Subthalamic nucleus deep brain stimulation evokes resonant neural activity.

Sinclair NC
McDermott HJ
Bulluss KJ
Fallon JB
Perera T
Xu SS
Brown P
Thevathasan W

Electrical stimulation of a tiny nerve centre deep in the brain is used as a treatment for Parkinson’s disease. Yet, it can prove challenging to place stimulating electrodes at the best site. We show that electrode placement at this key nerve centre can be confirmed by evoking a simple signature activity. Our finding paves the way for more accurate surgery and more rapid tailoring of treatment.

Scientific Abstract

Deep brain stimulation (DBS) is a rapidly expanding treatment for neurological and psychiatric conditions; however, a target-specific biomarker is required to optimize therapy. Here, we show that DBS evokes a large-amplitude resonant neural response focally in the subthalamic nucleus. This response is greatest in the dorsal region (the clinically optimal stimulation target for Parkinson disease), coincides with improved clinical performance, is chronically recordable, and is present under general anesthesia. These features make it a readily utilizable electrophysiological signal that could potentially be used for guiding electrode implantation surgery and tailoring DBS therapy to improve patient outcomes.

Evoked responses recorded from electrodes in 27 different subthalamic nuclei overlaid (colours represent different nuclei). Note the large and reproducible waveform that is evoked.
Evoked responses recorded from electrodes in 27 different subthalamic nuclei overlaid (colours represent different nuclei). Note the large and reproducible waveform that is evoked.
Citation
2018. Ann. Neurol., 83(5): 1027-1031.
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