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    Tremor Reduction by Deep Brain Stimulation Is Associated With Gamma Power Suppression in Parkinson's Disease

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    Author
    Beudel, M; Little, S; Pogosyan, A; Ashkan, K; Foltynie, T; Limousin, P; Zrinzo, L; Hariz, M; Bogdanovic, M; Cheeran, B; ...
    Date
    2015-07-01
    Source Title
    Neuromodulation
    Publisher
    WILEY-BLACKWELL
    University of Melbourne Author/s
    Thevathasan, Wesley
    Affiliation
    Medical Bionics
    Metadata
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    Document Type
    Journal Article
    Citations
    Beudel, M., Little, S., Pogosyan, A., Ashkan, K., Foltynie, T., Limousin, P., Zrinzo, L., Hariz, M., Bogdanovic, M., Cheeran, B., Green, A. L., Aziz, T., Thevathasan, W. & Brown, P. (2015). Tremor Reduction by Deep Brain Stimulation Is Associated With Gamma Power Suppression in Parkinson's Disease. NEUROMODULATION, 18 (5), pp.349-354. https://doi.org/10.1111/ner.12297.
    Access Status
    Open Access
    URI
    http://hdl.handle.net/11343/260391
    DOI
    10.1111/ner.12297
    Abstract
    OBJECTIVES: Rest tremor is a cardinal symptom of Parkinson's disease (PD), and is readily suppressed by deep brain stimulation (DBS) of the subthalamic nucleus (STN). The therapeutic effect of the latter on bradykinesia and rigidity has been associated with the suppression of exaggerated beta (13-30 Hz) band synchronization in the vicinity of the stimulating electrode, but there is no correlation between beta suppression and tremor amplitude. In the present study, we investigate whether tremor suppression is related to suppression of activities at other frequencies. MATERIALS AND METHODS: We recorded hand tremor and contralateral local field potential (LFP) activity from DBS electrodes during stimulation of the STN in 15 hemispheres in 11 patients with PD. DBS was applied with increasing voltages starting at 0.5 V until tremor suppression was achieved or until 4.5 V was reached. RESULTS: Tremor was reduced to 48.9% ± 10.9% of that without DBS once stimulation reached 2.5-3 V (t14 = -4.667, p < 0.001). There was a parallel suppression of low gamma (31-45 Hz) power to 92.5% ± 3% (t14 = -2.348, p = 0.034). This was not seen over a band containing tremor frequencies and their harmonic (4-12 Hz), or over the beta band. Moreover, low gamma power correlated with tremor severity (mean r = 0.43 ± 0.14, p = 0.008) within subjects. This was not the case for LFP power in the other two bands. CONCLUSIONS: Our findings support a relationship between low gamma oscillations and PD tremor, and reinforce the principle that the subthalamic LFP is a rich signal that may contain information about the severity of multiple different Parkinsonian features.

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