title: Subthalamic deep brain stimulation improves auditory sensory gating deficit in Parkinson's disease.
abstract: OBJECTIVE
  While motor effects of dopaminergic medication and subthalamic nucleus deep brain stimulation (STN-DBS) in Parkinson's disease (PD) patients are well explored, their effects on sensory processing are less well understood. Here, we studied the impact of levodopa and STN-DBS on auditory processing.
  
  
  METHODS
  Rhythmic auditory stimulation (RAS) was presented at frequencies between 1 and 6Hz in a passive listening paradigm. High-density EEG-recordings were obtained before (levodopa ON/OFF) and 5months following STN-surgery (ON/OFF STN-DBS). We compared auditory evoked potentials (AEPs) elicited by RAS in 12 PD patients to those in age-matched controls. Tempo-dependent amplitude suppression of the auditory P1/N1-complex was used as an indicator of auditory gating.
  
  
  RESULTS
  Parkinsonian patients showed significantly larger AEP-amplitudes (P1, N1) and longer AEP-latencies (N1) compared to controls. Neither interruption of dopaminergic medication nor of STN-DBS had an immediate effect on these AEPs. However, chronic STN-DBS had a significant effect on abnormal auditory gating characteristics of parkinsonian patients and restored a physiological P1/N1-amplitude attenuation profile in response to RAS with increasing stimulus rates.
  
  
  CONCLUSIONS
  This differential treatment effect suggests a divergent mode of action of levodopa and STN-DBS on auditory processing.
  
  
  CONCLUSIONS
  STN-DBS may improve early attentive filtering processes of redundant auditory stimuli, possibly at the level of the frontal cortex.
authors.affiliation: Department of Neurophysiology and Pathophysiology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246 Hamburg, Germany. Electronic address: a.gulberti@uke.uni-hamburg.de.
authors.forename: A
authors.initials: A
authors.lastname: Gulberti
authors.affiliation: Department of Neurosurgery, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246 Hamburg, Germany.
authors.forename: W
authors.initials: W
authors.lastname: Hamel
authors.affiliation: Department of Neurology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246 Hamburg, Germany.
authors.forename: C
authors.initials: C
authors.lastname: Buhmann
authors.affiliation: Department of Neurology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246 Hamburg, Germany; Department of Psychiatry, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246 Hamburg, Germany.
authors.forename: K
authors.initials: K
authors.lastname: Boelmans
authors.affiliation: Department of Neurology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246 Hamburg, Germany; Department of Paediatric and Adult Movement Disorders and Neuropsychiatry, Institute of Neurogenetics, University of Lübeck, Lübeck, Germany.
authors.forename: S
authors.initials: S
authors.lastname: Zittel
authors.affiliation: Department of Neurology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246 Hamburg, Germany.
authors.forename: C
authors.initials: C
authors.lastname: Gerloff
authors.affiliation: Department of Neurosurgery, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246 Hamburg, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Westphal
authors.affiliation: Department of Neurophysiology and Pathophysiology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246 Hamburg, Germany.
authors.forename: A K
authors.initials: AK
authors.lastname: Engel
authors.affiliation: Department of Neurophysiology and Pathophysiology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246 Hamburg, Germany.
authors.forename: T R
authors.initials: TR
authors.lastname: Schneider
authors.affiliation: Department of Neurophysiology and Pathophysiology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246 Hamburg, Germany.
authors.forename: C K E
authors.initials: CK
authors.lastname: Moll
mesh_terms: D000368:Aged; D000978:Antiparkinson Agents / Q000494:pharmacology / Q000627:therapeutic use; D001303:Auditory Cortex / Q000187:drug effects / Q000503:physiopathology*; D003131:Combined Modality Therapy; D046690:Deep Brain Stimulation; D004569:Electroencephalography; D005072:Evoked Potentials, Auditory / Q000187:drug effects / Q000502:physiology*; D005260:Female; D006801:Humans; D007980:Levodopa / Q000494:pharmacology / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000188:drug therapy / Q000503:physiopathology*; D055139:Sensory Gating / Q000187:drug effects / Q000502:physiology*; D020531:Subthalamic Nucleus / Q000187:drug effects / Q000503:physiopathology*
chemical_list: D000978:Antiparkinson Agents; D007980:Levodopa
keywords: Auditory evoked potentials; Deep brain stimulation; Parkinson’s disease; Sensory gating; Subthalamic nucleus