Intraoperative localisation of the subthalamic nucleus using movement related local field potentials in Parkinson´s disease

Objectives: The inaccurate implantation of deep brain stimulation electrode could cause in-effective therapy and varied side-effects. This study aims to intra-operatively localise the subthalamic nucleus (STN) using voluntary movement related local field potentials (LFPs) to improve the electrode implantation accuracy. Methods: STN LFPs were recorded during auditory cued clicking motor task in twelve patients with Parkinson´s disease. The neural oscillations were analysed using time-frequency analysis. The location of electrode contacts were verified with 3-D visualised MRI. Result: The beta oscillations (10-30Hz) attenuated during the movement and rebounded after the movement with excessive increase. The beta oscillations modulated over time period about 1 seconds. Beta oscillations including Parkinsonian excessive synchronisation and movement related responses were lacked outside the STN and were able to localise STN by recording LFPs around the nucleus. Conclusion: STN oscillations are alterable by the task of auditory cued movement. The movement varied beta oscillations are more robust for STN intraoperative localisation while low beta oscillation were attenuated by medication or high beta oscillation were not obviously synchronised in some patients.