Subthalamic beta dynamics mirror Parkinsonian bradykinesia months after neurostimulator implantation.

Subthalamic beta dynamics mirror Parkinsonian bradykinesia months after neurostimulator implantation.

Steiner LA, Neumann W-J, Staub-Bartelt F, Herz DM, Tan H, Pogosyan A, Kühn AA, Brown P
If brain signals are to be used to control when and how brain stimulation is applied for therapy, then we must be confident that such signals remain consistent and informative over time. Using a special brain pacemaker device that allowed us to record brain signals over long periods, we show that these signals remain informative about the clinical states of people with Parkinson’s for many months.
Scientific Abstract:

BACKGROUND: Exaggerated oscillatory activity in the beta frequency band in the subthalamic nucleus has been suggested to be related to bradykinesia in Parkinson's disease (PD). However, studies seeking correlations between such activity in the local field potential and motor performance have been limited to the immediate postoperative period, which may be confounded by a stun effect that leads to the temporary alleviation of PD deficits.

METHODS: Local field potentials were recorded simultaneously with motor performance in PD patients several months after neurostimulator implantation. This was enabled by the chronic implantation of a pulse generator with the capacity to record and transmit local field potentials from deep brain stimulation electrodes. Specifically, we investigated oscillatory beta power dynamics and objective measures of bradykinesia during an upper limb alternating pronation and supination task in 9 patients.

RESULTS: Although beta power was suppressed during continuously repeated movements, this suppression progressively diminished over time in tandem with a progressive decrement in the frequency and amplitude of movements. The relationship between changes within local field potentials and movement parameters was significant across patients, and not present for theta/alpha frequencies (5-12 Hz). Change in movement frequency furthermore related to beta power dynamics within patients.

CONCLUSIONS: Changes in beta power are linked to changes in movement performance and the sequence effect of bradykinesia months after neurostimulator implantation. These findings provide further evidence that beta power may serve as a biomarker for bradykinesia and provide a suitable substrate for feedback control in chronic adaptive deep brain stimulation.

Publication Year: 
2017. Mov. Disord., 32(8): 1183-1190.
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