Rhythm-specific pharmacological modulation of subthalamic activity in Parkinson's disease

Foffani, Guglielmo; Pesenti, A.; Tamma, Filippo; Bianchi, Anna Maria; Pellegrini, Mariangela; Locatelli, Marco; Moxon, Karen A.; Villani, R.

doi:10.1016/j.expneurol.2004.06.001

Cited by 466 publications

(426 citation statements)

References 76 publications

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“…This is consistent with previous studies showing that administration of the drug orphenadrine, in contrast to levodopa, increases rather than decreases STN beta oscillations while decreasing tremor and rigidity (Priori et al 2004) and that clinical improvement after DBS is not associated with a corresponding decrease in LFP beta activity in the STN of PD patients (Foffani et al 2006).…”

Section: Discussionsupporting

confidence: 81%

“…Most interestingly, our data show a significant positive correlation of neuronal oscillatory activity with the patient's benefit from dopaminergic medication. The study also confirmed previous reports that oscillatory LFP activity in the beta range is consistently observed in all PD patients off dopaminergic medications (Alonso-Frech et al 2006;Brown et al 2001;Cassidy et al 2002;Kuhn et al 2004;Levy et al 2002;Marceglia et al 2006;Priori et al 2004). Unexpectedly, however, the incidence of cells with oscillatory firing in the beta range varied considerably between patients.…”

Section: Discussionsupporting

confidence: 80%

“…This may account for the correlation between the beta oscillatory activity and L-dopa response (i.e., dopaminergic features) and not with the off motor scores, which combine both dopaminergic and nondopaminergic features. A dissociation between beta oscillatory LFPs and the clinical symptoms was also observed by Priori et al (2004), who showed that anticholinergic drug orphenadrine improved rigidity and tremor but also increased beta oscillatory activity. Dopaminergic medication and active movements are known to decrease STN beta synchronization (Brown et al 2001;Foffani et al 2005;Kuhn et al 2004;Levy et al 2002;Marsden et al 2001b;Priori et al 2002Priori et al , 2004 and deep brain stimulation in the STN may alleviate PD symptoms by disrupting this oscillatory activity (Brown et al 2004;Filali et al 2004;Jahanshahi et al 2000;Lozano et al 2002).…”

Section: Discussionmentioning

confidence: 98%

“…A dissociation between beta oscillatory LFPs and the clinical symptoms was also observed by Priori et al (2004), who showed that anticholinergic drug orphenadrine improved rigidity and tremor but also increased beta oscillatory activity. Dopaminergic medication and active movements are known to decrease STN beta synchronization (Brown et al 2001;Foffani et al 2005;Kuhn et al 2004;Levy et al 2002;Marsden et al 2001b;Priori et al 2002Priori et al , 2004 and deep brain stimulation in the STN may alleviate PD symptoms by disrupting this oscillatory activity (Brown et al 2004;Filali et al 2004;Jahanshahi et al 2000;Lozano et al 2002). It was previously hypothesized that dopamine action on the striatum acts as a filter for cortical input to the STN (Doyle et al 2005;Magill et al 2001Magill et al , 2004Sharott et al 2005).…”

Section: Discussionmentioning

confidence: 98%

“…The STN beta LFPs are decreased by dopaminergic medication and active movements (Alegre et al 2005;Alonso-Frech et al 2006;Cassidy et al 2002;Doyle et al 2005;Foffani et al 2005;Kuhn et al 2004;Levy et al 2002;Priori et al 2004;Williams et al 2003). It was previously suggested that the therapeutic effects of deep brain stimulation (DBS) arise from disrupting this pathologically increased synchronized beta activity (Brown et al 2004;Filali et al 2004;Jahanshahi et al 2000;Lozano et al 2002;Wingeier et al 2006).…”

Section: Introductionmentioning

confidence: 99%

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Beta Oscillatory Activity in the Subthalamic Nucleus and Its Relation to Dopaminergic Response in Parkinson's Disease

Weinberger

Mahant²,

Hutchison³

et al. 2006

Journal of Neurophysiology

525

389

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. Beta oscillatory activity in the subthalamic nucleus and its relation to dopaminergic response in Parkinson's disease. J Neurophysiol 96: 3248 -3256, 2006. First published September 27, 2006 doi:10.1152/jn.00697.2006. Recent studies suggest that beta (15-30 Hz) oscillatory activity in the subthalamic nucleus (STN) is dramatically increased in Parkinson's disease (PD) and may interfere with movement execution. Dopaminergic medications decrease beta activity and deep brain stimulation (DBS) in the STN may alleviate PD symptoms by disrupting this oscillatory activity. Depth recordings from PD patients have demonstrated beta oscillatory neuronal and local field potential (LFP) activity in STN, although its prevalence and relationship to neuronal activity are unclear. In this study, we recorded both LFP and neuronal spike activity from the STN in 14 PD patients during functional neurosurgery. Of 200 singleand multiunit recordings 56 showed significant oscillatory activity at about 26 Hz and 89% of these were coherent with the simultaneously recorded LFP. The incidence of neuronal beta oscillatory activity was significantly higher in the dorsal STN (P ϭ 0.01) and corresponds to the significantly increased LFP beta power recorded in the same region. Of particular interest was a significant positive correlation between the incidence of oscillatory neurons and the patient's benefit from dopaminergic medications, but not with baseline motor deficits off medication. These findings suggest that the degree of neuronal beta oscillatory activity is related to the magnitude of the response of the basal ganglia to dopaminergic agents rather than directly to the motor symptoms of PD. The study also suggests that LFP beta oscillatory activity is generated largely within the dorsal portion of the STN and can produce synchronous oscillatory activity of the local neuronal population.

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Section: Discussionsupporting

confidence: 81%

Section: Discussionsupporting

confidence: 80%

Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 98%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Beta Oscillatory Activity in the Subthalamic Nucleus and Its Relation to Dopaminergic Response in Parkinson's Disease

Weinberger

Mahant²,

Hutchison³

et al. 2006

Journal of Neurophysiology

525

389

View full text Add to dashboard Cite

show abstract

Overview of Chronopharmaceutics

Youan

2009

Chronopharmaceutics

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Adaptive deep brain stimulation in advanced Parkinson disease

Little

Pogosyan

Neal

et al. 2013

Annals of Neurology

1,070

1,108

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Objective: Brain–computer interfaces (BCIs) could potentially be used to interact with pathological brain signals to intervene and ameliorate their effects in disease states. Here, we provide proof-of-principle of this approach by using a BCI to interpret pathological brain activity in patients with advanced Parkinson disease (PD) and to use this feedback to control when therapeutic deep brain stimulation (DBS) is delivered. Our goal was to demonstrate that by personalizing and optimizing stimulation in real time, we could improve on both the efficacy and efficiency of conventional continuous DBS.Methods: We tested BCI-controlled adaptive DBS (aDBS) of the subthalamic nucleus in 8 PD patients. Feedback was provided by processing of the local field potentials recorded directly from the stimulation electrodes. The results were compared to no stimulation, conventional continuous stimulation (cDBS), and random intermittent stimulation. Both unblinded and blinded clinical assessments of motor effect were performed using the Unified Parkinson's Disease Rating Scale.Results: Motor scores improved by 66% (unblinded) and 50% (blinded) during aDBS, which were 29% (p = 0.03) and 27% (p = 0.005) better than cDBS, respectively. These improvements were achieved with a 56% reduction in stimulation time compared to cDBS, and a corresponding reduction in energy requirements (p < 0.001). aDBS was also more effective than no stimulation and random intermittent stimulation.Interpretation BCI-controlled DBS is tractable and can be more efficient and efficacious than conventional continuous neuromodulation for PD. Ann Neurol 2013;74:449–457

show abstract

Rhythm-specific pharmacological modulation of subthalamic activity in Parkinson's disease

Cited by 466 publications

References 76 publications

Beta Oscillatory Activity in the Subthalamic Nucleus and Its Relation to Dopaminergic Response in Parkinson's Disease

Beta Oscillatory Activity in the Subthalamic Nucleus and Its Relation to Dopaminergic Response in Parkinson's Disease

Overview of Chronopharmaceutics

Adaptive deep brain stimulation in advanced Parkinson disease

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