Toward asleep DBS: Cortico basal-ganglia neural activity during interleaved propofol/ketamine sedation mimics NREM/REM sleep activity

Abstract

Deep brain stimulation (DBS) is currently a standard long-term treatment for advanced motor symptoms in Parkinsons disease (PD). In an effort to enable DBS under sedation, asleep DBS, we characterized the cortico-basal ganglia neuronal network of two non-human 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 basal ganglia DBS targets. The brain state under ketamine and propofol mimicked rapid eye movement (REM) and Non-REM (NREM) sleep activity, respectively, and the IPK protocol imitates the NREM-REM sleep cycle. These promising results are the first step towards asleep DBS with non-distorted physiological navigation.