Brain, Vol. 122, No. 10, 1919-1931,
October 1999
© 1999 Oxford University Press
Neurophysiological effects of stimulation through electrodes in the human subthalamic nucleus
Playfair Neuroscience Unit, University of Toronto,Toronto Western Hospital, Toronto, Canada
Correspondence to:
P. Ashby, MD, Playfair Neuroscience Unit, University of Toronto, Toronto Hospital-Western Division 13–319, 399 Bathurst Street, Toronto, Ontario, Canada M5T 2S8 E-mail: pashby{at}playfair.utoronto.ca
The effects of stimulation through macroelectrodes implanted in the subthalamic nucleus (STN) were studied in 14 patients with parkinsonism. Single stimuli delivered directly to the STN electrodes with an external stimulator modulated voluntary electromyography (EMG) of contralateral muscles in most patients. A short-latency facilitation (`peak') was attributed to the activation of the corticospinal system. A longer latency inhibition (`dip'), often preceded or followed by facilitations, appeared to arise from the activation of large-diameter fibres running parallel to the electrode and to be transmitted through the motor cortex. It is possible that the dip could result from the inhibition of thalamocortical neurons. With high-frequency stimulation (~100 Hz) the peaks occurred at the stimulus frequency; the dips became confluent and outlasted the duration of the stimulus train. There was no evidence that high-frequency stimulation produced `blocking'. The studies were repeated in 12 patients a mean of 5.8 months after implantation of the stimulator. The same short-latency effects were obtained. They were present on 7 out of 23 sides at the settings in use and on the majority of sides if the stimulus intensity was slightly increased. There was no clear relationship between these short-latency effects and the patients' overall clinical improvement; the effects may result from the spread of current to large-fibre systems near the STN. In five patients, high-frequency stimulation on one side immediately reduced tremor in the contralateral limbs. This effect arose from the activation of large-diameter fibres and, like the dip, had about the same threshold at each of the contacts. Frequencies as low as 70 Hz were sufficient. We conclude that the control of tremor by STN stimulation is due to the activation of a large-fibre system.
parkinsonism; subthalamic nucleus; deep brain stimulation
C–T = condition–test; FDI = first dorsal interosseous; GPE = globus pallidus externus; GPI = globus pallidus internus; MEP = motor evoked potential; MPTP = 1-methyl-4-phenyl-1,2,3,6 tetrahydropyridine; SNPR = substantia nigra pars reticulata; STN = subthalamic nucleus; UPDRS = Unified Parkinson's Disease Rating Scale
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  R. Hilker, J. Voges, T. Weber, L. W. Kracht, J. Roggendorf, S. Baudrexel, M. Hoevels, V. Sturm, and W. D. Heiss STN-DBS activates the target area in Parkinson disease: An FDG-PET study Neurology, September 2, 2008; 71(10): 708 - 713. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. Costa, J. Valls-Sole, F. Valldeoriola, and J. Rumia Subcortical Interactions Between Somatosensory Stimuli of Different Modalities and Their Temporal Profile J Neurophysiol, September 1, 2008; 100(3): 1610 - 1621. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Li, G. W. Arbuthnott, M. J. Jutras, J. A. Goldberg, and D. Jaeger Resonant Antidromic Cortical Circuit Activation as a Consequence of High-Frequency Subthalamic Deep-Brain Stimulation J Neurophysiol, December 1, 2007; 98(6): 3525 - 3537. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. A. Basso and P. Liu Context-Dependent Effects of Substantia Nigra Stimulation on Eye Movements J Neurophysiol, June 1, 2007; 97(6): 4129 - 4142. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. Costa, J. Valls-Sole, F. Valldeoriola, J. Rumia, and E. Tolosa Motor responses of muscles supplied by cranial nerves to subthalamic nucleus deep brain stimuli Brain, January 1, 2007; 130(1): 245 - 255. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. Costa, J. Valls-Sole, F. Valldeoriola, C. Pech, and J. Rumia Single subthalamic nucleus deep brain stimuli inhibit the blink reflex in Parkinson's disease patients Brain, July 1, 2006; 129(7): 1758 - 1767. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 N. P. Stover, M. S. Okun, M. L. Evatt, D. V. Raju, R. A. E. Bakay, and J. L. Vitek Stimulation of the Subthalamic Nucleus in a Patient With Parkinson Disease and Essential Tremor Arch Neurol, January 1, 2005; 62(1): 141 - 143. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. Hanajima, P. Ashby, A. M. Lozano, A. E. Lang, and R. Chen Single Pulse Stimulation of the Human Subthalamic Nucleus Facilitates the Motor Cortex at Short Intervals J Neurophysiol, September 1, 2004; 92(3): 1937 - 1943. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. Devos, E. Labyt, P. Derambure, J. L. Bourriez, F. Cassim, N. Reyns, S. Blond, J. D. Guieu, A. Destee, and L. Defebvre Subthalamic nucleus stimulation modulates motor cortex oscillatory activity in Parkinson's disease Brain, February 1, 2004; 127(2): 408 - 419. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 W Hamel, U Fietzek, A Morsnowski, B Schrader, J Herzog, D Weinert, G Pfister, D Muller, J Volkmann, G Deuschl, et al. Deep brain stimulation of the subthalamic nucleus in Parkinson's disease: evaluation of active electrode contacts J. Neurol. Neurosurg. Psychiatry, August 1, 2003; 74(8): 1036 - 1046. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. C. McIntyre and W. M. Grill Extracellular Stimulation of Central Neurons: Influence of Stimulus Waveform and Frequency on Neuronal Output J Neurophysiol, October 1, 2002; 88(4): 1592 - 1604. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 N. Urbain, N. Rentero, D. Gervasoni, B. Renaud, and G. Chouvet The Switch of Subthalamic Neurons From an Irregular to a Bursting Pattern Does Not Solely Depend on Their GABAergic Inputs in the Anesthetic-Free Rat J. Neurosci., October 1, 2002; 22(19): 8665 - 8675. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E. Moro, R. J.A. Esselink, J. Xie, M. Hommel, A. L. Benabid, and P. Pollak The impact on Parkinson's disease of electrical parameter settings in STN stimulation Neurology, September 10, 2002; 59(5): 706 - 713. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. Williams, M. Tijssen, G. van Bruggen, A. Bosch, A. Insola, V. D. Lazzaro, P. Mazzone, A. Oliviero, A. Quartarone, H. Speelman, et al. Dopamine-dependent changes in the functional connectivity between basal ganglia and cerebral cortex in humans Brain, July 1, 2002; 125(7): 1558 - 1569. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. Cunic, L. Roshan, F. I. Khan, A. M. Lozano, A. E. Lang, and R. Chen Effects of subthalamic nucleus stimulation on motor cortex excitability in Parkinson's disease Neurology, June 11, 2002; 58(11): 1665 - 1672. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M Rizzone, M Lanotte, B Bergamasco, A Tavella, E Torre, G Faccani, A Melcarne, and L Lopiano Deep brain stimulation of the subthalamic nucleus in Parkinson's disease: effects of variation in stimulation parameters J. Neurol. Neurosurg. Psychiatry, August 1, 2001; 71(2): 215 - 219. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. Bikson, J. Lian, P. J Hahn, W. C Stacey, C. Sciortino, and D. M Durand Suppression of epileptiform activity by high frequency sinusoidal fields in rat hippocampal slices J. Physiol., February 15, 2001; 531(1): 181 - 191. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. F. Marsden, P. Limousin-Dowsey, P. Ashby, P. Pollak, and P. Brown Subthalamic nucleus, sensorimotor cortex and muscle interrelationships in Parkinson's disease Brain, February 1, 2001; 124(2): 378 - 388. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. A. Saint-Cyr, L. L. Trepanier, R. Kumar, A. M. Lozano, and A. E. Lang Neuropsychological consequences of chronic bilateral stimulation of the subthalamic nucleus in Parkinson's disease Brain, October 1, 2000; 123(10): 2091 - 2108. [Abstract] [Full Text] [PDF]
|
|