Abstract

OBJECTIVE: To investigate the progression of neural and motor features of Parkinson's disease in a longitudinal study, after washout of medication and bilateral subthalamic nucleus deep brain stimulation (STN DBS).METHODS: Participants with clinically established Parkinson's disease underwent bilateral implantation of DBS leads (18 participants, 13 male) within the STN using standard functional frameless stereotactic technique and multi-pass microelectrode recording. Both DBS leads were connected to an implanted investigative sensing neurostimulator (Activa PC+S, Medtronic, PLC). Resting state STN local field potentials (LFPs) were recorded and motor disability, (the Movement Disorder Society-Unified Parkinson's Disease Rating Scale - motor subscale, MDS-UPDRS III) was assessed off therapy at initial programming, and after 6months, 1year, and yearly out to 5years of treatment. The primary endpoint was measured at 3years. At each visit, medication had been held for over 12/24h and DBS was turned off for at least 60min, by which time LFP spectra reached a steady state.RESULTS: After 3years of chronic DBS, there were no increases in STN beta band dynamics (p=0.98) but there were increases in alpha band dynamics (p=0.0027, 25 STNs). Similar results were observed in a smaller cohort out to 5years. There was no increase in the MDS-UPDRS III score.INTERPRETATION: These findings provide evidence that the beta oscillopathy does not substantially progress following combined STN DBS plus medication in moderate to advanced Parkinson's disease.

View details for DOI 10.1002/acn3.51463

View details for PubMedID 34636182