gms | German Medical Science

62nd Annual Meeting of the German Society of Neurosurgery (DGNC)
Joint Meeting with the Polish Society of Neurosurgeons (PNCH)

German Society of Neurosurgery (DGNC)

7 - 11 May 2011, Hamburg

Deep brain stimulation of the subthalamic nucleus normalises Parkinson's disease related abnormalities of auditory evoked potentials and quantitative EEG

Meeting Abstract

  • A. Gulberti - Department of Neurophysiology and Pathophysiology, University Medical Center Hamburg-Eppendorf, Hamburg
  • C.K.E. Moll - Department of Neurophysiology and Pathophysiology, University Medical Center Hamburg-Eppendorf, Hamburg
  • T.R. Schneider - Department of Neurophysiology and Pathophysiology, University Medical Center Hamburg-Eppendorf, Hamburg
  • W. Hamel - Department of Neurosurgery, University Medical Center Hamburg-Eppendorf, Hamburg
  • A. Münchau - Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg
  • C. Buhmann - Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg
  • K. Boelmans - Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg
  • S. Zittel - Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg
  • C. Gerloff - Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg
  • M. Westphal - Department of Neurosurgery, University Medical Center Hamburg-Eppendorf, Hamburg
  • A.K. Engel - Department of Neurophysiology and Pathophysiology, University Medical Center Hamburg-Eppendorf, Hamburg

Deutsche Gesellschaft für Neurochirurgie. Polnische Gesellschaft für Neurochirurgen. 62. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Polnischen Gesellschaft für Neurochirurgen (PNCH). Hamburg, 07.-11.05.2011. Düsseldorf: German Medical Science GMS Publishing House; 2011. DocP 100

doi: 10.3205/11dgnc321, urn:nbn:de:0183-11dgnc3218

Published: April 28, 2011

© 2011 Gulberti et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.


Outline

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Objective: Some of the cardinal symptoms of Parkinson's disease (PD) share a pathological rhythmic dysregulation as common feature, indicating a disturbing rhythmicity within cortical and subcortical networks involving the basal ganglia (BG) as well. Deep brain stimulation (DBS) of the subthalamic nucleus (STN) clearly improves dopamine-dependent motor deficits in patients with PD. While there is evidence for dopaminergic sensitivity of central sensory processing, the effects of DBS on sensory information processing are less clear.

Methods: We investigated the effects of STN-DBS on auditory information processing using auditory evoked potentials (AEP) and power spectra analysis. We compared power spectra and amplitude, latency and habituation of AEPs in 12 patients with advanced PD to those of age-matched controls. The stimulus paradigm consisted of rhythmic metronome-like clicks presented at different interstimulus intervals (ISI). High-density EEG-recordings were carried out prior to and 4 months following surgery for STN-DBS in the practically defined OFF-state. We studied the effects of STN-DBS at the individual therapeutic DBS-frequency and with DBS switched off.

Results: Prior to surgery, PD patients showed significantly larger AEP amplitudes (P50, N1 and P2) in central and central-parietal areas compared to controls. Compared to controls N1 and P2 latencies were significantly increased and AEP habituation was reduced in PD patients. Moreover, in PD patients the general power level and the power of beta oscillations in particular were abnormal. Electrode implantation per se as well as STN-DBS had a normalizing effect on AEPs and power spectra. High-frequency STN-DBS led to a normalization of P2, but not P50 and N1 amplitudes. We could not find any significant difference between the two postoperative conditions Stimulation-ON vs. Stimulation-OFF. One possible explanation could be the long-lasting effects of chronic high-frequency DBS. Due to plastic neuronal changing, switching off the stimulator for 20 minutes is probably not enough to re-stabilize the preoperative auditory processing state. Another reason could be the changed and reduced postoperative medication.

Conclusions: Our findings support and expand previous reports of dysregulated central auditory processing in PD as expressed by AEPs and power spectra. The present results suggest that STN-DBS differentially affects the auditory evoked responses and may thus also influence sensorimotor processing at higher order sensory levels.