Sixty‐hertz stimulation improves bradykinesia and amplifies subthalamic low‐frequency oscillations

Blumenfeld, Zack; Koop, Mandy Miller; Prieto, Thomas; Shreve, Lauren; Velisar, Anca; Quinn, Emma J.; Trager, Megan H.; Brontë‐Stewart, Helen

doi:10.1002/mds.26837

Cited by 65 publications

(84 citation statements)

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“…Only 1 other study has so far examined the relationship between STN LFP power and kinematic variables months after electrode implantation. Although this study failed to find significant correlations, the latter were still negative and appreciable (about −0.5 for LFP power over 11‐15 Hz and about −0.4 for that over 15‐30 Hz) …”

Section: Discussioncontrasting

confidence: 70%

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Subthalamic beta dynamics mirror Parkinsonian bradykinesia months after neurostimulator implantation

et al. 2017

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BackgroundExaggerated oscillatory activity in the beta frequency band in the subthalamic nucleus has been suggested to be related to bradykinesia in Parkinson’s disease (PD). However, studies seeking correlations between such activity in the local field potential and motor performance have been limited to the immediate postoperative period, which may be confounded by a stun effect that leads to the temporary alleviation of PD deficits.MethodsLocal field potentials were recorded simultaneously with motor performance in PD patients several months after neurostimulator implantation. This was enabled by the chronic implantation of a pulse generator with the capacity to record and transmit local field potentials from deep brain stimulation electrodes. Specifically, we investigated oscillatory beta power dynamics and objective measures of bradykinesia during an upper limb alternating pronation and supination task in 9 patients.ResultsAlthough beta power was suppressed during continuously repeated movements, this suppression progressively diminished over time in tandem with a progressive decrement in the frequency and amplitude of movements. The relationship between changes within local field potentials and movement parameters was significant across patients, and not present for theta/alpha frequencies (5-12 Hz). Change in movement frequency furthermore related to beta power dynamics within patients.ConclusionsChanges in beta power are linked to changes in movement performance and the sequence effect of bradykinesia months after neurostimulator implantation. These findings provide further evidence that beta power may serve as a biomarker for bradykinesia and provide a suitable substrate for feedback control in chronic adaptive deep brain stimulation.

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Section: Discussioncontrasting

confidence: 70%

“…The 1 study thus far that examined the relationship between STN LFP power and kinematic variables many months after electrode implantation failed to find significant correlations . This study of 9 participants correlated the change in LFP power with stimulation with the change in movement amplitude and frequency across patients.…”

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confidence: 79%

Subthalamic beta dynamics mirror Parkinsonian bradykinesia months after neurostimulator implantation

et al. 2017

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“…Rating scales are valuable for clinical practice and research but are prone to interrater and intrarater variability . To obviate these shortcomings, a range of technologies measuring bradykinesia in PD have been developed …”

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confidence: 99%

The BRadykinesia Akinesia INcoordination (BRAIN) Tap Test: Capturing the Sequence Effect

Hasan

Burrows

Hellman³

et al. 2019

Movement Disord Clin Pract

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Background The BRadykinesia Akinesia INcoordination (BRAIN) tap test is an online keyboard tapping task that has been previously validated to assess upper limb motor function in Parkinson's disease (PD). Objectives To develop a new parameter that detects a sequence effect and to reliably distinguish between PD patients on and off medication. In addition, we sought to validate a mobile version of the test for use on smartphones and tablet devices. Methods The BRAIN test scores in 61 patients with PD and 93 healthy controls were compared. A range of established parameters captured number and accuracy of alternate taps. The new velocity score recorded the intertap speed. Decrement in the velocity score was used as a marker for the sequence effect. In the validation phase, 19 PD patients and 19 controls were tested using different hardware including mobile devices. Results Quantified slopes from the velocity score demonstrated bradykinesia (sequence effect) in PD patients (slope cut‐off −0.002) with 58% sensitivity and 81% specificity (discovery phase of the study) and 65% sensitivity and 88% specificity (validation phase). All BRAIN test parameters differentiated between on and off medication states in PD. Differentiation between PD patients and controls was possible on all hardware versions of the test. Conclusion The BRAIN tap test is a simple, user‐friendly, and free‐to‐use tool for the assessment of upper limb motor dysfunction in PD, which now includes a measure of bradykinesia.

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“…21 Tenkilohertz stimulation is effective for spinal cord stimulation for chronic leg and back pain, 22 and sub-50 Hz stimulation can be effective for stroke recovery, 15,16 chronic pain, 23 and catalepsy. Parkinsonian DBS is usually >100 Hz, although 60 Hz can effectively treat bradykinesia.…”

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confidence: 99%

Deep cerebellar stimulation reduces ataxic motor symptoms in the shaker rat

Anderson¹,

Figueroa²,

Dorval

et al. 2019

Annals of Neurology

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Objective: Degenerative cerebellar ataxias (DCAs) affect up to 1 in 5,000 people worldwide, leading to incoordination, tremor, and falls. Loss of Purkinje cells, nearly universal across DCAs, dysregulates the dentatothalamocortical network. To address the paucity of treatment strategies, we developed an electrical stimulation-based therapy for DCAs targeting the dorsal dentate nucleus. Methods: We tested this therapeutic strategy in the Wistar Furth shaker rat model of Purkinje cell loss resulting in tremor and ataxia. We implanted shaker rats with stimulating electrodes targeted to the dorsal dentate nucleus and tested a spectrum of frequencies ranging from 4 to 180 Hz. Results: Stimulation at 30 Hz most effectively reduced motor symptoms. Stimulation frequencies >100 Hz, commonly used for parkinsonism and essential tremor, worsened incoordination, and frequencies within the tremor physiologic range may worsen tremor. Interpretation: Low-frequency deep cerebellar stimulation may provide a novel strategy for treating motor symptoms of degenerative cerebellar ataxias.

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Sixty‐hertz stimulation improves bradykinesia and amplifies subthalamic low‐frequency oscillations

Cited by 65 publications

References 50 publications

Subthalamic beta dynamics mirror Parkinsonian bradykinesia months after neurostimulator implantation

Subthalamic beta dynamics mirror Parkinsonian bradykinesia months after neurostimulator implantation

The BRadykinesia Akinesia INcoordination (BRAIN) Tap Test: Capturing the Sequence Effect

Deep cerebellar stimulation reduces ataxic motor symptoms in the shaker rat

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