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Deep brain stimulation (DBS) of the subthalamic nucleus (STN) remains an empirical, yet highly effective, surgical treatment for advanced Parkinson's disease (PD). DBS outcome depends on accurate stimulation of the STN sensorimotor area which is a trial-and-error procedure taking place during and after surgery. Pathologically enhanced beta-band (13-35 Hz) oscillatory activity across the cortico-basal ganglia pathways is a prominent neurophysiological phenomenon associated with PD. We hypothesized that weighing together beta-band frequency peaks from simultaneous microelectrode recordings in "off-state" PD patients could map the individual neuroanatomical variability and serve as a biomarker for the location of the STN sensorimotor neurons. We validated our hypothesis with 9 and 11 patients that, respectively, responded well and poorly to bilateral DBS, after at least two years of follow up. We categorized "good" and "poor" DBS responders based on their clinical assessment alongside a > 40% and <30% change, respectively, in "off" unified PD rating scale motor scores. Good (poor) DBS responders had, in average, 1 mm (3.5 mm) vertical distance between the maximum beta-peak weighted across the parallel microelectrodes and the center of the stimulation area. The distances were statistically different in the two groups ( p = 0.0025 ). Our biomarker could provide personalized intra- and postoperative support in stimulating the STN sensorimotor area associated with optimal long-term clinical benefits.

Original publication

DOI

10.1109/jbhi.2014.2344102

Type

Journal article

Journal

IEEE journal of biomedical and health informatics

Publication Date

01/2015

Volume

19

Pages

174 - 180

Keywords

Subthalamic Nucleus, Humans, Parkinson Disease, Movement Disorders, Electroencephalography, Beta Rhythm, Treatment Outcome, Deep Brain Stimulation, Prosthesis Implantation, Sensitivity and Specificity, Reproducibility of Results, Electrodes, Implanted, Intraoperative Neurophysiological Monitoring, Biomarkers