Background Parkinson disease (PD) patients have difficulty with self-initiated (SI) movements, presumably related to basal ganglia thalamocortical (BGTC) circuit dysfunction, while showing less impairment with externally cued (EC) movements. Objectives We investigate the role of BGTC in movement initiation and the neural underpinning of impaired SI compared to EC movements in PD using multifocal intracranial recordings and correlating signals with symptom severity. Methods We compared time-resolved neural activities within and between globus pallidus internus (GPi) and motor cortex during between SI and EC movements recorded invasively in 13 PD patients undergoing deep brain stimulation implantation. We compared cortical (but not subcortical) dynamics with those recorded in 10 essential tremor (ET) patients, who do not have impairments in movement initiation. Results SI movements in PD are associated with greater low-beta (13–20 Hz) power suppression during pre-movement period in GPi and motor cortex compared to EC movements in PD and compared to SI movements in ET (motor cortex only). SI movements in PD are uniquely associated with significant low-beta pallidocortical coherence suppression during movement execution that correlates with bradykinesia severity. In ET, motor cortex neural dynamics during EC movements do not significantly differ from that observed in PD and do not significantly differ between SI and EC movements. Conclusion These findings implicate low beta BGTC oscillations in impaired SI movements in PD. These results provide a physiological basis for the strategy of using EC movements in PD, circumventing diseased neural circuits associated with SI movements and instead engaging circuits that function similarly to those without PD.

中文翻译：

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帕金森病自发运动期间改变的苍白皮质低 β 振荡

背景帕金森病 (PD) 患者自发 (SI) 运动有困难，这可能与基底神经节丘脑皮质 (BGTC) 电路功能障碍有关，而外部提示 (EC) 运动的损伤较小。目的 我们使用多灶颅内记录并将信号与症状严重程度相关联，研究 BGTC 在运动启动中的作用以及与 PD 中的 EC 运动相比，受损 SI 的神经基础。方法 我们比较了 13 名接受深部脑刺激植入的 PD 患者在 SI 和 EC 运动期间侵入性记录的苍白球 (GPi) 和运动皮层内部和之间的时间分辨神经活动。我们将皮质（但不是皮质下）动力学与 10 名特发性震颤（ET）患者记录的动力学进行了比较，在运动开始方面没有障碍的人。结果 与 PD 中的 EC 运动和 ET 中的 SI 运动（仅运动皮层）相比，PD 中的 SI 运动与 GPi 和运动皮层运动前期间更大的低β（13-20 Hz）功率抑制有关。PD 中的 SI 运动与运动执行过程中显着的低 β 苍白皮质相干性抑制独特相关，这与运动迟缓严重程度相关。在 ET 中，EC 运动期间的运动皮层神经动力学与 PD 中观察到的没有显着差异，并且在 SI 和 EC 运动之间没有显着差异。结论这些发现暗示 PD 中受损的 SI 运动中的低 β BGTC 振荡。这些结果为在 PD 中使用 EC 运动的策略提供了生理基础，