Synchronized neuronal discharge in the basal ganglia of parkinsonian patients is limited to oscillatory activity

It has been proposed that an increase in synchronization between neurons in the basal ganglia contributes to the clinical features of Parkinson's disease (PD). To examine this hypothesis, we looked for correlations in the discharge activity of pairs of neurons in the globus pallidus internus (GPi), globus pallidus externus (GPe), and the substantia nigra pars reticulata (SNr). Recordings were performed in PD patients undergoing functional stereotactic mapping for pallidotomy (eight patients) or subthalamic nucleus deep brain stimulation (four patients). A double-microelectrode setup was used to simultaneously record from neurons separated by distances as small as 250 mum. In the five pallidotomy patients without limb tremor during the procedure, none of the 73 GPi pairs and 15 GPe pairs displayed synchronous activity. In the three pallidotomy patients with limb tremor, 6 of 21 GPi pairs and 5 of 29 GPe pairs displayed oscillatory synchronization in the frequency range of the ongoing limb tremor (3-6 Hz) or at higher frequencies (15-30 Hz). Synchronized activity was not observed in the SNr (10 pairs). The findings indicate that oscillatory synchronization between pairs of GPi or GPe neurons is found in patients with limb tremor. These results also suggest that overt neuronal synchronization, which may be attributable to an increase in direct synaptic connections or common collateral afferent inputs, is not present in the basal ganglia of patients with PD.