Subthalamic stimulation and levodopa modulate cortical reactivity in Parkinson's patients

Elias Paolo Casula; Mario Stampanoni Bassi; Maria Concetta Pellicciari; Viviana Ponzo; Domenica Veniero; Antonella Peppe; Livia Brusa; Paolo Stanzione; Carlo Caltagirone; Alessandro Stefani; Giacomo Koch

doi:10.1016/j.parkreldis.2016.10.009

Subthalamic stimulation and levodopa modulate cortical reactivity in Parkinson's patients

Elias Paolo Casula, Mario Stampanoni Bassi, Maria Concetta Pellicciari, Viviana Ponzo, Domenica Veniero, Antonella Peppe, Livia Brusa, Paolo Stanzione, Carlo Caltagirone, Alessandro Stefani, Giacomo Koch

Research output: Contribution to journal › Article › peer-review

Abstract

BACKGROUND: The effects of deep brain stimulation of the subthalamic nucleus (DBS-STN) and L-dopa (LD) on cortical activity in Parkinson's disease (PD) are poorly understood.

OBJECTIVES: By combining transcranial magnetic stimulation (TMS) and electroencephalography (EEG) we explored the effects of STN-DBS, either alone or in combination with L-Dopa (LD), on TMS-evoked cortical activity in a sample of implanted PD patients.

METHODS: PD patients were tested in three clinical conditions: i) LD therapy with STN-DBS turned on (ON/ON condition); ii) without LD therapy with STN-DBS turned on (OFF/ON condition); iii) without LD therapy with STN-DBS turned off (OFF/OFF condition). TMS pulses were delivered over left M1 while simultaneously acquiring EEG. Eight age-matched healthy volunteers (HC) were tested as a control group.

RESULTS: STN-DBS enhanced early global TMS-evoked activity (∼45-80ms) and high-alpha TMS-evoked oscillations (11-13 Hz) as compared to OFF/OFF condition, independently from concomitant LD therapy. LD intake (ON/ON condition) produced a further increase of late TMS-evoked activity (∼80-130ms) and beta TMS-evoked oscillations (13-30 Hz), as compared to OFF/OFF and OFF/ON conditions, that normalized reactivity as compared to HC range of values.

CONCLUSIONS: Our data reveal that bilateral STN-DBS and LD therapy induce a modulation of specific cortical components and specific ranges of frequency. These findings demonstrate that STN-DBS and LD therapy may have synergistic effects on motor cortical activity.

Original language	English
Pages (from-to)	31-37
Number of pages	7
Journal	Parkinsonism and Related Disorders
Volume	34
DOIs	https://doi.org/10.1016/j.parkreldis.2016.10.009
Publication status	E-pub ahead of print - Oct 17 2016

Keywords

Journal Article

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Subthalamic stimulation and levodopa modulate cortical reactivity in Parkinson's patients. / Casula, Elias Paolo; Stampanoni Bassi, Mario; Pellicciari, Maria Concetta ; Ponzo, Viviana; Veniero, Domenica; Peppe, Antonella; Brusa, Livia; Stanzione, Paolo; Caltagirone, Carlo; Stefani, Alessandro; Koch, Giacomo.

In: Parkinsonism and Related Disorders, Vol. 34, 17.10.2016, p. 31-37.

Research output: Contribution to journal › Article › peer-review

Casula, Elias Paolo ; Stampanoni Bassi, Mario ; Pellicciari, Maria Concetta ; Ponzo, Viviana ; Veniero, Domenica ; Peppe, Antonella ; Brusa, Livia ; Stanzione, Paolo ; Caltagirone, Carlo ; Stefani, Alessandro ; Koch, Giacomo. / Subthalamic stimulation and levodopa modulate cortical reactivity in Parkinson's patients. In: Parkinsonism and Related Disorders. 2016 ; Vol. 34. pp. 31-37.

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abstract = "BACKGROUND: The effects of deep brain stimulation of the subthalamic nucleus (DBS-STN) and L-dopa (LD) on cortical activity in Parkinson's disease (PD) are poorly understood.OBJECTIVES: By combining transcranial magnetic stimulation (TMS) and electroencephalography (EEG) we explored the effects of STN-DBS, either alone or in combination with L-Dopa (LD), on TMS-evoked cortical activity in a sample of implanted PD patients.METHODS: PD patients were tested in three clinical conditions: i) LD therapy with STN-DBS turned on (ON/ON condition); ii) without LD therapy with STN-DBS turned on (OFF/ON condition); iii) without LD therapy with STN-DBS turned off (OFF/OFF condition). TMS pulses were delivered over left M1 while simultaneously acquiring EEG. Eight age-matched healthy volunteers (HC) were tested as a control group.RESULTS: STN-DBS enhanced early global TMS-evoked activity (∼45-80ms) and high-alpha TMS-evoked oscillations (11-13 Hz) as compared to OFF/OFF condition, independently from concomitant LD therapy. LD intake (ON/ON condition) produced a further increase of late TMS-evoked activity (∼80-130ms) and beta TMS-evoked oscillations (13-30 Hz), as compared to OFF/OFF and OFF/ON conditions, that normalized reactivity as compared to HC range of values.CONCLUSIONS: Our data reveal that bilateral STN-DBS and LD therapy induce a modulation of specific cortical components and specific ranges of frequency. These findings demonstrate that STN-DBS and LD therapy may have synergistic effects on motor cortical activity.",

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author = "Casula, {Elias Paolo} and {Stampanoni Bassi}, Mario and Pellicciari, {Maria Concetta} and Viviana Ponzo and Domenica Veniero and Antonella Peppe and Livia Brusa and Paolo Stanzione and Carlo Caltagirone and Alessandro Stefani and Giacomo Koch",

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T1 - Subthalamic stimulation and levodopa modulate cortical reactivity in Parkinson's patients

AU - Casula, Elias Paolo

AU - Stampanoni Bassi, Mario

AU - Pellicciari, Maria Concetta

AU - Ponzo, Viviana

AU - Veniero, Domenica

AU - Peppe, Antonella

AU - Brusa, Livia

AU - Stanzione, Paolo

AU - Caltagirone, Carlo

AU - Stefani, Alessandro

AU - Koch, Giacomo

PY - 2016/10/17

Y1 - 2016/10/17

N2 - BACKGROUND: The effects of deep brain stimulation of the subthalamic nucleus (DBS-STN) and L-dopa (LD) on cortical activity in Parkinson's disease (PD) are poorly understood.OBJECTIVES: By combining transcranial magnetic stimulation (TMS) and electroencephalography (EEG) we explored the effects of STN-DBS, either alone or in combination with L-Dopa (LD), on TMS-evoked cortical activity in a sample of implanted PD patients.METHODS: PD patients were tested in three clinical conditions: i) LD therapy with STN-DBS turned on (ON/ON condition); ii) without LD therapy with STN-DBS turned on (OFF/ON condition); iii) without LD therapy with STN-DBS turned off (OFF/OFF condition). TMS pulses were delivered over left M1 while simultaneously acquiring EEG. Eight age-matched healthy volunteers (HC) were tested as a control group.RESULTS: STN-DBS enhanced early global TMS-evoked activity (∼45-80ms) and high-alpha TMS-evoked oscillations (11-13 Hz) as compared to OFF/OFF condition, independently from concomitant LD therapy. LD intake (ON/ON condition) produced a further increase of late TMS-evoked activity (∼80-130ms) and beta TMS-evoked oscillations (13-30 Hz), as compared to OFF/OFF and OFF/ON conditions, that normalized reactivity as compared to HC range of values.CONCLUSIONS: Our data reveal that bilateral STN-DBS and LD therapy induce a modulation of specific cortical components and specific ranges of frequency. These findings demonstrate that STN-DBS and LD therapy may have synergistic effects on motor cortical activity.

AB - BACKGROUND: The effects of deep brain stimulation of the subthalamic nucleus (DBS-STN) and L-dopa (LD) on cortical activity in Parkinson's disease (PD) are poorly understood.OBJECTIVES: By combining transcranial magnetic stimulation (TMS) and electroencephalography (EEG) we explored the effects of STN-DBS, either alone or in combination with L-Dopa (LD), on TMS-evoked cortical activity in a sample of implanted PD patients.METHODS: PD patients were tested in three clinical conditions: i) LD therapy with STN-DBS turned on (ON/ON condition); ii) without LD therapy with STN-DBS turned on (OFF/ON condition); iii) without LD therapy with STN-DBS turned off (OFF/OFF condition). TMS pulses were delivered over left M1 while simultaneously acquiring EEG. Eight age-matched healthy volunteers (HC) were tested as a control group.RESULTS: STN-DBS enhanced early global TMS-evoked activity (∼45-80ms) and high-alpha TMS-evoked oscillations (11-13 Hz) as compared to OFF/OFF condition, independently from concomitant LD therapy. LD intake (ON/ON condition) produced a further increase of late TMS-evoked activity (∼80-130ms) and beta TMS-evoked oscillations (13-30 Hz), as compared to OFF/OFF and OFF/ON conditions, that normalized reactivity as compared to HC range of values.CONCLUSIONS: Our data reveal that bilateral STN-DBS and LD therapy induce a modulation of specific cortical components and specific ranges of frequency. These findings demonstrate that STN-DBS and LD therapy may have synergistic effects on motor cortical activity.

KW - Journal Article

U2 - 10.1016/j.parkreldis.2016.10.009

DO - 10.1016/j.parkreldis.2016.10.009

M3 - Article

C2 - 27771287

VL - 34

SP - 31

EP - 37

JO - Parkinsonism and Related Disorders

JF - Parkinsonism and Related Disorders

SN - 1353-8020

ER -