TY - JOUR
T1 - Magnetoencephalography to measure the effect of contact point-specific deep brain stimulation in Parkinson's disease
T2 - A proof of concept study
AU - Boon, Lennard I.
AU - Potters, Wouter V.
AU - Hillebrand, Arjan
AU - de Bie, Rob M. A.
AU - Bot, Maarten
AU - Richard Schuurman, P.
AU - van den Munckhof, Pepijn
AU - Twisk, Jos W.
AU - Stam, Cornelis J.
AU - Berendse, Henk W.
AU - van Rootselaar, Anne-Fleur
N1 - Funding Information: This study was supported by Amsterdam Neuroscience; 05 Amsterdam Neuroscience Alliantieproject – ND 2016. The funding source had no involvement in the study design, collection, analysis and interpretation of the data, writing of the report, and in the decision to submit the article for publication. Publisher Copyright: © 2023 The Author(s)
PY - 2023/1/1
Y1 - 2023/1/1
N2 - Background: Deep brain stimulation (DBS) of the subthalamic nucleus (STN) is an effective treatment for disabling fluctuations in motor symptoms in Parkinson's disease (PD) patients. However, iterative exploration of all individual contact points (four in each STN) by the clinician for optimal clinical effects may take months. Objective: In this proof of concept study we explored whether magnetoencephalography (MEG) has the potential to noninvasively measure the effects of changing the active contact point of STN-DBS on spectral power and functional connectivity in PD patients, with the ultimate aim to aid in the process of selecting the optimal contact point, and perhaps reduce the time to achieve optimal stimulation settings. Methods: The study included 30 PD patients who had undergone bilateral DBS of the STN. MEG was recorded during stimulation of each of the eight contact points separately (four on each side). Each stimulation position was projected on a vector running through the longitudinal axis of the STN, leading to one scalar value indicating a more dorsolateral or ventromedial contact point position. Using linear mixed models, the stimulation positions were correlated with band-specific absolute spectral power and functional connectivity of i) the motor cortex ipsilateral tot the stimulated side, ii) the whole brain. Results: At group level, more dorsolateral stimulation was associated with lower low-beta absolute band power in the ipsilateral motor cortex (p =.019). More ventromedial stimulation was associated with higher whole-brain absolute delta (p =.001) and theta (p =.005) power, as well as higher whole-brain theta band functional connectivity (p =.040). At the level of the individual patient, switching the active contact point caused significant changes in spectral power, but the results were highly variable. Conclusions: We demonstrate for the first time that stimulation of the dorsolateral (motor) STN in PD patients is associated with lower low-beta power values in the motor cortex. Furthermore, our group-level data show that the location of the active contact point correlates with whole-brain brain activity and connectivity. As results in individual patients were quite variable, it remains unclear if MEG is useful in the selection of the optimal DBS contact point.
AB - Background: Deep brain stimulation (DBS) of the subthalamic nucleus (STN) is an effective treatment for disabling fluctuations in motor symptoms in Parkinson's disease (PD) patients. However, iterative exploration of all individual contact points (four in each STN) by the clinician for optimal clinical effects may take months. Objective: In this proof of concept study we explored whether magnetoencephalography (MEG) has the potential to noninvasively measure the effects of changing the active contact point of STN-DBS on spectral power and functional connectivity in PD patients, with the ultimate aim to aid in the process of selecting the optimal contact point, and perhaps reduce the time to achieve optimal stimulation settings. Methods: The study included 30 PD patients who had undergone bilateral DBS of the STN. MEG was recorded during stimulation of each of the eight contact points separately (four on each side). Each stimulation position was projected on a vector running through the longitudinal axis of the STN, leading to one scalar value indicating a more dorsolateral or ventromedial contact point position. Using linear mixed models, the stimulation positions were correlated with band-specific absolute spectral power and functional connectivity of i) the motor cortex ipsilateral tot the stimulated side, ii) the whole brain. Results: At group level, more dorsolateral stimulation was associated with lower low-beta absolute band power in the ipsilateral motor cortex (p =.019). More ventromedial stimulation was associated with higher whole-brain absolute delta (p =.001) and theta (p =.005) power, as well as higher whole-brain theta band functional connectivity (p =.040). At the level of the individual patient, switching the active contact point caused significant changes in spectral power, but the results were highly variable. Conclusions: We demonstrate for the first time that stimulation of the dorsolateral (motor) STN in PD patients is associated with lower low-beta power values in the motor cortex. Furthermore, our group-level data show that the location of the active contact point correlates with whole-brain brain activity and connectivity. As results in individual patients were quite variable, it remains unclear if MEG is useful in the selection of the optimal DBS contact point.
KW - Contact point-specific
KW - Deep brain stimulation
KW - Functional connectivity
KW - Magnetoencephalography
KW - Parkinson's disease
KW - Spectral power
UR - http://www.scopus.com/inward/record.url?scp=85159182965&partnerID=8YFLogxK
U2 - https://doi.org/10.1016/j.nicl.2023.103431
DO - https://doi.org/10.1016/j.nicl.2023.103431
M3 - Article
C2 - 37187041
SN - 2213-1582
VL - 38
JO - NeuroImage: Clinical
JF - NeuroImage: Clinical
M1 - 103431
ER -