Subthalamic neuronal responses to cortical stimulation§

Authors

  • Marcus L.F. Janssen MD,

    Corresponding author
    1. Department of Neuroscience, Maastricht University Medical Center, Maastricht, The Netherlands
    2. Department of Neurosurgery, Maastricht University Medical Center, Maastricht, The Netherlands
    3. Maastricht Institute for Neuromodulative Development (MIND), Maastricht, The Netherlands
    4. European Graduate School of Neuroscience (EURON), Maastricht, The Netherlands
    • Maastricht University, Department of Neuroscience, Universiteitssingel 50 (Box 38), 6229 ER, Maastricht. The Netherlands
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  • Daphne G.M. Zwartjes MSc,

    1. MIRA Institute for Biomedical Engineering and Technical Medicine, Department of Electrical Engineering, Mathematics and Computer Science, Biomedical Signals and Systems Group, University of Twente, Enschede, The Netherlands
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    • Dr. Janssen and Dr. Zwartjes contributed equally to this work.

  • Yasin Temel MD, PhD,

    1. Department of Neuroscience, Maastricht University Medical Center, Maastricht, The Netherlands
    2. Department of Neurosurgery, Maastricht University Medical Center, Maastricht, The Netherlands
    3. Maastricht Institute for Neuromodulative Development (MIND), Maastricht, The Netherlands
    4. European Graduate School of Neuroscience (EURON), Maastricht, The Netherlands
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  • Vivianne van Kranen-Mastenbroek MD, PhD,

    1. Maastricht Institute for Neuromodulative Development (MIND), Maastricht, The Netherlands
    2. Department of Neurophysiology, Maastricht University Medical Center, Maastricht, The Netherlands
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  • Annelien Duits PhD,

    1. Maastricht Institute for Neuromodulative Development (MIND), Maastricht, The Netherlands
    2. Department of Clinical Neuropsychology, Maastricht University Medical Center, Maastricht, The Netherlands
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  • Lo J. Bour MD, PhD,

    1. Department of Neurology/Clinical Neurophysiology, Academic Medical Center, Amsterdam, The Netherlands
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  • Peter H. Veltink PhD,

    1. MIRA Institute for Biomedical Engineering and Technical Medicine, Department of Electrical Engineering, Mathematics and Computer Science, Biomedical Signals and Systems Group, University of Twente, Enschede, The Netherlands
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  • Tjitske Heida PhD,

    1. MIRA Institute for Biomedical Engineering and Technical Medicine, Department of Electrical Engineering, Mathematics and Computer Science, Biomedical Signals and Systems Group, University of Twente, Enschede, The Netherlands
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  • Veerle Visser-Vandewalle MD, PhD

    1. Department of Neurosurgery, Maastricht University Medical Center, Maastricht, The Netherlands
    2. Maastricht Institute for Neuromodulative Development (MIND), Maastricht, The Netherlands
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  • Funding agencies: BrainGain Smart Mix Program of the Netherlands Ministry of Economic Affairs and the Netherlands Ministry of Education, Culture and Science (grant number SSM06011).

  • Relevant conflicts of interest/financial disclosures: Nothing to report.

  • §

    Full financial disclosures and author roles may be found in the online version of this article.

Abstract

Background:

Deep brain stimulation of the subthalamic nucleus alleviates motor symptoms in Parkinson's disease patients. However, some patients suffer from cognitive and emotional changes. These side effects are most likely caused by current spread to the cognitive and limbic territories in the subthalamic nucleus. The aim of this study was to identify the motor part of the subthalamic nucleus to reduce stimulation-induced behavioral side effects, by using motor cortex stimulation.

Methods:

We describe the results of subthalamic nucleus neuronal responses to stimulation of the hand area of the motor cortex and evaluate the safety of this novel technique.

Results:

Responses differed between regions within the subthalamic nucleus. In the anterior and lateral electrode at dorsal levels of the subthalamic nucleus, an early excitation (∼5–45 ms) and subsequent inhibition (45–105 ms) were seen. The lateral electrode also showed a late excitation (∼125–160 ms). Focal seizures were observed following motor cortex stimulation.

Conclusions:

To prevent seizures the current density should be lowered, so that motor cortex stimulation-evoked responses can be safely used during deep brain stimulation surgery. © 2011 Movement Disorder Society

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