Electrophysiological characterization of the hyperdirect pathway and its functional relevance for subthalamic deep brain stimulation

Bahne Hendrik Bahners; Gunnar Waterstraat; Silja Kannenberg; Gabriel Curio; Alfons Schnitzler; Vadim Nikulin; Esther Florin

doi:10.1016/j.expneurol.2022.114031

Electrophysiological characterization of the hyperdirect pathway and its functional relevance for subthalamic deep brain stimulation

Exp Neurol. 2022 Jun:352:114031. doi: 10.1016/j.expneurol.2022.114031. Epub 2022 Mar 2.

Authors

Bahne Hendrik Bahners¹, Gunnar Waterstraat², Silja Kannenberg¹, Gabriel Curio³, Alfons Schnitzler⁴, Vadim Nikulin⁵, Esther Florin⁶

Affiliations

¹ Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty, Heinrich-Heine-University, Düsseldorf, Germany.
² Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Neurophysics Group, Department of Neurology, Berlin, Germany.
³ Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Neurophysics Group, Department of Neurology, Berlin, Germany; Bernstein Center for Computational Neuroscience, Berlin, Germany.
⁴ Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty, Heinrich-Heine-University, Düsseldorf, Germany; Department of Neurology, Center for Movement Disorders and Neuromodulation, Medical Faculty, Heinrich-Heine-University, Düsseldorf, Germany.
⁵ Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany.
⁶ Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty, Heinrich-Heine-University, Düsseldorf, Germany. Electronic address: Esther.Florin@hhu.de.

PMID: 35247373
DOI: 10.1016/j.expneurol.2022.114031

Abstract

The subthalamic nucleus (STN) receives input from various cortical areas via hyperdirect pathway (HDP) which bypasses the basal-ganglia loop. Recently, the HDP has gained increasing interest, because of its relevance for STN deep brain stimulation (DBS). To understand the HDP's role cortical responses evoked by STN-DBS have been investigated. These responses have short (<2 ms), medium (2-15 ms), and long (20-70 ms) latencies. Medium-latency responses are supposed to represent antidromic cortical activations via HDP. Together with long-latency responses the medium responses can potentially be used as biomarker of DBS efficacy as well as side effects. We here propose that the activation sequence of the cortical evoked responses can be conceptualized as high frequency oscillations (HFO) for signal analysis. HFO might therefore serve as marker for antidromic activation. Using existing knowledge on HFO recordings, this approach allows data analyses and physiological modeling to advance the pathophysiological understanding of cortical DBS-evoked high-frequency activity.

Keywords: Antidromic activation; High frequency oscillations; Signal-to-noise ratio; Stimulation evoked responses.

Publication types

Review
Research Support, Non-U.S. Gov't

MeSH terms

Basal Ganglia
Deep Brain Stimulation*
Reaction Time
Subthalamic Nucleus* / physiology