Longer β oscillatory episodes reliably identify pathological subthalamic activity in Parkinsonism
Mov Disord.. 2018-08-25; 33(10): 1609-1618
DOI: 10.1002/mds.27418
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Deffains M(1)(2), Iskhakova L(1)(2), Katabi S(1), Israel Z(3), Bergman H(1)(2)(3).
Author information:
(1)Department of Medical Neurobiology, Institute of Medical Research
Israel-Canada (IMRIC), The Hebrew University-Hadassah Medical School, Jerusalem,
Israel.
(2)The Edmond and Lily Safra Center for Brain Sciences, The Hebrew University,
Jerusalem, Israel.
(3)Department of Neurosurgery, Hadassah University Hospital, Jerusalem, Israel.
BACKGROUND: The efficacy of deep brain stimulation (DBS) – primarily of the
subthalamic nucleus (STN) – for advanced Parkinson’s disease (PD) is commonly
attributed to the suppression of pathological synchronous β oscillations along
the cortico-thalamo-basal ganglia network. Conventional continuous
high-frequency DBS indiscriminately influences pathological and normal neural
activity. The DBS protocol would therefore be more effective if stimulation was
only applied when necessary (closed-loop adaptive DBS).
OBJECTIVES AND METHODS: Our study aimed to identify a reliable biomarker of the
pathological neuronal activity in parkinsonism that could be used as a trigger
for adaptive DBS. To this end, we examined the oscillatory features of paired
spiking activities recorded in three distinct nodes of the basal ganglia network
of 2 African green monkeys before and after induction of parkinsonism (by MPTP
intoxication).
RESULTS: Parkinsonism-related basal ganglia β oscillations consisted of
synchronized time-limited episodes, rather than a continuous stretch, of β
oscillatory activity. Episodic basal ganglia β oscillatory activity, although
prolonged in parkinsonism, was not necessarily pathological given that short β
episodes could also be detected in the healthy state. Importantly, prolongation
of the basal ganglia β episodes was more pronounced than their intensification
in the parkinsonian state-especially in the STN. Hence, deletion of longer β
episodes was more effective than deletion of stronger β episodes in reducing
parkinsonian STN synchronized oscillatory activity.
CONCLUSIONS: Prolonged STN β episodes are pathological in parkinsonism and can
be used as optimal trigger for future adaptive DBS applications. © 2018
International Parkinson and Movement Disorder Society.
© 2018 International Parkinson and Movement Disorder Society.