The goal of this study was to characterize the spectral characteristics and spatial topography of local field potential (LFP) activity in the internal segment of the globus pallidus (GPi) in patients with Parkinson's disease utilizing directional (segmented) deep brain stimulation (dDBS) leads. Data were collected from externalized dDBS leads of three patients with idiopathic Parkinson's disease after overnight withdrawal of parkinsonian medication at rest and during a cued reach-to-target task. Oscillatory activity across lead contacts/segments was examined in the context of lead locations and contact orientations determined using co-registered preoperative 7 Tesla (T) MRI and postoperative CT scans. Each of the three patients displayed a unique frequency spectrum of oscillatory activity in the pallidum, with prominent peaks ranging from 5 to 35 Hz, that modulated variably across subjects during volitional movement. Despite subject-specific spectral profiles, a consistent finding across patients was that oscillatory power was strongest and had the largest magnitude of modulation during movement in LFPs recorded from segments facing the postero-lateral "sensorimotor" region of GPi, whereas antero-medially-directed segmented contacts facing the internal capsule and/or anterior GPi, had relatively weaker LFP power and less modulation in the 5 to 35 Hz. In each subject, contact configurations chosen for clinically therapeutic stimulation (following data collection and blinded to physiology recordings), were in concordance with the contact pairs showing the largest amplitude of LFP oscillations in the 5-35 Hz range. Although limited to three subjects, these findings provide support for the hypothesis that the sensorimotor territory of the GPi corresponds to the site of maximal power of oscillatory activity in the 5 to 35 Hz and provides the greatest benefit in motor signs during stimulation in the GPi. Variability in oscillatory activity across patients is likely related to Parkinson's disease phenotype as well as small differences in recording location (i.e. lead location), highlighting the importance of lead location for optimizing stimulation efficacy. These data also provide compelling evidence for the use of LFP activity for the development of predictive stimulation models that may optimize patient benefits while reducing clinic time needed for programming.

中文翻译：

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定向深部脑刺激导线揭示了帕金森氏病患者的苍白球内部的空间不同的振荡活动。

这项研究的目的是利用定向（分段）深部脑刺激（dDBS）导线表征帕金森氏病患者苍白球（GPi）内部部分的局部场电位（LFP）活性的光谱特征和空间形貌。从三名特发性帕金森病患者的外部dDBS线索中收集了数据，这些患者是在静息状态下隔夜停药并在提示达到目标任务期间停药。使用共同注册的术前7 Tesla（T）MRI和术后CT扫描确定的导线位置和接触方向，检查了导线接触/段之间的振荡活动。三位患者中的每位患者在苍白球均显示出独特的振荡活动频谱，具有从5到35 Hz的显着峰值，在主体运动过程中会在对象之间进行不同程度的调制。尽管有特定受试者的频谱特征，但在患者中的一致发现是，在LFP的运动过程中，从面对GPi的后外侧“感觉运动”区域的段记录到的振荡力最强，并且具有最大的调制幅度，而前内侧指向面向内囊和/或前GPi的分段接触具有相对较弱的LFP功率和5至35 Hz的较少调制。在每个受试者中，选择用于临床治疗刺激的接触配置（在数据收集之后且对生理记录不了解）与接触对一致，显示LFP振荡的最大振幅在5-35 Hz范围内。尽管仅限于三个主题，但这些发现为以下假设提供了支持：GPi的感觉运动区域对应于5至35 Hz的振荡活动的最大能量位点，并在GPi刺激过程中最大程度地改善了运动征象。患者振荡活动的差异可能与帕金森氏病表型以及记录位置（即导联位置）的细微差异有关，突出了导联位置对于优化刺激功效的重要性。这些数据还为使用LFP活性开发预测性刺激模型提供了令人信服的证据，该模型可以优化患者的获益，同时减少编程所需的临床时间。这些发现为以下假设提供了支持：GPi的感觉运动区域对应于5至35 Hz的振荡活动的最大能量位点，并且在GPi刺激过程中最大程度地改善了运动体征。患者振荡活动的差异可能与帕金森氏病表型以及记录位置（即导联位置）的细微差异有关，突出了导联位置对于优化刺激功效的重要性。这些数据还为使用LFP活性开发预测性刺激模型提供了令人信服的证据，该模型可以优化患者的获益，同时减少编程所需的临床时间。这些发现为以下假设提供了支持：GPi的感觉运动区域对应于5至35 Hz的振荡活动的最大能量位点，并且在GPi刺激过程中最大程度地改善了运动体征。患者振荡活动的差异可能与帕金森氏病表型以及记录位置（即导联位置）的细微差异有关，突出了导联位置对于优化刺激功效的重要性。这些数据还为使用LFP活性开发预测性刺激模型提供了令人信服的证据，该模型可以优化患者的获益，同时减少编程所需的临床时间。