• Pnina Rappel, Shai Grosberg, David Arkadir, Eduard Linetsky, Muneer Abu Snineh, Atira S Bick, Idit Tamir, Dan Valsky, Odeya Marmor, Yasmin Abo Foul, Or Peled, Moran Gilad, Chen Daudi, Shiri Ben-Naim, Hagai Bergman, Zvi Israel, and Renana Eitan.
• Department of Medical Neurobiology (Physiology), Institute of Medical Research-Israel-Canada, the Hebrew University-Hadassah Medical School, Jerusalem, Israel.
• Mov. Disord. 2020 Feb 1; 35 (2): 337-343.

BackgroundTherapeutic outcomes of STN-DBS for movement and psychiatric disorders depend on electrode location within the STN. Electrophysiological and functional mapping of the STN has progressed considerably in the past years, identifying beta-band oscillatory activity in the dorsal STN as a motor biomarker. It also has been suggested that STN theta-alpha oscillations, involved in impulse control and action inhibition, have a ventral source. However, STN local field potential mapping of motor, associative, and limbic areas is often limited by poor spatial resolution.ObjectivesProviding a high-resolution electrophysiological map of the motor, associative and limbic anatomical sub-areas of the subthalamic nucleus.MethodsWe have analyzed high-spatial-resolution STN microelectrode electrophysiology recordings of PD patients (n = 303) that underwent DBS surgery. The patients' STN intraoperative recordings of spiking activity (933 electrode trajectories) were combined with their imaging data (n = 83 patients, 151 trajectories).ResultsWe found a high theta-alpha (7-10 Hz) oscillatory area, located near the STN ventromedial border in 29% of the PD patients. Theta-alpha activity in this area has higher power and lower central frequency in comparison to theta-alpha activity in more dorsal subthalamic areas. When projected on the DISTAL functional atlas, the theta-alpha oscillatory area overlaps with the STN limbic subarea.ConclusionsWe suggest that theta-alpha oscillations can serve as an electrophysiological marker for the ventral subthalamic nucleus limbic subarea. Therefore, theta-alpha oscillations can guide optimal electrode placement in neuropsychiatric STN-DBS procedures and provide a reliable biomarker input for future closed-loop DBS device. © 2019 International Parkinson and Movement Disorder Society.© 2019 International Parkinson and Movement Disorder Society.

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