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Movement related dynamics of subthalmo-cortical alpha connectivity in Parkinson's disease.

ABSTRACT: Functional neurosurgical techniques provide a unique opportunity to explore patterns of interaction between the cerebral cortex and basal ganglia in patients with Parkinson's disease (PD). Previous work using simultaneous magnetoencephalographic (MEG) and local field potential (LFP) recordings from the region of the subthalamic nucleus (STNr) has characterised resting patterns of connectivity in the alpha and beta frequency bands and their modulation by dopaminergic medication. Recently we have also characterised the effect of movement on patterns of gamma band coherence between the STNr and cortical sites. Here we specifically investigate how the prominent coherence between the STNr and temporal cortex in the alpha band is modulated by movement both on and off dopaminergic medication in patients following the insertion of Deep Brain Stimulation (DBS) electrodes. We show that movement is associated with a suppression of local alpha power in the temporal cortex and STNr that begins about 2s prior to a self-paced movement and is independent of dopaminergic status. In contrast, the peak reduction in coherence between these sites occurs after movement onset and is more marked in the on than in the off dopaminergic medication state. The difference in alpha band coherence on and off medication was found to correlate with the drug related improvement in clinical parameters. Overall, the movement-related behaviour of activities in the alpha band in patients with PD serves to highlight the role of dopamine in modulating large-scale, interregional synchronisation.

SUBMITTER: Oswal A

PROVIDER: S-EPMC3591253 | biostudies-literature | 2013 Apr

REPOSITORIES: biostudies-literature

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Movement related dynamics of subthalmo-cortical alpha connectivity in Parkinson's disease.

Oswal Ashwini A Brown Peter P Litvak Vladimir V

NeuroImage 20121228

Functional neurosurgical techniques provide a unique opportunity to explore patterns of interaction between the cerebral cortex and basal ganglia in patients with Parkinson's disease (PD). Previous work using simultaneous magnetoencephalographic (MEG) and local field potential (LFP) recordings from the region of the subthalamic nucleus (STNr) has characterised resting patterns of connectivity in the alpha and beta frequency bands and their modulation by dopaminergic medication. Recently we have ...[more]

PMID: 23277109

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Project description:Recent electrocorticography data have demonstrated excessive coupling of beta-phase to gamma-amplitude in primary motor cortex and that deep brain stimulation facilitates motor improvement by decreasing baseline phase-amplitude coupling. However, both the dynamic modulation of phase-amplitude coupling during movement and the general cortical neurophysiology of other movement disorders, such as essential tremor, are relatively unexplored. To clarify the relationship of these interactions in cortical oscillatory activity to movement and disease state, we recorded local field potentials from hand sensorimotor cortex using subdural electrocorticography during a visually cued, incentivized handgrip task in subjects with Parkinson's disease (n = 11), with essential tremor (n = 9) and without a movement disorder (n = 6). We demonstrate that abnormal coupling of the phase of low frequency oscillations to the amplitude of gamma oscillations is not specific to Parkinson's disease, but also occurs in essential tremor, most prominently for the coupling of alpha to gamma oscillations. Movement kinematics were not significantly different between these groups, allowing us to show for the first time that robust alpha and beta desynchronization is a shared feature of sensorimotor cortical activity in Parkinson's disease and essential tremor, with the greatest high-beta desynchronization occurring in Parkinson's disease and the greatest alpha desynchronization occurring in essential tremor. We also show that the spatial extent of cortical phase-amplitude decoupling during movement is much greater in subjects with Parkinson's disease and essential tremor than in subjects without a movement disorder. These findings suggest that subjects with Parkinson's disease and essential tremor can produce movements that are kinematically similar to those of subjects without a movement disorder by reducing excess sensorimotor cortical phase-amplitude coupling that is characteristic of these diseases.

Project description:ObjectivesFirstly, to identify subthalamic region stimulation clusters that predict maximum improvement in rigidity, bradykinesia and tremor, or emergence of side-effects; and secondly, to map-out the cortical fingerprint, mediated by the hyperdirect pathways which predict maximum efficacy.MethodsHigh angular resolution diffusion imaging in twenty patients with advanced Parkinson's disease was acquired prior to bilateral subthalamic nucleus deep brain stimulation. All contacts were screened one-year from surgery for efficacy and side-effects at different amplitudes. Voxel-based statistical analysis of volumes of tissue activated models was used to identify significant treatment clusters. Probabilistic tractography was employed to identify cortical connectivity patterns associated with treatment efficacy.ResultsAll patients responded well to treatment (46% mean improvement off medication UPDRS-III [p < 0.0001]) without significant adverse events. Cluster corresponding to maximum improvement in tremor was in the posterior, superior and lateral portion of the nucleus. Clusters corresponding to improvement in bradykinesia and rigidity were nearer the superior border in a further medial and posterior location. The rigidity cluster extended beyond the superior border to the area of the zona incerta and Forel-H2 field. When the clusters where averaged, the coordinates of the area with maximum overall efficacy was X = -10(-9.5), Y = -13(-1) and Z = -7(-3) in MNI(AC-PC) space. Cortical connectivity to primary motor area was predictive of higher improvement in tremor; whilst that to supplementary motor area was predictive of improvement in bradykinesia and rigidity; and connectivity to prefrontal cortex was predictive of improvement in rigidity.InterpretationThese findings support the presence of overlapping stimulation sites within the subthalamic nucleus and its superior border, with different cortical connectivity patterns, associated with maximum improvement in tremor, rigidity and bradykinesia.

Dataset Information

Movement related dynamics of subthalmo-cortical alpha connectivity in Parkinson's disease.

Publications

Movement related dynamics of subthalmo-cortical alpha connectivity in Parkinson's disease.

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