühn
- Neurology, Charité - Universitätsmedizin Berlin, 13353 Berlin, Germany
| | - Fred H Hamker
- Bernstein Center for Computational Neuroscience, Charité - Universitätsmedizin Berlin, 10115 Berlin, Germany; Computer Science, Chemnitz University of Technology, Chemnitz 09111, Germany.
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17
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Huebl J, Brücke C, Schneider GH, Blahak C, Krauss JK, Kühn AA. Bradykinesia induced by frequency-specific pallidal stimulation in patients with cervical and segmental dystonia. Parkinsonism Relat Disord 2015; 21:800-3. [PMID: 25976986 DOI: 10.1016/j.parkreldis.2015.04.023] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2015] [Revised: 03/09/2015] [Accepted: 04/28/2015] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Pallidal deep brain stimulation (DBS) is an effective treatment for patients with primary dystonia leading to a substantial reduction of symptom severity. However, stimulation induced side effects such as bradykinesia have also been reported recently. The influence of stimulation parameters on such side effects have not yet been systemically assessed in these patients. METHODS Here we tested the effect of stimulation frequency and duration of stimulation period on hand motor function in 22 patients with primary cervical and segmental dystonia using an unimanual tapping task. Patients performed the task at 4 different stimulation frequencies (0 Hz = OFF stimulation, 20, 50 and ≥130 Hz = high frequency stimulation) after either an SHORT (5 min, N = 16) or a LONG (60 min, N = 6) stimulation period (i.e. changing of DBS-frequency). The change of overall mobility under HFS compared to the preoperative state was assessed with a 5-point Likert-scale. Tapping performance was analysed using a repeated measures ANOVA with the main factor 'FREQUENCY'. Tapping performance at HFS and changes in general mobility were correlated using Spearman's Rho. RESULTS We found a frequency specific modulation of hand motor function: HFS led to deterioration and 20 Hz stimulation to improvement of tapping rate. The effects were predominant in the 'LONG' group suggesting a significant contribution of stimulation duration. CONCLUSIONS This is important to consider during DBS-programming and evaluation of potential side effects. Furthermore, the impairment in hand motor function under HFS was mirrored by the patients' observation of a deterioration of general mobility.
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Affiliation(s)
- Julius Huebl
- Department of Neurology, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Christof Brücke
- Department of Neurology, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Gerd-Helge Schneider
- Department of Neurosurgery, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Christian Blahak
- Department of Neurology, Universitätsmedizin Mannheim, University of Heidelberg, Mannheim, Germany
| | - Joachim K Krauss
- Department of Neurosurgery, Medizinische Hochschule Hannover, Hannover, Germany
| | - Andrea A Kühn
- Department of Neurology, Charité - Universitätsmedizin Berlin, Berlin, Germany; NeuroCure, ExzellenzCluster, Charité - Universitätsmedizin Berlin, Berlin, Germany; Berlin School of Mind and Brain, Humboldt-Universität zu Berlin, Berlin, Germany.
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18
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Brücke C, Horn A, Huppke P, Kupsch A, Schneider GH, Kühn AA. Failure of Pallidal Deep Brain Stimulation in a Case of Rapid-Onset Dystonia Parkinsonism (DYT12). Mov Disord Clin Pract 2014; 2:76-78. [PMID: 30713884 DOI: 10.1002/mdc3.12124] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2014] [Revised: 10/28/2014] [Accepted: 10/29/2014] [Indexed: 11/12/2022] Open
Affiliation(s)
- Christof Brücke
- Department of Neurology Charité-University Medicine Berlin Germany
| | - Andreas Horn
- Department of Neurology Charité-University Medicine Berlin Germany
| | - Peter Huppke
- Department of Pediatrics University of Göttingen Göttingen Germany
| | - Andreas Kupsch
- Department of Neurology Charité-University Medicine Berlin Germany.,Department of Neurology/Stereotaxy Otto-von-Guericke University Magdeburg Germany
| | | | - Andrea A Kühn
- Department of Neurology Charité-University Medicine Berlin Germany
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19
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Abstract
Myoclonus dystonia syndrome is often misdiagnosed in young children and appropriate treatment is delayed, which has a negative impact on motor development, participation, and emotional well-being. In severely affected patients, deep brain stimulation of the globus pallidus internus has been used successfully to treat both dystonia and myoclonus. Here, the authors present a case of early successful treatment of myoclonus dystonia syndrome by pallidal deep brain stimulation in a patient at the age of 17 years leading to 83% reduction in dystonia score and 89% reduction in myoclonus. The patient gained significant improvement in motor function as well as increased participation and reduced stigma.
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Affiliation(s)
- Andrea A Kühn
- Department of Neurology, Charité-University Medicine, Berlin, Germany
| | - Patricia Krause
- Department of Neurology, Charité-University Medicine, Berlin, Germany
| | | | - Christian Zentner
- Department of Neurology, Martha Maria Hospital, Halle/Saale, Germany
| | - Christof Brücke
- Department of Neurology, Charité-University Medicine, Berlin, Germany
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20
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Neumann WJ, Huebl J, Brücke C, Gabriëls L, Bajbouj M, Merkl A, Schneider GH, Nuttin B, Brown P, Kühn AA. Different patterns of local field potentials from limbic DBS targets in patients with major depressive and obsessive compulsive disorder. Mol Psychiatry 2014; 19:1186-92. [PMID: 24514569 PMCID: PMC4813757 DOI: 10.1038/mp.2014.2] [Citation(s) in RCA: 78] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2013] [Revised: 12/15/2013] [Accepted: 01/06/2014] [Indexed: 12/11/2022]
Abstract
The role of distinct limbic areas in emotion regulation has been largely inferred from neuroimaging studies. Recently, the opportunity for intracranial recordings from limbic areas has arisen in patients undergoing deep brain stimulation (DBS) for neuropsychiatric disorders including major depressive disorder (MDD) and obsessive compulsive disorder (OCD). Here we test the hypothesis that distinct temporal patterns of local field potential (LFP) activity in the human limbic system reflect disease state and symptom severity in MDD and OCD patients. To this end, we recorded LFPs via implanted DBS electrodes from the bed nucleus of stria terminalis (BNST area) in 12 patients (5 OCD, 7 MDD) and from the subgenual cingulate cortex in 7 MDD patients (CG25 area). We found a distinct pattern of oscillatory activity with significantly higher α-power in MDD compared with OCD in the BNST area (broad α-band 8-14 Hz; P<0.01) and a similar level of α-activity in the CG25 area as in the BNST area in MDD patients. The mean α-power correlated with severity of depressive symptoms as assessed by the Beck depression inventory in MDD (n=14, r=0.55, P=0.042) but not with severity of obsessive compulsive symptoms in OCD. Here we show larger α-band activity in MDD patients compared with OCD recorded from intracranial DBS targets. Our results suggest that α-activity in the limbic system may be a signature of symptom severity in MDD and may serve as a potential state biomarker for closed loop DBS in MDD.
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Affiliation(s)
- W-J Neumann
- Department of Neurology, Charité–University Medicine Berlin, Berlin, Germany
| | - J Huebl
- Department of Neurology, Charité–University Medicine Berlin, Berlin, Germany
| | - C Brücke
- Department of Neurology, Charité–University Medicine Berlin, Berlin, Germany
| | - L Gabriëls
- Department of Psychiatry, University Hospital Leuven, Leuven, Belgium
| | - M Bajbouj
- Department of Psychiatry and Psychotherapy, Charité–University Medicine Berlin, Berlin, Germany
| | - A Merkl
- Department of Neurology, Charité–University Medicine Berlin, Berlin, Germany
,Department of Psychiatry and Psychotherapy, Charité–University Medicine Berlin, Berlin, Germany
| | - G-H Schneider
- Department of Neurosurgery, Charité–University Medicine Berlin, Berlin, Germany
| | - B Nuttin
- Department of Neurosurgery, University Hospital Leuven, Leuven, Belgium
| | - P Brown
- Nuffield Department of Clinical Neurosciences, University of Oxford, and National Institute of Health Related Research Oxford Biomedical Research Centre, Oxford, UK
| | - AA Kühn
- Department of Neurology, Charité–University Medicine Berlin, Berlin, Germany
,Berlin School of Mind and Brain, Charité–University Medicine Berlin, Berlin, Germany
,NeuroCure, Charité–University Medicine Berlin, Berlin, Germany
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Siegert S, Herrojo Ruiz M, Brücke C, Huebl J, Schneider GH, Ullsperger M, Kühn AA. Error signals in the subthalamic nucleus are related to post-error slowing in patients with Parkinson's disease. Cortex 2014; 60:103-20. [DOI: 10.1016/j.cortex.2013.12.008] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2013] [Revised: 08/30/2013] [Accepted: 12/13/2013] [Indexed: 10/25/2022]
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22
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Barow E, Neumann WJ, Brücke C, Huebl J, Horn A, Brown P, Krauss JK, Schneider GH, Kühn AA. Deep brain stimulation suppresses pallidal low frequency activity in patients with phasic dystonic movements. ACTA ACUST UNITED AC 2014; 137:3012-3024. [PMID: 25212852 DOI: 10.1093/brain/awu258] [Citation(s) in RCA: 149] [Impact Index Per Article: 14.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Deep brain stimulation of the globus pallidus internus alleviates involuntary movements in patients with dystonia. However, the mechanism is still not entirely understood. One hypothesis is that deep brain stimulation suppresses abnormally enhanced synchronized oscillatory activity within the motor cortico-basal ganglia network. Here, we explore deep brain stimulation-induced modulation of pathological low frequency (4-12 Hz) pallidal activity that has been described in local field potential recordings in patients with dystonia. Therefore, local field potentials were recorded from 16 hemispheres in 12 patients undergoing deep brain stimulation for severe dystonia using a specially designed amplifier allowing simultaneous high frequency stimulation at therapeutic parameter settings and local field potential recordings. For coherence analysis electroencephalographic activity (EEG) over motor areas and electromyographic activity (EMG) from affected neck muscles were recorded before and immediately after cessation of high frequency stimulation. High frequency stimulation led to a significant reduction of mean power in the 4-12 Hz band by 24.8 ± 7.0% in patients with predominantly phasic dystonia. A significant decrease of coherence between cortical EEG and pallidal local field potential activity in the 4-12 Hz range was revealed for the time period of 30 s after switching off high frequency stimulation. Coherence between EMG activity and pallidal activity was mainly found in patients with phasic dystonic movements where it was suppressed after high frequency stimulation. Our findings suggest that high frequency stimulation may suppress pathologically enhanced low frequency activity in patients with phasic dystonia. These dystonic features are the quickest to respond to high frequency stimulation and may thus directly relate to modulation of pathological basal ganglia activity, whereas improvement in tonic features may depend on long-term plastic changes within the motor network.
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Affiliation(s)
- Ewgenia Barow
- Department of Neurology, Campus Virchow Klinikum, Charité-University Medicine Berlin, Berlin, Germany
| | - Wolf-Julian Neumann
- Department of Neurology, Campus Virchow Klinikum, Charité-University Medicine Berlin, Berlin, Germany
| | - Christof Brücke
- Department of Neurology, Campus Virchow Klinikum, Charité-University Medicine Berlin, Berlin, Germany
| | - Julius Huebl
- Department of Neurology, Campus Virchow Klinikum, Charité-University Medicine Berlin, Berlin, Germany
| | - Andreas Horn
- Department of Neurology, Campus Virchow Klinikum, Charité-University Medicine Berlin, Berlin, Germany
| | - Peter Brown
- Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | - Joachim K Krauss
- Department of Neurosurgery, Medical University Hannover, MHH, Hannover, Germany
| | - Gerd-Helge Schneider
- Department of Neurosurgery, Campus Virchow Klinikum, Charité-University Medicine Berlin, Berlin, Germany
| | - Andrea A Kühn
- Department of Neurology, Campus Virchow Klinikum, Charité-University Medicine Berlin, Berlin, Germany
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Hohlefeld FU, Huchzermeyer C, Huebl J, Schneider GH, Brücke C, Schönecker T, Kühn AA, Curio G, Nikulin VV. Interhemispheric functional interactions between the subthalamic nuclei of patients with Parkinson's disease. Eur J Neurosci 2014; 40:3273-83. [PMID: 25195608 DOI: 10.1111/ejn.12686] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2014] [Revised: 07/04/2014] [Accepted: 07/09/2014] [Indexed: 02/01/2023]
Abstract
Parkinson's disease (PD) is characterized by widespread neural interactions in cortico-basal-ganglia networks primarily in beta oscillations (approx. 10-30 Hz), as suggested by previous findings of levodopa-modulated interhemispheric coherence between the bilateral subthalamic nuclei (STN) in local field potential recordings (LFPs). However, due to confounding effects of volume conduction the existence of 'genuine' interhemispheric subcortical coherence remains an open question. To address this issue we utilized the imaginary part of coherency (iCOH) which, in contrast to the standard coherence, is not susceptible to volume conduction. LFPs were recorded from eight patients with PD during wakeful rest before and after levodopa administration. We demonstrated genuine coherence between the bilateral STN in both 10-20 and 21-30 Hz oscillations, as revealed by a non-zero iCOH. Crucially, increased iCOH in 10-20 Hz oscillations positively correlated with the worsening of motor symptoms in the OFF medication condition across patients, which was not the case for standard coherence. Furthermore, across patients iCOH was increased after levodopa administration in 21-30 Hz oscillations. These results suggest a functional distinction between low and high beta oscillations in STN-LFP in line with previous studies. Furthermore, the observed functional coupling between the bilateral STN might contribute to the understanding of bilateral effects of unilateral deep brain stimulation. In conclusion, the present results imply a significant contribution of time-delayed neural interactions to interhemispheric coherence, and the clinical relevance of long-distance neural interactions between bilateral STN for motor symptoms in PD.
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Affiliation(s)
- F U Hohlefeld
- Neurophysics Group, Department of Neurology, Charité - Universitätsmedizin Berlin, Campus Benjamin Franklin, Hindenburgdamm 30, Berlin, Germany
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Hübl J, Spitzer B, Brücke C, Schönecker T, Kupsch A, Alesch F, Schneider GH, Kühn A. Der Einfluss von Dopamin auf neuronale Aktivitätsmuster während emotionaler Reizverarbeitung im Nucleus subthalamicus bei Parkinsonpatienten. KLIN NEUROPHYSIOL 2014. [DOI: 10.1055/s-0034-1384571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- J. Hübl
- Klinik für Neurologie, Charité – Universitätsmedizin Berlin, Campus Virchow Klinikum, Berlin
| | - B. Spitzer
- Dahlem Institute for Neuroimaging of Emotion, Freie Universität Berlin, Berlin
| | - C. Brücke
- Klinik für Neurologie, Charité – Universitätsmedizin Berlin, Campus Virchow Klinikum, Berlin
| | - T. Schönecker
- Klinik für Neurologie, Charité – Universitätsmedizin Berlin, Campus Virchow Klinikum, Berlin
| | - A. Kupsch
- Klinik für Neurologie, Charité – Universitätsmedizin Berlin, Campus Virchow Klinikum, Berlin
| | - F. Alesch
- Klinik für Neurochirurgie, Allgemeines Krankenhaus Wien, Wien
| | - G.-H. Schneider
- Klinik für Neurochirurgie, Charité – Universitätsmedizin Berlin, Campus Virchow Klinikum, Berlin
| | - A. Kühn
- Klinik für Neurologie, Charité – Universitätsmedizin Berlin, Campus Virchow Klinikum, Berlin
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Herrojo Ruiz M, Rusconi M, Brücke C, Haynes JD, Schönecker T, Kühn AA. Encoding of sequence boundaries in the subthalamic nucleus of patients with Parkinson's disease. ACTA ACUST UNITED AC 2014; 137:2715-30. [PMID: 25031238 DOI: 10.1093/brain/awu191] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Sequential behaviour is widespread not only in humans but also in animals, ranging in different degrees of complexity from locomotion to birdsong or music performance. The capacity to learn new motor sequences relies on the integrity of basal ganglia-cortical loops. In Parkinson's disease the execution of habitual action sequences as well as the acquisition of novel sequences is impaired partly due to a deficiency in being able to generate internal cues to trigger movement sequences. In addition, patients suffering from Parkinson's disease have difficulty initiating or terminating a self-paced sequence of actions. Direct recordings from the basal ganglia in these patients show an increased level of beta (14-30 Hz) band oscillatory activity associated with impairment in movement initiation. In this framework, the current study aims to evaluate in patients with Parkinson's disease the neuronal activity in the subthalamic nucleus related to the encoding of sequence boundaries during the explicit learning of sensorimotor sequences. We recorded local field potential activity from the subthalamic nucleus of 12 patients who underwent deep brain stimulation for the treatment of advanced Parkinson's disease, while the patients in their usual medicated state practiced sequences of finger movements on a digital piano with corresponding auditory feedback. Our results demonstrate that variability in performance during an early phase of sequence acquisition correlates across patients with changes in the pattern of subthalamic beta-band oscillations; specifically, an anticipatory suppression of beta-band activity at sequence boundaries is linked to better performance. By contrast, a more compromised performance is related to attenuation of beta-band activity before within-sequence elements. Moreover, multivariate pattern classification analysis reveals that differential information about boundaries and within-sequence elements can be decoded at least 100 ms before the keystroke from the amplitude of oscillations of subthalamic nucleus activity across different frequency bands, not just from the beta-band. Additional analysis was performed to assess the strength of how much the putative signal encoding class of ordinal position (boundaries, within-sequence elements) is reflected in each frequency band. This analysis demonstrates that suppression of power in the beta-band contains the most class-related information, whereas enhancement of gamma band (31-100 Hz) activity is the second main contributor to the encoding. Our findings support the hypothesis that subthalamic nucleus-mediated gating of salient boundary elements during sequence encoding may be a prerequisite for the adequate acquisition of action sequences and the transition to habitual behaviour.
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Affiliation(s)
- María Herrojo Ruiz
- 1 Department of Neurology, Campus Virchow, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Marco Rusconi
- 2 Bernstein Centre for Computational Neuroscience Berlin, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Christof Brücke
- 1 Department of Neurology, Campus Virchow, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - John-Dylan Haynes
- 2 Bernstein Centre for Computational Neuroscience Berlin, Charité-Universitätsmedizin Berlin, Berlin, Germany 3 Berlin Centre for Advanced Neuroimaging, Charité-Universitätsmedizin Berlin, Berlin, Germany 4 Berlin School of Mind and Brain, Humboldt Universität zu Berlin, Berlin, Germany 5 Excellence Cluster NeuroCure, Charité-Universitätsmedizin Berlin, Berlin, Germany 6 Department of Psychology, Humboldt Universität zu Berlin, Berlin, Germany
| | - Thomas Schönecker
- 1 Department of Neurology, Campus Virchow, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Andrea A Kühn
- 1 Department of Neurology, Campus Virchow, Charité-Universitätsmedizin Berlin, Berlin, Germany 4 Berlin School of Mind and Brain, Humboldt Universität zu Berlin, Berlin, Germany 5 Excellence Cluster NeuroCure, Charité-Universitätsmedizin Berlin, Berlin, Germany
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Hübl J, Poshtiban A, Siegert S, Brücke C, Bock A, Schneider GH, Mandat T, Kühn AA. Oszillatorische Aktivität im Globus pallidus internus (GPi) bei sechs Patienten mit Pantothenat-Kinase-assoziierter Neurodegeneration (PKAN). KLIN NEUROPHYSIOL 2014. [DOI: 10.1055/s-0034-1371324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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27
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Neumann WJ, Bock A, Jha A, Huebl J, Brücke C, Schneider GH, Litvak V, Sander T, Kühn AA. Kortiko-subthalamische oszillatorische Konnektivität in Patienten mit idiopathischem Parkinson-Syndrom. KLIN NEUROPHYSIOL 2014. [DOI: 10.1055/s-0034-1371286] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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28
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Degen K, Neumann WJ, Hübl J, Brücke C, Schneider GH, Kühn A. Die Power der oszillatorischen 8 – 30 Hz STN-Aktivität korreliert mit dem motorischen Defizit im UPDRS III bei Patienten mit idiopathischem Parkinson-Syndrom. KLIN NEUROPHYSIOL 2014. [DOI: 10.1055/s-0034-1371196] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Huebl J, Spitzer B, Brücke C, Schönecker T, Kupsch A, Alesch F, Schneider GH, Kühn AA. Oscillatory subthalamic nucleus activity is modulated by dopamine during emotional processing in Parkinson's disease. Cortex 2014; 60:69-81. [PMID: 24713195 DOI: 10.1016/j.cortex.2014.02.019] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2013] [Revised: 01/09/2014] [Accepted: 02/12/2014] [Indexed: 11/19/2022]
Abstract
Dopaminergic denervation in Parkinson's disease (PD) leads to motor deficits but also depression, lack of motivation and apathy. These symptoms can be reversed by dopaminergic treatment, which may even lead to an increased hedonic tone in some patients with PD. Here, we tested the effects of dopamine on emotional processing as indexed by changes in local field potential (LFP) activity of the subthalamic nucleus (STN) in 28 PD patients undergoing deep brain stimulation. LFP activity from the STN was recorded after the administration of levodopa (ON group) or after overnight withdrawal of medication (OFF group) during presentation of an emotional picture-viewing task. Neutral and emotionally arousing pleasant and unpleasant stimuli were chosen from the International Affective Picture System. We found a double dissociation of the alpha band response depending on dopamine state and stimulus valence: dopamine enhanced the processing of pleasant stimuli, while activation during unpleasant stimuli was reduced, as indexed by the degree of desynchronization in the alpha frequency band. This pattern was reversed in the OFF state and more pronounced in the subgroup of non-depressed PD patients. Further, we found an early gamma band increase with unpleasant stimuli that occurred when ON but not OFF medication and was correlated with stimulus arousal. The late STN alpha band decrease is thought to represent active processing of sensory information. Our findings support the idea that dopamine enhances approach-related processes during late stimulus evaluation in PD. The early gamma band response may represent local encoding of increased attention, which varies as a function of stimulus arousal.
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Affiliation(s)
- Julius Huebl
- Department of Neurology, Charité - University Medicine Berlin, Berlin, Germany
| | - Bernhard Spitzer
- Dahlem Institute for Neuroimaging of Emotion, Free University Berlin, Berlin, Germany
| | - Christof Brücke
- Department of Neurology, Charité - University Medicine Berlin, Berlin, Germany
| | - Thomas Schönecker
- Department of Neurology, Charité - University Medicine Berlin, Berlin, Germany
| | - Andreas Kupsch
- Department of Neurology, Charité - University Medicine Berlin, Berlin, Germany
| | - François Alesch
- Neurosurgical Department of the Vienna General Hospital, Vienna, Austria
| | - Gerd-Helge Schneider
- Department of Neurosurgery, Charité - University Medicine Berlin, Berlin, Germany
| | - Andrea A Kühn
- Department of Neurology, Charité - University Medicine Berlin, Berlin, Germany; Berlin School of Mind and Brain, Charité - University Medicine Berlin, Berlin, Germany; NeuroCure, Charité - University Medicine Berlin, Berlin, Germany.
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30
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Hohlefeld FU, Huchzermeyer C, Huebl J, Schneider GH, Nolte G, Brücke C, Schönecker T, Kühn AA, Curio G, Nikulin VV. Functional and effective connectivity in subthalamic local field potential recordings of patients with Parkinson's disease. Neuroscience 2013; 250:320-32. [PMID: 23876322 DOI: 10.1016/j.neuroscience.2013.07.028] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2013] [Revised: 06/24/2013] [Accepted: 07/11/2013] [Indexed: 01/16/2023]
Abstract
In Parkinson's disease (PD) levodopa-associated changes in the power and long-range temporal correlations of beta oscillations have been demonstrated, yet the presence and modulation of genuine connectivity in local field potentials (LFP) recorded from the subthalamic nucleus (STN) remains an open question. The present study investigated LFP recorded bilaterally from the STN at wakeful rest in ten patients with PD after overnight withdrawal of levodopa (OFF) and after a single dose levodopa administration (ON). We utilized connectivity measures being insensitive to volume conduction (functional connectivity: non-zero imaginary part of coherency; effective connectivity: phase-slope index). We demonstrated the presence of neuronal interactions in the frequency range of 10-30 Hz in STN-LFP without a preferential directionality of interactions between different contacts along the electrode tracks. While the direction of neuronal interactions per se was preserved after levodopa administration, functional connectivity and the ventral-dorsal information flow were modulated by medication. The OFF-ON differences in functional connectivity were correlated with the levodopa-induced improvement in clinical Unified Parkinson's Disease Rating Scale scores. We hypothesize that regional neuronal interactions, as reflected in STN-LFP connectivity, might represent a basis for the intra-nuclear spatial specificity of deep brain stimulation. Moreover, our results suggest the potential use of volume conduction-insensitive measures of connectivity in STN-LFP as a marker of clinical motor symptoms in PD.
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Affiliation(s)
- F U Hohlefeld
- Neurophysics Group, Department of Neurology, Charité - Universitätsmedizin Berlin, Campus Benjamin Franklin, Berlin, Germany.
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Herrojo Ruiz M, Brücke C, Nikulin VV, Schneider GH, Kühn AA. Beta-band amplitude oscillations in the human internal globus pallidus support the encoding of sequence boundaries during initial sensorimotor sequence learning. Neuroimage 2013; 85 Pt 2:779-93. [PMID: 23711534 DOI: 10.1016/j.neuroimage.2013.05.085] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2013] [Revised: 05/14/2013] [Accepted: 05/19/2013] [Indexed: 11/17/2022] Open
Abstract
Sequential behavior characterizes both simple everyday tasks, such as getting dressed, and complex skills, such as music performance. The basal ganglia (BG) play an important role in the learning of motor sequences. To study the contribution of the human BG to the initial encoding of sequence boundaries, we recorded local field potentials in the sensorimotor area of the internal globus pallidus (GPi) during the early acquisition of sensorimotor sequences in patients undergoing deep brain stimulation for dystonia. We demonstrated an anticipatory modulation of pallidal beta-band neuronal oscillations that was specific to sequence boundaries, as compared to within-sequence elements, and independent of both the movement parameters and the initiation/termination of ongoing movement. The modulation at sequence boundaries emerged with training, in parallel with skill learning, and correlated with the degree of long-range temporal correlations (LRTC) in the dynamics of ongoing beta-band amplitude oscillations. The implication is that LRTC of beta-band oscillations in the sensorimotor GPi might facilitate the emergence of beta power modulations by the sequence boundaries in parallel with sequence learning. Taken together, the results reveal the oscillatory mechanisms in the human BG that contribute at an initial learning phase to the hierarchical organization of sequential behavior as reflected in the formation of boundary-delimited representations of action sequences.
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Affiliation(s)
- María Herrojo Ruiz
- Department of Neurology, Campus Virchow, Charité-University Medicine Berlin, Berlin 13353, Germany.
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Hübl J, Spitzer B, Brücke C, Schönecker T, Kupsch A, Alesch F, Schneider GH, Kühn AA. Dopaminerger Einfluss auf neuronale Korrelate emotionaler Verarbeitung bei Patienten mit Morbus Parkinson. KLIN NEUROPHYSIOL 2013. [DOI: 10.1055/s-0033-1337144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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33
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Restle F, Nickels E, Brücke C, Ebersbach G, Kühn A. Modulation of motor cortical plasticity after BIG-physiotherapy in patients suffering from Parkinson's Disease. KLIN NEUROPHYSIOL 2013. [DOI: 10.1055/s-0033-1337272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Kroneberg D, Kühn A, Brücke C, Schneider GH. Veränderung der intrakortikalen Inhibition und kortikalen Plastizität bei einer Patientin mit tardiver Dystonie nach Tiefer Hirnstimulation. KLIN NEUROPHYSIOL 2013. [DOI: 10.1055/s-0033-1337168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Neumann WJ, Huebl J, Brücke C, Gabriëls L, Brown P, Nuttin B, Kühn AA. Local field potentials of the bed nucleus of stria terminalis in patients with major depressive and obsessive compulsive disorder. KLIN NEUROPHYSIOL 2013. [DOI: 10.1055/s-0033-1337276] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Brücke C, Bock A, Huebl J, Krauss JK, Schönecker T, Schneider GH, Brown P, Kühn AA. Thalamic gamma oscillations correlate with reaction time in a Go/noGo task in patients with essential tremor. Neuroimage 2013; 75:36-45. [PMID: 23466935 DOI: 10.1016/j.neuroimage.2013.02.038] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2012] [Revised: 01/23/2013] [Accepted: 02/14/2013] [Indexed: 10/27/2022] Open
Abstract
Intracerebral recordings of neuronal activity in patients undergoing deep brain stimulation have revealed characteristic movement-related desynchronization at frequencies <30 Hz and increased activity in the gamma band (~30-100 Hz) in the basal ganglia and thalamus. Thalamic gamma activity is also found during arousal. Here, we explore oscillatory gamma band activity recorded from the ventralis intermedius nucleus of the thalamus during motor performance in a Go/noGo task in 10 patients with essential tremor after implantation of deep brain stimulation electrodes. We show that movement-related gamma activity is lateralized to the nucleus contralateral to the moved side similar to previous findings in the globus pallidus internus and the subthalamic nucleus. The onset of contralateral gamma band synchronization following imperative Go cues is positively correlated with reaction time. Remarkably, baseline levels of gamma activity shortly before the Go cue correlated with the reaction times. Here, faster responses occurred in patients with higher levels of pre-cue gamma activity. Our findings support the role of gamma activity as a physiological prokinetic activity in the motor system. Moreover, we suggest that subtle fluctuations in pre-cue gamma band activity may have an impact on task performance and may index arousal-related states.
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Affiliation(s)
- Christof Brücke
- Department of Neurology, Charité - Universitätsmedizin Berlin, Germany
| | - Antje Bock
- Department of Neurology, Charité - Universitätsmedizin Berlin, Germany
| | - Julius Huebl
- Department of Neurology, Charité - Universitätsmedizin Berlin, Germany
| | - Joachim K Krauss
- Department of Neurosurgery, Medizinische Hochschule Hannover, Germany
| | - Thomas Schönecker
- Department of Neurology, Charité - Universitätsmedizin Berlin, Germany
| | | | - Peter Brown
- Nuffield Department of Clinical Neurology, University Oxford, UK
| | - Andrea A Kühn
- Department of Neurology, Charité - Universitätsmedizin Berlin, Germany.
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Neumann WJ, Huebl J, Brücke C, Ruiz MH, Kupsch A, Schneider GH, Kühn AA. Enhanced low-frequency oscillatory activity of the subthalamic nucleus in a patient with dystonia. Mov Disord 2012; 27:1063-6. [PMID: 22700436 DOI: 10.1002/mds.25078] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2011] [Revised: 03/06/2012] [Accepted: 05/13/2012] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Local field potentials were recorded from the subthalamic nucleus (STN) in a patient with dystonia to further elucidate disease-specific aspects of basal ganglia oscillatory activity. METHODS STN local field potentials and electromyograms (EMGs) from dystonic muscles were recorded to provide an estimate of the power spectra and coherence between the STN activity and EMG. RESULTS STN power spectra revealed a distinct peak at approximately 7 Hz in our patient. This finding is similar to the pallidal activity seen in dystonic patients but clearly different from the subthalamic beta activity of patients with Parkinson's disease. Significant coherence between STN activity and EMG was present in the 4- to 12-Hz band in this patient. CONCLUSIONS Dystonia is associated with pathological activity in the theta range present throughout the cortical-basal ganglia network. This activity differs from that in Parkinson's disease, suggesting that different movement disorders may involve distinct oscillatory circuit disturbances. © 2012 Movement Disorder Society.
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Affiliation(s)
- Wolf-Julian Neumann
- Department of Neurology, Charité University Medicine Berlin, Campus Virchow Klinikum, Augustenburger Platz 1, Berlin, Germany
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Neumann WJ, Hübl J, Brücke C, Capelle HH, Müller-Vahl K, Krauss JK, Kühn AA. Pallidale und thalamische Oszillationen bei Patienten mit Tourette-Syndrom. KLIN NEUROPHYSIOL 2012. [DOI: 10.1055/s-0032-1301490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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39
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Brücke C, Hübl J, Merkl A, Schneider GH, Bajbouj M, Kühn AA. Emotional processing in the Cg25 area: Preliminary LFP data from 3 patients with major depressive disorder. KLIN NEUROPHYSIOL 2012. [DOI: 10.1055/s-0032-1301668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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40
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Brücke C, Hübl J, Kupsch A, Blahak C, Lütjens G, Brown P, Krauss JM, Schneider GH, Kühn AA. Pallidale Gamma Oszillationen korrelieren mit der Bewegungsgeschwindigkeit bei Patienten mit Dystonie. KLIN NEUROPHYSIOL 2012. [DOI: 10.1055/s-0032-1301631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Huebl J, Schoenecker T, Siegert S, Brücke C, Schneider GH, Kupsch A, Yarrow K, Kühn AA. Modulation of subthalamic alpha activity to emotional stimuli correlates with depressive symptoms in Parkinson's disease. Mov Disord 2011; 26:477-83. [PMID: 21287598 DOI: 10.1002/mds.23515] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2010] [Revised: 08/31/2010] [Accepted: 09/28/2010] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Deep brain stimulation of the subthalamic nucleus is an effective treatment for patients with advanced Parkinson's disease. However, affective side effects following subthalamic deep brain stimulation have been reported. Here, we aim to elucidate the influence of affective state on emotional processing as indexed by local field potential activity and to identify neurophysiological markers in patients at risk of developing depressive symptoms during subthalamic deep brain stimulation. METHODS Subthalamic local field potentials were directly recorded via electrodes implanted for deep brain stimulation in 12 Parkinson's disease patients while viewing emotionally salient and neutral pictures. Parkinson's disease patients were assessed for depressive symptoms using the Beck depression inventory at the time of operation and 3 months after continuous subthalamic nucleus deep brain stimulation. RESULTS We found a significant event-related desynchronization in the local alpha frequency band (8-12 Hz) for emotionally arousing but not neutral pictures. The the event-related desynchronization (ERD) in the alpha frequency band was reduced for pleasant stimuli in patients with mild to moderate depressive symptoms compared with patients without depression. The alpha-ERD to unpleasant stimuli showed the opposite pattern. Consistently, the index of event-related alpha desynchronization (alpha ERD for pleasant stimuli minus alpha ERD for unpleasant stimuli) correlated with the Beck depression inventory at the time of the recordings and at 3 months after continuous deep brain stimulation. The alpha ERD to unpleasant pictures correlated significantly with the Beck depression inventory score at 3 months after chronic deep brain stimulation. DISCUSSION In conclusion, we found mood-congruent stimulus processing in the subthalamic nucleus of Parkinson's disease patients. Electrophysiological markers such as event-related desynchronization of subthalamic alpha activity reflect state-dependent emotional processing and may potentially be used to predict depressive mood disturbances in Parkinson's disease patients with chronic subthalamic deep brain stimulation at an early stage.
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Affiliation(s)
- Julius Huebl
- Department of Neurology, Charité-University Medicine Berlin, Germany
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Siegert S, Ullsperger M, Brücke C, Hübl J, Kupsch A, Schneider GH, Yarrow K, Kühn AA. Fehlerspezifische Aktivierung des Nucleus subthalamicus bei Parkinsonpatienten. KLIN NEUROPHYSIOL 2009. [DOI: 10.1055/s-0029-1216218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Hübl J, Brücke C, Siegert S, Kaiser I, Alesch F, Schneider GH, Kupsch A, Yarrow K, Kühn AA. Dopamin verstärkt positives Priming angenehmer Stimuli im STN bei Parkinsonpatienten. KLIN NEUROPHYSIOL 2009. [DOI: 10.1055/s-0029-1216220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Kempf F, Brücke C, Salih F, Trottenberg T, Kupsch A, Schneider GH, Doyle Gaynor LM, Hoffmann KT, Vesper J, Wöhrle J, Altenmüller DM, Krauss JK, Mazzone P, Di Lazzaro V, Yelnik J, Kühn AA, Brown P. Gamma activity and reactivity in human thalamic local field potentials. Eur J Neurosci 2009; 29:943-53. [DOI: 10.1111/j.1460-9568.2009.06655.x] [Citation(s) in RCA: 72] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
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Kühn AA, Tsui A, Aziz T, Ray N, Brücke C, Kupsch A, Schneider GH, Brown P. Pathological synchronisation in the subthalamic nucleus of patients with Parkinson's disease relates to both bradykinesia and rigidity. Exp Neurol 2008; 215:380-7. [PMID: 19070616 DOI: 10.1016/j.expneurol.2008.11.008] [Citation(s) in RCA: 416] [Impact Index Per Article: 26.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2008] [Revised: 10/21/2008] [Accepted: 11/08/2008] [Indexed: 10/21/2022]
Abstract
Parkinson's disease (PD) is associated with exaggerated oscillatory synchrony in the basal ganglia at frequencies over 8-35 Hz. Studies have demonstrated a suppression of local field potential (LFP) activity in the subthalamic nucleus (STN) upon treatment with the dopamine prodrug, levodopa, with the degree of suppression of power in the 8-35 Hz band correlating with the improvement in combined measures of bradykinesia and rigidity. However, these studies do not explicitly address the question of what is more important in predicting clinical change - synchronisation of neuronal activity or the specific frequency within the 8-35 Hz band over which the latter occurs. In addition, they have not demonstrated a relationship between treatment-induced changes in synchronisation and changes in bradykinesia or rigidity on their own. To this end, we collected and analysed LFP and clinical data in 30 patients with PD. We found significant correlations between levodopa-induced power suppression and rigidity and bradykinesia, when these clinical features were considered separately, but only when power suppression profiles were re-aligned to the frequency of peak synchronisation. Under these circumstances correlations with rigidity persisted despite partialising out the effect of bradykinesia and vice versa. These data suggest that levodopa-induced improvements in both rigidity and bradykinesia scale with the degree of suppression of oscillatory power in the STN LFP, and that this is true irrespective of the frequency at which synchronisation occurs across a broad band from 8-35 Hz.
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Affiliation(s)
- Andrea A Kühn
- Department of Neurology, Charité, University Medicine Berlin, Campus Virchow, Berlin, Germany
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Kühn AA, Brücke C, Schneider GH, Trottenberg T, Kivi A, Kupsch A, Capelle HH, Krauss JK, Brown P. Increased beta activity in dystonia patients after drug-induced dopamine deficiency. Exp Neurol 2008; 214:140-3. [DOI: 10.1016/j.expneurol.2008.07.023] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2008] [Revised: 07/22/2008] [Accepted: 07/25/2008] [Indexed: 10/21/2022]
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Kühn AA, Brücke C, Hübl J, Schneider GH, Kupsch A, Eusebio A, Ashkan K, Holland P, Aziz T, Vandenberghe W, Nuttin B, Brown P. Motivation modulates motor-related feedback activity in the human basal ganglia. Curr Biol 2008; 18:R648-R650. [DOI: 10.1016/j.cub.2008.06.003] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Brücke C, Hübl J, Kempf F, Krauss JK, Yarrow K, Kupsch A, Schneider GH, Brown P, Kühn AA. TUO28 Pallidal gamma activity is correlated to movement amplitude in patients with dystonia. Clin Neurophysiol 2008. [DOI: 10.1016/s1388-2457(08)60162-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Brücke C, Kempf F, Kupsch A, Schneider GH, Krauss JK, Aziz T, Yarrow K, Pogosyan A, Brown P, Kühn AA. Movement-related synchronization of gamma activity is lateralized in patients with dystonia. Eur J Neurosci 2008; 27:2322-9. [PMID: 18430031 DOI: 10.1111/j.1460-9568.2008.06203.x] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
There is evidence for synchronization at frequencies both under 30 Hz and over 60-80 Hz in the so-called gamma frequency band in patients with Parkinson's disease (PD). Gamma activity increases after dopaminergic therapy and during voluntary movement, suggesting that it might be physiological and relate to motor processing in the basal ganglia (BG). We recorded local field potential (LFP) activity during a choice reaction time task in 11 patients with dystonia undergoing implantation of the internal globus pallidus for therapeutic stimulation. The spectral content of the LFP was averaged with respect to movement onset over 6-11 Hz, 18-25 Hz and 60-80 Hz, separately for responses ipsilateral and contralateral to movement. There was a perimovement increase in 60-80 Hz activity in the LFP, but only contralateral to movement. In contrast, low-frequency LFP activity decreased symmetrically during movement. This occurred earlier in the 18-25 Hz band than in the 6-11 Hz band, and was followed by a postmovement increase in oscillatory activity in the 18-25 Hz band that was contralateral to movement. The presence of a lateralized movement-related increase in gamma activity in the BG of patients with dystonia, similar to that recorded in patients with treated PD, suggests that this may be a residual feature of normal BG function. Moreover, the results provide further support for functional distinctions between BG oscillatory activities of different frequency.
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Affiliation(s)
- Christof Brücke
- Department of Neurology, Campus Virchow, Charité-University Medicine Berlin, Augustenburger Platz 1, 13353 Berlin, Germany
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Androulidakis AG, Brücke C, Kempf F, Kupsch A, Aziz T, Ashkan K, Kühn AA, Brown P. Amplitude modulation of oscillatory activity in the subthalamic nucleus during movement. Eur J Neurosci 2008; 27:1277-84. [DOI: 10.1111/j.1460-9568.2008.06085.x] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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