Deep brain stimulation (DBS) is currently a standard procedure for advanced Parkinson’s disease. Many centers employ awake physiological navigation and stimulation assessment to optimize DBS localization and outcome. To enable DBS under sedation, asleep DBS, we characterized the cortico-basal ganglia neuronal network of two nonhuman primates under propofol, ketamine, and interleaved propofol-ketamine (IPK) sedation. Further, we compared these sedation states in the healthy and Parkinsonian condition to those of healthy sleep. Ketamine increases high-frequency power and synchronization while propofol increases low-frequency power and synchronization in polysomnography and neuronal activity recordings. Thus, ketamine does not mask the low-frequency oscillations used for physiological navigation toward the basal ganglia DBS targets. The brain spectral state under ketamine and propofol mimicked rapid eye movement (REM) and Non-REM (NREM) sleep activity, respectively, and the IPK protocol resembles the NREM-REM sleep cycle. These promising results are a meaningful step toward asleep DBS with nondistorted physiological navigation.
Bibliographical noteFunding Information:
We thank Tamar Ravins-Yaish for assistance with animal care; Atira Bick and ELSC neuroimaging unit (ENU) for assistance with the MRI scan; and Sharon Freeman for general assistance. We thank Anatoly Shapochnikov for help in preparing the experimental setup. This work was supported by grants from the Israel Science Foundation, German Collaborative Research Center TRR295 (Returning dynamic motor network disorders using neuromodulation) Adelis and the Rosetrees Trust (to HBe) and research grant of the department of anesthesiology, Hadassah Medical Center (to SF).
© 2021, The Author(s).