337 Neural Network Changes with Loss of Consciousness in Parkinson's Disease

Abstract

INTRODUCTION: Consciousness is likely mediated by multiple parallel yet interacting cortico-subcortical recurrent networks. The pallidocortical circuit is of particular interest given the putative role of pallidum in consciousness, according to the mesocircuit model, though this has not been well studied. METHODS: We characterized changes in pallidocortical circuits in awake versus propofol-induced unconscious states in humans by directly and simultaneously recording from perirolandic cortices and the pallidum in twelve Parkinson Disease (PD) patients undergoing implantation of therapeutic deep brain stimulation (DBS) leads. RESULTS: Propofol-induced LOC resulted in power increases up to 20 Hz in globus pallidus internus (GPi), 35 Hz in globus pallidus externus (GPe), and 100 Hz in sensorimotor cortices (S1/M1). At a network level, LOC resulted in increased pallidocortical alpha coherence with increases in Granger causality (GC) in the alpha/low beta range from GPe to all other nodes. In contrast, LOC was associated with decreased network-wide beta coherence with decreased GC in the beta range from M1 to the rest of the network. CONCLUSION: These results not only confirm the LOC-related changes in pallidocortical circuitry, but GC results suggest that widely reported LOC-related increases in alpha band power emanate from GPe. These findings support a significant role of the GPe in modulating consciousness. Simultaneous LOC-related suppression of beta synchrony from M1 to other nodes suggests that distinct oscillatory frequencies can act independently, conveying unique network level activity. Given the pathophysiologic role of beta synchrony in PD, LOC-related suppresion of beta synchrony may be amplified in this patient population, but may also highlight a parallel network mediating LOC-related loss of motor control.