Outline - Lorentz Center · - Basal ganglia oscillations in OCD ... Outline - Short description stereotactic procedure for DBS - Targets for DBS in the basal ganglia - Model(s) of

‘Brainwaves’ in the human basal ganglia

L.J. Bour Department of Neurology/Clinical Neurophysiology, Academic

Medical Center, University of Amsterdam,Amsterdam

Brainwaves meeting Leiden, 25 june 2009

Outline

- Short description stereotactic

procedure for DBS

- Targets for DBS in the basal ganglia

- Model(s) of the network of cortex, basal ganglia and thalamus

- Micro electrode recording (MER) and local field potentials (LFP)

- Basal ganglia oscillations in Parkinson’s Disease and Essential Tremor

- Basal ganglia oscillations in Dystonia

- Basal ganglia oscillations in OCD

- What does oscillatory activity in the brain mean?

Outline


procedure for DBS




- Basal ganglia oscillations in Parkinson’s Disease and Essential Tremor




DBS-neurosurgery

DBS-neurosurgery

• Movement Disorders– Parkinson’s Disease (STN,GPi)– Dystonia (GPi)– Essential Tremor (VIM)– Gilles de la Tourette (GPi, Thal)

• Psychiatric Disorders – OCD (Nucleus Accumbens..)– Depression

• Alzheimer (?)• Epilepsy

– Hippocampus (?)

3D Imaging and planning

Surgical Procedure

Effect of Unilateral DBS turned off and on in PD patient

Outline


procedure for DBS




- Basal ganglia oscillations in Parkinson’s disease




Sagital View Basal Ganglia

Globus

Pallidus


Globus

Pallidus

Subthalamic

Nucleus


Globus

Pallidus

Subthalamic

Nucleus

Substantia

Nigra


Globus

Pallidus

Subthalamic

Nucleus

Substantia

Nigra

Thalamus


Globus

Pallidus

Subthalamic

Nucleus

Substantia

Nigra

Thalamus

VIM


Sagital View Basal GangliaDopamine Pathways

Sagital View Basal GangliaDopamine Pathways Serotonin Pathways

Outline


procedure for DBS

- Indicate targets for DBS in the basal ganglia

- Models of the network of cortex, basal ganglia and thalamus






Model

Model

Outline


procedure for DBS








Needle for MER/test stimulation/LFP

Electrode Array

CentralLateral Medial

Anterior

Posterior

4 mm

Implanted electode in STNSagital view: 13.0 mm lateral

Anterior

Implanted electode in GPSagital view: 20.0 mm lateral

Anterior

Outline


procedure for DBS




- Basal ganglia oscillations in Essential Tremor and Parkinson’s Disease




Parkinson Patient spike trains and power spectra of rectified MER activity in the STN

Parkinson Patient Oscillatory Beta Activity (12-22 Hz) in the dorsal part of the STN

Power spectrum MER activity Power spectrum LFP activity

Parkinson Patient Spike detection and spike clustering in STN

0 1000 2000 3000 4000 5000 6000 7000 8000 9000 10000-0.1

-0.05

0

0.05

0.1

time (ms)

Volta

ge

00.05

0.10.15 0 0.01

0.020.03

0

0.02

0.04

0.060.08

coeff 24

Best projection of the wavelet coefficients

coeff 2

coef

f 12

-0.2 -0.1 0 0.1

-0.10

0.10.2

-0.04

-0.02

0

0.02

pc1

Scores pc1 vs. pc2 vs. pc3

pc2

pc3

Parkinson Patient Synchronous Beta Activity (17-20 Hz) in the dorsal part of the STN

Coherence spectrum of spike activity of two single units measured at the same microneedle

Parkinson Patient Disappearance of Beta Activity (15-30 Hz) in the STN with DBS

From Hammond, Bergman and Brown, Brain 2008

Effect of pallidotomy on STN Beta activity

Effect of pallidotomy on STN Beta activity

pallidotomy patients n=7; no pallidotomy n=35

100

150

200

250

300

3-8Hz 8-12Hz 12-20Hz 20-30Hz 30-60Hz 60-100Hz

Pallidotomy Contralateral Control

Absolute spectral power* * * *

Essential Tremor Patient MER activity in Thalamus (VIM) and EMG FEDC muscle

Essential Tremor Patient MER ~ 6 Hz activity in Thalamus (VIM) ; bistability

5 sec ->

Outline


procedure for DBS








Dystonia Patient Myoclonus and Dystonia

Dystonia Patient MER activity in the GP

Coherence Analysis between LFP of the GPi

and EMG Activity of Two Skeletal Muscles

Coherence Analysis between LFP of the GPi

and EMG Activity of Two Skeletal Muscles

5 sec

Warning cue Imperative Cue

GO

NOGO

Warning cue Imperative Cue

Flash

LED

LED

Event Related Spectral Pertubation of LFP (De)synchronization in GPi with Go/Nogo Paradigm

Event Related Spectral Pertubation of LFP (De)synchronization in GPi with Go/Nogo Paradigm

Go NoGo

Outline


procedure for DBS








OCD Patient

Delta power increase with exposure (increase of anxiety)‏

Event Related Spectral Pertubation of LFP (De)synchronization in Accumbens with Go Nogo

Event Related Spectral Pertubation of LFP (De)synchronization in Accumbens with Go Nogo

Event Related Spectral Pertubation of LFP (De)synchronization in Nucleus Accumbens with Reward Paradigm

3/4/5 sec

Warning Cue

Money

No Money

Push

Symbol O

1 sec

Reward

Symbol 5

Symbol 5

Total Amount

Total Amount



Outline


procedure for DBS








Brainwaves in the Basal Ganglia1) Pathological ongoing synchronous firing of neuronal populations

PD/Essential Tremor: 3-7 Hz

Beta activity in PD:

15-30 Hz

Abnormal cortical drive in Dystonia: 3-10 Hz

Increase in sub-delta power in OCD: < 2 Hz

2) (De)Synchronizations

of different frequencies in relation to:

Events:

2-20 Hz

Movement:

30 and 60 Hz

Emotion (?):

20-30 Hz

Thank you for your attention

With many thanks to: M.F. Contarino, R.A.M. De Bie, M.A.J. De Koning Tijssen, D. Denys, E.M. Foncke, P. van den Munckhof, P.R. Schuurman, J.D. Speelman, A.F. Van Rootselaar.

Documents

Outline - Lorentz Center · - Basal ganglia oscillations in OCD ... Outline - Short description stereotactic procedure for DBS - Targets for DBS in the basal ganglia - Model(s) of