Toward adaptive deep brain stimulation for dystonia

Piña-Fuentes, Dan; Beudel, Martijn; Little, Simon; Zijl, Jonathan van; Elting, Jan Willem J.; Oterdoom, D L Marinus; Egmond, Martje E van; Dijk, J. Marc C. van; Tijssen, Marina A. J.

doi:10.3171/2018.5.focus18155

Cited by 45 publications

(37 citation statements)

References 77 publications

(85 reference statements)

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“…As reported previously (Deffains et al, , 2016Kondabolu et al, 2016;Lemaire et al, 2012;Piña-Fuentes et al, 2018;Silberstein, 2003;Singh and Papa, 2019), abnormal oscillations of the LFP have been recorded in the striatum of both PD and dystonic patients ( Figure 8A). The LFP most likely represents the sub-threshold (e.g., synaptic input) activity, whereas the MUA reflects the efferent (output) activity of the local neuronal population (Buzsaki et al, 2012;Logothetis, 2003).…”

Section: Lack Of Bursty and Oscillatory Pattern In The Spn Spiking Acsupporting

confidence: 85%

“…Parkinsonism-related β oscillations have been observed in local field potentials (LFPs) recorded in all BG structures, including the striatum (Deffains et al, 2016;Kondabolu et al, 2016;Lemaire et al, 2012;Singh and Papa, 2019). Similarly, low frequency (4-12Hz) LFP oscillations have been recorded in the BG network of dystonic patients (Piña-Fuentes et al, 2018;Silberstein et al, 2003). Finally, synchronous β oscillations are commonly observed in the spiking activity of the STN, GPe and GPi of MPTP-treated monkeys (Deffains et al, , 2016Soares et al, 2004) and PD patients (Brown, 2003;Kuhn et al, 2005;Moshel et al, 2013;Zaidel et al, 2010).…”

Section: Introductionmentioning

confidence: 95%

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What is the true discharge rate and pattern of the striatal projection neurons in Parkinson’s disease and Dystonia?

Valsky

Grosberg²,

Israel

et al. 2020

eLife

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Dopamine and striatal dysfunctions play a key role in the pathophysiology of Parkinson's disease (PD) and Dystonia, but our understanding of the changes in the discharge rate and pattern of striatal projection neurons (SPNs) remains limited. Here, we recorded and examined multi-unit signals from the striatum of PD and dystonic patients undergoing deep brain stimulation surgeries. Contrary to earlier human findings, we found no drastic changes in the spontaneous discharge of the well-isolated and stationary SPNs of the PD patients compared to the dystonic patients or to the normal levels of striatal activity reported in healthy animals. Moreover, cluster analysis using SPN discharge properties did not characterize two well-separated SPN subpopulations, indicating no SPN subpopulation-specific (D1 or D2 SPNs) discharge alterations in the pathological state. Our results imply that small to moderate changes in spontaneous SPN discharge related to PD and Dystonia are likely amplified by basal ganglia downstream structures.

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Section: Lack Of Bursty and Oscillatory Pattern In The Spn Spiking Acsupporting

confidence: 85%

Section: Introductionmentioning

confidence: 95%

What is the true discharge rate and pattern of the striatal projection neurons in Parkinson’s disease and Dystonia?

Valsky

Grosberg²,

Israel

et al. 2020

eLife

View full text Add to dashboard Cite

show abstract

“…The practical experience of cl-DBS in dystonia and GTS are currently limited. In dystonia patients, electrophysiological recordings from both the GPi and STN revealed signals in the low-frequency range (theta to alpha: 4-12 Hz), 201,[218][219][220][221][222][223] coherent with the tonic and phasic components in peripheral muscle EMG, and correlating with the severity of dystonia. 166,222,[224][225][226] The temporal characteristics of this feature have been found to be suitable for cl-DBS, and a first subject has been piloted intraoperatively.…”

Section: Cl-dbs In Tremormentioning

confidence: 99%

Deep Brain Stimulation in Movement Disorders: From Experimental Surgery to Evidence‐Based Therapy

Volkmann²,

et al. 2019

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Deep brain stimulation (DBS) of 3 different targets is the most important therapeutic innovation of the past 30 years for patients with fluctuating Parkinson's disease (PD), disabling dystonia, tremors, and refractory Gilles de la Tourette syndrome. When compared with medical treatment alone, controlled studies have shown better motor, nonmotor, and particularly quality‐of‐life outcomes with large effect sizes for advanced complicated PD that cannot be improved with medication, and also for PD patients with only early fluctuations. Class 1 studies have also shown superiority over medical treatment for generalized, segmental, and botulinum‐toxin refractory focal cervical dystonia. Long‐term efficacy is established for all indications with open studies. For tremors, open studies have shown that DBS is remarkably effective on PD and essential tremor, but efficacy on severe essential tremor and cerebellar tremors is limited by a tendency for tolerance/habituation, including concerns about long‐term efficacy. Open studies of disabling Gilles de la Tourette syndrome show an improvement in tics. New developments hold a promise for further improvement. New hardware with directional stimulation and new stimulation paradigms are further areas of research. The targets of DBS are refined with new imaging processing that will help to diversify the surgical targets. New indications are being explored. Closed‐loop DBS using brain or peripheral sensor signals have shown favorable clinical short‐term results. Long‐term data are lacking, and it is hoped that similar approaches for other movement or behavioral disorders may be developed. Exciting new developments carry the hope for a more pathophysiology‐based approach for DBS for various brain circuit disorders. © 2019 International Parkinson and Movement Disorder Society

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“…Parkinsonism-related β oscillations have been observed in local field potentials (LFPs) recorded in all BG structures, including the striatum (25,(29)(30)(31). Similarly, low frequency (4-12Hz) LFP oscillations have been recorded in the BG network of dystonic patients (32,33). Finally, synchronous β oscillations are commonly observed in the spiking activity of the STN, GPe and GPi of MPTP-treated monkeys (25,34,35) and PD patients (36,37).…”

Section: Introductionmentioning

confidence: 95%

Do human recordings reveal drastic modulations in the discharge of striatal projection neurons in Parkinson’s disease?

Valsky¹,

Israel

Boraud

et al. 2020

Preprint

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Dopamine depletion of the striatum plays a key role in the pathophysiology of Parkinson's disease (PD), but our understanding of the changes in the discharge rate and pattern of the striatal projection neurons (SPNs) remains limited. Here, we recorded multi-unit signals from the striatum of PD (N = 934) and dystonic (N = 718) patients undergoing deep brain stimulation surgeries. Using an innovative automated data-driven approach to classify striatal units, we showed that the SPN discharge rate is inversely proportional to the isolation quality and stationarity of the SPNs. In contrast to earlier studies in both PD patients and the non-human primate model of PD, we found no drastic changes in the spiking activity (discharge rate and pattern) of the well-isolated and stationary SPNs of PD patients compared to either dystonic patients or the normal levels of striatal activity reported in healthy animals. Moreover, cluster analysis using SPN discharge properties did not characterize two well-separated SPN subpopulations. There was therefore no specific SPN subpopulation (D1 or D2 SPNs) strongly affected by the pathological state. Instead, our results suggest that moderate changes in SPN discharge are most likely amplified by basal ganglia downstream structures, thus leading to the clinical (motor and non-motor) symptoms of PD.

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Toward adaptive deep brain stimulation for dystonia

Cited by 45 publications

References 77 publications

What is the true discharge rate and pattern of the striatal projection neurons in Parkinson’s disease and Dystonia?

What is the true discharge rate and pattern of the striatal projection neurons in Parkinson’s disease and Dystonia?

Deep Brain Stimulation in Movement Disorders: From Experimental Surgery to Evidence‐Based Therapy

Do human recordings reveal drastic modulations in the discharge of striatal projection neurons in Parkinson’s disease?

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