NDLI: Effect of intraoperative subthalamic nucleus DBS on human single-unit activity in the ipsilateral and contralateral subthalamic nucleus.

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Effect of intraoperative subthalamic nucleus DBS on human single-unit activity in the ipsilateral and contralateral subthalamic nucleus.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Toleikis, J. Richard Metman, Leo Verhagen Pilitsis, Julie G. Barborica, Andrei Toleikis, Sandra C. Bakay, Roy A. E.
Description	Country affiliation: United States Author Affiliation: Toleikis JR ( Department of Anesthesiology, Rush University Medical Center, Chicago, Illinois 60612, USA.)
Abstract	OBJECT: Insight may be gained into the physiological mechanisms of deep brain stimulation (DBS) by analyzing local and contralateral subthalamic nucleus (STN) single-unit activity during activation of previously placed DBS electrodes. Special techniques are required to perform such analysis due to the presence of a large stimulus artifact. The purpose of this study was to determine the effects of DBS stimulation on single unit activity acquired from patients undergoing new or revised DBS placements. METHODS: Subthalamic nucleus single unit activity was acquired from awake patients during activation of a previously implanted STN DBS electrode. Stimulation was contralateral to the recording site in 4 cases and ipsilateral in 3. Data were acquired at stimulation frequencies of 30, 60, and 130 Hz and with other stimulation parameters at clinically effective settings. Cells were included if they showed kinesthetic activity before and after the stimulation paradigm and if their action potential morphology was maintained throughout the experiment. Analysis of single-unit activity acquired before, during, and after stimulation was performed employing a time-domain algorithm to overcome the stimulus artifact. RESULTS: Both ipsilateral and contralateral acute stimulation resulted in reversible STN firing rate suppression. The degree of suppression became greater as stimulus frequency increased and was significant at 60 Hz (t-test, p < 0.05) and 130 Hz (p < 0.01). Suppression with ipsilateral 130-Hz stimulation ranged between 52.8% and 99.8%, whereas with similar contralateral STN stimulation, the range was lower (1.9%-50.3%). Return to baseline activity levels typically occurred within seconds after stimulation ended. CONCLUSIONS: Stimulation of the STN at clinically effective frequencies has an acute suppressive rather than an excitatory effect on STN single-unit activity. The effect is bilateral, even though the degree of suppression is greater on the ipsilateral than the contralateral STN. The authors' algorithm helps reveal this effect in human patients.
File Format	HTM / HTML
ISSN	00223085
e-ISSN	19330693
Journal	Journal of Neurosurgery
Issue Number	5
Volume Number	116
Language	English
Publisher	American Association of Neurological Surgeons
Publisher Date	2012-05-01
Publisher Place	United States
Access Restriction	Open
Subject Keyword	Discipline Neurosurgery Deep Brain Stimulation Functional Laterality Physiology Neurons Subthalamic Nucleus Action Potentials Algorithms Artifacts Brain Mapping Data Interpretation, Statistical Electric Stimulation Electrodes, Implanted Electrophysiological Phenomena Intraoperative Period Magnetic Resonance Imaging Parkinson Disease Physiopathology Therapy Cytology Research Support, Non-u.s. Gov't
Content Type	Text
Resource Type	Article
Subject	Neurology (clinical) Surgery

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