My Editor’s Choice

Professor Ulf Ziemann,Editor-in-Chief, Clinical Neurophysiology

Professor Ulf Ziemann
Editor-in-Chief, Clinical Neurophysiology

The Editor’s Choice—

Latency of subthalamic nucleus deep brain stimulation-evoked cortical activity as a potential biomarker for postoperative motor side effects

Clinical Neurophysiology Volume 131, Issue 6

Irwin ZT, Awad MZ, Gonzalez CL, Nakhmani A, Bentley JN, Moore TA, Smithson KG, Guthrie BL, Walker HC (2020) Latency of subthalamic nucleus deep brain stimulation-evoked cortical activity as a potential biomarker for postoperative motor side effects. Clin Neurophysiol. 131:1221–1229.

Parkinson’s disease (PD) is frequent with a life-time prevalence of approximately 1%. Deep brain stimulation (DBS) is an effective treatment for the motor symptoms of PD, but adverse motor effects, such as worsening of speech, gait and bradykinesia may occur with inadvertent stimulation of the internal capsule. Predictive biomarkers of adverse motor effects are still not well explored, in particular not in patients operated under general anesthesia. Irwin and colleagues report, in this issue of Clinical Neurophysiology, on 11 PD patients with DBS electrode placement during general anesthesia, and 8 additional awake ambulatory PD patients who had experienced adverse motor effects. They recorded short- and long-latency responses from the scalp with EEG. In both groups, DBS with capsular side effects elicited short-latency responses at <1 ms. This short-latency response but not the long-latency response was preserved under general anesthesia in all patients. The latency of the early response predicted the occurrence of adverse motor effects in both groups. Short-latency evoked cortical activity may serve as a predictive biomarker, even if DBS electrode placement is performed under general anesthesia.

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