| Literature DB >> 28211850 |
Ariel Tankus1,2,3,4, Ido Strauss2, Tanya Gurevich3,4,5, Anat Mirelman1,3, Nir Giladi3,4,5,6, Itzhak Fried2,3,7, Jeffrey M Hausdorff1,4,8.
Abstract
The subthalamic nucleus (STN) is the main target for neurosurgical treatment of motor signs of Parkinson's disease (PD). Despite the therapeutic effect on both upper and lower extremities, its role in motor control and coordination and its changes in Parkinson's disease are not fully clear. We intraoperatively recorded single unit activity in ten patients with PD who performed repetitive feet or hand movements while undergoing implantation of a deep brain stimulator. We found both distinct and overlapping representations of upper and lower extremity movement kinematics in subthalamic units and observed evidence for re-routing to a multi-limb representation that participates in limb coordination. The well-known subthalamic somatotopy showed a large overlap of feet and hand representations in the PD patients. This overlap and excessive amounts of kinematics or coordination units may reflect pathophysiology or compensatory mechanisms. Our findings thus explain, at the single neuron level, the important subthalamic role in motor control and coordination and indicate the effect of PD on the neuronal representation of movement.Entities:
Mesh:
Year: 2017 PMID: 28211850 PMCID: PMC5304178 DOI: 10.1038/srep42467
Source DB: PubMed Journal: Sci Rep ISSN: 2045-2322 Impact factor: 4.379
Patient clinical evaluation and demographics.
| Gender | Age | Dominant Hand | Disease Duration | Hoehn and Yahr | Activities of Daily Living (UPDRS II) | Motor Examination (UPDRS III) | Total UPDRS Score | ||||
|---|---|---|---|---|---|---|---|---|---|---|---|
| OFF | ON | OFF | ON | OFF | ON | ||||||
| P1 | M | 45 | R | 15 | 3 | 19* | 27* | 60* | |||
| P2 | M | 41 | R | 8 | 2 | Not Available | |||||
| P3 | M | 70 | R | 17 | 3 | 3 | 0 | 15 | 6 | 19 | 7 |
| P4 | M | 66 | R | 9 | 2.5 | 15 | 8 | 33 | 26 | 50 | 36 |
| P5 | M | 61 | R | 6 | 3 | 9 | 1 | 15 | 3 | 28 | 8 |
| P6 | M | 59 | R | 8 | 2 | 17 | 14 | 39 | 23 | 59 | 40 |
| P7 | M | 57 | R | 10 | 2 | 10 | 2 | 17 | 15 | 27 | 17 |
| P8 | M | 47 | R | 7 | 2.5 | 11 | 7 | 29 | 16 | 47 | 30 |
| P9 | F | 74 | R | 17 | 2.5 | 23* | 17* | 57* | |||
| P10 | F | 72 | R | 14 | 3 | 11* | 16* | 54* | |||
| Mean (SD) | — | 59.2 (11.7) | — | 11.1 (4.2) | 2.55 (0.44) | 10.8 (4.9) | 5.3 (5.4) | 24.7 (10.4) | 14.8 (9.1) | 38.3 (15.8) | 23.0 (14.3) |
*MDS-UPDRS. Mean and standard deviation (SD) of UPDRS scores excludes patients who performed the MDS-UPDRS version. MDS = Movement Disorders Society. UPDRS = Unified Parkinson’s Disease Rating Scale (higher scores indicate worse symptoms).
Figure 1Three right STN neurons, each demonstrating a different type of selectivity.
Each graph shows the smoothed firing rate (blue) and the corresponding linear regression kinematic model (red) at a certain condition, along with the coefficient of determination (r2) between them (see Methods). In parentheses above each graph are the kinematic parameters composing the model, and the pace of movements or performing limb employed during this condition. (a) The neuron is responsive to left foot movements during both the unipedal and bipedal conditions. It is also related to orientation of the right foot during bipedal movements, but this may be due to the high correlation between orientation of the left and right feet. The correlation is much lower for unipedal right foot movements. (b) Bipedal control neuron. The firing rate is related to normal-pace orientation of either foot during bipedal movements, but not during unipedal movements. (c) Unimanual control neuron. A combined model of orientation, angular velocity, and acceleration during slow movements explains high percentages of the variability in firing rate during unimanual, but not bimanual, movements.
Figure 2Histograms of the optimal time lags used in the linear models mapping kinematics to firing rates.
(a) The percentage of models for each range of time lags. Models include all types of movement. (b–i) The same as (a), but only models for movements of a specific limb in either a single-limb or a two-limb movement are included. Above each histogram is the type of movement. For two-limb movements, the parentheses (L/R) denote whether kinematics of left or right limb was employed in the model, respectively. For all types of movement, both positive and negative optimal time lags were observed. The large range of optimal time lags may result from Parkinson’s disease.
Percentage (of the total 89 recorded units) and number (in parentheses) of pure unipedal or pure unimanual units according to the laterality of the limb performing the movement they relate to.
| Single Limb Movements | ||||
|---|---|---|---|---|
| Contralateral | Ipsilateral | Both contra- and ipsi-lateral movements (but single limb at a time) | Total | |
| Foot | 31% (28) | 26% (23) | 18% (16) | 39% (35) |
| Hand | 15% (13) | 15% (13) | 12% (11) | 17% (15) |
| Same unit is related to both feet and hand movements | 4.5% (4) | 1.1% (1) | 1.1% (1) | 4.5% (4) |
| Total | 42% (37) | 39% (35) | 29% (26) | 51% (45) |
Figure 3Localization of task-related neurons and somatotopy.
(a) Recording sites marked on a coronal section of a 7T MRI subcortical probabilistic atlas45, 15 mm posterior to AC (STN: green; substantia nigra: blue; red nucleus: red; GPi: magenta; GPe: yellow; Striatum: cyan). In the expanded image, the gray background indicates the STN. Similarly, the bottom panel is a sagittal section 12 mm from the midline showing the STN as gray levels. In both sections, the location of each electrode is marked by a circle and colored according to the percentage of units recorded on that electrode which directly encode movement kinematics (see Results). Higher percentages of such units were recorded by electrodes inferior to the yellow dashed line, which is 3.6 mm below the AC-PC line. (b) Subthalamic somatotopic organization with overlap in the representation of feet and hand movements. The amount of units related to feet movements only (blue), hand movements only (red), and both hand movements and feet movements (green) is displayed as a stacked histogram plotted at recording locations. Units related solely to feet movements were found in the superior-mesial part only, whereas those related merely to hand movements lied in the more inferior-lateral part of the recording zone. The figure shows only 8 recording sites, because it depicts the results for the 9 patients implanted in the Right STN, and for one of these subjects this recording site did not yield any responsive units.