Local Fields Potentials of the Subthalamic Nucleus in Patients With Parkinson's Disease and Neuropsychiatric Fluctuations
Neuropsychiatric fluctuations are frequent and debilitating non-motor disorders in Parkinson's disease. Subthalamic stimulation is an effective treatment for motor and non-motor neuropsychiatric fluctuations in Parkinson's disease, which has also allowed to better characterize the electrophysiological activity of the subthalamic nucleus in patients with Parkinson's disease. Numerous studies have been carried out on electrophysiological activity correlated with motor disorders, showing that akinesia is correlated with an abnormal synchronization in the beta frequency band (13-30Hz) in the dorsal motor part of the subnucleus. thalamic. This abnormal synchronization is reduced when the akinesia improves with dopaminergic treatment. On the cognitive-behavioural non-motor side, electrophysiological studies are less numerous, but suggest an involvement of the subthalamic nucleus (with an abnormal synchronization in the lower frequency bands). Currently, the electrophysiological correlates of neuropsychiatric fluctuations are unknown. In addition, all studies on electrophysiological activity are carried out immediately after the intervention, and before the implantation of the pacemaker. It is unknown whether the electrophysiological correlates of motor and non-motor fluctuations change following their transient improvement observed in the setting of chronic stimulation of the subthalamic nucleus and chronic reduction of dopaminergic treatment. The new PERCEPT stimulators (Medtronic) available on the market make it possible to record long-term electrophysiological activity for the first time. With this study we want to define the electrophysiological markers of neuropsychiatric fluctuations and their change over time.
• Age between 30 and 75 years
• Diagnosis of Parkinson's disease with fluctuations and/or dyskinesias
• Ability to collaborate and fill a questionnaire in the OFF state condition (this criterion will be assessed based on the results of the preoperative screening to retain indication for STN stimulation, which takes place whenever a PD patient has to undergo DBS surgery)
• Surgery for bilateral STN stimulation with a Percept® (Medtronic) in the last 10 days
• Absence of dementia (defined as MoCA score \> 24)