Abstract
Identification of brain structures traversed during implantation of deep brain‐stimulating (DBS) electrodes into the subthalamic nucleus (STN‐DBS) for the treatment of Parkinson's disease (PD) frequently relies on subjective correspondence between kinesthetic response and multiunit activity. However, recent work suggests that local field potentials (LFP) could be used as a more robust signal to objectively differentiate subcortical structures. The goal of this study was to analyze the spectral properties of LFP collected during STN‐DBS in order to objectively identify commonly traversed brain regions and improve our understanding of aberrant oscillations in the PD‐related pathophysiological cortico‐basal ganglia network. In 21 PD patients, LFP were collected and analyzed during STN‐DBS implantation surgery. Spectral power for delta‐, theta‐, alpha‐, low‐beta‐, and high‐beta‐frequency bands was assessed at multiple depths throughout the subcortical structures traversed on the trajectory to the ventral border of STN. Similar to previous findings, beta‐band oscillations had an increased magnitude within the borders of the motor‐related area of STN, however, across several subjects, we also observed increased high‐beta magnitude within the borders of thalamus. Comparing across all patients using relative power, we observed a gradual increase in the magnitude of both low‐ and high‐beta‐frequency bands as the electrode descended from striatum to STN. These results were also compared with frequency bands below beta, and similar trends were observed. Our results suggest that LFP signals recorded during the implantation of a DBS electrode evince distinct oscillatory signatures that distinguish subcortical structures.
Highlights
Parkinson’s disease (PD), a movement disorder characterized by bradykinesia, rigidity, and tremor, results from progressive loss of nigrostriatal dopaminergic innervation (Obeso et al 2000)
A schematic of the common trajectory for subthalamic nucleus (STN)-deep brain stimulation (DBS) implantation is provided in Figure 1A, highlighting the four structures most frequently traversed: striatum, thalamus, STN, and substantia nigra pars reticulata (SNr)
We found that power spectral analyses of intraoperative local field potentials (LFP), across several frequency bands (i.e., d, h, a, and b), could consistently distinguish between basal ganglia (BG) structures routinely traversed during STN-DBS implantation surgery
Summary
Parkinson’s disease (PD), a movement disorder characterized by bradykinesia, rigidity, and tremor, results from progressive loss of nigrostriatal dopaminergic innervation (Obeso et al 2000). Neuroanatomical and electrophysiological studies in animal models of parkinsonism that mimic neuronal loss in the substantia nigra pars compacta (SNc) reveal widespread dysregulation throughout the basal ganglia (BG) circuitry (Ungerstedt 1968; Burns et al 1983; Waters et al 1987; Smeyne and Jackson-Lewis 2005). The BG is composed of several complex parallel loops that integrate distinct cortical areas (Alexander et al 1986; Wichmann and DeLong 1998; Wichmann et al 2000), and the classical model of BG function in PD, predicated on dopamine deficiency, has proven successful in identifying critical therapeutic targets – initially for ablation, and more recently for deep brain stimulation (DBS) (Ghika et al 1998; Krack et al 1998; Kumar et al 1998; Limousin et al 1998).
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