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© 2021. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.

Abstract

Objective

To investigate the progression of neural and motor features of Parkinson's disease in a longitudinal study, after washout of medication and bilateral subthalamic nucleus deep brain stimulation (STN DBS).

Methods

Participants with clinically established Parkinson's disease underwent bilateral implantation of DBS leads (18 participants, 13 male) within the STN using standard functional frameless stereotactic technique and multi‐pass microelectrode recording. Both DBS leads were connected to an implanted investigative sensing neurostimulator (Activa™ PC + S, Medtronic, PLC). Resting state STN local field potentials (LFPs) were recorded and motor disability, (the Movement Disorder Society‐Unified Parkinson's Disease Rating Scale – motor subscale, MDS‐UPDRS III) was assessed off therapy at initial programming, and after 6 months, 1 year, and yearly out to 5 years of treatment. The primary endpoint was measured at 3 years. At each visit, medication had been held for over 12/24 h and DBS was turned off for at least 60 min, by which time LFP spectra reached a steady state.

Results

After 3 years of chronic DBS, there were no increases in STN beta band dynamics (p = 0.98) but there were increases in alpha band dynamics (p = 0.0027, 25 STNs). Similar results were observed in a smaller cohort out to 5 years. There was no increase in the MDS‐UPDRS III score.

Interpretation

These findings provide evidence that the beta oscillopathy does not substantially progress following combined STN DBS plus medication in moderate to advanced Parkinson's disease.

Details

Title
Lack of progression of beta dynamics after long‐term subthalamic neurostimulation
Author
Anderson, Ross W 1   VIAFID ORCID Logo  ; Wilkins, Kevin B 2   VIAFID ORCID Logo  ; Parker, Jordan E 3   VIAFID ORCID Logo  ; Petrucci, Matthew N 2   VIAFID ORCID Logo  ; Kehnemouyi, Yasmine 4   VIAFID ORCID Logo  ; Neuville, Raumin S 5   VIAFID ORCID Logo  ; Cassini, Declan 2 ; Trager, Megan H 6   VIAFID ORCID Logo  ; Koop, Mandy M 7   VIAFID ORCID Logo  ; Velisar, Anca 8   VIAFID ORCID Logo  ; Blumenfeld, Zack 9   VIAFID ORCID Logo  ; Quinn, Emma J 10 ; Henderson, Jaimie 11   VIAFID ORCID Logo  ; Helen M. Bronte‐Stewart 11   VIAFID ORCID Logo 

 Department of Neurology and Neurological Sciences, Stanford University School of Medicine, Stanford, California, USA; Department of Neurosurgery, Kaiser Permanente, Redwood City, California, USA 
 Department of Neurology and Neurological Sciences, Stanford University School of Medicine, Stanford, California, USA 
 Department of Neurology and Neurological Sciences, Stanford University School of Medicine, Stanford, California, USA; Department of Psychology, The University of California, Los Angeles, California, USA 
 Department of Neurology and Neurological Sciences, Stanford University School of Medicine, Stanford, California, USA; Department of Bioengineering, Stanford Schools of Engineering & Medicine, Stanford, California, USA 
 Department of Neurology and Neurological Sciences, Stanford University School of Medicine, Stanford, California, USA; The University of California School of Medicine, Irvine, California, USA 
 Department of Neurology and Neurological Sciences, Stanford University School of Medicine, Stanford, California, USA; Columbia University College of Physicians and Surgeons, New York City, New York, USA 
 Department of Neurology and Neurological Sciences, Stanford University School of Medicine, Stanford, California, USA; Cleveland Clinic, Cleveland, Ohio, USA 
 Department of Neurology and Neurological Sciences, Stanford University School of Medicine, Stanford, California, USA; The Smith‐Kettlewell Eye Research Institute, San Francisco, California, USA 
 Department of Neurology and Neurological Sciences, Stanford University School of Medicine, Stanford, California, USA; California Institute of Technology, Pasadena, California, USA 
10  Department of Neurology and Neurological Sciences, Stanford University School of Medicine, Stanford, California, USA; Credit Karma, San Francisco, California, USA 
11  Department of Neurology and Neurological Sciences, Stanford University School of Medicine, Stanford, California, USA; Department of Neurosurgery, Stanford University School of Medicine, Stanford, California, USA 
Pages
2110-2120
Section
Research Articles
Publication year
2021
Publication date
Nov 2021
Publisher
John Wiley & Sons, Inc.
e-ISSN
23289503
Source type
Scholarly Journal
Language of publication
English
ProQuest document ID
2600212128
Copyright
© 2021. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.