Deep brain stimulation promotes excitation and inhibition in subthalamic nucleus in Parkinson's disease.
Subthalamic nucleus single-unit recordings were undertaken before and during pedunculopontine [corrected] nucleus-stimulation at clinically relevant frequency (25 Hz) in six patients with Parkinson's disease. Pedunculopontine [corrected] nucleus stimulation changed the firing activity of almost every subthalamic nucleus cell (44/48) by decreasing the ongoing discharge in bursting subthalamic nucleus neurons (-62.1%) and exciting irregular (+63.2%) and tonic/regular discharges (+20.1%). These conflicting data challenge the definition of pedunculopontine [corrected] nucleus as a new target area for Parkinson's disease. If the modulation of subthalamic nucleus bursting units may corroborate the pedunculopontine [corrected] nucleus therapeutic role, the simultaneous excitatory influence during nonbursty patterns might interfere with a favorable outcome on motor signs. As a result, the implantation of pedunculopontine [corrected] nucleus alone may be hazardous while the association of subthalamic nucleus plus pedunculopontine [corrected] nucleus seems to be reasonable.
Galati
Salvatore
S
Department of Neuroscience, Tor Vergata University, Rome, Italy.
Scarnati
Eugenio
E
Mazzone
Paolo
P
Stanzione
Paolo
P
Stefani
Alessandro
A
D046690:Deep Brain Stimulation / Q000379:methods; D004567:Electrodes, Implanted; D004569:Electroencephalography; D006801:Humans; D010300:Parkinson Disease / Q000503:physiopathology*; D020531:Subthalamic Nucleus / Q000503:physiopathology*