期刊
BRAIN
卷 139, 期 -, 页码 2503-2515出版社
OXFORD UNIV PRESS
DOI: 10.1093/brain/aww182
关键词
deep brain stimulation; Parkinson's disease; Parkinson's disease: imaging; subthalamic nucleus; beta oscillations
资金
- German Research Agency (DFG - Deutsche Forschungsgemeinschaft) [KFO 247]
- Abbvie
- Allergan
- German Research Foundation (DFG) [HE 6013/1-2]
- Stiftung Charite
- Max-Rubner-Preis
- Berlin Institute of Health
- Prof. Klaus Thiemann Foundation
- Medtronic
- St. Jude Medical
- Boston Scientific
- Ipsen Pharma
- DFG [KFO247]
- Swiss National Science Foundation (NCCR Synapsy) [32003B_159780, SPUM 33CM30_140332/1]
- Foundation Parkinson Switzerland
- Foundation Synapsis
- Roger de Spoelberch Foundation
- Partridge Foundation
Deep brain stimulation of the subthalamic nucleus is an established treatment for the motor symptoms of Parkinson's disease. Given the frequent occurrence of stimulation-induced affective and cognitive adverse effects, a better understanding about the role of the subthalamic nucleus in non-motor functions is needed. The main goal of this study is to characterize anatomical circuits modulated by subthalamic deep brain stimulation, and infer about the inner organization of the nucleus in terms of motor and non-motor areas. Given its small size and anatomical intersubject variability, functional organization of the subthalamic nucleus is difficult to investigate in vivo with current methods. Here, we used local field potential recordings obtained from 10 patients with Parkinson's disease to identify a subthalamic area with an analogous electrophysiological signature, namely a predominant beta oscillatory activity. The spatial accuracy was improved by identifying a single contact per macroelectrode for its vicinity to the electrophysiological source of the beta oscillation. We then conducted whole brain probabilistic tractography seeding from the previously identified contacts, and further described connectivity modifications along the macroelectrode's main axis. The designated subthalamic 'beta' area projected predominantly to motor and premotor cortical regions additional to connections to limbic and associative areas. More ventral subthalamic areas showed predominant connectivity to medial temporal regions including amygdala and hippocampus. We interpret our findings as evidence for the convergence of different functional circuits within subthalamic nucleus' portions deemed to be appropriate as deep brain stimulation target to treat motor symptoms in Parkinson's disease. Potential clinical implications of our study are illustrated by an index case where deep brain stimulation of estimated predominant non-motor subthalamic nucleus induced hypomanic behaviour.
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