Neurophysiological gradient in the Parkinsonian subthalamic nucleus as a marker for motor symptoms and apathy

Elena Bernasconi; Deborah Amstutz; Alberto Averna; Petra Fischer; Mario Sousa; Ines Debove; Katrin Petermann; Laura Alva; Andreia D Magalhães; M Lenard Lachenmayer; Thuy-Anh K Nguyen; Michael Schuepbach; Andreas Nowacki; Claudio Pollo; Paul Krack; Gerd Tinkhauser

doi:10.1038/s41531-024-00848-2

Neurophysiological gradient in the Parkinsonian subthalamic nucleus as a marker for motor symptoms and apathy

NPJ Parkinsons Dis. 2025 Jan 3;11(1):4. doi: 10.1038/s41531-024-00848-2.

Authors

Elena Bernasconi^{1

2

3}, Deborah Amstutz^{1

4}, Alberto Averna^{1

3}, Petra Fischer⁵, Mario Sousa^{1

4}, Ines Debove¹, Katrin Petermann¹, Laura Alva¹, Andreia D Magalhães¹, M Lenard Lachenmayer¹, Thuy-Anh K Nguyen^{6

7}, Michael Schuepbach⁸, Andreas Nowacki⁶, Claudio Pollo⁶, Paul Krack¹, Gerd Tinkhauser^{9

10}

Affiliations

¹ Department of Neurology, Bern University Hospital and University of Bern, Bern, Switzerland.
² Graduate School of Cellular and Biomedical Sciences (GCB), University of Bern, Bern, Switzerland.
³ Department of Biomedical Research, University of Bern, Bern, Switzerland.
⁴ Graduate School for Health Sciences, University of Bern, Bern, Switzerland.
⁵ School of Physiology, Pharmacology & Neuroscience, University of Bristol, University Walk, BS8 1TD, Bristol, UK.
⁶ Department of Neurosurgery, Bern University Hospital and University of Bern, Bern, Switzerland.
⁷ ARTORG Center for Biomedical Engineering Research, University of Bern, Bern, Switzerland.
⁸ Institute of Neurology, Konolfingen, Switzerland.
⁹ Department of Neurology, Bern University Hospital and University of Bern, Bern, Switzerland. [email protected].
¹⁰ Department of Biomedical Research, University of Bern, Bern, Switzerland. [email protected].

Abstract

Sensing-based deep brain stimulation should optimally consider both the motor and neuropsychiatric domain to maximize quality of life of Parkinson's disease (PD) patients. Here we characterize the neurophysiological properties of the subthalamic nucleus (STN) in 69 PD patients using a newly established neurophysiological gradient metric and contextualize it with motor symptoms and apathy. We could evidence a STN power gradient that holds most of the spectral information between 5 and 30 Hz spanning along the dorsal-ventral axis. It shows elevated power in the sub-beta range (8-12 Hz) toward the ventral STN, and elevated dorsal beta power (16-24 Hz) indicative for the hemispheres contralateral to the more affected hemi-body side. The rigidity response to DBS was highest dorsally on the axis. Importantly, apathetic symptoms can be related to reduced ventral alpha power. In conclusion, the STN spectral gradient may inform about the motor and neuropsychiatric domain, supporting integrative closed-loop strategies.

Abstract

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