Alterations of resting-state networks of Parkinson‘s disease patients after subthalamic DBS surgery

Sure, Matthias; Mertiens, Sean; Vesper, Jan; Schnitzler, Alfons; Florin, Esther

doi:10.1016/j.nicl.2023.103317

Cited by 5 publications

(5 citation statements)

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“…Overall, this confirms that RSNs in PD determined via PAC are sensitive to changes in the patient's condition, e.g., the medication state, which was already evident when comparing RSNs before and after electrode implantation (Sure et al, 2023). In the present case, however, it is striking that the changes occurred mainly between HC and PD and less between PD-OFF and PD-ON.…”

Section: Alteration In Various Rsnssupporting

confidence: 85%

“…We determined significantly altered PAC RSNs in PD patients compared to HC and that dopaminergic medication has a normalizing effect for the SMN. Therefore, in extension to Florin and Baillet (2015) and Sure et al (2023) , PAC-RSN are present in both healthy and patient groups and RSN of different groups can be compared. Since Schneider et al (2020) indicated a normalization effect for RSN with other methods, our results suggest that this effect is independent of the method used for RSN estimation.…”

Section: Discussionmentioning

confidence: 99%

“…An estimate of variance was determined using the jackknife method, analogous to Sure et al (2023) . For each vertex, we used a paired two-sided t -test for the comparison between PD-OFF and PD-ON and an unpaired t -test for the comparison between HC and PD.…”

Section: Methodsmentioning

confidence: 99%

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Alterations of PAC-based resting state networks in Parkinson’s disease are partially alleviated by levodopa medication

Mertiens,

Sure,

Schnitzler

et al. 2023

Front. Syst. Neurosci.

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IntroductionParkinson’s disease (PD) is a neurodegenerative disorder affecting the whole brain, leading to several motor and non-motor symptoms. In the past, it has been shown that PD alters resting state networks (RSN) in the brain. These networks are usually derived from fMRI BOLD signals. This study investigated RSN changes in PD patients based on maximum phase-amplitude coupling (PAC) throughout the cortex. We also tested the hypothesis that levodopa medication shifts network activity back toward a healthy state.MethodsWe recorded 23 PD patients and 24 healthy age-matched participants for 30 min at rest with magnetoencephalography (MEG). PD patients were measured once in the dopaminergic medication ON and once in the medication OFF state. A T1-MRI brain scan was acquired from each participant for source reconstruction. After correcting the data for artifacts and performing source reconstruction using a linearly constrained minimum variance beamformer, we extracted visual, sensorimotor (SMN), and frontal RSNs based on PAC.ResultsWe found significant changes in all networks between healthy participants and PD patients in the medication OFF state. Levodopa had a significant effect on the SMN but not on the other networks. There was no significant change in the optimal PAC coupling frequencies between healthy participants and PD patients.DiscussionOur results suggest that RSNs, based on PAC in different parts of the cortex, are altered in PD patients. Furthermore, levodopa significantly affects the SMN, reflecting the clinical alleviation of motor symptoms and leading to a network normalization compared to healthy controls.

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Section: Alteration In Various Rsnssupporting

confidence: 85%

Section: Discussionmentioning

confidence: 99%

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Alterations of PAC-based resting state networks in Parkinson’s disease are partially alleviated by levodopa medication

Mertiens,

Sure,

Schnitzler

et al. 2023

Front. Syst. Neurosci.

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“…To compare the conditions statistically, we also created surrogate RSNs using the jackknife resampling method (Mertiens et al, 2023; Sure et al, 2023). To this end, we followed the same megPAC routine with the exception of leaving one subject out each time and concatenating the time series of remaining subjects to derive the RSNs.…”

Section: Methodsmentioning

confidence: 99%

Resting State Network alterations during Deep Brain Stimulation in Parkinson’s Disease

Kandemir,

Schnitzler,

Florin

2023

Preprint

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BackgroundCurrent treatment strategies for Parkinson’s disease (PD) include medication and deep brain stimulation (DBS). While these treatment options are effective, their exact mechanisms remain elusive.ObjectivesWe aim at identifying alterations in whole-brain electrophysiological resting state networks (RSNs) due to DBS and medication with the objective to gain insights into neural correlates of DBS and medication.MethodsWe recorded 18 PD patients with DBS at rest in the magnetoencephalogram (MEG) in 4 conditions: medication off - stimulation off, medication off - stimulation on, medication on - stimulation off, and medication on - stimulation on. We derived RSNs and determined 4 consistent networks across conditions: visual, frontal auditory, and SMN (sensorimotor network).ResultIn the SMN, medication had a suppressing effect on functional connectivity. Surprisingly, we could not find a significant change due to DBS. Both medication and stimulation increased functional connectivity in the frontal network. In the auditory network, stimulation decreased functional connectivity while medication both decreased and increased functional connectivity in some parts of the network. Finally, medication and stimulation had opposing effects on the visual network: medication suppressed while DBS increased functional connectivity.ConclusionOverall, our findings reveal that DBS and medication have differential effects on various RSNs, which is relevant for understanding not only their complementary treatment effects but also the side effects.

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“…During this time, the placement of electrodes or on-scalp MEG sensors is limited due to the open wounds and oedema induced by surgery. Additionally, there is a possible temporary postoperative amelioration of clinical symptoms, a phenomenon called "the stun effect" ( Chen et al, 2006;Eusebio & Brown, 2009;Sure et al, 2023). Therefore, the postoperative state is not fully representative of the patient's chronic condition.…”

mentioning

confidence: 99%

Combining Magnetoencephalography with Telemetric Streaming of Intracranial Recordings and Deep Brain Stimulation – a Feasibility Study

Hnazaee

Sure

O'Neill

et al. 2023

Preprint

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The combination of subcortical Local Field Potential (LFP) recordings and stimulation with Magnetoencephalography (MEG) in Deep Brain Stimulation (DBS) patients enables the investigation of cortico-subcortical communication patterns and provides insights into DBS mechanisms. Until now, these recordings have been carried out in post-surgical patients with externalised leads. However, a new generation of telemetric stimulators makes it possible to record and stream LFP data in chronically implanted patients. Nevertheless, whether such streaming can be combined with MEG has not been tested. In the present study, we tested the most commonly implanted telemetric stimulator - Medtronic Percept PC with a phantom in three different MEG systems: two cryogenic scanners (CTF and MEGIN) and an experimental Optically Pumped Magnetometry (OPM)-based system. We found that when used in combination with the new SenSight segmented leads, Percept PC telemetric streaming only generates band-limited interference in the MEG at 123Hz and harmonics. However, the 'legacy streaming mode' used with older lead models generates multiple, dense artefact peaks in the physiological range of interest (below 50Hz). The effect of stimulation on MEG critically depends on whether it is done in bipolar (between two contacts on the lead) or monopolar (between a lead contact and the stimulator case) mode. Monopolar DBS creates severe interference in the MEG as previously reported. However, we found that the OPM system is more resilient to this interference and could provide artefact-free measurements, at least for limited frequency ranges. A resting measurement in the MEGIN system from a Parkinson's patient implanted with Percept PC and subthalamic SenSight leads revealed artefact patterns consistent with our phantom recordings. Moreover, analysis of LFP-MEG coherence in this patient showed oscillatory coherent networks consistent in their frequency and topography with those described in published group studies done with externalised leads. In conclusion, Percept PC telemetric streaming with SenSight leads is compatible with MEG. Furthermore, OPM sensors could provide additional new opportunities for studying DBS effects.

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Alterations of resting-state networks of Parkinson‘s disease patients after subthalamic DBS surgery

Cited by 5 publications

References 65 publications

Alterations of PAC-based resting state networks in Parkinson’s disease are partially alleviated by levodopa medication

Alterations of PAC-based resting state networks in Parkinson’s disease are partially alleviated by levodopa medication

Resting State Network alterations during Deep Brain Stimulation in Parkinson’s Disease

Combining Magnetoencephalography with Telemetric Streaming of Intracranial Recordings and Deep Brain Stimulation – a Feasibility Study

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