Neuronal activity features of the subthalamic nucleus associated with
optimal DBS electrode insertion path in Parkinson's disease
Abstract
Deep brain stimulation (DBS) of the subthalamic nucleus (STN) is a
standard treatment for advanced Parkinson’s disease (PD). The precise
positioning of the electrode can significantly influence the results of
DBS and the overall improvement in the quality of life for PD patients
receiving this therapy. We hypothesize that single unit activity (SUA)
features can serve as a valid marker of the optimal DBS-electrode
insertion trajectory, leading to the most favorable outcome of STN-DBS
surgery. We analyzed spontaneous SUA data recorded during Microelectrode
Recording (MER) for 21 patients with PD who underwent DBS surgery. We
compared 29 linear and 6 nonlinear characteristics of the STN neural
activity recorded along different microelectrode insertion paths to
determine features corresponding to favorable stimulation outcomes. Our
research indicated that the SUA features of pause neurons in a dorsal
STN region significantly affected stimulation outcomes. For the
trajectories chosen for lead insertion, firing rate, burst rate, and
oscillatory activity at 8-12 and 12-20 bands were significantly
decreased. Moreover, nonlinear feature analysis showed a significant
increase in mutual information for the chosen trajectories. Our findings
highlight the significance of specific indicators, such as the activity
of pause neurons in the dorsal region and numerous linear SUA
characteristics, in determining the optimal lead installation
trajectory. Furthermore, our findings emphasize the importance of
investigating paths rejected during test-stimulation to understand motor
impairment in Parkinson’s disease and its treatment mechanisms.