Brain Advance Access published online on August 22, 2003
Brain, doi:10.1093/brain/awg229
© 2003 by Guarantors of Brain
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Article
1 Department of Neurological Sciences, Università di Milano, IRCCS Ospedale Maggiore di Milano, Italy; Department of Biomedical Engineering, Politecnico di Milano, Italy; Department of Clinical Neurology, Ospedale San Paulo, Milano, Italy; School of Biomedical Engineering, Science and Health Systems, Drexel University, Philadelphia, PA, USA
* Corresponding author. E-mail: alberto.priori{at}unimi.it.
Received 16 January 2003
; revised 16 March 2003
; accepted 21 April 2003
Despite several studies and models, much remains unclear about how the human basal ganglia operate. Deep brain stimulation (DBS) of the subthalamic nucleus (STN) is an effective treatment for complicated Parkinson's disease, but how DBS acts also remains unknown. The clinical benefit of DBS at frequencies >100 Hz suggests the possible importance of neural rhythms operating at frequencies higher than the range normally considered for basal ganglia processing (<100 Hz). The electrodes implanted for DBS also offer the opportunity to record neural activity from the human basal ganglia. This study aimed to assess whether oscillations at frequencies >100 Hz operate in the human STN. While recording local field potentials from the STN of nine patients with Parkinson's disease through DBS electrodes, we found a dopamine- and movement-dependent 300-Hz rhythm. At rest, and in the absence of dopaminergic medication, in most cases (eight out of 11 nuclei) the 100-1000 Hz band showed no consistent rhythm. Levodopa administration elicited (or markedly increased) a 300-Hz rhythm at rest [(mean ± SD) central frequency: 319 ± 33 Hz; bandwidth: 72 ± 21 Hz; power increase (after medication - before medication)/before medication: 1.30 ± 1.25; n = 11, P = 0.00098]. The 300-Hz rhythm was also increased by apomorphine, but not by orphenadrine. The 300-Hz rhythm was modulated by voluntary movement. Before levodopa administration, movement-related power increase in the 300-Hz rhythm was variably present in different subjects, whereas after levodopa it became a robust phenomenon [before 0.014 ± 0.014 arbitrary units (AU), after 0.178 ± 0.339 AU; n = 8, P = 0.0078]. The dopamine-dependent 300-Hz rhythm probably reflects a bistable compound nuclear activity and supports high-resolution information processing in the basal ganglia circuit. An absent 300-Hz subthalamic rhythm could be a pathophysiological clue in Parkinson's disease. The 300-Hz rhythm also provides the rationale for an excitatory--and not only inhibitory--interpretation of DBS mechanism of action in humans.
Keywords: deep brain stimulation; event-related synchronization; high frequency; levodopa; subthalamus
300-Hz subthalamic oscillations in Parkinson's disease
2 Department of Neurological Sciences, Università di Milano, IRCCS Ospedale Maggiore di Milano, Italy
3 Department of Clinical Neurology, Ospedale San Paulo, Milano, Italy
4 School of Biomedical Engineering, Science and Health Systems, Drexel University, Philadelphia, PA, USA
5 Department of Biomedical Engineering, Politecnico di Milano, Italy
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