Brain Advance Access originally published online on January 8, 2007
Brain 2007 130(2):457-468; doi:10.1093/brain/awl358
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Dopaminergic therapy promotes lateralized motor activity in the subthalamic area in Parkinson's disease
1 Sobell Department of Motor Neuroscience and Movement Disorders, Institute of Neurology London, UK 2 Unit of Functional, Institute of Neurology London, UK 3 Department of Neurology, Charité Campus Virchow, Humboldt University Berlin, Germany 4 Department of Neurosurgery, Charité Campus Virchow, Humboldt University Berlin, Germany 5 Department of Neurosurgery, University Hospital of Northern Sweden Sweden
Correspondence to: Prof. P. Brown, Sobell Department of Motor Neuroscience and Movement Disorders, Institute of Neurology, Queen Square, London, WCIN 3BG, UK E-mail: p.brown{at}ion.ucl.ac.uk
Treatment of patients with Parkinson's disease with levodopa has profound effects on both movement and the pattern of movement-related reactivity in the subthalamic nucleus (STN), as reflected in the local field potential (LFP). The most striking change is the promotion of reactivity in the gamma frequency band, but it remains unclear whether the latter is itself a pathological feature, possibly associated with levodopa induced dyskinesias, or is primarily physiological. Gamma band reactivity in the cerebral cortex of humans without Parkinson's disease occurs contralateral to movement, so we posited that lateralization of subcortical gamma reactivity should occur following levodopa if the latter restores a more physiological pattern in patients with Parkinson's disease. Accordingly, we studied movement-related changes in STN LFP activity in 11 Parkinson's disease patients (age 59 ± 2.7 years, three females) while they performed ipsi- and contralateral self-paced joystick movements ON and OFF levodopa. A bilaterally symmetrical gamma band power increase occurred around movement onset in the OFF state. Following levodopa this feature became significantly more pronounced in the subthalamic region contralateral to movement. The physiological nature of this asymmetric pattern of gamma reactivity was confirmed in the STN of two tremor patients without Parkinson's disease. Although levodopa treatment in the Parkinson's disease patients did not lead to lateralization of power suppression at lower frequencies (8–30 Hz), it did increase the degree of power suppression. These findings suggest that dopaminergic therapy restores a more physiological pattern of reactivity in the STN of patients with Parkinson's disease.
Key Words: deep brain stimulation; local field potentials; Parkinson's disease; subthalamic nucleus; synchronous oscillatory activity
Abbreviations: DBS, deep brain stimulation; ERD, event-related desynchronization; ERS, event-related synchronization; LFP, local field potential; STN, subthalamic nucleus
Received September 25, 2006. Revised November 6, 2006. Accepted November 28, 2006.
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