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Deep brain stimulation can suppress pathological synchronisation in parkinsonian patients
  1. A Eusebio1,2,
  2. W Thevathasan1,3,
  3. L Doyle Gaynor1,
  4. A Pogosyan1,
  5. E Bye1,
  6. T Foltynie1,
  7. L Zrinzo1,
  8. K Ashkan4,
  9. T Aziz5,
  10. P Brown1,3
  1. 1Sobell Department of Motor Neuroscience and Movement Disorders, Institute of Neurology, London, UK
  2. 2Department of Neurology and Movement Disorders, Timone University Hospital, Marseille, France
  3. 3Department of Clinical Neurology, John Radcliffe Hospital, Oxford, UK
  4. 4Neurosurgery, King's College Hospital, Denmark Hill, London, UK
  5. 5Department of Neurological Surgery, John Radcliffe Hospital, Oxford, UK
  1. Correspondence to Professor P Brown, Department of Clinical Neurology, John Radcliffe Hospital, Oxford OX3 9DU, UK; peter.brown{at}clneuro.ox.ac.uk

Abstract

Background Although deep brain stimulation (DBS) of the subthalamic nucleus (STN) is a highly effective therapeutic intervention in severe Parkinson's disease, its mechanism of action remains unclear. One possibility is that DBS suppresses local pathologically synchronised oscillatory activity.

Methods To explore this, the authors recorded from DBS electrodes implanted in the STN of 16 patients with Parkinson's disease during simultaneous stimulation (pulse width 60 μs; frequency 130 Hz) of the same target using a specially designed amplifier. The authors analysed data from 25 sides.

Results The authors found that DBS progressively suppressed peaks in local field potential activity at frequencies between 11 and 30 Hz as voltage was increased beyond a stimulation threshold of 1.5 V. Median peak power had fallen to 54% of baseline values by a stimulation intensity of 3.0 V.

Conclusion The findings suggest that DBS can suppress pathological 11–30 Hz activity in the vicinity of stimulation in patients with Parkinson's disease. This suppression occurs at stimulation voltages that are clinically effective.

  • Parkinson's disease
  • basal ganglia
  • deep brain stimulation
  • oscillations
  • neurophysiology
  • electrical stimulation
  • motor physiology
  • movement disorders
  • motor

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Footnotes

  • P Brown holds a consultancy with Medtronic Inc.

  • Funding This work was supported by the Medical Research Council, Wellcome Trust, the Oxford NIHR Biomedical Research Centre, Parkinson's Disease UK and Fondation pour la Recherche Médicale.

  • Competing interests None.

  • Patient consent Obtained.

  • Ethics approval Ethics approval was provided by the Joint Ethics Committee of the National Hospital for Neurology and the Institute of Neurology.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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