Movement-related neurons of the subthalamic nucleus in patients with Parkinson disease

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Object. The subthalamic nucleus (STN) is a target in the surgical treatment of Parkinson disease (PD). Little is known about the neurons within the human STN that modulate movement. The authors' goal was to examine the distribution of movement-related neurons within the STN of humans by using microelectrode recording to identify neuronal receptive fields.

Methods. Data were retrospectively collected from microelectrode recordings that had been obtained in 38 patients with PD during surgery for placement of STN deep brain stimulation electrodes. The recordings had been obtained in awake, nonsedated patients. Antiparkinsonian medications were withheld the night before surgery. Neuronal discharges were amplified, filtered, and displayed on an oscilloscope and fed to an audio monitor. The receptive fields were identified by the presence of reproducible, audible changes in the firing rate that were time-locked to the movement of specific joint(s).

The median number of electrode tracks per patient was six (range two–nine). The receptive fields were identified in 278 (55%) of 510 STN neurons studied. One hundred one tracks yielded receptive field data. Fourteen percent of 64 cells tested positive for face receptive fields, 32% of 687 cells tested positive for upper-extremity receptive fields, and 21% of 242 cells tested positive for lower-extremity receptive fields. Sixty-eight cells (24%) demonstrated multiple-joint receptive fields. Ninety-three cells (65%) with movement-related receptive fields were located in the dorsal half of the STN, and 96.8% of these were located in the rostral two thirds of the STN. Analysis of receptive field locations from pooled data and along individual electrode tracks failed to reveal a consistent somatotopic organization.

Conclusions. Data from this study demonstrate a regional compartmentalization of neurons with movement-related receptive fields within the STN, supporting the existence of specific motor territories within the STN in patients suffering from PD.

Article Information

Address reprint requests to: Aviva Abosch, M.D., Ph.D., Department of Neurosurgery, Emory University, 1365-B Clifton Road, NE, Suite B6400, Atlanta, Georgia 30322. email: aabosch@emory.edu.

© AANS, except where prohibited by US copyright law.

Headings

Figures

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    Sagittal diagram of three electrode tracks showing the location of an STN neuron (gray circle at tip of arrow) from which movement-related receptive field information was obtained. The neuron responded to opening and closing of the contralateral hand. Uppermost traces represent accelerometer data (Accl), middle traces show electromyography (EMG) recording, and bottom bar graphs shows neuronal firing, over time. AC = anterior commissure; Hpth = hypothalamus; H2 = H2 fields of Forel; IC = internal capsule; mcp = midcommissural point; PC = posterior commissure; Vim = nucleus ventralis intermedius.

  • View in gallery

    Graph showing the distribution of pooled receptive field data (144 cells) within a sagittal representation of the STN, 12 mm lateral to the midline. Asterisk indicates location of the midcommissural point (MCP).

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