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Title: Deep brain stimulation for Parkinson's disease modulates high-frequency evoked and spontaneous neural activity.
Austin Authors: Sinclair, Nicholas C;McDermott, Hugh J;Fallon, James B;Perera, Thushara;Brown, Peter;Bulluss, Kristian J ;Thevathasan, Wesley
Affiliation: Bionics Institute, Melbourne, Australia
Department of Neurology, Austin Healths, Melbourne, Australia
Department of Medicine, The University of Melbourne, Parkville, Australia
Department of Neurosurgery, St Vincent's, Melbourne, Australia
Medical Research Council Brain Network Dynamics Unit, and Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom
Department of Medical Bionics, The University of Melbourne, Melbourne, Australia
Department of Surgery, Austin Health, The University of Melbourne, Heidelberg, Victoria, Australia
Department of Neurosurgery, Austin Health, Heidelberg, Victoria, Australia
Department of Neurology, Austin Health, Heidelberg, Victoria, Australia
Issue Date: 2-Jul-2019
Date: 2019-07-02
Publication information: Neurobiology of disease 2019; 130: 104522
Abstract: Deep brain stimulation is an established therapy for Parkinson's disease; however, its effectiveness is hindered by limited understanding of therapeutic mechanisms and the lack of a robust feedback signal for tailoring stimulation. We recently reported that subthalamic nucleus deep brain stimulation evokes a neural response resembling a decaying high-frequency (200-500 Hz) oscillation that typically has a duration of at least 10 ms and is localizable to the dorsal sub-region. As the morphology of this response suggests a propensity for the underlying neural circuitry to oscillate at a particular frequency, we have named it evoked resonant neural activity. Here, we determine whether this evoked activity is modulated by therapeutic stimulation - a critical attribute of a feedback signal. Furthermore, we investigated whether any related changes occurred in spontaneous local field potentials. Evoked and spontaneous neural activity was intraoperatively recorded from 19 subthalamic nuclei in patients with Parkinson's disease. Recordings were obtained before therapeutic stimulation and during 130 Hz stimulation at increasing amplitudes (0.67-3.38 mA), 'washout' of therapeutic effects, and non-therapeutic 20 Hz stimulation. Therapeutic efficacy was assessed using clinical bradykinesia and rigidity scores. The frequency and amplitude of evoked resonant neural activity varied with the level of 130 Hz stimulation (p < .001). This modulation coincided with improvement in bradykinesia and rigidity (p < .001), and correlated with spontaneous beta band suppression (p < .001). Evoked neural activity occupied a similar frequency band to spontaneous high-frequency oscillations (200-400 Hz), both of which decreased to around twice the 130 Hz stimulation rate. Non-therapeutic stimulation at 20 Hz evoked, but did not modulate, resonant activity. These results indicate that therapeutic deep brain stimulation alters the frequency of evoked and spontaneous oscillations recorded in the subthalamic nucleus that are likely generated by loops within the cortico-basal ganglia-thalamo-cortical network. Evoked resonant neural activity therefore has potential as a tool for providing insight into brain network function and has key attributes of a dynamic feedback signal for optimizing therapy.
DOI: 10.1016/j.nbd.2019.104522
Journal: Neurobiology of disease
PubMed URL: 31276793
Type: Journal Article
Subjects: Deep brain stimulation
Evoked resonant neural activity
High frequency oscillations
Local field potentials
Parkinson's disease
Subthalamic nucleus
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