Differential Regional Involvement of the Subthalamic Nucleus in Non-motor Symptoms of Parkinson's Disease: Analysis of Intraoperative Electrophysiological Signals During Deep Brain Stimulation Surgery
Yi-Jen Guo1, Szu-Yen Pan1, Ting-Chun Fang1
1Taichung Veterans General Hospital
Objective:
 To investigate the correlation between PD non-motor symptoms and STN signals during DBS surgery.
Background:

The impact of deep brain stimulation (DBS) of the subthalamic nucleus (STN) on non-motor symptoms remains inconclusive. This study aims to investigate the correlation between non-motor symptoms and local field potentials (LFPs) from different regions of the STN during DBS surgery in Parkinson's disease (PD) patients.

Design/Methods:

Pre-operative clinical assessment questionnaires and intra-operative microelectrode neurophysiological recordings were collected from patients with PD during STN-DBS at Taichung Veterans General Hospital between July 2020 and July 2023. The STN signals were categorized into dorsal and ventral regions based on the recorded length. Neuroexplorer 5 software was used to calculate the mean power percentages at each recorded point across different frequency bands. Correlations between clinical scores and LFP data were analyzed, controlling for age and the interval between clinical assessments and surgery.

Results:

Data from 49 sets of STN recordings were analyzed. Emotional scores showed a significant correlation (p<0.05) with the mean power percentage in the right ventral STN. This included BDI-II scores (delta: R=-0.534; theta: R=0.589; beta: R=0.461; gamma: R=0.466) and BAI scores (delta: R=-0.484; theta: R=0.464; beta: R=0.500; gamma: R=0.496). Impulsive-compulsive behaviors (QUIP-RS) correlated with the mean power percentage in the right STN (Ventral: delta: R=-0.671; alpha: R=0.746; beta: R=0.787; gamma: R=0.481; Dorsal: delta: R=-0.653; alpha: R=0.724; beta: R=0.832; gamma: R=0.622). Sleep quality (PDSS) was associated with the mean power percentage in the right dorsal STN (delta: R=0.485; alpha: R=-0.516; beta: R=-0.633; gamma: R=-0.540).

Conclusions:

The percentage of right-side STN LFP power frequency distribution correlated with non-motor symptoms in PD patients, with regional involvement varying across different non-motor domains. These differences may offer valuable insights for future monitoring and treatment of non-motor symptoms in PD.

10.1212/WNL.0000000000210900
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