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Research Articles, Neurobiology of Disease
Petra Fischer , Chiung Chu Chen , Ya Ju Chang , Chien-Hung Yeh , Alek Pogosyan , Damian M. Herz , Binith Cheeran , Alexander L. Green , Tipu Z. Aziz , Jonathan Hyam , Simon Little , Thomas Foltynie , Patricia Limousin , Ludvic Zrinzo , Harutomo Hasegawa , Michael Samuel , Keyoumars Ashkan , Peter Brown and Huiling Tan
Journal of Neuroscience 14 May 2018, 3596-17; DOI: https://doi.org/10.1523/JNEUROSCI.3596-17.2018
Petra Fischer
Medical Research Council Brain Network Dynamics Unit at the sUniversity of Oxford, OX1 3TH, Oxford, United Kingdom. Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, University of Oxford, OX3 9DU, Oxford, United Kingdom.
Chiung Chu Chen
Division of Movement Disorders, Department of Neurology, Chang Gung Memorial Hospital, 333, Linkou, Taipei, Taiwan
Ya Ju Chang
Department of Physical Therapy, Graduate Institute of Rehabilitation Science, Chang Gung University, 333, Taipei, Taiwan
Chien-Hung Yeh
Medical Research Council Brain Network Dynamics Unit at the sUniversity of Oxford, OX1 3TH, Oxford, United Kingdom. Division of Movement Disorders, Department of Neurology, Chang Gung Memorial Hospital, 333, Linkou, Taipei, Taiwan
Alek Pogosyan
Medical Research Council Brain Network Dynamics Unit at the sUniversity of Oxford, OX1 3TH, Oxford, United Kingdom. Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, University of Oxford, OX3 9DU, Oxford, United Kingdom.
Damian M. Herz
Medical Research Council Brain Network Dynamics Unit at the sUniversity of Oxford, OX1 3TH, Oxford, United Kingdom. Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, University of Oxford, OX3 9DU, Oxford, United Kingdom.
Binith Cheeran
Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, University of Oxford, OX3 9DU, Oxford, United Kingdom.
Alexander L. Green
Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, University of Oxford, OX3 9DU, Oxford, United Kingdom.
Tipu Z. Aziz
Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, University of Oxford, OX3 9DU, Oxford, United Kingdom.
Jonathan Hyam
Unit of Functional Neurosurgery, Sobell Department of Motor Neuroscience and Movement Disorders, University College London Institute of Neurology, WC1N 3BG, London, United Kingdom.
Simon Little
Unit of Functional Neurosurgery, Sobell Department of Motor Neuroscience and Movement Disorders, University College London Institute of Neurology, WC1N 3BG, London, United Kingdom.
Thomas Foltynie
Unit of Functional Neurosurgery, Sobell Department of Motor Neuroscience and Movement Disorders, University College London Institute of Neurology, WC1N 3BG, London, United Kingdom.
Patricia Limousin
Unit of Functional Neurosurgery, Sobell Department of Motor Neuroscience and Movement Disorders, University College London Institute of Neurology, WC1N 3BG, London, United Kingdom.
Ludvic Zrinzo
Unit of Functional Neurosurgery, Sobell Department of Motor Neuroscience and Movement Disorders, University College London Institute of Neurology, WC1N 3BG, London, United Kingdom.
Harutomo Hasegawa
Departments of Neurology and Neurosurgery, King's College Hospital, King's College London, SE5 9RS, London, United Kingdom.
Michael Samuel
Departments of Neurology and Neurosurgery, King's College Hospital, King's College London, SE5 9RS, London, United Kingdom.
Keyoumars Ashkan
Departments of Neurology and Neurosurgery, King's College Hospital, King's College London, SE5 9RS, London, United Kingdom.
Peter Brown
Medical Research Council Brain Network Dynamics Unit at the sUniversity of Oxford, OX1 3TH, Oxford, United Kingdom. Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, University of Oxford, OX3 9DU, Oxford, United Kingdom.
Huiling Tan
Medical Research Council Brain Network Dynamics Unit at the sUniversity of Oxford, OX1 3TH, Oxford, United Kingdom. Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, University of Oxford, OX3 9DU, Oxford, United Kingdom.

Abstract

Gait disturbances in Parkinson's disease are commonly refractory to current treatment options and majorly impair patient's quality of life. Auditory cues facilitate gait and prevent motor blocks. We investigated how neural dynamics in the human subthalamic nucleus of Parkinsons's disease patients (14 male, 2 female) vary during stepping and whether rhythmic auditory cues enhance the observed modulation. Oscillations in the beta band were suppressed after ipsilateral heel strikes, when the contralateral foot had to be raised, and re-appeared after contralateral heel strikes, when the contralateral foot rested on the floor. The timing of this 20-30 Hz beta modulation was clearly distinct between the left and right subthalamic nucleus, and was alternating within each stepping cycle. This modulation was similar, whether stepping movements were made while sitting, standing, or during gait, confirming the utility of the stepping in place paradigm. During stepping in place beta modulation increased with auditory cues that assisted patients in timing their steps more regularly. Our results suggest a link between the degree of power modulation within high beta frequency bands and stepping performance. These findings raise the possibility that alternating deep brain stimulation patterns may be superior to constant stimulation for improving Parkinsonian gait.

SIGNIFICANCE STATEMENT

Gait disturbances in Parkinson's disease majorly reduce patients' quality of life and are often refractory to current treatment options. We investigated how neural activity in the subthalamic nucleus of patients who received deep brain stimulation surgery covaries with the stepping cycle. 20-30Hz beta activity was modulated relative to each step, alternating between the left and right STN. The stepping performance of patients improved when auditory cues were provided, which went along with enhanced beta modulation. This raises the possibility that alternating stimulation patterns may also enhance beta modulation and may be more beneficial for gait control than continuous stimulation, which needs to be tested in future studies.

Footnotes

BC has received travel support and unrestricted educational grants for organising CPD events from Medtronic, St. Jude Medical and Boston Scientific (manufacturers of DBS electrodes). TA has performed consultancy for and received speaking fees from Medtronic. SL has been a participant in a DBS teaching course funded by Medtronic. TF, PL and LZ have received speaking fees and travel support from Medtronic and St. Jude Medical. MS has received travel support from Medtronic and St. Jude Medical, received speaker fees from St Jude Medical and performed consultancy for St Jude Medical. PB has received fees and non-financial support from Medtronic and personal fees from Boston Scientific.

The Yanks could use deGrom, Noah Syndergaard , and maybe Zack Wheeler or Steven Matz . The Mets are open to anything, but reluctant to move deGrom. They would deal any of the other three pitchers, though Syndergaard will likely have more value this winter.

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Bird's slump continues 00:03:25
The BNNY panel discusses Greg Bird's struggles at the plate, and how long the Yankees can wait for an improvement in a tight division race.

Chris Carelli, SNY.TV Facebook | Twitter | JW Anderson Black APR002 Sneakers LzxM2Z1l
| Thom Browne Classic Longwing Crepe Sole Brogues HvX83
: Not all the prospects make it, no matter how much we like them and regardless of the evident talent.

There was a point that Yankees first baseman Greg Bird , then 22 years old, filled fans' visions of a new beginning at the position. Bird's sweet swing, seemingly built for Yankee Stadium as well as patience at the plate made it easy to envision him in pinstripes for years to come.

Bird was spectacular over a two-month stretch as Mark Teixeira's replacement when the veteran went down with an injury in 2015. Bird was so good in fact that it seemed as if it would be rather simple for the Yankees to transition from Teixeira when the veteran's contract would come to an end the following season...

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After Ronald Acuna Jr. connected on a 1-2 slider, Yankees RHP David Robertson thought he had an out. Instead, he gave the lead back to the Braves in the top of the 11th inning.

Yankees C Austin Romine signaled for the slider to be down to get the 20-year-old Acuna chasing. However, he lifted it out to right field, an area no pitcher wants to see a high fly ball go at Yankee Stadium.

The infamous short porch did the trick.

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The Yankees optioned RHP Jonathan Loaisiga to the minors following Monday's 5-3 loss to the Atlanta Braves and will reinstate RHP A.J. Cole off the 10-day disabled list.

Loaisiga, whom the Yankees promoted from Double-A Trenton last month to replace the injured Masahiro Tanaka , will likely be recalled for next Monday's doubleheader against the Baltimore Orioles.

He allowed three runs and five hits in four innings on Monday, throwing a season-high 92 pitches, while the bullpen was forced to throw seven innings.

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Martino on Bird's struggles 00:00:53
Andy Martino questions how long the Yankees can stay patient with Greg Bird as he continues to slump during a tight divisional race.

David Robertson allowed a tiebreaking two-run home run to Ronald Acuña Jr. in the top of the 11th inning and the Yankees struggled with runners in scoring position as they lost to the Atlanta Braves 5-3 on Monday at Yankee Stadium. >> Box score

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"Pocos nervios" y "más confianza" en la última oportunidad para aprobar la EBAU PEDRO FERNÁNDEZ

Mucha menos intranquilidad que en la convocatoria anterior, pero la misma confianza en obtener resultados positivos. Ese sentir reinaba entre los 1.010 estudiantes que en el mediodía de ayer dieron comienzo a la segunda fase de exámenes de la EBAU en Asturias.

"En junio sí que tenía nervios, pero ahora no, me ha parecido más fácil incluso y espero sacar buena nota", aseguraba Guillermo García, procedente del colegio Santa Teresa de Jesús de Oviedo.

García, que pugna por un aprobado con el que acceder al grado de Liderazgo, Emprendimiento e Innovación en un centro privado de Madrid, ha sido uno de los casi 500 jóvenes que se enfrentaron a la prueba inicial en las facultades de Economía y de Química en la capital del Principado (hubo otras cinco sedes en la región, en Gijón, Avilés, Ribadesella, Cangas del Narcea y Tapia de Casariego). De ellos, unos doscientos repetían cita con el fin de mejorar calificaciones y acceder a titulaciones universitarias que exigen nota media más allá del aprobado.

"No lo había preparado mucho, pero me salió bastante bien, es lo mismo todos los años", contaba al salir del examen Jiarun Ma, alumna del colegio Auseva de Oviedo. La estudiante, quien aún no ha decidido hacia dónde orientará su futuro académico, se alegraba de no haberse encontrado en la misma situación que en la convocatoria de junio, cuando "cayeron cosas que no se esperaba la gente".

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