目的:丘脑底核(STN)β活性(13-30Hz)是帕金森病(PD)的适应性深部脑刺激(aDBS)最被接受的生物标志物。我们假设β范围内的不同频率可能表现出不同的时间动态,因此,与运动减慢和适应性刺激模式的不同关系。我们的目标是强调需要一种客观的方法来确定aDBS反馈信号。
方法:记录15名PD患者在休息和执行提示运动任务时的STNLFP。对于不同的β候选频率,评估了β爆发对运动性能的影响:与运动减慢相关的单个频率最强,个体β峰值频率,由运动执行调制最多的频率,以及整个-,低和高β波段。进一步研究了这些候选频率在其爆发动力学和理论aDBS刺激模式方面的差异。
结果:单个运动减慢频率通常不同于单个β峰值或β相关的运动调制频率。与作为aDBS的反馈信号的选定目标频率的最小偏差导致脉冲串重叠和刺激触发的理论起始的对齐大幅下降(对于1Hz,达到75%,对于3赫兹的偏差,为〜40%)。
结论:β频率范围内的临床时间动态是高度不同的,偏离参考生物标志物频率会导致适应性刺激模式的改变。
结论:临床神经生理学询问可能有助于确定aDBS的患者特异性反馈信号。
Subthalamic nucleus (STN) beta activity (13-30 Hz) is the most accepted biomarker for adaptive deep brain stimulation (aDBS) for Parkinson\'s disease (PD). We hypothesize that different frequencies within the beta range may exhibit distinct temporal dynamics and, as a consequence, different relationships to motor slowing and adaptive stimulation patterns. We aim to highlight the need for an objective method to determine the aDBS feedback signal.
STN LFPs were recorded in 15 PD patients at rest and while performing a cued motor task. The impact of beta bursts on motor performance was assessed for different beta candidate frequencies: the individual frequency strongest associated with motor slowing, the individual beta peak frequency, the frequency most modulated by movement execution, as well as the entire-, low- and high beta band. How these candidate frequencies differed in their bursting dynamics and theoretical aDBS stimulation patterns was further investigated.
The individual motor slowing frequency often differs from the individual beta peak or beta-related movement-modulation frequency. Minimal deviations from a selected target frequency as feedback signal for aDBS leads to a substantial drop in the burst overlapping and in the alignment of the theoretical onset of stimulation triggers (to ∼ 75% for 1 Hz, to ∼ 40% for 3 Hz deviation).
Clinical-temporal dynamics within the beta frequency range are highly diverse and deviating from a reference biomarker frequency can result in altered adaptive stimulation patterns.
A clinical-neurophysiological interrogation could be helpful to determine the patient-specific feedback signal for aDBS.