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medRxiv
By Nair, S., Joshi, P., Filyushkina, V. and 4 others.
Dopamine replacement reshapes subthalamic activity in Parkinson's disease, but whether this response reflects anatomically organized network reconfiguration remains unclear.
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To determine whether levodopa preferentially reorganizes dorsal subthalamic spectral activity and cortico-subthalamic directionality.
Twelve participants undergoing bilateral subthalamic deep brain stimulation contributed 30 contacts (14 dorsal, 16 ventral). Recordings obtained OFF and ON medication underwent spectral parameterization and multiband state-space analysis. Simultaneous electroencephalography in six participants enabled assessment of directional cortico-subthalamic coupling using the phase slope index.
Levodopa suppressed beta power more strongly dorsally than ventrally (-2.473 versus -0.120 dB; p=0.0438). Dorsal theta power increased, with a trend toward an increase after baseline normalization (p=0.07). Dorsal contacts exhibited greater theta-beta (+5.904 versus +1.610 dB; p=0.006) and gamma-beta (+2.516 versus +0.384 dB; p=0.0188) state-space shifts, principally driven by beta suppression. Gamma changes did not differ regionally. Concurrently, dorsal low-beta and beta interactions shifted toward cortical leading at selected electrodes, whereas ventral responses were less consistent.
Levodopa produces a topographically organized subthalamic response, combining preferential dorsal beta suppression with altered cortico-subthalamic directionality. These findings position contact anatomy as a key consideration in characterizing dopaminergic network responses and motivate clinical validation of spatially informed multiband biomarkers for adaptive stimulation.
This is a preprint: it has not been peer reviewed yet, and its findings may change.
Published in medRxiv (preprint). The abstract is shown as published and remains the work of its authors; read the full article at the source.
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