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Controlling Parkinson's Disease With Adaptive Deep Brain Stimulation
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Subthalamic deep brain stimulation affects heading perception in Parkinson's disease.

Sinem Balta Beylergil1,2, Angela M Noecker1, Mikkel Petersen3

  • 1Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH, USA.

Journal of Neurology
|May 18, 2021
PubMed
Summary

Subthalamic deep brain stimulation (STN DBS) improved vestibular perception in Parkinson's disease (PD) patients, particularly in the rightward direction. Visual perception remained unaffected, suggesting DBS has distinct effects on sensory processing in PD.

Keywords:
Basal gangliaCerebellumMotion perceptionOptic flowVestibularVisual

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Area of Science:

  • Neuroscience
  • Neurology
  • Human Perception

Background:

  • Parkinson's disease (PD) is characterized by visuospatial impairments and falls.
  • Understanding how subthalamic deep brain stimulation (STN DBS) affects visuospatial perception is crucial for PD management.
  • The specific impact of STN DBS on visual versus vestibular perception of motion requires further investigation.

Purpose of the Study:

  • To investigate the differential effects of STN DBS on visual and vestibular perception of linear motion (heading) in Parkinson's disease patients.
  • To determine if these effects are specific to the modulated subthalamic nucleus (STN) location.
  • To compare visuospatial perception in PD patients with STN DBS to healthy controls.

Main Methods:

  • Employed a two-alternative forced-choice paradigm in 14 PD patients with bilateral STN DBS and 19 healthy controls (HC).
  • Utilized immersive virtual reality to present passive en bloc linear motion and 3D optic-flow stimuli.
  • Measured vestibular and visual heading perception using psychometric functions (Weibull) to assess accuracy and discrimination thresholds.

Main Results:

  • PD patients exhibited significantly lower accuracy and higher thresholds in vestibular heading perception compared to HC.
  • STN DBS significantly improved vestibular discrimination accuracy and reduced thresholds in the rightward direction.
  • No significant effects of STN DBS were observed on visual heading perception accuracy or discrimination thresholds.
  • Patient-specific models linked improvements in vestibular perception to modulation of the dorsal STN.

Conclusions:

  • STN DBS demonstrates differential effects on vestibular and visual heading perception in Parkinson's disease.
  • The dorsal STN appears to be a key area through which STN DBS influences vestibular heading perception, potentially via cerebellar pathways.
  • These findings highlight the complex modulation of visuospatial processing by STN DBS in PD.