School of Medicine, University of California San Francisco, 533 Parnassus Ave, San Francisco, CA, 94143, United States.
Department of Neurological Surgery, University of California San Francisco, 505 Parnassus Ave, Rm M779, San Francisco, CA, 94143, United States.
Parkinsonism Relat Disord. 2024 May;122:106089. doi: 10.1016/j.parkreldis.2024.106089. Epub 2024 Mar 6.
Deep brain stimulation (DBS) of the subthalamic nucleus (STN) or globus pallidus (GP) is an established therapy for Parkinson's disease (PD). Novel DBS devices can record local field potential (LFP) physiomarkers from the STN or GP. While beta (13-30 Hz) and gamma (40-90 Hz) STN and GP LFP oscillations correlate with PD motor severity and with therapeutic effects of treatments, STN-GP interactions in electrophysiology in patients with PD are not well characterized.
Simultaneous bilateral STN and GP LFPs were recorded in a patient with PD who received bilateral STN-DBS and GP-DBS. Power spectra in each target and STN-GP coherence were assessed in various ON- and OFF-levodopa and DBS states, both at rest and with voluntary movement.
OFF-levodopa and OFF-DBS, beta peaks were present at bilateral STN and GP, coincident with prominent STN-GP beta coherence. Levodopa and dual-target-DBS (simultaneous STN-DBS and GP-DBS) completely suppressed STN-GP coherence. Finely-tuned gamma (FTG) activity at half the stimulation frequency (62.5 Hz) was seen in the STN during GP-DBS at rest. To assess the effects of movement on FTG activity, we recorded LFPs during instructed movement. We observed FTG activity in bilateral GP and bilateral STN during contralateral body movements while on GP-DBS and ON-levodopa. No FTG was seen with STN-DBS or dual-target-DBS.
Dual-target-DBS and levodopa suppressed STN-GP coherence. FTG throughout the basal ganglia was induced by GP-DBS in the presence of levodopa and movement. This bilateral STN-FTG and GP-FTG corresponded with the least severe bradykinesia state, suggesting a pro-kinetic role for FTG.
深脑刺激（DBS）丘脑底核（STN）或苍白球（GP）是治疗帕金森病（PD）的一种既定疗法。新型 DBS 设备可从 STN 或 GP 记录局部场电位（LFP）生理标志物。虽然 STN 和 GP 的β（13-30 Hz）和γ（40-90 Hz）LFP 振荡与 PD 运动严重程度以及治疗效果相关，但 PD 患者电生理学中的 STN-GP 相互作用尚未得到很好的描述。
记录一名接受双侧 STN-DBS 和 GP-DBS 的 PD 患者的双侧 STN 和 GP 的 LFPs。在各种 ON-和 OFF-左旋多巴和 DBS 状态下，无论是在休息时还是在自愿运动时，评估每个目标和 STN-GP 相干性的功率谱。
在 OFF-左旋多巴和 OFF-DBS 时，双侧 STN 和 GP 均存在β峰，与明显的 STN-GPβ相干性一致。左旋多巴和双靶点-DBS（同时进行 STN-DBS 和 GP-DBS）完全抑制了 STN-GP 相干性。在 GP-DBS 休息时，在 STN 中以刺激频率的一半（62.5 Hz）观察到精细调谐的γ（FTG）活动。为了评估运动对 FTG 活动的影响，我们在指令运动期间记录了 LFPs。当 ON-左旋多巴和 ON-DBS 时，我们在进行对侧肢体运动期间观察到双侧 GP 和双侧 STN 中的 FTG 活动。在用 STN-DBS 或双靶点-DBS 时没有观察到 FTG。
双靶点-DBS 和左旋多巴抑制了 STN-GP 相干性。在左旋多巴和运动存在的情况下，GP-DBS 诱导了整个基底节的 FTG。这种双侧 STN-FTG 和 GP-FTG 与最轻微的运动迟缓状态相对应，表明 FTG 具有促运动作用。
