{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T07:52:39Z","timestamp":1788335559764,"version":"build-2803163510"},"reference-count":46,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2023,2,9]],"date-time":"2023-02-09T00:00:00Z","timestamp":1675900800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100013301","name":"Parkinson\u2019s Foundation","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100013301","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,3,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Globus pallidus internus deep brain stimulation is an established therapy for patients with medication-refractory Parkinson\u2019s disease. Clinical outcomes are highly dependent on applying stimulation to precise locations in the brain. However, robust neurophysiological markers are needed to determine the optimal electrode location and to guide postoperative stimulation parameter selection. In this study, we evaluated evoked resonant neural activity in the pallidum as a potential intraoperative marker to optimize targeting and stimulation parameter selection to improve outcomes of deep brain stimulation for Parkinson\u2019s disease. Intraoperative local field potential recordings were acquired in 22 patients with Parkinson\u2019s disease undergoing globus pallidus internus deep brain stimulation implantation (N = 27 hemispheres). A control group of patients undergoing implantation in the subthalamic nucleus (N = 4 hemispheres) for Parkinson\u2019s disease or the thalamus for essential tremor (N = 9 patients) were included for comparison. High-frequency (135\u2005Hz) stimulation was delivered from each electrode contact sequentially while recording the evoked response from the other contacts. Low-frequency stimulation (10\u2005Hz) was also applied as a comparison. Evoked resonant neural activity features, including amplitude, frequency and localization were measured and analysed for correlation with empirically derived postoperative therapeutic stimulation parameters. Pallidal evoked resonant neural activity elicited by stimulation in the globus pallidus internus or externus was detected in 26 of 27 hemispheres and varied across hemispheres and across stimulating contacts within individual hemispheres. Bursts of high-frequency stimulation elicited evoked resonant neural activity with similar amplitudes (P = 0.9) but a higher frequency (P = 0.009) and a higher number of peaks (P = 0.004) than low-frequency stimulation. We identified a \u2018hotspot\u2019 in the postero-dorsal pallidum where stimulation elicited higher evoked resonant neural activity amplitudes (P &amp;lt; 0.001). In 69.6% of hemispheres, the contact that elicited the maximum amplitude intraoperatively matched the contact empirically selected for chronic therapeutic stimulation by an expert clinician after 4 months of programming sessions. Pallidal and subthalamic nucleus evoked resonant neural activity were similar except for lower pallidal amplitudes. No evoked resonant neural activity was detected in the essential tremor control group. Given its spatial topography and correlation with postoperative stimulation parameters empirically selected by expert clinicians, pallidal evoked resonant neural activity shows promise as a potential marker to guide intraoperative targeting and to assist the clinician with postoperative stimulation programming. Importantly, evoked resonant neural activity may also have the potential to guide directional and closed-loop deep brain stimulation programming for Parkinson\u2019s disease.<\/jats:p>","DOI":"10.1093\/braincomms\/fcad025","type":"journal-article","created":{"date-parts":[[2023,2,6]],"date-time":"2023-02-06T22:01:34Z","timestamp":1675720894000},"source":"Crossref","is-referenced-by-count":44,"title":["Globus pallidus internus deep brain stimulation evokes resonant neural activity in Parkinson\u2019s disease"],"prefix":"10.1093","volume":"5","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6556-8957","authenticated-orcid":false,"given":"Kara A","family":"Johnson","sequence":"first","affiliation":[{"name":"Norman Fixel Institute for Neurological Diseases, University of Florida , Gainesville, FL , USA"},{"name":"Department of Neurology, University of Florida , Gainesville, FL , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jackson N","family":"Cagle","sequence":"additional","affiliation":[{"name":"Norman Fixel Institute for Neurological Diseases, University of Florida , Gainesville, FL , USA"},{"name":"Department of Neurology, University of Florida , Gainesville, FL , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Janine Lobo","family":"Lopes","sequence":"additional","affiliation":[{"name":"Norman Fixel Institute for Neurological Diseases, University of Florida , Gainesville, FL , USA"},{"name":"Department of Neurology, University of Florida , Gainesville, FL , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joshua K","family":"Wong","sequence":"additional","affiliation":[{"name":"Norman Fixel Institute for Neurological Diseases, University of Florida , Gainesville, FL , USA"},{"name":"Department of Neurology, University of Florida , Gainesville, FL , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael S","family":"Okun","sequence":"additional","affiliation":[{"name":"Norman Fixel Institute for Neurological Diseases, University of Florida , Gainesville, FL , USA"},{"name":"Department of Neurology, University of Florida , Gainesville, FL , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aysegul","family":"Gunduz","sequence":"additional","affiliation":[{"name":"Norman Fixel Institute for Neurological Diseases, University of Florida , Gainesville, FL , USA"},{"name":"J. Crayton Pruitt Family Department of Biomedical Engineering, University of Florida , Gainesville, FL , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aparna Wagle","family":"Shukla","sequence":"additional","affiliation":[{"name":"Norman Fixel Institute for Neurological Diseases, University of Florida , Gainesville, FL , USA"},{"name":"Department of Neurology, University of Florida , Gainesville, FL , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Justin D","family":"Hilliard","sequence":"additional","affiliation":[{"name":"Norman Fixel Institute for Neurological Diseases, University of Florida , Gainesville, FL , USA"},{"name":"Department of Neurosurgery, University of Florida , Gainesville, FL , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kelly D","family":"Foote","sequence":"additional","affiliation":[{"name":"Norman Fixel Institute for Neurological Diseases, University of Florida , Gainesville, FL , USA"},{"name":"Department of Neurosurgery, University of Florida , Gainesville, FL , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Coralie","family":"de Hemptinne","sequence":"additional","affiliation":[{"name":"Norman Fixel Institute for Neurological Diseases, University of Florida , Gainesville, FL , USA"},{"name":"Department of Neurology, University of Florida , Gainesville, FL , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2023,2,9]]},"reference":[{"issue":"13","key":"2023030704552191400_","doi-asserted-by":"crossref","first-page":"956","DOI":"10.1056\/NEJMoa000827","article-title":"Deep-brain stimulation of the subthalamic nucleus or the pars interna of the globus pallidus in Parkinson\u2019s disease","volume":"345","author":"Deep-Brain Stimulation for Parkinson\u2019s Disease Study Group","year":"2001","journal-title":"N Eng J 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