AUTHOR=David Fabian J. , Munoz Miranda J. , Shils Jay L. , Pauciulo Michael W. , Hale Philip T. , Nichols William C. , Afshari Mitra , Sani Sepehr , Verhagen Metman Leo , Corcos Daniel M. , Pal Gian D. 

TITLE=Subthalamic Peak Beta Ratio Is Asymmetric in Glucocerebrosidase Mutation Carriers With Parkinson's Disease: A Pilot Study

JOURNAL=Frontiers in Neurology

VOLUME=12

YEAR=2021

URL=https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2021.723476

DOI=10.3389/fneur.2021.723476

ISSN=1664-2295

ABSTRACT=<p><bold>Introduction:</bold> Up to 27% of individuals undergoing subthalamic nucleus deep brain stimulation (STN-DBS) have a genetic form of Parkinson's disease (PD). G<italic>lucocerebrosidase</italic> (<italic>GBA</italic>) mutation carriers, compared to sporadic PD, present with a more aggressive disease, less asymmetry, and fare worse on cognitive outcomes with STN-DBS. Evaluating STN intra-operative local field potentials provide the opportunity to assess and compare symmetry between <italic>GBA</italic> and non-<italic>GBA</italic> mutation carriers with PD; thus, providing insight into genotype and STN physiology, and eligibility for and programming of STN-DBS. The purpose of this pilot study was to test differences in left and right STN resting state beta power in non-<italic>GBA</italic> and <italic>GBA</italic> mutation carriers with PD.</p><p><bold>Materials and Methods:</bold> STN (left and right) resting state local field potentials were recorded intraoperatively from 4 <italic>GBA</italic> and 5 non-<italic>GBA</italic> patients with PD while off medication. Peak beta power expressed as a ratio to total beta power (peak beta ratio) was compared between STN hemispheres and groups while co-varying for age, age of disease onset, and disease severity.</p><p><bold>Results:</bold> Peak beta ratio was significantly different between the left and the right STN for the <italic>GBA</italic> group (<italic>p</italic> &lt; 0.01) but not the non-<italic>GBA</italic> group (<italic>p</italic> = 0.56) after co-varying for age, age of disease onset, and disease severity.</p><p><bold>Discussion:</bold> Peak beta ratio in <italic>GBA</italic> mutation carriers was more asymmetric compared with non-mutation carriers and this corresponded with the degree of clinical asymmetry as measured by rating scales. This finding suggests that <italic>GBA</italic> mutation carriers have a physiologic signature that is distinct from that found in sporadic PD.</p>