title: Subcortical evoked activity and motor enhancement in Parkinson's disease.
abstract: Enhancements in motor performance have been demonstrated in response to intense stimuli both in healthy subjects and in the form of 'paradoxical kinesis' in patients with Parkinson's disease. Here we identify a mid-latency evoked potential in local field potential recordings from the region of the subthalamic nucleus, which scales in amplitude with both the intensity of the stimulus delivered and corresponding enhancements in biomechanical measures of maximal handgrips, independent of the dopaminergic state of our subjects with Parkinson's disease. Recordings of a similar evoked potential in the related pedunculopontine nucleus - a key component of the reticular activating system - provide support for this neural signature in the subthalmic nucleus being a novel correlate of ascending arousal, propagated from the reticular activating system to exert an 'energizing' influence on motor circuitry. Future manipulation of this system linking arousal and motor performance may provide a novel approach for the non-dopaminergic enhancement of motor performance in patients with hypokinetic disorders such as Parkinson's disease.
authors.affiliation: Functional Neurosurgery-Experimental Neurology Group, Nuffield Department of Clinical Neurosciences, University of Oxford, Level 6, West Wing, John Radcliffe Hospital, OX3 9DU, United Kingdom; Sobell Department of Motor Neuroscience & Movement Disorders, UCL Institute of Neurology, United Kingdom.
authors.forename: Anam
authors.initials: A
authors.lastname: Anzak
authors.affiliation: Functional Neurosurgery-Experimental Neurology Group, Nuffield Department of Clinical Neurosciences, University of Oxford, Level 6, West Wing, John Radcliffe Hospital, OX3 9DU, United Kingdom; Sobell Department of Motor Neuroscience & Movement Disorders, UCL Institute of Neurology, United Kingdom; Nuffield Department of Clinical Neurosciences, University of Oxford, Level 6, West Wing, John Radcliffe Hospital, OX3 9DU, United Kingdom.
authors.forename: Huiling
authors.initials: H
authors.lastname: Tan
authors.affiliation: Functional Neurosurgery-Experimental Neurology Group, Nuffield Department of Clinical Neurosciences, University of Oxford, Level 6, West Wing, John Radcliffe Hospital, OX3 9DU, United Kingdom; Sobell Department of Motor Neuroscience & Movement Disorders, UCL Institute of Neurology, United Kingdom; Nuffield Department of Clinical Neurosciences, University of Oxford, Level 6, West Wing, John Radcliffe Hospital, OX3 9DU, United Kingdom.
authors.forename: Alek
authors.initials: A
authors.lastname: Pogosyan
authors.affiliation: Department of Neurosurgery, Institute of Neurosciences, Frenchay Hospital, Bristol, United Kingdom.
authors.forename: Sadaquate
authors.initials: S
authors.lastname: Khan
authors.affiliation: Department of Neurosurgery, Institute of Neurosciences, Frenchay Hospital, Bristol, United Kingdom.
authors.forename: Shazia
authors.initials: S
authors.lastname: Javed
authors.affiliation: Department of Neurosurgery, Institute of Neurosciences, Frenchay Hospital, Bristol, United Kingdom.
authors.forename: Steven S
authors.initials: SS
authors.lastname: Gill
authors.affiliation: Department of Neurosurgery, King's College Hospital, Kings College London, United Kingdom.
authors.forename: Keyoumars
authors.initials: K
authors.lastname: Ashkan
authors.affiliation: Department of Neurosurgery, King's College Hospital, Kings College London, United Kingdom.
authors.forename: Harith
authors.initials: H
authors.lastname: Akram
authors.affiliation: Sobell Department of Motor Neuroscience & Movement Disorders, UCL Institute of Neurology, United Kingdom.
authors.forename: Thomas
authors.initials: T
authors.lastname: Foltynie
authors.affiliation: Sobell Department of Motor Neuroscience & Movement Disorders, UCL Institute of Neurology, United Kingdom.
authors.forename: Patricia
authors.initials: P
authors.lastname: Limousin
authors.affiliation: Sobell Department of Motor Neuroscience & Movement Disorders, UCL Institute of Neurology, United Kingdom.
authors.forename: Ludvic
authors.initials: L
authors.lastname: Zrinzo
authors.affiliation: Sobell Department of Motor Neuroscience & Movement Disorders, UCL Institute of Neurology, United Kingdom.
authors.forename: Alexander L
authors.initials: AL
authors.lastname: Green
authors.affiliation: Sobell Department of Motor Neuroscience & Movement Disorders, UCL Institute of Neurology, United Kingdom.
authors.forename: Tipu
authors.initials: T
authors.lastname: Aziz
authors.affiliation: Functional Neurosurgery-Experimental Neurology Group, Nuffield Department of Clinical Neurosciences, University of Oxford, Level 6, West Wing, John Radcliffe Hospital, OX3 9DU, United Kingdom; Sobell Department of Motor Neuroscience & Movement Disorders, UCL Institute of Neurology, United Kingdom; Nuffield Department of Clinical Neurosciences, University of Oxford, Level 6, West Wing, John Radcliffe Hospital, OX3 9DU, United Kingdom. Electronic address: peter.brown@ndcn.ox.ac.uk.
authors.forename: Peter
authors.initials: P
authors.lastname: Brown
mesh_terms: D000161:Acoustic Stimulation; D000328:Adult; D000368:Aged; D000978:Antiparkinson Agents / Q000627:therapeutic use; D003463:Cues; D046690:Deep Brain Stimulation / Q000379:methods*; D004576:Electromyography; D005071:Evoked Potentials / Q000187:drug effects / Q000502:physiology*; D005260:Female; D018737:Hand Strength / Q000502:physiology; D006801:Humans; D007980:Levodopa / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D009043:Motor Activity / Q000187:drug effects / Q000502:physiology*; D010300:Parkinson Disease / Q000503:physiopathology / Q000628:therapy*; D010775:Photic Stimulation; D011571:Psychoacoustics; D011930:Reaction Time / Q000187:drug effects / Q000502:physiology; D020531:Subthalamic Nucleus / Q000502:physiology*
chemical_list: D000978:Antiparkinson Agents; D007980:Levodopa
keywords: Arousal; Evoked activity; Local field potentials; Pedunculopontine nucleus; Subthalamic nucleus