Pnina Rappel1,2, Shai Grosberg1, David Arkadir3, Eduard Linetsky3, Muneer Abu Snineh3, Atira S Bick1,3, Idit Tamir3,4,5, Dan Valsky1,2, Odeya Marmor1,2, Yasmin Abo Foul3, Or Peled3, Moran Gilad3, Chen Daudi3, Shiri Ben-Naim3, Hagai Bergman1,2,4, Zvi Israel3,4, Renana Eitan1,3,6,7. 1. Department of Medical Neurobiology (Physiology), Institute of Medical Research-Israel-Canada, the Hebrew University-Hadassah Medical School, Jerusalem, Israel. 2. The Edmond and Lily Safra Center for Brain Research, the Hebrew University, Jerusalem, Israel. 3. The Brain Division, Hadassah-Hebrew University Medical Center, Jerusalem, Israel. 4. The Center for Functional and Restorative Neurosurgery, Hadassah-Hebrew University Medical Center, Jerusalem, Israel. 5. Department of Neurosurgery, University of California San Francisco, San Francisco, California, USA. 6. Jerusalem Mental Health Center, Hebrew University Medical School, Jerusalem, Israel. 7. Functional Neuroimaging Laboratory, Brigham and Women's Hospital, Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA.
Abstract
BACKGROUND: Therapeutic outcomes of STN-DBS for movement and psychiatric disorders depend on electrode location within the STN. Electrophysiological and functional mapping of the STN has progressed considerably in the past years, identifying beta-band oscillatory activity in the dorsal STN as a motor biomarker. It also has been suggested that STN theta-alpha oscillations, involved in impulse control and action inhibition, have a ventral source. However, STN local field potential mapping of motor, associative, and limbic areas is often limited by poor spatial resolution. OBJECTIVES: Providing a high-resolution electrophysiological map of the motor, associative and limbic anatomical sub-areas of the subthalamic nucleus. METHODS: We have analyzed high-spatial-resolution STN microelectrode electrophysiology recordings of PD patients (n = 303) that underwent DBS surgery. The patients' STN intraoperative recordings of spiking activity (933 electrode trajectories) were combined with their imaging data (n = 83 patients, 151 trajectories). RESULTS: We found a high theta-alpha (7-10 Hz) oscillatory area, located near the STN ventromedial border in 29% of the PD patients. Theta-alpha activity in this area has higher power and lower central frequency in comparison to theta-alpha activity in more dorsal subthalamic areas. When projected on the DISTAL functional atlas, the theta-alpha oscillatory area overlaps with the STN limbic subarea. CONCLUSIONS: We suggest that theta-alpha oscillations can serve as an electrophysiological marker for the ventral subthalamic nucleus limbic subarea. Therefore, theta-alpha oscillations can guide optimal electrode placement in neuropsychiatric STN-DBS procedures and provide a reliable biomarker input for future closed-loop DBS device.
BACKGROUND: Therapeutic outcomes of STN-DBS for movement and psychiatric disorders depend on electrode location within the STN. Electrophysiological and functional mapping of the STN has progressed considerably in the past years, identifying beta-band oscillatory activity in the dorsal STN as a motor biomarker. It also has been suggested that STN theta-alpha oscillations, involved in impulse control and action inhibition, have a ventral source. However, STN local field potential mapping of motor, associative, and limbic areas is often limited by poor spatial resolution. OBJECTIVES: Providing a high-resolution electrophysiological map of the motor, associative and limbic anatomical sub-areas of the subthalamic nucleus. METHODS: We have analyzed high-spatial-resolution STN microelectrode electrophysiology recordings of PDpatients (n = 303) that underwent DBS surgery. The patients' STN intraoperative recordings of spiking activity (933 electrode trajectories) were combined with their imaging data (n = 83 patients, 151 trajectories). RESULTS: We found a high theta-alpha (7-10 Hz) oscillatory area, located near the STN ventromedial border in 29% of the PDpatients. Theta-alpha activity in this area has higher power and lower central frequency in comparison to theta-alpha activity in more dorsal subthalamic areas. When projected on the DISTAL functional atlas, the theta-alpha oscillatory area overlaps with the STN limbic subarea. CONCLUSIONS: We suggest that theta-alpha oscillations can serve as an electrophysiological marker for the ventral subthalamic nucleus limbic subarea. Therefore, theta-alpha oscillations can guide optimal electrode placement in neuropsychiatric STN-DBS procedures and provide a reliable biomarker input for future closed-loop DBS device.