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Sixty‐hertz stimulation improves bradykinesia and amplifies subthalamic low‐frequency oscillations
Author(s) -
Blumenfeld Zack,
Koop Mandy Miller,
Prieto Thomas E.,
Shreve Lauren A.,
Velisar Anca,
Quinn Emma J.,
Trager Megan H.,
BrontëStewart Helen
Publication year - 2017
Publication title -
movement disorders
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.352
H-Index - 198
eISSN - 1531-8257
pISSN - 0885-3185
DOI - 10.1002/mds.26837
Subject(s) - deep brain stimulation , subthalamic nucleus , local field potential , beta (programming language) , kinematics , stimulation , alpha (finance) , physics , beta rhythm , neuroscience , physical medicine and rehabilitation , medicine , psychology , audiology , parkinson's disease , electroencephalography , surgery , computer science , disease , construct validity , classical mechanics , patient satisfaction , programming language
Background The objective of this study was to investigate the hypothesis that attenuation of subthalamic nucleus (STN) alpha‐/beta‐band oscillations is causal to improvement in bradykinesia. Methods STN local field potentials from a sensing neurostimulator (Activa ® PC+S; Medtronic, Inc.) and kinematics from wearable sensors were recorded simultaneously during 60‐ and 140‐Hz deep brain stimulation (DBS) in 9 freely moving PD subjects (15 STNs) performing repetitive wrist flexion‐extension. Kinematics were recorded during 20‐Hz DBS in a subgroup. Results Both 60‐ and 140‐Hz DBS improved the angular velocity and frequency of movement ( P = 0.002 and P = 0.029, respectively, for 60 Hz; P < 0.001 and P < 0.001, respectively, for 140 Hz), but 60‐Hz DBS did not attenuate beta‐band power (13‐30 Hz). In fact, 60‐Hz DBS amplified alpha/low‐beta (11‐15 Hz, P = 0.007) and attenuated high‐beta power (19‐27 Hz, P < 0.001), whereas 140‐Hz DBS broadly attenuated beta power (15‐30 Hz, P < 0.001). Only 60‐Hz DBS improved the regularity of angular range ( P = 0.046) and 20‐Hz DBS did not worsen bradykinesia. There was no correlation between beta‐power modulation and bradykinesia. Conclusions These novel results obtained from freely moving PD subjects demonstrated that both 140‐ and 60‐Hz DBS improved bradykinesia and attenuated high beta oscillations; however, 60‐Hz DBS amplified a subband of alpha/low‐beta oscillations, and DBS at a beta‐band frequency did not worsen bradykinesia. Based on recent literature, we suggest that both 140‐ and 60‐Hz DBS decouple the cortico‐STN hyperdirect pathway, whereas 60‐Hz DBS increases coupling within striato‐STN circuitry. These results inform future algorithms for closed‐loop DBS in PD. © 2016 International Parkinson and Movement Disorder Society