Category: Surgical Therapy: Parkinson's Disease
Objective: The objective of this study is to investigate the depositions of abnormal proteins, including phosphorylated tau (p-tau) and phosphorylated transactivation response DNA-binding protein of 43 kDa (p-TDP-43), around the tip of the deep brain stimulation (DBS) electrode.
Background: DBS is an established and effective surgical treatment for movement disorders including Parkinson’s disease (PD). Post-mortem studies of patients with PD have shown that gliosis and inflammatory responses were visible around the tracts of DBS electrodes.
Method: Neuropathological examination was performed in the two autopsy cases with PD with DBS lead placement. Case #1 underwent the DBS lead placement into the left ventralis intermediate (Vim) nucleus of the thalamus for treatment of refractory tremor in the right hand at the age of 79 years, and died of aspiration pneumonia at the age of 88 years. In Case #2, placement of the DBS lead to the bilateral subthalamic nucleus was performed at the age of 70 years, and died of septic shock at the age of 84 years. Thalamus and subthalamic nucleus were also examined in five PD cases without DBS. For immunohistochemistry, primary antibodies against p-TDP-43 and p-tau were used.
Results: The post-mortem neuropathological examination revealed fibrous gliosis, mild infiltration of lymphocytes, and hemosiderin depositions around the DBS lead tip-associated defects in both cases. Moreover, depositions of p-TDP-43 as well as p-tau were visible around the electrode termination site in Case #1. No p-TDP-43-positive structures were observed in any brain regions, except for the left Vim nucleus of the thalamus. In PD patients without DBS placement, no p-TDP-43-positive structures were observed in the thalamus and subthalamic nucleus.
Conclusion: p-TDP-43 could be accumulated around the DBS lead tip in response to chronic electrical stimulation of DBS. Further cases of DBS implantation should be examined to reveal the mechanisms involved.
To cite this abstract in AMA style:
G. Beck, R. Yamashita, Y. Yonenobu, K. Maeda, S. Murayama, H. Mochizuki. Deposition of phosphorylated TDP-43 around the tip of deep brain stimulation leads [abstract]. Mov Disord. 2024; 39 (suppl 1). https://www.mdsabstracts.org/abstract/deposition-of-phosphorylated-tdp-43-around-the-tip-of-deep-brain-stimulation-leads/. Accessed May 14, 2025.« Back to 2024 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/deposition-of-phosphorylated-tdp-43-around-the-tip-of-deep-brain-stimulation-leads/