Open AccessLack of progression of beta dynamics after long‐term subthalamic neurostimulation
Author(s) -
Anderson Ross W.,
Wilkins Kevin B.,
Parker Jordan E.,
Petrucci Matthew N.,
Kehnemouyi Yasmine,
Neuville Raumin S.,
Cassini Declan,
Trager Megan H.,
Koop Mandy M.,
Velisar Anca,
Blumenfeld Zack,
Quinn Emma J.,
Henderson Jaimie,
BronteStewart Helen M.
Publication year - 2021
Publication title -
annals of clinical and translational neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.824
H-Index - 42
ISSN - 2328-9503
DOI - 10.1002/acn3.51463
Subject(s) - subthalamic nucleus , deep brain stimulation , medicine , parkinson's disease , neurostimulation , rating scale , local field potential , cohort , physical medicine and rehabilitation , motor symptoms , clinical endpoint , disease , physical therapy , neuroscience , stimulation , clinical trial , psychology , developmental psychology
Objective To investigate the progression of neural and motor features of Parkinson's disease in a longitudinal study, after washout of medication and bilateral subthalamic nucleus deep brain stimulation (STN DBS). Methods Participants with clinically established Parkinson's disease underwent bilateral implantation of DBS leads (18 participants, 13 male) within the STN using standard functional frameless stereotactic technique and multi‐pass microelectrode recording. Both DBS leads were connected to an implanted investigative sensing neurostimulator (Activa™ PC + S, Medtronic, PLC). Resting state STN local field potentials (LFPs) were recorded and motor disability, (the Movement Disorder Society‐Unified Parkinson's Disease Rating Scale – motor subscale, MDS‐UPDRS III) was assessed off therapy at initial programming, and after 6 months, 1 year, and yearly out to 5 years of treatment. The primary endpoint was measured at 3 years. At each visit, medication had been held for over 12/24 h and DBS was turned off for at least 60 min, by which time LFP spectra reached a steady state. Results After 3 years of chronic DBS, there were no increases in STN beta band dynamics ( p = 0.98) but there were increases in alpha band dynamics ( p = 0.0027, 25 STNs). Similar results were observed in a smaller cohort out to 5 years. There was no increase in the MDS‐UPDRS III score. Interpretation These findings provide evidence that the beta oscillopathy does not substantially progress following combined STN DBS plus medication in moderate to advanced Parkinson's disease.