02036nas a2200193 4500008004100000245011900041210006900160260001200229520131200241100002101553700001601574700001601590700002501606700002101631700002301652700001901675700002501694856012301719 2023 eng d00aMultisensory Flicker Modulates Widespread Brain Networks and Reduces Interictal Epileptiform Discharges in Humans.0 aMultisensory Flicker Modulates Widespread Brain Networks and Red c03/20233 a

Modulating brain oscillations has strong therapeutic potential. However, commonly used non-invasive interventions such as transcranial magnetic or direct current stimulation have limited effects on deeper cortical structures like the medial temporal lobe. Repetitive audio- visual stimulation, or sensory flicker, modulates such structures in mice but little is known about its effects in humans. Using high spatiotemporal resolution, we mapped and quantified the neurophysiological effects of sensory flicker in human subjects undergoing presurgical intracranial seizure monitoring. We found that flicker modulates both local field potential and single neurons in higher cognitive regions, including the medial temporal lobe and prefrontal cortex, and that local field potential modulation is likely mediated via resonance of involved circuits. We then assessed how flicker affects pathological neural activity, specifically interictal epileptiform discharges, a biomarker of epilepsy also implicated in Alzheimer’s and other diseases. In our patient population with focal seizure onsets, sensory flicker decreased the rate interictal epileptiform discharges. Our findings support the use of sensory flicker to modulate deeper cortical structures and mitigate pathological activity in humans.

1 aBlanpain, Lou, T1 aChen, Emily1 aPark, James1 aWalelign, Michael, Y1 aGross, Robert, E1 aCabaniss, Brian, T1 aWillie, Jon, T1 aSinger, Annabelle, C uhttps://www.neurotechcenter.org/publications/2023/multisensory-flicker-modulates-widespread-brain-networks-and-reduces02781nas a2200349 4500008004100000022001400041245012100055210006900176260001200245300001200257490000700269520164600276100001901922700001701941700002201958700002401980700001802004700002402022700001702046700002502063700001802088700002202106700002102128700002302149700002302172700001902195700002402214700002102238700002402259700002602283856012202309 2023 eng d a2330-161900aPatients with Cognitive Impairment in Parkinson's Disease Benefit from Deep Brain Stimulation: A Case-Control Study.0 aPatients with Cognitive Impairment in Parkinsons Disease Benefit c03/2023 a382-3910 v103 a

BACKGROUND: Deep brain stimulation (DBS) for Parkinson's disease (PD) is generally contraindicated in persons with dementia but it is frequently performed in people with mild cognitive impairment or normal cognition, and current clinical guidelines are primarily based on these cohorts.

OBJECTIVES: To determine if moderately cognitive impaired individuals including those with mild dementia could meaningfully benefit from DBS in terms of motor and non-motor outcomes.

METHODS: In this retrospective case-control study, we identified a cohort of 40 patients with PD who exhibited moderate (two or more standard deviations below normative scores) cognitive impairment (CI) during presurgical workup and compared their 1-year clinical outcomes to a cohort of 40 matched patients with normal cognition (NC). The surgery targeted subthalamus, pallidus or motor thalamus, in a unilateral, bilateral or staged approach.

RESULTS: At preoperative baseline, the CI cohort had higher Unified Parkinson's Disease Rating Scale (UPDRS) subscores, but similar levodopa responsiveness compared to the NC cohort. The NC and CI cohorts demonstrated comparable degrees of postoperative improvement in the OFF-medication motor scores, motor fluctuations, and medication reduction. There was no difference in adverse event rates between the two cohorts. Outcomes in the CI cohort did not depend on the target, surgical staging, or impaired cognitive domain.

CONCLUSIONS: Moderately cognitively impaired patients with PD can experience meaningful motor benefit and medication reduction with DBS.

1 aBlock, Cady, K1 aPatel, Margi1 aRisk, Benjamin, B1 aStaikova, Ekaterina1 aLoring, David1 aEsper, Christine, D1 aScorr, Laura1 aHigginbotham, Lenora1 aAia, Pratibha1 aDeLong, Mahlon, R1 aWichmann, Thomas1 aFactor, Stewart, A1 aYong, Nicholas, Au1 aWillie, Jon, T1 aBoulis, Nicholas, M1 aGross, Robert, E1 aBuetefisch, Cathrin1 aMiocinovic, Svjetlana uhttps://www.neurotechcenter.org/publications/2023/patients-cognitive-impairment-parkinsons-disease-benefit-deep-brain