The effect of STN DBS on modulating brain oscillations: consequences for motor and cognitive behavior

David, Fabian J.; Munoz, Miranda J.; Corcos, Daniel M.

doi:10.1007/s00221-020-05834-7

Cited by 14 publications

(13 citation statements)

References 202 publications

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“…STN-DBS improved amplitude for both encoding types, selectively worsened error during proprioception encoding, and improved velocity for both encoding types ( Figure 5 ). Our findings were consistent with previous studies that showed that STN-DBS improved intensive aspects of control such as movement amplitude and velocity but impaired coordinative/integrative aspects of control such as error ( 36 , 43 , 78 , 79 ). Of note is the amount that STN-DBS increased error: it was 0.008 m. While this was statistically significant, the clinical significance of this error magnitude may not be readily apparent.…”

Section: Discussionsupporting

confidence: 93%

“…Memory and sensory-motor integration are critical for coordinative aspects of movement because they are required to synthesize information about amplitude, velocity, and location in order to plan and execute accurate movements. It is theorized that STN-DBS might disrupt power in low frequency bands, such as theta and alpha, and reduce coupling between low and high frequencies that underlie the integrative aspects of movement ( 36 , 43 , 78 ). This disruption could impair sensory-motor integration and may have driven the greater error observed during proprioceptive reaching ( Figure 5E ).…”

Section: Discussionmentioning

confidence: 99%

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Encoding type, medication, and deep brain stimulation differentially affect memory-guided sequential reaching movements in Parkinson's disease

David

Rivera²,

Entezar³

et al. 2022

Front. Neurol.

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Memory-guided movements, vital to daily activities, are especially impaired in Parkinson's disease (PD). However, studies examining the effects of how information is encoded in memory and the effects of common treatments of PD, such as medication and subthalamic nucleus deep brain stimulation (STN-DBS), on memory-guided movements are uncommon and their findings are equivocal. We designed two memory-guided sequential reaching tasks, peripheral-vision or proprioception encoded, to investigate the effects of encoding type (peripheral-vision vs. proprioception), medication (on- vs. off-), STN-DBS (on- vs. off-, while off-medication), and compared STN-DBS vs. medication on reaching amplitude, error, and velocity. We collected data from 16 (analyzed n = 7) participants with PD, pre- and post-STN-DBS surgery, and 17 (analyzed n = 14) healthy controls. We had four important findings. First, encoding type differentially affected reaching performance: peripheral-vision reaches were faster and more accurate. Also, encoding type differentially affected reaching deficits in PD compared to healthy controls: peripheral-vision reaches manifested larger deficits in amplitude. Second, the effect of medication depended on encoding type: medication had no effect on amplitude, but reduced error for both encoding types, and increased velocity only during peripheral-vision encoding. Third, the effect of STN-DBS depended on encoding type: STN-DBS increased amplitude for both encoding types, increased error during proprioception encoding, and increased velocity for both encoding types. Fourth, STN-DBS was superior to medication with respect to increasing amplitude and velocity, whereas medication was superior to STN-DBS with respect to reducing error. We discuss our findings in the context of the previous literature and consider mechanisms for the differential effects of medication and STN-DBS.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Encoding type, medication, and deep brain stimulation differentially affect memory-guided sequential reaching movements in Parkinson's disease

David

Rivera²,

Entezar³

et al. 2022

Front. Neurol.

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“…In fact, the reduction in beta power after administration of levodopa is positively correlated with improvement of motor impairment (3). Similarly, continuous high frequency DBS results in a reduction in beta power and correlates with an improvement in motor function in PD (4)(5)(6).…”

Section: Introductionmentioning

confidence: 98%

Subthalamic Peak Beta Ratio Is Asymmetric in Glucocerebrosidase Mutation Carriers With Parkinson's Disease: A Pilot Study

et al. 2021

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Introduction: Up to 27% of individuals undergoing subthalamic nucleus deep brain stimulation (STN-DBS) have a genetic form of Parkinson's disease (PD). Glucocerebrosidase (GBA) mutation carriers, compared to sporadic PD, present with a more aggressive disease, less asymmetry, and fare worse on cognitive outcomes with STN-DBS. Evaluating STN intra-operative local field potentials provide the opportunity to assess and compare symmetry between GBA and non-GBA mutation carriers with PD; thus, providing insight into genotype and STN physiology, and eligibility for and programming of STN-DBS. The purpose of this pilot study was to test differences in left and right STN resting state beta power in non-GBA and GBA mutation carriers with PD.Materials and Methods: STN (left and right) resting state local field potentials were recorded intraoperatively from 4 GBA and 5 non-GBA patients with PD while off medication. Peak beta power expressed as a ratio to total beta power (peak beta ratio) was compared between STN hemispheres and groups while co-varying for age, age of disease onset, and disease severity.Results: Peak beta ratio was significantly different between the left and the right STN for the GBA group (p < 0.01) but not the non-GBA group (p = 0.56) after co-varying for age, age of disease onset, and disease severity.Discussion: Peak beta ratio in GBA mutation carriers was more asymmetric compared with non-mutation carriers and this corresponded with the degree of clinical asymmetry as measured by rating scales. This finding suggests that GBA mutation carriers have a physiologic signature that is distinct from that found in sporadic PD.

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“…A recent meta-analysis, which included all DBS treatment targets from PD to essential tremor (ET) and dystonia, found that cognitive function improved by 31%, deteriorated by 12%, and remained unchanged by 13% [ 12 ]. However, other studies have shown that STN-DBS decreases overall cognition, memory, verbal fluency, and executive function [ 13 , 14 ]. In our cohort, we found that STN-DBS effectively improved the cognitive status of the patients.…”

Section: Discussionmentioning

confidence: 99%

Nomogram to Predict Cognitive State Improvement after Deep Brain Stimulation for Parkinson’s Disease

et al. 2022

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Purpose: Parkinson’s disease (PD) is a common neurodegenerative disease, for which cognitive impairment is a non-motor symptom (NMS). Bilateral subthalamic nucleus deep brain stimulation (STN-DBS) is an effective treatment for PD. This study established a nomogram to predict cognitive improvement rate after STN-DBS in PD patients. Methods: We retrospectively analyzed 103 PD patients who underwent STN-DBS. Patients were followed up to measure improvement in MoCA scores one year after surgery. Univariate and multivariate logistic regression analyses were used to identify factors affecting improvement in cognitive status. A nomogram was developed to predict this factor. The discrimination and fitting performance were evaluated by receiver operating characteristics (ROC) analysis, calibration diagram, and decision curve analysis (DCA). Results: Among 103 patients, the mean improvement rate of the MoCA score was 37.3% and the median improvement rate was 27.3%, of which 64% improved cognition, 27% worsened cognition, and 8.7% remained unchanged. Logistic multivariate regression analysis showed that years of education, UPDRSIII drug use, MoCA Preop, and MMSE Preop scores were independent factors affecting the cognitive improvement rate. A nomogram model was subsequently developed. The C-index of the nomogram was 0.98 (95%CI, 0.97–1.00), and the area under the ROC was 0.98 (95%CI 0.97–1.00). The calibration plot and DCA demonstrated the goodness-of-fit between nomogram predictions and actual observations. Conclusion: Our nomogram could effectively predict the possibility of achieving good cognitive improvement one year after STN-DBS in patients with PD. This model has value in judging the expected cognitive improvement of patients with PD undergoing STN-DBS.

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The effect of STN DBS on modulating brain oscillations: consequences for motor and cognitive behavior

Cited by 14 publications

References 202 publications

Encoding type, medication, and deep brain stimulation differentially affect memory-guided sequential reaching movements in Parkinson's disease

Encoding type, medication, and deep brain stimulation differentially affect memory-guided sequential reaching movements in Parkinson's disease

Subthalamic Peak Beta Ratio Is Asymmetric in Glucocerebrosidase Mutation Carriers With Parkinson's Disease: A Pilot Study

Nomogram to Predict Cognitive State Improvement after Deep Brain Stimulation for Parkinson’s Disease

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