title: Toward an electrophysiological "sweet spot" for deep brain stimulation in the subthalamic nucleus.
abstract: Enhanced beta-band activity recorded in patients suffering from Parkinson's Disease (PD) has been described as a potential physiomarker for disease severity. Beta power is suppressed by Levodopa intake and STN deep brain stimulation (DBS) and correlates with disease severity across patients. The aim of the present study was to explore the promising signature of the physiomarker in the spatial domain. Based on local field potential data acquired from 54 patients undergoing STN-DBS, power values within alpha, beta, low beta, and high beta bands were calculated. Values were projected into common stereotactic space after DBS lead localization. Recorded beta power values were significantly higher at posterior and dorsal lead positions, as well as in active compared with inactive pairs. The peak of activity in the beta band was situated within the sensorimotor functional zone of the nucleus. In contrast, higher alpha activity was found in a more ventromedial region, potentially corresponding to associative or premotor functional zones of the STN. Beta- and alpha-power peaks were then used as seeds in a fiber tracking experiment. Here, the beta-site received more input from primary motor cortex whereas the alpha-site was more strongly connected to premotor and prefrontal areas. The results summarize predominant spatial locations of frequency signatures recorded in STN-DBS patients in a probabilistic fashion. The site of predominant beta-activity may serve as an electrophysiologically determined target for optimal outcome in STN-DBS for PD in the future. Hum Brain Mapp 38:3377-3390, 2017. © 2017 Wiley Periodicals, Inc.
authors.affiliation: Department of Neurology, Movement Disorders and Neuromodulation Unit, Charité - University Medicine, Berlin, D-10117, Germany.|Berenson-Allen Center for Noninvasive Brain Stimulation, Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts.
authors.forename: Andreas
authors.identifier: http://orcid.org/0000-0002-0695-6025
authors.initials: A
authors.lastname: Horn
authors.affiliation: Department of Neurology, Movement Disorders and Neuromodulation Unit, Charité - University Medicine, Berlin, D-10117, Germany.
authors.forename: Wolf-Julian
authors.initials: WJ
authors.lastname: Neumann
authors.affiliation: Department of Neurology, Movement Disorders and Neuromodulation Unit, Charité - University Medicine, Berlin, D-10117, Germany.
authors.forename: Katharina
authors.initials: K
authors.lastname: Degen
authors.affiliation: Department of Neurosurgery, Charité - University Medicine, Berlin, D-10117, Germany.
authors.forename: Gerd-Helge
authors.initials: GH
authors.lastname: Schneider
authors.affiliation: Department of Neurology, Movement Disorders and Neuromodulation Unit, Charité - University Medicine, Berlin, D-10117, Germany.|NeuroCure - Cluster of Excellence, Berlin, D-10117, Germany.|Berlin School of Mind and Brain, Berlin, D-10117, Germany.|Deutsches Zentrum für Neurodegenerative Erkrankungen, Berlin, D-10117, Germany.
authors.forename: Andrea A
authors.initials: AA
authors.lastname: Kühn
keywords: DTI; Parkinson's disease; beta power; deep brain stimulation; diffusion spectrum imaging; magnetic resonance imaging