Abstract
High frequency subthalamic nucleus (STN) deep brain stimulation (DBS) improves the cardinal motor signs of Parkinson’s disease (PD) and attenuates STN alpha/beta band neural synchrony in a voltage-dependent manner. While there is a growing interest in the behavioral effects of lower frequency (60 Hz) DBS, little is known about its effect on STN neural synchrony. Here we demonstrate for the first time that during intra-operative 60 Hz STN DBS, one or more bands of resting state neural synchrony were amplified in the STN in PD. We recorded intra-operative STN resting state local field potentials (LFPs) from twenty-eight STNs in seventeen PD subjects after placement of the DBS lead (model 3389, Medtronic, Inc.) before and during three randomized neurostimulation sets (130 Hz/1.35V, 130 Hz/2V, 60 Hz/2V). During 130 Hz/2V DBS, baseline (no DBS) STN alpha (8 – 12 Hz) and beta (13 – 35 Hz) band power decreased (N=14, P < 0.001 for both), whereas during 60 Hz/2V DBS, alpha band and peak frequency power increased (P = 0.012, P = 0.007, respectively). The effect of 60 Hz/2V DBS opposed that of power-equivalent (130 Hz/1.35V) DBS (alpha: P < 0.001, beta: P = 0.006). These results show that intra-operative 60 Hz STN DBS amplified whereas 130 Hz STN DBS attenuated resting state neural synchrony in PD; the effects were frequency-specific. We demonstrate that neurostimulation may be useful as a tool to selectively modulate resting state resonant bands of neural synchrony and to investigate its influence on motor and non-motor behaviors in PD and other neuropsychiatric diseases.
Highlights
High frequency subthalamic nucleus (STN) deep brain stimulation (DBS) provides consistent long-term improvement of the cardinal motor signs of Parkinson’s disease (PD) [1,2,3,4,5,6]
We investigated whether the effect of low frequency STN DBS on resting state neural synchrony in the STN in PD was the same or different from that seen at high frequency and, if different, whether this was due to a different total power delivered or due to frequency itself
We have previously shown that the baseline resting state local field potentials (LFPs) spectral peaks are similar and coherent between bilateral STNs of an individual but vary among PD subjects, and it was interesting that the effects of 60 Hz DBS appeared to be patient-specific [28]
Summary
High frequency subthalamic nucleus (STN) deep brain stimulation (DBS) provides consistent long-term improvement of the cardinal motor signs of Parkinson’s disease (PD) [1,2,3,4,5,6]. Low Frequency Stimulation Amplifies Subthalamic Neural Synchrony and being on the Neurosurgical Advisory Board for Neuropace. This does not alter the authors' adherence to PLOS ONE policies on sharing data and materials. DBS and dopaminergic medication attenuate pathological neuronal oscillations and neural synchrony in the alpha/beta band (8–30 Hz) in the Parkinsonian STN, and the degree of attenuation by either therapy has been correlated with the degree of improvement in bradykinesia and rigidity [7,8,9,10,11,12,13,14,15,16,17,18,19,20]. This has led to the suggestion that neural synchrony in the alpha/beta band is related to Parkinsonian limb motor disability, and that successful high frequency DBS overrides pathological neural oscillations and synchrony in the sensorimotor network [21,22]
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