Abstract
Research investigating the pathophysiology of Parkinson's disease (PD) mostly focuses on basal ganglia dysfunction. However, the main output from the basal ganglia is via the thalamus, and corticothalamic feedback constitutes the primary source of synapses in the thalamus. We therefore focus on the thalamocortical interplay. During the surgical intervention in six patients, local field potentials (LFPs) were recorded from pallidal-recipient thalamic nuclei VA and VLa. Simultaneously, EEG was recorded from several sites on the scalp. The highest thalamocortical coherence was found in the theta frequency band (4-9 Hz) with a mean peak frequency of 7.5 Hz. The magnitude of thalamocortical theta coherence was comparable to the magnitude of EEG coherence between scalp electrode pairs. Thalamocortical theta coherence reached 70% and was maximal with frontal scalp sites on both hemispheres. In the 13-20 Hz beta frequency band, maximal coherence was comparatively low but localized on the scalp ipsilateral to the site of thalamic LFP recording. The high thalamocortical coherence underlines the importance of thalamic function for the genesis of scalp EEG. We discuss the PD pathophysiology within the framework of dysrhythmic thalamocortical interplay, which has important consequences for the choice of therapeutic strategy in patients with severe forms of PD.