Dopaminergic therapy promotes lateralized motor activity in the subthalamic area in Parkinson's disease

• Published in: Brain (London, England : 1878) England : 1878), 2007-02, Vol.130 (2), p.457-468
• Main Authors: Androulidakis, Alexandros G., Kühn, Andrea A., Chu Chen, Chiung, Blomstedt, Patric, Kempf, Florian, Kupsch, Andreas, Schneider, Gerd-Helge, Doyle, Louise, Dowsey-Limousin, Patricia, Hariz, Marwan I., Brown, Peter
• Format: Article
• Language: English
• Subjects: Adult; Aged; Antiparkinson Agents - therapeutic use; Biological and medical sciences; deep brain stimulation; Deep Brain Stimulation - methods; Degenerative and inherited degenerative diseases of the nervous system. Leukodystrophies. Prion diseases; Electrodes, Implanted; Electroencephalography; Evoked Potentials - drug effects; Female; Headache. Facial pains. Syncopes. Epilepsia. Intracranial hypertension. Brain oedema. Cerebral palsy; Humans; Levodopa - therapeutic use; local field potentials; Male; Medical sciences; Middle Aged; Motor Activity - drug effects; Nervous system (semeiology, syndromes); Neurology; Parkinson Disease - drug therapy; Parkinson Disease - physiopathology; Parkinson Disease/drug therapy/physiopathology; Parkinson's disease; Signal Processing, Computer-Assisted; subthalamic nucleus; Subthalamic Nucleus - drug effects; Subthalamic Nucleus - physiopathology; Subthalamic Nucleus/drug effects/physiopathology; synchronous oscillatory activity
• ISSN: 0006-8950; 1460-2156; 1460-2156
• DOI: 10.1093/brain/awl358

Treatment of patients with Parkinson's disease with levodopa has profound effects on both movement and the pattern of movement-related reactivity in the subthalamic nucleus (STN), as reflected in the local field potential (LFP). The most striking change is the promotion of reactivity in the gamma frequency band, but it remains unclear whether the latter is itself a pathological feature, possibly associated with levodopa induced dyskinesias, or is primarily physiological. Gamma band reactivity in the cerebral cortex of humans without Parkinson's disease occurs contralateral to movement, so we posited that lateralization of subcortical gamma reactivity should occur following levodopa if the latter restores a more physiological pattern in patients with Parkinson's disease. Accordingly, we studied movement-related changes in STN LFP activity in 11 Parkinson's disease patients (age 59 ± 2.7 years, three females) while they performed ipsi- and contralateral self-paced joystick movements ON and OFF levodopa. A bilaterally symmetrical gamma band power increase occurred around movement onset in the OFF state. Following levodopa this feature became significantly more pronounced in the subthalamic region contralateral to movement. The physiological nature of this asymmetric pattern of gamma reactivity was confirmed in the STN of two tremor patients without Parkinson's disease. Although levodopa treatment in the Parkinson's disease patients did not lead to lateralization of power suppression at lower frequencies (8–30 Hz), it did increase the degree of power suppression. These findings suggest that dopaminergic therapy restores a more physiological pattern of reactivity in the STN of patients with Parkinson's disease.