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Marie-Laure Welter, MD; Jean-Luc Houeto, MD; Anne-Marie Bonnet, MD; Paul-Boulos Bejjani, MD; Valérie Mesnage, MD; Didier Dormont, MD; Soledad Navarro, MD; Philippe Cornu, MD, PhD; Yves Agid, MD, PhD; Bernard Pidoux, MD, PhD

Arch Neurol. 2004;61:89-96.

Background  High-frequency stimulation of the subthalamic nucleus (STN) is a neurosurgical alternative to medical treatment in levodopa-responsive forms of Parkinson disease. The mechanism of action of STN stimulation remains controversial, although an inhibition of overactive STN neurons has been postulated.

Objective  To determine the effects of high-frequency STN stimulation on the neuronal activity of STN neurons in Parkinson disease patients.

Patients  Single-unit recordings of the neuronal activity of the STN were obtained before, during, and after the application of intra-STN electrical stimulation in 15 Parkinson disease patients. Changes in firing frequency and pattern were analyzed using various combinations of stimulus frequency (range, 14-140 Hz).

Results  Stimulation at a frequency greater than 40 Hz applied within the STN significantly decreased the firing frequency and increased the burst-like activity in the firing pattern of STN neurons. An aftereffect was observed in cells that had been totally inhibited during high-frequency stimulation.

Conclusion  The beneficial effects of high-frequency stimulation result from a change in the firing pattern of cellular discharge and a blockade of the spontaneous overactivity of STN neurons.

From the Centre d'Investigation Clinique, Fédération de Neurologie, Institut National de la Santé et de la Recherche Médicale Unit 289 (Drs Welter, Houeto, Bonnet, Bejjani, Mesnage, and Agid), and the Services de Neuroradiologie (Dr Dormont) et de Neurochirurgie (Drs Navarro and Cornu), and Fédération de Neurophysiologie Clinique (Dr Pidoux), Hôpital de la Salpêtrière, Paris, France.

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