Medical Research Council Brain Network Dynamics Unit, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK.
Department of Neurosurgery, King's College Hospital, Denmark Hill, London, UK.
Neurobiol Dis. 2023 Mar;178:106019. doi: 10.1016/j.nbd.2023.106019. Epub 2023 Jan 24.
Evoked resonant neural activity (ERNA) is induced by subthalamic deep brain stimulation (DBS) and was recently suggested as a marker of lead placement and contact selection in Parkinson's disease. Yet, its underlying mechanisms and how it is modulated by stimulation parameters are unclear. Here, we recorded local field potentials from 27 Parkinson's disease patients, while leads were externalised to scrutinise the ERNA. First, we show that ERNA in the time series waveform and spectrogram likely represent the same activity, which was contested before. Second, our results show that the ERNA has fast and slow dynamics during stimulation, consistent with the synaptic failure hypothesis. Third, we show that ERNA parameters are modulated by different DBS frequencies, intensities, medication states and stimulation modes (continuous DBS vs. adaptive DBS). These results suggest the ERNA might prove useful as a predictor of the best DBS frequency and lowest effective intensity in addition to contact selection. Changes with levodopa and DBS mode suggest that the ERNA may indicate the state of the cortico-basal ganglia circuit making it a putative biomarker to track clinical state in adaptive DBS.
诱发共振神经活动（ERNA）是由丘脑底核深部脑刺激（DBS）引起的，最近被认为是帕金森病中导联放置和接触选择的标志物。然而，其潜在机制以及刺激参数如何调节它尚不清楚。在这里，我们记录了 27 名帕金森病患者的局部场电位，同时将导联引出以仔细研究 ERNA。首先，我们表明，时间序列波形和频谱中的 ERNA 可能代表相同的活动，这在之前是有争议的。其次，我们的结果表明，在刺激过程中，ERNA 具有快速和缓慢的动力学，与突触衰竭假说一致。第三，我们表明，ERNA 参数可通过不同的 DBS 频率、强度、药物状态和刺激模式（连续 DBS 与自适应 DBS）进行调节。这些结果表明，除了接触选择外，ERNA 可能作为最佳 DBS 频率和最低有效强度的预测因子证明是有用的。与左旋多巴和 DBS 模式的变化表明，ERNA 可能表明皮质基底节回路的状态，使其成为适应 DBS 中跟踪临床状态的潜在生物标志物。
