Artikel
Physiological characterization of thalamo-cortical networks during Deep Brain Stimulation surgery
Die physiologische Charakterizierung von thalamo-kortikalen Netzwerken während der Tiefen Hirnstimulation
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Autoren
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Georgios Naros
- Eberhard-Karls-Universität, Klinik für Neurochirurgie, Tübingen, Deutschland; Eberhard-Karls-Universität, Sektion für funktionelle und restaurative Neurochirurgie, Tübingen, Deutschland
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Florian Grimm
- Eberhard-Karls-Universität, Klinik für Neurochirurgie, Tübingen, Deutschland; Eberhard-Karls-Universität, Sektion für funktionelle und restaurative Neurochirurgie, Tübingen, Deutschland
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Daniel Weiß
- Eberhard-Karls-Universität, Neurologie mit Schwerpunkt Neurodegenerative Erkrankungen, Tübingen, Deutschland
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Alireza Gharabaghi
- Eberhard-Karls-Universität, Klinik für Neurochirurgie, Tübingen, Deutschland; Eberhard-Karls-Universität, Sektion für funktionelle und restaurative Neurochirurgie, Tübingen, Deutschland
| Veröffentlicht: | 8. Mai 2019 |
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Gliederung
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Objective: During Deep Brain Stimulation (DBS) electrophysiological recordings are used for intraoperative targeting. At the same time, they enable insights into subcortical-cortical networks. In this study, we present our findings using intraoperative electrical stimulation and cortical/subcortical electrophysiological recordings in evaluation of thalamo-cortical networks during DBS.
Methods: Thirteen patients with Essential Tremor (ET) or Holmes Tremor (HT), who were selected for DBS of the ventral intermediate (VIM) nucleus of the thalamus, participated in the study. After insertion of microelectrodes, nucleo-cortical evoked potentials (EP) were elicited by subcortical electrical stimulation in 1 mm steps until reaching target depth. Multi-channel electroencephalography (EEG) and local field potentials (LFP) were recorded. Cortical effects of subcortical stimulation were assessed in the time series and frequency domain. Functional and effective connectivity between subcortical (LFP) and cortical (EEG) signals was calculated.
Results: Intraoperative LFP recordings revealed an increase of β-activity in the target region. This power increase represented subcortical regions with high functional connectivity to the ipsilateral SMC. Hence, there was a strong positive correlation between nucleo-cortical coherence in the β (15-20Hz) and γ (70-80Hz) frequencies and LFP power (r=0.877 and r=0.856). EPs after electrical stimulation of these subcortical regions project to the ipsilateral SMC and support connectivity analysis. There was a positive correlation between the depths associated with the strongest ipsilateral EP and the depths with highest coherence (r=0.77). Transferring the post-stimulation cortical activity into the frequency domain, a synchronization in the β (15-25Hz) band frequencies was observed for the ipsilateral SMC after thalamic stimulation.
Conclusion: There is a functional interaction between the VIM and the ipsilateral SMC in the β- and γ-frequencies. Thalamic regions interacting with the ipsilateral SMC are characterized by an increase of spectral β-power in subcortical LFP recordings. Evoked-potentials after subcortical electrical stimulation projecting to the ipsilateral SMC reveal thalamo-cortical connections. Synchronization in the β-band of the ipsilateral SMC after thalamic stimulation suggests a subcortical generator of these oscillations.
