Deep Brain Stimulation Therapy in Parkinson Disease: The Role of Cortical Phase-Amplitude Coupling Reduction

Influence of inter-electrode distance on subthalamic nucleus local field potential recordings in Parkinson's disease

OBJECTIVES

To evaluate spectra and their correlations with clinical symptoms of local field potentials (LFP) acquired from wide- and close-spaced contacts (i.e. between contacts 0-3 or LFP03, and contacts 1-2 or LFP12 respectively) on the same DBS electrode within the subthalamus (STN) in Parkinson's disease (PD), before and after levodopa administration.

METHODS

LFP12 and LFP03 were recorded from 20 PD patients. We evaluated oscillatory power, local and switched phase-amplitude coupling (l- and Sw-PAC) and correlation with motor symptoms (UPDRSIII).

RESULTS

Before levodopa, both LFP03 and LFP12 power in the α band inversely correlated with UPDRSIII. Differences between contacts were found in the low-frequency bands power. After levodopa, differences in UPDRSIII were associated to changes in LFP03 low-β and LFP12 HFO (high frequency oscillations, 250-350 Hz) power, while a modulation of the low-β power and an increased β-LFO (low frequency oscillations, 15-45 Hz) PAC was found only for LFP12.

CONCLUSION

This study reveals differences in spectral pattern between LFP12 and LFP03 before and after levodopa administration, as well as different correlations with PD motor symptoms.

SIGNIFICANCE

Differences between LFP12 and LFP03 may offer an opportunity for optimizing adaptive deep brain stimulation (aDBS) protocols for PD. LFP12 can be used to detect β-HFO coupling and β power (i.e. bradykinesia), while LFP03 are optimal for low frequency oscillations (dyskinesias).