Therapeutic deep brain stimulation reduces cortical phase-amplitude coupling in Parkinson's disease

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Abstract
By examining Parkinson's disease patients undergoing deep brain stimulation (DBS) implantation surgery, this study shows that therapeutic DBS acts on the primary motor cortex to reversibly reduce excessive coupling between the phase of the beta rhythm and the amplitude of broadband activity over a similar time course as the reduction in parkinsonian motor signs. Deep brain stimulation (DBS) is increasingly applied for the treatment of brain disorders, but its mechanism of action remains unknown. Here we evaluate the effect of basal ganglia DBS on cortical function using invasive cortical recordings in Parkinson's disease (PD) patients undergoing DBS implantation surgery. In the primary motor cortex of PD patients, neuronal population spiking is excessively synchronized to the phase of network oscillations. This manifests in brain surface recordings as exaggerated coupling between the phase of the beta rhythm and the amplitude of broadband activity. We show that acute therapeutic DBS reversibly reduces phase-amplitude interactions over a similar time course as that of the reduction in parkinsonian motor signs. We propose that DBS of the basal ganglia improves cortical function by alleviating excessive beta phase locking of motor cortex neurons.

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