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. 2020 Feb 28:14:71.
doi: 10.3389/fnhum.2020.00071. eCollection 2020.

Tailoring Subthalamic Nucleus Deep Brain Stimulation for Parkinson's Disease Using Evoked Resonant Neural Activity

Wesley Thevathasan  1   2   3 , Nicholas C Sinclair  1   4 , Kristian J Bulluss  1   5   6 , Hugh J McDermott  1   4
Affiliations

Tailoring Subthalamic Nucleus Deep Brain Stimulation for Parkinson's Disease Using Evoked Resonant Neural Activity

Wesley Thevathasan et al. Front Hum Neurosci. .
No abstract available

Keywords: Parkinson's disease; biomarker; deep brain stimulation; evoked resonant neural activity; subthalamic nucleus.

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Figures

Figure 1
Figure 1
DBS evoked resonant neural activity (ERNA). (A) Periodically omitting one pulse in otherwise continuous 130 Hz DBS allows several ERNA peaks to be observed. Yellow trace: stimulation applied; black arrow: omitted pulse. (B) Short bursts of pulses (e.g., 10 pulses at 130 Hz) can be used as a “probe” to measure ERNA during periods off DBS therapy. (C) Applying burst probe stimulation in the vicinity of the STN elicits ERNA that varies with electrode position. Columns show the ERNA recorded at each electrode for different stimulating electrodes (indicated by crossed axes) in a single example STN from a person with PD. A 3D reconstruction illustrates the electrode positions (green: STN, blue: substantia nigra). (D) Normalized ERNA amplitude varies with electrode position with respect to (w.r.t) the STN in people with PD (20 hemispheres tested) (box: 25th−75th percentiles; line: median; whiskers: range). ***p ≤ 0.001, **p < 0.01, *p < 0.05. (E) ERNA recorded in a person with PD at electrode implantation (blue) and under general anesthesia 560 days postop (red). (F) Mean Unified Parkinson's Disease Rating Scale (UPDRS) improvement from stimulation after ranking electrodes within each hemisphere according to ERNA amplitude (rank 1: largest ERNA; bars: standard error). Results from 10 PD patients tested post-surgery (20 hemispheres). (G) ERNA frequency decreases with increasing DBS amplitude (19 hemispheres tested). Red bars: p ≤ 0.001; yellow bars: p < 0.05. (H) ERNA frequency correlates with relative beta band (13–30 Hz) amplitude across the stimulation levels shown in (G) (ρ = 0.58, p < 0.001). Colors represent different hemispheres tested. (A,B,G,H) reproduced from Sinclair et al. (2019), used with permission. (C–F) reproduced from Sinclair et al. (2018), used with permission.
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