scholarly journals Average beta burst duration profiles provide a signature of dynamical changes between the ON and OFF medication states in Parkinson’s disease

2021 ◽  
Vol 17 (7) ◽  
pp. e1009116
Author(s):  
Benoit Duchet ◽  
Filippo Ghezzi ◽  
Gihan Weerasinghe ◽  
Gerd Tinkhauser ◽  
Andrea A. Kühn ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Deep Brain Stimulation ◽  
Subthalamic Nucleus ◽  
Brain Stimulation ◽  
Motor Impairment ◽  
Burst Duration ◽  
Motor Symptoms ◽  
Beta Oscillations ◽  
Deep Brain

Parkinson’s disease motor symptoms are associated with an increase in subthalamic nucleus beta band oscillatory power. However, these oscillations are phasic, and there is a growing body of evidence suggesting that beta burst duration may be of critical importance to motor symptoms. This makes insights into the dynamics of beta bursting generation valuable, in particular to refine closed-loop deep brain stimulation in Parkinson’s disease. In this study, we ask the question “Can average burst duration reveal how dynamics change between the ON and OFF medication states?”. Our analysis of local field potentials from the subthalamic nucleus demonstrates using linear surrogates that the system generating beta oscillations is more likely to act in a non-linear regime OFF medication and that the change in a non-linearity measure is correlated with motor impairment. In addition, we pinpoint the simplest dynamical changes that could be responsible for changes in the temporal patterning of beta oscillations between medication states by fitting to data biologically inspired models, and simpler beta envelope models. Finally, we show that the non-linearity can be directly extracted from average burst duration profiles under the assumption of constant noise in envelope models. This reveals that average burst duration profiles provide a window into burst dynamics, which may underlie the success of burst duration as a biomarker. In summary, we demonstrate a relationship between average burst duration profiles, dynamics of the system generating beta oscillations, and motor impairment, which puts us in a better position to understand the pathology and improve therapies such as deep brain stimulation.

scholarly journals Neuropsychological and quality of life assessment in patients with Parkinson's disease submitted to bilateral deep brain stimulation in the subthalamic nucleus

2012 ◽  
Vol 6 (4) ◽  
pp. 260-265 ◽  
Author(s):  
Alessandra Shenandoa Heluani ◽  
Fábio Henrique de Gobbi Porto ◽  
Sergio Listik ◽  
Alexandre Walter de Campos ◽  
Alexandre Aluizio Costa Machado ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Deep Brain Stimulation ◽  
Subthalamic Nucleus ◽  
Brain Stimulation ◽  
Life Assessment ◽  
Motor Symptoms ◽  
Deep Brain

ABSTRACT Deep brain stimulation (DBS) has been widely used to control motor symptoms and improve quality of life in patients with Parkinsons disease (PD). Recently, DBS in the subthalamic nucleus (STN) has become the preferred target for patients with mixed motor symptoms. Despite resultant motor and quality of life improvements, the procedure has been associated with cognitive decline, mainly in language skills, and also with psychiatric symptoms. Objective: To evaluate the influence of DBS in the STN on cognition, mood and quality of life. Methods: We studied 20 patients with PD submitted to DBS in the STN from May 2008 to June 2012 with an extensive battery of cognitive tests including memory, language, praxis, executive functions and attention assessments; the Parkinson's Disease Quality of Life Questionnaire (PDQ-39); and the Hospital Anxiety and Depression Scale (HAD), were applied both before and after the surgery. Data was analyzed using SPSS version 17.0 and results compared using the paired Student's t test. Results: A total of 20 patients with pre and post-operative assessments were included. A statistically significant improvement was found in total score and on subscales of mobility, activities of daily living and emotional well-being from the PDQ-39 (P=0.009, 0.025, 0.001 and 0.034, respectively). No significant difference was found on the cognitive battery or mood scale. Conclusion: DBS in the SNT improved quality of life in PD with no negative impact on cognitive skills and mood.

scholarly journals Syncope Associated with Subthalamic Nucleus Deep Brain Stimulation in a Patient with Parkinson’s Disease

2013 ◽  
Vol 2013 ◽  
pp. 1-2
Author(s):  
Dursun Aygun ◽  
Ersoy Kocabicak ◽  
Onur Yildiz ◽  
Musa Kazim Onar ◽  
Hatice Guz ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Deep Brain Stimulation ◽  
Subthalamic Nucleus ◽  
Brain Stimulation ◽  
Early Period ◽  
Motor Symptoms ◽  
The Right ◽  
Stn Dbs ◽  
Deep Brain

In advanced Parkinson's disease (PD), deep brain stimulation (DBS) may be an alternative option for the treatment of motor symptoms. Side effects associated with subthalamic nucleus (STN) DBS in patients with PD are emerging as the most frequent sensory and motor symptoms. DBS-related syncope is reported as extremely rare. We wanted to discuss the mechanisms of syncope associated with STN DBS in a patient with Parkinson's disease.Case report.Sixty-three-year-old female patient is followed up with diagnosis of idiopathic Parkinson's disease for 6 years in our clinic. The patient has undergone STN DBS due to painful dystonia and drug resistant tremor. During the operation, when the left STN was stimulated at 5 milliampere (mAmp), the patient developed presyncopal symptoms. However, when the stimulation was stopped symptoms improved. During the early period after the operation, when the right STN was stimulated at 1.3 millivolts (mV), she developed the pre-yncopal symptoms and then syncope. Our case shows that STN DBS may lead to directly autonomic symptoms resulting in syncope during stimulation-on (stim-on).

scholarly journals Deep brain stimulation in the subthalamic nucleus for Parkinson's disease can restore dynamics of striatal networks

2021 ◽  
Author(s):  
Elie M Adam ◽  
Emery N. Brown ◽  
Nancy Kopell ◽  
Michelle M McCarthy
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Deep Brain Stimulation ◽  
Subthalamic Nucleus ◽  
Brain Stimulation ◽  
Gamma Oscillations ◽  
Medium Spiny Neuron ◽  
Beta Oscillations ◽  
Movement Disability ◽  
Deep Brain

Deep brain stimulation (DBS) of the subthalamic nucleus (STN) is highly effective in alleviating movement disability in patients with Parkinson's disease (PD). However, its therapeutic mechanism of action is unknown. The healthy striatum exhibits rich dynamics resulting from an interaction of beta, gamma and theta oscillations. These rhythms are at the heart of selection, initiation and execution of motor programs, and their loss or exaggeration due to dopamine (DA) depletion in PD is a major source of the behavioral deficits observed in PD patients. Interrupting abnormal rhythms and restoring the interaction of rhythms as observed in the healthy striatum may then be instrumental in the therapeutic action of DBS. We develop a biophysical networked model of a BG pathway to study how abnormal beta oscillations can emerge throughout the BG in PD, and how DBS can restore normal beta, gamma and theta striatal rhythms. Our model incorporates STN projections to the striatum, long known but understudied, that were recently shown to preferentially target fast spiking interneurons (FSI) in the striatum. We find that DBS in STN is able to normalize striatal medium spiny neuron (MSN) activity by recruiting FSI dynamics, and restoring the inhibitory potency of FSIs observed in normal condition. We also find that DBS allows the re-expression of gamma and theta rhythms, thought to be dependent on high DA levels and thus lost in PD, through cortical noise control. Our study shows how BG connectivity can amplify beta oscillations, and delineates the role of DBS in disrupting beta oscillations and providing corrective input to STN efferents to restore healthy striatal dynamics. It also suggests how gamma oscillations can be leveraged to enhance or supplement DBS treatment and improve its effectiveness.

scholarly journals Average beta burst duration profiles provide a signature of dynamical changes between the ON and OFF medication states in Parkinson’s disease

2020 ◽  
Author(s):  
Benoit Duchet ◽  
Filippo Ghezzi ◽  
Gihan Weerasinghe ◽  
Gerd Tinkhauser ◽  
Andrea A. Kühn ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Subthalamic Nucleus ◽  
Motor Impairment ◽  
Burst Duration ◽  
Pathological State ◽  
Motor Symptoms ◽  
Biologically Inspired ◽  
Beta Oscillations ◽  
Healthy State

AbstractParkinson’s disease motor symptoms are associated with an increase in subthalamic nucleus beta band oscillatory power. But these oscillations are phasic, and there is a growing body of evidence suggesting that beta burst duration may be of critical importance to motor symptoms, making insights into the dynamics of beta bursting generation valuable. In this study, we ask the question “Can average burst duration reveal how dynamics change between the ON and OFF medication states?”. Our analysis of local field potentials from the subthalamic nucleus demonstrates using linear surrogates that the system generating beta oscillations acts in a more non-linear regime OFF medication and that the change in the degree of non-linearity is correlated with motor impairment. Further, we pinpoint specific dynamical changes responsible for changes in the temporal patterning of beta oscillations between medication states by fitting to data biologically inspired models, and simpler beta envelope models. Finally, we show that the non-linearity can be directly extracted from average burst duration profiles under the assumption of constant noise in envelope models. This reveals that average burst duration profiles provide a window into burst dynamics, which may underlie the success of burst duration as a biomarker. In summary, we demonstrate a relationship between average burst duration profiles, dynamics of the system generating beta oscillations, and motor impairment, which puts us in a better position to understand the pathology and improve therapies such as deep brain stimulation.Author summaryIn Parkinson’s disease, motor impairment is associated with abnormal oscillatory activity of neurons in deep motor regions of the brain. These oscillations come in the shape of bursts, and the duration of these bursts has recently been shown to be of importance to motor symptoms. To better understand the disease and refine therapies, we relate the duration of these bursts to properties of the system generating them in the pathological state and in a proxy of the healthy state. The data suggest that the system generating bursts is more complex in the pathological state, and we show that a measure of this complexity is associated with motor impairment. We propose biologically inspired models and simpler models that can generate the burst patterns observed in the pathological and healthy state. The models confirm what was observed in data, and tell us how burst generation mechanisms could differ in the disease. Finally, we identify a mathematical link allowing to infer properties of the burst generating system from burst duration. This sheds some light on the significance of burst duration as a marker of pathology.

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