Bicycling suppresses abnormal beta synchrony in the Parkinsonian basal ganglia

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2017
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Storzer, Lena
Butz, Markus
Hirschmann, Jan
Abbasi, Omid
Vesper, Jan
Schnitzler, Alfons
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Annals of neurology. 2017, 82(4), pp. 592-601. ISSN 0364-5134. eISSN 1531-8249. Available under: doi: 10.1002/ana.25047
Zusammenfassung

Objective
Freezing of gait is a poorly understood symptom of Parkinson disease, and can severely disrupt the locomotion of affected patients. However, bicycling ability remains surprisingly unaffected in most patients suffering from freezing, suggesting functional differences in the motor network. The purpose of this study was to characterize and contrast the oscillatory dynamics underlying bicycling and walking in the basal ganglia.

Methods
We present the first local field potential recordings directly comparing bicycling and walking in Parkinson disease patients with electrodes implanted in the subthalamic nuclei for deep brain stimulation. Low (13–22Hz) and high (23–35Hz) beta power changes were analyzed in 22 subthalamic nuclei from 13 Parkinson disease patients (57.5 ± 5.9 years old, 4 female). The study group consisted of 5 patients with and 8 patients without freezing of gait.

Results
In patients without freezing of gait, both bicycling and walking led to a suppression of subthalamic beta power (13–35Hz), and this suppression was stronger for bicycling. Freezers showed a similar pattern in general. Superimposed on this pattern, however, we observed a movement-induced, narrowband power increase around 18Hz, which was evident even in the absence of freezing.

Interpretation
These results indicate that bicycling facilitates overall suppression of beta power. Furthermore, movement leads to exaggerated synchronization in the low beta band specifically within the basal ganglia of patients susceptible to freezing. Abnormal ∼18Hz oscillations are implicated in the pathophysiology of freezing of gait, and suppressing them may form a key strategy in developing potential therapies.

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ISO 690STORZER, Lena, Markus BUTZ, Jan HIRSCHMANN, Omid ABBASI, Maciej GRATKOWSKI, Dietmar SAUPE, Jan VESPER, Sarang S. DALAL, Alfons SCHNITZLER, 2017. Bicycling suppresses abnormal beta synchrony in the Parkinsonian basal ganglia. In: Annals of neurology. 2017, 82(4), pp. 592-601. ISSN 0364-5134. eISSN 1531-8249. Available under: doi: 10.1002/ana.25047
BibTex
@article{Storzer2017-10Bicyc-40819,
  year={2017},
  doi={10.1002/ana.25047},
  title={Bicycling suppresses abnormal beta synchrony in the Parkinsonian basal ganglia},
  number={4},
  volume={82},
  issn={0364-5134},
  journal={Annals of neurology},
  pages={592--601},
  author={Storzer, Lena and Butz, Markus and Hirschmann, Jan and Abbasi, Omid and Gratkowski, Maciej and Saupe, Dietmar and Vesper, Jan and Dalal, Sarang S. and Schnitzler, Alfons}
}
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    <dcterms:abstract xml:lang="eng">Objective&lt;br /&gt;Freezing of gait is a poorly understood symptom of Parkinson disease, and can severely disrupt the locomotion of affected patients. However, bicycling ability remains surprisingly unaffected in most patients suffering from freezing, suggesting functional differences in the motor network. The purpose of this study was to characterize and contrast the oscillatory dynamics underlying bicycling and walking in the basal ganglia.&lt;br /&gt;&lt;br /&gt;Methods&lt;br /&gt;We present the first local field potential recordings directly comparing bicycling and walking in Parkinson disease patients with electrodes implanted in the subthalamic nuclei for deep brain stimulation. Low (13–22Hz) and high (23–35Hz) beta power changes were analyzed in 22 subthalamic nuclei from 13 Parkinson disease patients (57.5 ± 5.9 years old, 4 female). The study group consisted of 5 patients with and 8 patients without freezing of gait.&lt;br /&gt;&lt;br /&gt;Results&lt;br /&gt;In patients without freezing of gait, both bicycling and walking led to a suppression of subthalamic beta power (13–35Hz), and this suppression was stronger for bicycling. Freezers showed a similar pattern in general. Superimposed on this pattern, however, we observed a movement-induced, narrowband power increase around 18Hz, which was evident even in the absence of freezing.&lt;br /&gt;&lt;br /&gt;Interpretation&lt;br /&gt;These results indicate that bicycling facilitates overall suppression of beta power. Furthermore, movement leads to exaggerated synchronization in the low beta band specifically within the basal ganglia of patients susceptible to freezing. Abnormal ∼18Hz oscillations are implicated in the pathophysiology of freezing of gait, and suppressing them may form a key strategy in developing potential therapies.</dcterms:abstract>
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