Neuronal Activity and Synaptic Plasticity in a Reimplanted STN-DBS Patient with Parkinson’s Disease: Recordings from Two Surgeries

Abstract

The authors report the case of an elderly male in his 60s who, after 5 months of efficacious treatment with chronic deep brain stimulation of the subthalamic nucleus (STN-DBS), developed a hardware-related erosion necessitating removal of the complete DBS system. One and a half years following the first implantation, a new STN-DBS system was implanted along an immediately adjacent trajectory, and reproduction of clinical efficacy was reported. Additionally, 2 microstimulation protocols were compared between the 2 surgeries, i.e., one to assess the stimulation frequency response of STN neurons and another to assess inhibitory synaptic plasticity in the substantia nigra pars reticulata (SNr). The spontaneous neuronal firing rates of STN neurons in each hemisphere were also compared between the 2 surgeries. The results suggest that the frequency-sensitivity of STN neurons may have been reduced (i.e., more resistant to neuronal suppression), while the spontaneous baseline firing rates of STN neurons and the plasticity measured in the SNr remained unchanged (2 factors that may be indicative of neurodegenerative processes).

Recurrent Infections Leading to DBS Removal but Reimplantation Achieving a Good Outcome: a Case Report

“…Our case and similar results suggest that positive clinical outcomes can be reproduced following extraction and reimplantation of bilateral DBS leads by adjacent trajectories within the STN [21].…”