Neurodegeneration, Neuroprotection, and Disease-Oriented NeuroscienceResearch PaperParkinsonian impairment correlates with spatially extensive subthalamic oscillatory synchronization
Section snippets
Patients and procedures
The patients (n=18, mean age 60.4±7.0 years, range 38–71, 9 males) participated with informed consent. All patients had advanced idiopathic PD with motor fluctuations and/or dyskinesia. The mean disease duration was 15.2±5.4 years (range 9–27 years). The mean pre-operative Unified Parkinson's Disease Rating Scale (UPDRS) motor score tested no more than 6 months prior to surgery was 42.9±15.7 when off drugs overnight and 11.1±7.4 after levodopa challenge (P<0.001, two tailed paired t-test). The
Amplitude spectra of subthalamic LFP activity
Fig 1 shows example raw and group mean LFP frequency spectra from the four monopolar contacts (Fig 1A) and the three corresponding bipolar contact pairs (Fig 1B) at the level at which bipolar contact pair 01 registers the highest step increase in beta power during the graded descent of the DBS electrode through the surgical target. This level, hereafter termed the PTL, is believed to correspond to the point at which the lowermost electrode contact, 0, enters into dorsal STN (Chen et al., 2006,
Discussion
The principal finding in the current study was the presence of correlations between the strength of spatially extended oscillatory synchronization in the STN and bordering zona incerta and motor impairment in PD patients; specifically, the greater the evidence for spatially extended oscillatory synchronization, the worse the bradykinesia and rigidity. Spatially extended oscillatory synchronization was indexed by phase coherence over distances of 2 or 4 mm. Correlations were evident in the beta
Conclusion
We have shown that the stronger spatially extended oscillatory synchronization is in the STN and bordering zona incerta, the worse the bradykinesia and rigidity in patients with Parkinson's disease. Clinical correlations with the phase coherence between sites were depth, frequency band and phenotype specific. These new data strengthen the link between pathological synchronization and the different motor features of Parkinsonism and suggest that the presence of synchronization over distance in
Acknowledgments
Alek Pogosyan was supported by the Medical Research Council, Patricia Limousin, Tom Foltynie, Ludvic Zrinzo and Marwan Hariz by the Parkinson's appeal, Irene Martinez-Torres by a grant from Fondo de Inversion Sanitaria (FIS), Instituto de Salud Carlos III, Spanish Department of Science and Innovation (FI08/00108), Fumiaki Yoshida by the Uehara Memorial Fundation, and Peter Brown by the Medical Research Council, Parkinson's Disease Society (UK) and the NIHR Biomedical Research Centre, Oxford.
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2021, World NeurosurgeryCitation Excerpt :Furthermore, as a growing body of evidence has suggested that the region of STN with maximal beta band activity can predict effective contacts and better clinical outcome in DBS surgery for PD patients,4-6 there has been increasing interest in recording beta LPF intraoperatively.2 Previously, most LFPs have been recorded from the implanted macroelectrodes during the periods before implanting a subcutaneous pulse generator (staged operation)6-12 or immediately after implantation in the operating room.5,13-16 However, accumulating evidence suggests that LFPs can be recorded with single-unit neuronal activity simultaneously from microelectrodes and this simultaneous recording might be useful in delineating the border of STN accurately.17-21
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