IEEE J Biomed Health Inform - Beta-band frequency peaks inside the subthalamic nucleus as a biomarker for motor improvement after deep brain stimulation in Parkinson's disease.

Tópicos

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Resumo

Deep brain stimulation (DBS) of the subthalamic nucleus (STN) remains an empirical, yet highly effective, surgical treatment for advanced Parkinson's disease (PD). DBS outcome depends on accurate stimulation of the STN sensorimotor area which is a trial-and-error procedure taking place during and after surgery. Pathologically enhanced beta-band (13-35 Hz) oscillatory activity across the cortico-basal ganglia pathways is a prominent neurophysiological phenomenon associated with PD. We hypothesized that weighing together beta-band frequency peaks from simultaneous microelectrode recordings in "off-state" PD patients could map the individual neuroanatomical variability and serve as a biomarker for the location of the STN sensorimotor neurons. We validated our hypothesis with 9 and 11 patients that, respectively, responded well and poorly to bilateral DBS, after at least two years of follow up. We categorized "good" and "poor" DBS responders based on their clinical assessment alongside a > 40% and <30% change, respectively, in "off" unified PD rating scale motor scores. Good (poor) DBS responders had, in average, 1 mm (3.5 mm) vertical distance between the maximum beta-peak weighted across the parallel microelectrodes and the center of the stimulation area. The distances were statistically different in the two groups ( p = 0.0025 ). Our biomarker could provide personalized intra- and postoperative support in stimulating the STN sensorimotor area associated with optimal long-term clinical benefits.

Resumo Limpo

deep brain stimul dbs subthalam nucleus stn remain empir yet high effect surgic treatment advanc parkinson diseas pd dbs outcom depend accur stimul stn sensorimotor area trialanderror procedur take place surgeri patholog enhanc betaband hz oscillatori activ across corticobas ganglia pathway promin neurophysiolog phenomenon associ pd hypothes weigh togeth betaband frequenc peak simultan microelectrod record offstat pd patient map individu neuroanatom variabl serv biomark locat stn sensorimotor neuron valid hypothesi patient respect respond well poor bilater dbs least two year follow categor good poor dbs respond base clinic assess alongsid chang respect unifi pd rate scale motor score good poor dbs respond averag mm mm vertic distanc maximum betapeak weight across parallel microelectrod center stimul area distanc statist differ two group p biomark provid person intra postop support stimul stn sensorimotor area associ optim longterm clinic benefit

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