Subthalamic activity during diphasic dyskinesias in Parkinson's disease

Mov Disord. 2012 Aug;27(9):1178-81. doi: 10.1002/mds.25090. Epub 2012 Jun 28.

Abstract

Background: Diphasic dyskinesias are a subtype of levodopa-induced dyskinesias that appear typically at the onset and end of levodopa antiparkinsonian action. The pathophysiology of diphasic dyskinesias is not well understood.

Methods: We analyzed local field potentials recorded from the subthalamic nucleus in 7 Parkinson's disease (PD) patients who showed typical diphasic dyskinesias during postoperative recordings through a deep brain stimulation electrode. The evolution of the different oscillatory activities related to the onset and end of diphasic dyskinesias was studied by windowed fast Fourier transforms.

Results: Typical "off"-state beta activity disappeared with the onset of diphasic dyskinesias, whereas gamma activity was absent or minimal until their end. Theta activity during diphasic dyskinesias was similar to that observed during peak-dose dyskinesias.

Conclusions: From a neurophysiological viewpoint, patients exhibited oscillatory activity typical of the "on" medication state during diphasic dyskinesias. The minimal presence of gamma activity during diphasic dyskinesias, however, suggests that this "on" state might be incomplete or limited to dopaminergic mechanisms affecting the lower limbs.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Antiparkinson Agents / therapeutic use
  • Apomorphine / therapeutic use
  • Cohort Studies
  • Deep Brain Stimulation
  • Disease Progression
  • Dyskinesias / complications
  • Dyskinesias / physiopathology*
  • Electrodes, Implanted
  • Female
  • Humans
  • Levodopa / therapeutic use
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Neurosurgical Procedures
  • Parkinson Disease / complications
  • Parkinson Disease / physiopathology*
  • Subthalamic Nucleus / physiopathology*
  • Theta Rhythm

Substances

  • Antiparkinson Agents
  • Levodopa
  • Apomorphine