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This study addresses the molecular mechanisms underlying the action of subthalamic nucleus high frequency stimulation (STN-HFS) in the treatment of Parkinson's disease and its interaction with levodopa (L-DOPA), focusing on the striatum. Striatal gene expression profile was assessed in rats with nigral dopamine neuron lesion, either treated or not, using agilent microarrays and qPCR verification. The treatments consisted in anti-akinetic STN-HFS (5 days), chronic L-DOPA treatment inducing dyskinesia (LIDs) or the combination of the two treatments that exacerbated LIDs. STN-HFS modulated 71 striatal genes. The main biological processes associated with the differentially expressed gene products include regulation of growth, of apoptosis and of synaptic transmission, and extracellular region is a major cellular component implicated. In particular, several of these genes have been shown to support survival or differentiation of striatal or of dopaminergic neurons. These results indicate that STN HFS may induce widespread anatomo-functional rearrangements in the striatum and create a molecular environment favorable for neuroprotection and neuroplasticity. STN-HFS and L-DOPA treatment share very few common gene regulation features indicating that the molecular substrates underlying their striatal action are mostly different; among the common effects is the down-regulation of Adrb1, which encodes the adrenergic beta-1-receptor, supporting a major role of this receptor in Parkinson's disease. In addition to genes already reported to be associated with LIDs (preprodynorphin, thyrotropin-releasing hormone, metabotropic glutamate receptor 4, cannabinoid receptor 1), the comparison between DOPA and DOPA/HFS identifies immunity-related genes as potential players in L-DOPA side effects.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3617149 | PMC |
http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0060447 | PLOS |
Sci Adv
September 2025
Movement Disorder and Neuromodulation Unit, Department of Neurology, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.
Subthalamic deep brain stimulation (STN-DBS) provides unprecedented spatiotemporal precision for the treatment of Parkinson's disease (PD), allowing for direct real-time state-specific adjustments. Inspired by findings from optogenetic stimulation in mice, we hypothesized that STN-DBS can mimic dopaminergic reinforcement of ongoing movement kinematics during stimulation. To investigate this hypothesis, we delivered DBS bursts during particularly fast and slow movements in 24 patients with PD.
View Article and Find Full Text PDFJ Neuroeng Rehabil
September 2025
Institute for Neuromodulation and Neurotechnology, University Hospital and University of Tübingen, 72076, Tübingen, Germany.
Innovative technology allows for personalization of stimulation frequency in dual-site deep brain stimulation (DBS), offering promise for challenging symptoms in advanced Parkinson's disease (PD), particularly freezing of gait (FoG). Early results suggest that combining standard subthalamic nucleus (STN) stimulation with substantia nigra pars reticulata (SNr) stimulation may improve FoG outcomes. However, patient response and the optimal SNr stimulation frequency vary.
View Article and Find Full Text PDFBrain Stimul
September 2025
Medical Research Council Brain Network Dynamics Unit, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom. Electronic address:
Background: Precisely timed brain stimulation, such as phase-locked deep brain stimulation (PLDBS), offers a promising approach to modulating dysfunctional neural networks by enhancing or suppressing specific oscillations. However, its clinical application has been hindered by the lack of user-friendly systems and the challenge of real-time phase estimation amid stimulation artifacts.
Material And Method: In this work, we developed a clinically translatable PLDBS framework that enables real-time, cycle-by-cycle stimulation using standard amplifiers and a computer-in-the-loop system.
Eur J Neurol
September 2025
Department of Neuroscience 'Rita Levi Montalcini', University of Torino, Torino, Italy.
Background: The factors contributing to a poor response to subthalamic nucleus deep brain stimulation (STN-DBS) in Parkinson's disease (PD) are not yet fully understood. Accordingly, predicting the outcome might be challenging particularly in those who display an optimal response to the Levodopa challenge test.
Objective: To determine which factors may contribute to poor outcome of STN-DBS in PD.
Cureus
August 2025
Neurology, Emory University, Atlanta, USA.
Deep brain stimulation (DBS) and the use of directional subsegmental stimulation have significantly advanced symptom management in patients with Parkinson's disease (PD) and essential tremor (ET). This study examines the use of directional programming in a tertiary care center. We retrospectively reviewed medical records of 12 PD patients (all with bilateral subthalamic nucleus (STN) implants) and 13 ET patients (12 with bilateral and 1 with unilateral ventral intermediate nucleus (VIM) implants) who received directional leads.
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