Abstract
BackgroundThe discovery of abnormal synchronization of neuronal activity in the basal ganglia in Parkinson's disease (PD) has prompted the development of novel neuromodulation paradigms. Coordinated reset neuromodulation intends to specifically counteract excessive synchronization and to induce cumulative unlearning of pathological synaptic connectivity and neuronal synchrony.MethodsIn this prospective case series, six PD patients were evaluated before and after coordinated reset neuromodulation according to a standardized protocol that included both electrophysiological recordings and clinical assessments.ResultsCoordinated reset neuromodulation of the subthalamic nucleus (STN) applied to six PD patients in an externalized setting during three stimulation days induced a significant and cumulative reduction of beta band activity that correlated with a significant improvement of motor function.ConclusionsThese results highlight the potential effects of coordinated reset neuromodulation of the STN in PD patients and encourage further development of this approach as an alternative to conventional high-frequency deep brain stimulation in PD. © 2014 The Authors. Movement Disorders published by Wiley Periodicals, Inc. on behalf of International Parkinson and Movement Disorder Society.
Highlights
The discovery of abnormal synchronization of neuronal activity in the basal ganglia in Parkinson’s disease (PD) has prompted the development of novel neuromodulation paradigms
Acute coordinated reset (CR)-induced effects were already observed on day 1 in five patients, with a mean acute aftereffect on the peak beta band power averaged over the 3 stimulation days of 16.1% (P 5 0.04)
Effects of CR neuromodulation on the local field potential (LFP) theta band power are presented in Figure 1G, L, and Table 1
Summary
The discovery of abnormal synchronization of neuronal activity in the basal ganglia in Parkinson’s disease (PD) has prompted the development of novel neuromodulation paradigms. Methods: In this prospective case series, six PD patients were evaluated before and after coordinated reset neuromodulation according to a standardized protocol that included both electrophysiological recordings and clinical assessments. Results: Coordinated reset neuromodulation of the subthalamic nucleus (STN) applied to six PD patients in an externalized setting during three stimulation days induced a significant and cumulative reduction of beta band activity that correlated with a significant improvement of motor function. Conclusions: These results highlight the potential effects of coordinated reset neuromodulation of the STN in PD patients and encourage further development of this approach as an alternative to conventional high-frequency deep brain stimulation in PD. Methods: Family members were examined clinically longitudinally, and 5 underwent dopaminergic PET imaging. Conclusion: PD associated with a DNAJC13 p.N855S mutation presents as late-onset, often slowly progressive, usually dopamine-responsive typical PD.
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