Neurophysiological Correlates of Gait in the Human Basal Ganglia and the PPN Region in Parkinson’s Disease

• Published in: Frontiers in human neuroscience Vol. 14; p. 194
• Main Authors: Molina, Rene, Hass, Chris J., Sowalsky, Kristen, Schmitt, Abigail C., Opri, Enrico, Roper, Jaime A., Martinez-Ramirez, Daniel, Hess, Christopher W., Foote, Kelly D., Okun, Michael S., Gunduz, Aysegul
• Format: Journal Article
• Language: English
• Published: Switzerland Frontiers Research Foundation 04.06.2020; Frontiers Media S.A
• Subjects: Basal ganglia; brainstem; Data collection; DBS; Deep brain stimulation; deep brain stimulation (DBS); Dopamine; Dopamine receptors; Gait; Globus pallidus; Human Neuroscience; Movement disorders; Neurodegenerative diseases; Parkinson's disease; Parkinson’s disease (PD); Pedunculopontine tegmental nucleus; Physiology; Signal processing; Surgery; Synchronization; Transplants & implants; United States > US; Parkinson’s disease (PD); brainstem; deep brain stimulation (DBS); DBS; gait; deep brain stimulation
• ISSN: 1662-5161; 1662-5161
• DOI: 10.3389/fnhum.2020.00194

This study aimed to characterize the neurophysiological correlates of gait in the human pedunculopontine nucleus (PPN) region and the globus pallidus internus (GPi) in Parkinson's disease (PD) cohort. Though much is known about the PPN region through animal studies, there are limited physiological recordings from ambulatory humans. The PPN has recently garnered interest as a potential deep brain stimulation (DBS) target for improving gait and freezing of gait (FoG) in PD. We used bidirectional neurostimulators to record from the human PPN region and GPi in a small cohort of severely affected PD subjects with FoG despite optimized dopaminergic medications. Five subjects, with confirmed on-dopaminergic medication FoG, were implanted with bilateral GPi and bilateral PPN region DBS electrodes. Electrophysiological recordings were obtained during various gait tasks for 5 months postoperatively in both the off- and on-medication conditions (obtained during the no stimulation condition). The results revealed suppression of low beta power in the GPi and a 1-8 Hz modulation in the PPN region which correlated with human gait. The PPN feature correlated with walking speed. GPi beta desynchronization and PPN low-frequency synchronization were observed as subjects progressed from rest to ambulatory tasks. Our findings add to our understanding of the neurophysiology underpinning gait and will likely contribute to the development of novel therapies for abnormal gait in PD. Clinicaltrials.gov identifier; NCT02318927.