Subthalamic deep brain stimulation for Parkinson's disease: Correlation between locations of oscillatory activity and optimal site of stimulation

Guo, Song; Zhuang, Ping; Hallett, Mark; Zheng, Zhe; Zhang, Yuqing; Li, Jianyu; Li, Yongjie

doi:10.1016/j.parkreldis.2012.08.005

Cited by 40 publications

(42 citation statements)

References 31 publications

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“…Consistent with our previous findings [35], we further demonstrate that neurons with TFB and βFB oscillations mainly localize in the upper portion of the STN. The region near the dorsal region of the STN is presumed to receive sensory-motor projections [37], and this is where stimulation produces the greatest improvement in parkinsonian motor signs.…”

Section: Discussionsupporting

confidence: 93%

“…Similarly, we found that the proportion of βFB oscillatory activity in the AR-type is significantly higher than that in the mixed-type suggesting that the βFB activity is associated with rigidity/bradyknesia. In contrast, the high proportion of TFB oscillatory neurons observed in the mixed-type suggests that the TFB oscillatory activity is involved in tremor pathophysiology [35]. The results support the view that there is a strong association between the amount of underlying cellular pathology, the resulting Downloaded by [Stockholm University Library] at 06:45 18 August 2015 M a n u s c r i p t A c c e p t e d M a n u s c r i p t 11 level of abnormal basal ganglia activity, and the subsequent motor deficit [36].…”

Section: Discussionmentioning

confidence: 78%

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Characteristics of subthalamic oscillatory activity in parkinsonian akinetic-rigid type and mixed type

Feng

Zhuang

Hallett

et al. 2015

International Journal of Neuroscience

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Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 78%

Characteristics of subthalamic oscillatory activity in parkinsonian akinetic-rigid type and mixed type

Feng

Zhuang

Hallett

et al. 2015

International Journal of Neuroscience

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“…Detailed surgical procedure has been presented in our previous study. 17,22 In brief, all patients underwent preoperative contrast enhanced volumetric T1 and T2weighted magnetic resonance imaging (MRI) of the brain. On the day of surgery, Cosman-Roberts-Wells (CRW) frame (Radionics, Burlington, MA, USA) were applied to the skull under local anesthesia, and a full head computed tomography (CT) scan was obtained using 1-mm slice thickness.…”

Section: Surgical Proceduresmentioning

confidence: 99%

“…As previously described, 22 all neuronal and EMG data were analyzed using Spike 2 (Cambridge Electronic Design, Cambridge, UK). Only spikes having a signal-to-noise ratio greater than 2:1 were used.…”

Section: Signal Processingmentioning

confidence: 99%

<p>Asymmetry of Subthalamic Neuronal Firing Rate and Oscillatory Characteristics in Parkinson’s Disease</p>

Zhao

Zhuang

et al. 2020

NDT

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Purpose: The aim of this study was to compare the neuronal firing rate and oscillatory activity of the subthalamic nucleus (STN) between the more affected (MA) and the less affected (LA) hemispheres in Parkinson's disease (PD). Patients and Methods: We recorded and analyzed the intra-operative microelectrode recordings (MER) from the STN of 24 PD subjects. Lateralized Unified Parkinson's Disease Rating Scale (UPDRS) III sub-scores (item 20-26) were calculated. The STN corresponding to the MA side was designated as the MA STN while the other side as the LA STN. Single unit characteristics including interspike intervals were identified and spectral analyses were assessed. Further, the mean spontaneous firing rate (MSFR) of neurons was calculated. The correlations between clinical symptoms and neuronal activity were analyzed. Results: The firing rate in the MA and LA sides were 43.18 ± 0.74 Hz and 36.94 ± 1.32 Hz, respectively, with an increase of 16.9% in the MA group. The number of neurons that oscillated in the Tremor-Frequency Band (TFB), β-Frequency Band (βFB), and the nonoscillatory cells in the MA group were 43, 115, and 62 versus 78, 68, and 54 in the LA group, respectively. The proportions of the three types of neurons were different between both groups. The firing rate of the STN neurons and the UPDRS III sub-scores were positively correlated. Additionally, we observed a positive correlation between the percentage of βFB oscillatory neurons and bradykinesia score. Conclusion: The firing rate of the STN in the MA hemisphere is higher than in the LA side, following disease progression and there seems to be an increase in firing rate. The βFB oscillatory neurons are at a larger proportion in the MA group while there were larger percentage of TFB oscillatory cells in the LA group. The proportion of βFB oscillatory neurons is selectively correlated with the severity of bradykinesia.

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“…While STN length may guarantee that the trajectory is within the STN, the precise intranuclear position can vary. In our experience, and consistent with many other centers, the most successful active contacts for global symptom reduction are located in the vicinity of the dorsolateral border of the STN [7,29,35,36], and perhaps in the caudal zona incerta, as depicted by the asterisk (*) in Figure 4. However, an anterior trajectory yielding a satisfactory STN length would miss the optimal target.…”

Section: Discussionsupporting

confidence: 88%

The Relationship of Electrophysiologic Subthalamic Nucleus Length as a Predictor of Outcomes in Deep Brain Stimulation for Parkinson Disease

Shenai

Patel²,

Romeo³

et al. 2017

Stereotact Funct Neurosurg

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Background: Intraoperative measurement of subthalamic nucleus (STN) width through microelectrode recording (MER) is a common proxy for optimal electrode location during deep brain stimulation (DBS) surgery for Parkinson disease. We assessed whether the MER-determined STN width is a predictor of postoperative Unified Parkinson Disease Rating Scale (UPDRS) improvement. Methods: Records were reviewed for patients who underwent single-sided STN DBS placement for Parkinson disease between 2005 and 2010 at the UAB Medical Center. Reviews of preoperative and 3-month postoperative UPDRS part III, intraoperative MER records, and postoperative MRI scans were conducted. Results: The final cohort consisted of 73 patients (mean age 59 ± 9.7 years, length of disease 13 ± 9.7 years). STN widths were defined as depths associated with increased background activity and motor-driven, spiking action potentials on MER. The mean contralateral UPDRS improvement was 58% (± 24). The mean STN width was 5.1 mm (± 1.6, min = 0.0, max = 8.7). No significant relationship between STN width and UPDRS improvement was found, with and without AC-PC normalization (R² < 0.05). Conclusion: This analysis raises questions about seeking the maximal electrophysiological width of STN as a proxy for optimal outcome in DBS for PD. We suggest this strategy for DBS placement in Parkinson disease be subject to more robust prospective investigation.

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Subthalamic deep brain stimulation for Parkinson's disease: Correlation between locations of oscillatory activity and optimal site of stimulation

Cited by 40 publications

References 31 publications

Characteristics of subthalamic oscillatory activity in parkinsonian akinetic-rigid type and mixed type

Characteristics of subthalamic oscillatory activity in parkinsonian akinetic-rigid type and mixed type

<p>Asymmetry of Subthalamic Neuronal Firing Rate and Oscillatory Characteristics in Parkinson’s Disease</p>

The Relationship of Electrophysiologic Subthalamic Nucleus Length as a Predictor of Outcomes in Deep Brain Stimulation for Parkinson Disease

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