Principles of gait encoding in the subthalamic nucleus of people with Parkinson’s disease

Abstract

ABSTRACTDisruption of subthalamic nucleus dynamics in Parkinson’s disease leads to impairments during walking. Here, we aimed to uncover the principles through which the subthalamic nucleus encodes functional and dysfunctional walking in people with Parkinson’s disease. We conceived a neurorobotic platform that allowed us to deconstruct the key components of walking under well-controlled conditions. We exploited this platform in 18 patients with Parkinson’s disease, which allowed us to demonstrate that the subthalamic nucleus encodes the initiation, termination, and vigor of leg muscle activation. We found that the same fundamental principles determine the encoding of walking. We translated this understanding into a machine-learning framework that decoded muscle activation, walking states, locomotor vigor, and freezing of gait. These results expose key principles through which subthalamic nucleus dynamics encode walking, opening the possibility to operate neuroprosthetic systems with these signals to improve walking in people with Parkinson’s disease.One Sentence SummaryThe subthalamic nucleus encodes the initiation, termination, and vigor of muscle activity, which supports real-time decoding of gait in people with Parkinson’s disease.