Paradoxical Modulation of STN β-Band Activity with Medication Compared to Deep Brain Stimulation

Meghan E. Hill; Luke A. Johnson; Jing Wang; David Escobar Sanabria; Rémi Patriat; Scott E. Cooper; Michael C. Park; Noam Harel; Jerrold L. Vitek; Joshua E. Aman

doi:10.1002/mds.29634

Paradoxical Modulation of STN β-Band Activity with Medication Compared to Deep Brain Stimulation

Meghan E. Hill, Luke A. Johnson, Jing Wang, David Escobar Sanabria, Rémi Patriat, Scott E. Cooper, Michael C. Park, Noam Harel, Jerrold L. Vitek, Joshua E. Aman

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Abstract

Background: Excessive subthalamic nucleus (STN) β-band (13–35 Hz) synchronized oscillations has garnered interest as a biomarker for characterizing disease state and developing adaptive stimulation systems for Parkinson's disease (PD). Objectives: To report on a patient with abnormal treatment-responsive modulation in the β-band. Methods: We examined STN local field potentials from an externalized deep brain stimulation (DBS) lead while assessing PD motor signs in four conditions (OFF, MEDS, DBS, and MEDS+DBS). Results: The patient presented here exhibited a paradoxical increase in β power following administration of levodopa and pramipexole (MEDS), but an attenuation in β power during DBS and MEDS+DBS despite clinical improvement of 50% or greater under all three therapeutic conditions. Conclusions: This case highlights the need for further study on the role of β oscillations in the pathophysiology of PD and the importance of personalized approaches to the development of β or other biomarker-based DBS closed loop algorithms.

Original language	English (US)
Pages (from-to)	192-197
Number of pages	6
Journal	Movement Disorders
Volume	39
Issue number	1
DOIs	https://doi.org/10.1002/mds.29634
State	Published - Jan 2024

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Publisher Copyright:
© 2023 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.

Keywords

Parkinson's disease
deep brain stimulation
levodopa
local field potentials
β-band activity

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ANDI
NM

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title = "Paradoxical Modulation of STN β-Band Activity with Medication Compared to Deep Brain Stimulation",

abstract = "Background: Excessive subthalamic nucleus (STN) β-band (13–35 Hz) synchronized oscillations has garnered interest as a biomarker for characterizing disease state and developing adaptive stimulation systems for Parkinson's disease (PD). Objectives: To report on a patient with abnormal treatment-responsive modulation in the β-band. Methods: We examined STN local field potentials from an externalized deep brain stimulation (DBS) lead while assessing PD motor signs in four conditions (OFF, MEDS, DBS, and MEDS+DBS). Results: The patient presented here exhibited a paradoxical increase in β power following administration of levodopa and pramipexole (MEDS), but an attenuation in β power during DBS and MEDS+DBS despite clinical improvement of 50% or greater under all three therapeutic conditions. Conclusions: This case highlights the need for further study on the role of β oscillations in the pathophysiology of PD and the importance of personalized approaches to the development of β or other biomarker-based DBS closed loop algorithms.",

keywords = "Parkinson's disease, deep brain stimulation, levodopa, local field potentials, β-band activity",

author = "Hill, {Meghan E.} and Johnson, {Luke A.} and Jing Wang and {Escobar Sanabria}, David and R{\'e}mi Patriat and Cooper, {Scott E.} and Park, {Michael C.} and Noam Harel and Vitek, {Jerrold L.} and Aman, {Joshua E.}",

note = "Publisher Copyright: {\textcopyright} 2023 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.",

year = "2024",

month = jan,

doi = "10.1002/mds.29634",

language = "English (US)",

volume = "39",

pages = "192--197",

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AU - Hill, Meghan E.

AU - Johnson, Luke A.

AU - Wang, Jing

AU - Escobar Sanabria, David

AU - Patriat, Rémi

AU - Cooper, Scott E.

AU - Park, Michael C.

AU - Harel, Noam

AU - Vitek, Jerrold L.

AU - Aman, Joshua E.

PY - 2024/1

Y1 - 2024/1

N2 - Background: Excessive subthalamic nucleus (STN) β-band (13–35 Hz) synchronized oscillations has garnered interest as a biomarker for characterizing disease state and developing adaptive stimulation systems for Parkinson's disease (PD). Objectives: To report on a patient with abnormal treatment-responsive modulation in the β-band. Methods: We examined STN local field potentials from an externalized deep brain stimulation (DBS) lead while assessing PD motor signs in four conditions (OFF, MEDS, DBS, and MEDS+DBS). Results: The patient presented here exhibited a paradoxical increase in β power following administration of levodopa and pramipexole (MEDS), but an attenuation in β power during DBS and MEDS+DBS despite clinical improvement of 50% or greater under all three therapeutic conditions. Conclusions: This case highlights the need for further study on the role of β oscillations in the pathophysiology of PD and the importance of personalized approaches to the development of β or other biomarker-based DBS closed loop algorithms.

AB - Background: Excessive subthalamic nucleus (STN) β-band (13–35 Hz) synchronized oscillations has garnered interest as a biomarker for characterizing disease state and developing adaptive stimulation systems for Parkinson's disease (PD). Objectives: To report on a patient with abnormal treatment-responsive modulation in the β-band. Methods: We examined STN local field potentials from an externalized deep brain stimulation (DBS) lead while assessing PD motor signs in four conditions (OFF, MEDS, DBS, and MEDS+DBS). Results: The patient presented here exhibited a paradoxical increase in β power following administration of levodopa and pramipexole (MEDS), but an attenuation in β power during DBS and MEDS+DBS despite clinical improvement of 50% or greater under all three therapeutic conditions. Conclusions: This case highlights the need for further study on the role of β oscillations in the pathophysiology of PD and the importance of personalized approaches to the development of β or other biomarker-based DBS closed loop algorithms.

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KW - local field potentials

KW - β-band activity

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Paradoxical Modulation of STN β-Band Activity with Medication Compared to Deep Brain Stimulation

Abstract

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