The effects of levodopa and ongoing deep brain stimulation on subthalamic beta oscillations in Parkinson's disease.
Local field potentials (LFPs) recorded through electrodes implanted in the subthalamic nucleus (STN) for deep brain stimulation (DBS) in patients with Parkinson's disease (PD) show that oscillations in the beta frequency range (8-20 Hz) decrease after levodopa intake. Whether and how DBS influences the beta oscillations and whether levodopa- and DBS-induced changes interact remains unclear. We examined the combined effect of levodopa and DBS on subthalamic beta LFP oscillations, recorded in nine patients with PD under four experimental conditions: without levodopa with DBS turned off; without levodopa with DBS turned on; with levodopa with DBS turned on; and with levodopa with DBS turned off. The analysis of STN-LFP oscillations showed that whereas levodopa abolished beta STN oscillations in all the patients (p=0.026), DBS significantly decreased the beta oscillation only in five of the nine patients studied (p=0.043). Another difference was that whereas levodopa completely suppressed beta oscillations, DBS merely decreased them. When we combined levodopa and DBS, the levodopa-induced beta disruption prevailed and combining levodopa and DBS induced no significant additive effect (p=0.500). Our observations suggest that levodopa and DBS both modulate LFP beta oscillations.
Giannicola
Gaia
G
Centro Clinico per la Neurostimolazione, le Neurotecnologie ed i Disordini del Movimento, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Via Francesco Sforza 35, 20122 Milan, Italy.
Marceglia
Sara
S
Rossi
Lorenzo
L
Mrakic-Sposta
Simona
S
Rampini
Paolo
P
Tamma
Filippo
F
Cogiamanian
Filippo
F
Barbieri
Sergio
S
Priori
Alberto
A
D000465:Algorithms; D000978:Antiparkinson Agents / Q000627:therapeutic use*; D001611:Beta Rhythm / Q000187:drug effects*; D003131:Combined Modality Therapy; D003627:Data Interpretation, Statistical; D046690:Deep Brain Stimulation; D005260:Female; D006801:Humans; D007980:Levodopa / Q000627:therapeutic use*; D008137:Longitudinal Studies; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures; D010300:Parkinson Disease / Q000188:drug therapy / Q000601:surgery / Q000628:therapy*; D013238:Stereotaxic Techniques; D020531:Subthalamic Nucleus / Q000503:physiopathology*; D014057:Tomography, X-Ray Computed
D000978:Antiparkinson Agents; D007980:Levodopa