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The modulatory effect of adaptive deep brain stimulation on beta bursts in Parkinson ’ s disease

View Article: PubMed Central - PubMed

ABSTRACT

Pilot studies suggest that adaptive deep brain stimulation (DBS) may be more effective than conventional DBS for the treatment of Parkinson's disease. Tinkhauser et al. show that adaptive DBS regulates pathological beta synchronisation in the subthalamic nucleus by selectively limiting long duration beta bursts, which are related to clinical impairment.

No MeSH data available.


Related in: MedlinePlus

Relationship between burst duration and burst amplitude for the representative 75% threshold. (A) The mean amplitudes for different durations for noStim, adaptive and conventional DBS. SEMs are shown for noStim only. The strong positive correlation indicates the longer the burst duration, the higher the burst amplitude. A slight flattening of this relation can be seen during adaptive DBS at longer burst durations. A second order polynomial was fitted to the data of the three conditions (see equations). Within subjects, a significant correlation could be found for almost all the hemispheres and conditions (noStim 14/16, adaptive DBS 11/16, conventional DBS 13/16). The results of the correlation analyses between burst duration and burst amplitude across all the thresholds are shown in Supplementary Fig. 5. (B) Mean burst amplitude for noStim, adaptive and conventional DBS averaged across hemispheres and time windows. Both adaptive DBS and conventional DBS show a significant reduction in beta amplitude compared to noStim. However, no difference was found between adaptive and conventional DBS. (C) Integrated burst amplitude (normalized to 100%, which corresponds to total integrated amplitude summed across all time windows) for short bursts (100–600 ms) and long bursts (>600 ms). Stimulation conditions show significantly different amplitude effects when burst duration is considered. Adaptive DBS has a higher integrated amplitude in shorter bursts, while conventional DBS and noStim have a higher integrated amplitude in longer bursts. Supplementary Fig. 7 illustrates mean amplitude as well as the integrated amplitude across the different thresholds. Values are represented as mean + SEM; *P < 0.05, **P < 0.01, ***P < 0.001. aDBS = adaptive DBS; cDBS = conventional DBS.
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awx010-F5: Relationship between burst duration and burst amplitude for the representative 75% threshold. (A) The mean amplitudes for different durations for noStim, adaptive and conventional DBS. SEMs are shown for noStim only. The strong positive correlation indicates the longer the burst duration, the higher the burst amplitude. A slight flattening of this relation can be seen during adaptive DBS at longer burst durations. A second order polynomial was fitted to the data of the three conditions (see equations). Within subjects, a significant correlation could be found for almost all the hemispheres and conditions (noStim 14/16, adaptive DBS 11/16, conventional DBS 13/16). The results of the correlation analyses between burst duration and burst amplitude across all the thresholds are shown in Supplementary Fig. 5. (B) Mean burst amplitude for noStim, adaptive and conventional DBS averaged across hemispheres and time windows. Both adaptive DBS and conventional DBS show a significant reduction in beta amplitude compared to noStim. However, no difference was found between adaptive and conventional DBS. (C) Integrated burst amplitude (normalized to 100%, which corresponds to total integrated amplitude summed across all time windows) for short bursts (100–600 ms) and long bursts (>600 ms). Stimulation conditions show significantly different amplitude effects when burst duration is considered. Adaptive DBS has a higher integrated amplitude in shorter bursts, while conventional DBS and noStim have a higher integrated amplitude in longer bursts. Supplementary Fig. 7 illustrates mean amplitude as well as the integrated amplitude across the different thresholds. Values are represented as mean + SEM; *P < 0.05, **P < 0.01, ***P < 0.001. aDBS = adaptive DBS; cDBS = conventional DBS.

Mentions: In summary, adaptive DBS changed the distribution of beta bursts so that there were fewer long bursts, and more short bursts in adaptive DBS than in conventional DBS or noStim. This was also reflected in the accumulated duration of such bursts over the 200 s recording. But why should the frequency of long bursts matter? This may be explained by a significant positive correlation between burst duration and burst amplitude. Figure 5A illustrates the relationship at a group level across conditions using the same representative threshold of 75% as elsewhere. A significant positive correlation was consistently present within hemispheres for noStim (14/16 hemispheres significant, mean rs = 0.8350 ± 0.0393), adaptive DBS (11/16 significant, rs = 0.8144 ± 0.0281) and conventional DBS (13/16 significant, rs = 0.8451 ± 0.0247), and when repeated for other thresholds between 55 and 90% (Supplementary Fig. 5A and B). Thus bursts with longer duration had higher average amplitudes. Supplementary Fig. 6 shows representative time frequency spectra of the three conditions and demonstrates that high amplitude bursts were reduced during adaptive DBS relative to conventional DBS, although beta activity was generally suppressed in this latter condition.Figure 5


The modulatory effect of adaptive deep brain stimulation on beta bursts in Parkinson ’ s disease
Relationship between burst duration and burst amplitude for the representative 75% threshold. (A) The mean amplitudes for different durations for noStim, adaptive and conventional DBS. SEMs are shown for noStim only. The strong positive correlation indicates the longer the burst duration, the higher the burst amplitude. A slight flattening of this relation can be seen during adaptive DBS at longer burst durations. A second order polynomial was fitted to the data of the three conditions (see equations). Within subjects, a significant correlation could be found for almost all the hemispheres and conditions (noStim 14/16, adaptive DBS 11/16, conventional DBS 13/16). The results of the correlation analyses between burst duration and burst amplitude across all the thresholds are shown in Supplementary Fig. 5. (B) Mean burst amplitude for noStim, adaptive and conventional DBS averaged across hemispheres and time windows. Both adaptive DBS and conventional DBS show a significant reduction in beta amplitude compared to noStim. However, no difference was found between adaptive and conventional DBS. (C) Integrated burst amplitude (normalized to 100%, which corresponds to total integrated amplitude summed across all time windows) for short bursts (100–600 ms) and long bursts (>600 ms). Stimulation conditions show significantly different amplitude effects when burst duration is considered. Adaptive DBS has a higher integrated amplitude in shorter bursts, while conventional DBS and noStim have a higher integrated amplitude in longer bursts. Supplementary Fig. 7 illustrates mean amplitude as well as the integrated amplitude across the different thresholds. Values are represented as mean + SEM; *P < 0.05, **P < 0.01, ***P < 0.001. aDBS = adaptive DBS; cDBS = conventional DBS.
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awx010-F5: Relationship between burst duration and burst amplitude for the representative 75% threshold. (A) The mean amplitudes for different durations for noStim, adaptive and conventional DBS. SEMs are shown for noStim only. The strong positive correlation indicates the longer the burst duration, the higher the burst amplitude. A slight flattening of this relation can be seen during adaptive DBS at longer burst durations. A second order polynomial was fitted to the data of the three conditions (see equations). Within subjects, a significant correlation could be found for almost all the hemispheres and conditions (noStim 14/16, adaptive DBS 11/16, conventional DBS 13/16). The results of the correlation analyses between burst duration and burst amplitude across all the thresholds are shown in Supplementary Fig. 5. (B) Mean burst amplitude for noStim, adaptive and conventional DBS averaged across hemispheres and time windows. Both adaptive DBS and conventional DBS show a significant reduction in beta amplitude compared to noStim. However, no difference was found between adaptive and conventional DBS. (C) Integrated burst amplitude (normalized to 100%, which corresponds to total integrated amplitude summed across all time windows) for short bursts (100–600 ms) and long bursts (>600 ms). Stimulation conditions show significantly different amplitude effects when burst duration is considered. Adaptive DBS has a higher integrated amplitude in shorter bursts, while conventional DBS and noStim have a higher integrated amplitude in longer bursts. Supplementary Fig. 7 illustrates mean amplitude as well as the integrated amplitude across the different thresholds. Values are represented as mean + SEM; *P < 0.05, **P < 0.01, ***P < 0.001. aDBS = adaptive DBS; cDBS = conventional DBS.
Mentions: In summary, adaptive DBS changed the distribution of beta bursts so that there were fewer long bursts, and more short bursts in adaptive DBS than in conventional DBS or noStim. This was also reflected in the accumulated duration of such bursts over the 200 s recording. But why should the frequency of long bursts matter? This may be explained by a significant positive correlation between burst duration and burst amplitude. Figure 5A illustrates the relationship at a group level across conditions using the same representative threshold of 75% as elsewhere. A significant positive correlation was consistently present within hemispheres for noStim (14/16 hemispheres significant, mean rs = 0.8350 ± 0.0393), adaptive DBS (11/16 significant, rs = 0.8144 ± 0.0281) and conventional DBS (13/16 significant, rs = 0.8451 ± 0.0247), and when repeated for other thresholds between 55 and 90% (Supplementary Fig. 5A and B). Thus bursts with longer duration had higher average amplitudes. Supplementary Fig. 6 shows representative time frequency spectra of the three conditions and demonstrates that high amplitude bursts were reduced during adaptive DBS relative to conventional DBS, although beta activity was generally suppressed in this latter condition.Figure 5

View Article: PubMed Central - PubMed

ABSTRACT

Pilot studies suggest that adaptive deep brain stimulation (DBS) may be more effective than conventional DBS for the treatment of Parkinson's disease. Tinkhauser et al. show that adaptive DBS regulates pathological beta synchronisation in the subthalamic nucleus by selectively limiting long duration beta bursts, which are related to clinical impairment.

No MeSH data available.


Related in: MedlinePlus