Deep brain stimulation suppresses pallidal low frequency activity in patients with phasic dystonic movements

Abstract

Deep brain stimulation of the globus pallidus internus alleviates involuntary movements in patients with dystonia. However, the mechanism is still not entirely understood. One hypothesis is that deep brain stimulation suppresses abnormally enhanced synchronized oscillatory activity within the motor cortico-basal ganglia network. Here, we explore deep brain stimulation-induced modulation of pathological low frequency (4-12 Hz) pallidal activity that has been described in local field potential recordings in patients with dystonia. Therefore, local field potentials were recorded from 16 hemispheres in 12 patients undergoing deep brain stimulation for severe dystonia using a specially designed amplifier allowing simultaneous high frequency stimulation at therapeutic parameter settings and local field potential recordings. For coherence analysis electroencephalographic activity (EEG) over motor areas and electromyographic activity (EMG) from affected neck muscles were recorded before and immediately after cessation of high frequency stimulation. High frequency stimulation led to a significant reduction of mean power in the 4-12 Hz band by 24.8 ± 7.0% in patients with predominantly phasic dystonia. A significant decrease of coherence between cortical EEG and pallidal local field potential activity in the 4-12 Hz range was revealed for the time period of 30 s after switching off high frequency stimulation. Coherence between EMG activity and pallidal activity was mainly found in patients with phasic dystonic movements where it was suppressed after high frequency stimulation. Our findings suggest that high frequency stimulation may suppress pathologically enhanced low frequency activity in patients with phasic dystonia. These dystonic features are the quickest to respond to high frequency stimulation and may thus directly relate to modulation of pathological basal ganglia activity, whereas improvement in tonic features may depend on long-term plastic changes within the motor network.

Effect GPi Stimulation on Human Thalamic Neuronal Activity: A Decade Later

“…For instance, alpha (4-12 Hz) frequencies are associated with phasic dystonia. Interestingly phasic dystonia as well as alpha frequencies are reduced during GPi DBS [9]. In the same way beta (20-30 Hz) frequencies in the subthalamic nucleus are associated to rigidity and akinesia that are both reduced during DBS [10].…”

Modulation of local field potentials by high-frequency stimulation of afferent axons in the hippocampal CA1 region

“…Therefore, many previous studies investigated the LFP signals after the termination of HFS to infer the LFP activity during HFS (Barow et al, 2014;Wingeier et al, 2006;Fo®ani et al, 2006). However, the LFP activity could recover rapidly after HFS (Fig.…”

“…To avoid the artifacts, LFP signals collected after the termination of HFS have been used to infer the LFP activity during HFS (Barow et al, 2014;Wingeier et al, 2006;Fo®ani et al, 2006). Nevertheless, the neuronal activity under the stimulation of HFS could be di®erent from the activity after the withdrawal of stimulation (Lehmkuhle et al, 2009;Swann et al, 2011).…”

Motor behaviors in the sheep evoked by electrical stimulation of the subthalamic nucleus

“…ET and dystonia are associated with abnormal oscillations within the theta-alpha range (4-12 Hz) [72][73][74][75]. The abnormal low-frequency oscillations in dystonia also subside with DBS or other interventions that ameliorate the phasic or dyskinetic symptoms [76,77]. Furthermore, a significant coherence can be detected between the exaggerated low-frequency brain activity and the tremor in ET and PD, and the phasic movements in dystonia [76,[78][79][80].…”