Subthalamic nucleus oscillations correlate with vulnerability to freezing of gait in patients with Parkinson's disease

Chiung-Chu Chen; Chien-Hung Yeh; Hsiao-Lung Chan; Ya-Ju Chang; Po-Hsun Tu; Chih-Hua Yeh; Chin-Song Lu; Petra Fischer; Gerd Tinkhauser; Huiling Tan; Peter Brown

Neurobiology of Disease (Dec 2019)

Subthalamic nucleus oscillations correlate with vulnerability to freezing of gait in patients with Parkinson's disease

Chiung-Chu Chen,
Chien-Hung Yeh,
Hsiao-Lung Chan,
Ya-Ju Chang,
Po-Hsun Tu,
Chih-Hua Yeh,
Chin-Song Lu,
Petra Fischer,
Gerd Tinkhauser,
Huiling Tan,
Peter Brown

Affiliations

Chiung-Chu Chen: Division of Movement Disorders, Department of Neurology, Chang Gung Memorial Hospital, Linkou, Taiwan; Neuroscience Research Center, Chang Gung Memorial Hospital, Linkou, Taiwan; School of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan; Corresponding author at: Division of Movement Disorders, Department of Neurology, Chang Gung Memorial Hospital, 333, Taoyuan, Taiwan.
Chien-Hung Yeh: Division of Movement Disorders, Department of Neurology, Chang Gung Memorial Hospital, Linkou, Taiwan; Medical Research Council Brain Network Dynamics Unit at the University of Oxford, OX1 3TH Oxford, United Kingdom; Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, University of Oxford, OX3 9DU Oxford, United Kingdom
Hsiao-Lung Chan: Neuroscience Research Center, Chang Gung Memorial Hospital, Linkou, Taiwan; Department of Electrical Engineering, College of Engineering, Chang Gung University, Taoyuan, Taiwan
Ya-Ju Chang: Neuroscience Research Center, Chang Gung Memorial Hospital, Linkou, Taiwan; School of Physical Therapy and Graduate Institute of Rehabilitation Science, College of Medicine, Healthy Aging Research Center, Chang Gung University, Taoyuan, Taiwan
Po-Hsun Tu: School of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan; Department of Neurosurgery, Chang Gung Memorial Hospital, Linkou, Taiwan
Chih-Hua Yeh: School of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan; Department of Neuroradiology, Chang Gung Memorial Hospital, Linkou, Taiwan
Chin-Song Lu: Division of Movement Disorders, Department of Neurology, Chang Gung Memorial Hospital, Linkou, Taiwan; Neuroscience Research Center, Chang Gung Memorial Hospital, Linkou, Taiwan; Professor Lu Neurological Clinic, Taoyuan, Taiwan
Petra Fischer: Medical Research Council Brain Network Dynamics Unit at the University of Oxford, OX1 3TH Oxford, United Kingdom; Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, University of Oxford, OX3 9DU Oxford, United Kingdom
Gerd Tinkhauser: Medical Research Council Brain Network Dynamics Unit at the University of Oxford, OX1 3TH Oxford, United Kingdom; Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, University of Oxford, OX3 9DU Oxford, United Kingdom; Department of Neurology, Bern University Hospital and University of Bern, Bern, Switzerland
Huiling Tan: Medical Research Council Brain Network Dynamics Unit at the University of Oxford, OX1 3TH Oxford, United Kingdom; Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, University of Oxford, OX3 9DU Oxford, United Kingdom
Peter Brown: Medical Research Council Brain Network Dynamics Unit at the University of Oxford, OX1 3TH Oxford, United Kingdom; Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, University of Oxford, OX3 9DU Oxford, United Kingdom

Journal volume & issue: Vol. 132

Abstract

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Freezing of gait (FOG) is a disabling clinical phenomenon often found in patients with advanced Parkinson's disease (PD). FOG impairs motor function, causes falls and leads to loss of independence. Whereas dual tasking that distracts patients' attention precipitates FOG, auditory or visual cues ameliorate this phenomenon. The pathophysiology of FOG remains unclear. Previous studies suggest that the basal ganglia are involved in the generation of FOG. Investigation of the modulation of neuronal activities within basal ganglia structures during walking is warranted. To this end, we recorded local field potentials (LFP) from the subthalamic nucleus (STN) while PD patients performed single-task gait (ST) or walked while dual-tasking (DT). An index of FOG (iFOG) derived from trunk accelerometry was used as an objective measure to differentiate FOG-vulnerable gait from normal gait. Two spectral activities recorded from the STN region were associated with vulnerability to freezing. Greater LFP power in the low beta (15–21 Hz) and theta (5–8 Hz) bands were noted during periods of vulnerable gait in both ST and DT states. Whereas the elevation of low beta activities was distributed across STN, the increase in theta activity was focal and found in ventral STN and/or substantia nigra (SNr) in ST. The results demonstrate that low beta and theta band oscillations within the STN area occur during gait susceptible to freezing in PD. They also add to the evidence that narrow band ~18 Hz activity may be linked to FOG.

Published in Neurobiology of Disease

ISSN: 0969-9961 (Print); 1095-953X (Online)
Publisher: Elsevier
Country of publisher: United States
LCC subjects: Medicine: Internal medicine: Neurosciences. Biological psychiatry. Neuropsychiatry
Website: https://www.journals.elsevier.com/neurobiology-of-disease

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