TY - JOUR
T1 - Frequency-correlated decreases of motor cortex activity associated with subthalamic nucleus stimulation in Parkinson's disease
AU - Haslinger, Bernhard
AU - Kalteis, Karin
AU - Boecker, Henning
AU - Alesch, Francois
AU - Ceballos-Baumann, Andrés O.
N1 - Funding Information:
This work was supported by the SFB 462 ‘Sensomotorik’, and grant Ce 41-1 Deutsche Forschungsgemeinschaft Bonn and the Deutsche Parkinson Vereinigung e.V., Neuss, Germany. The authors thank all patients for participating, our radiochemistry group and cyclotron staff for their reliable supply of H 2 15 O and B. Dzewas, C. Kruschke and J. Grahneis for technical assistance.
PY - 2005/11/15
Y1 - 2005/11/15
N2 - According to the classical model of basal ganglia organization, deep brain stimulation (DBS) in the subthalamic nucleus (STN) for the treatment of Parkinson's disease (PD) blocks overactive excitatory projections to inhibitory basal ganglia output structures. This would release the break on thalamofrontal neurons alleviating the poverty of movement, the hallmark of PD. Such parallels to a functional lesion certainly simplify the mechanism of STN DBS. Here, we applied parametric analyses of H215O positron emission tomography (PET) scans at rest while systematically varying stimulation frequency in 6 patients with STN DBS for akinetic PD. A strong positive correlation of rCBF to increasing stimulation frequency was detected around the STN bilaterally. More importantly, we show that gradual increases in STN stimulation frequency are tightly correlated with decreases in motor cortex activity. This demonstrates an active modulation of resting activity within the subcortical stimulation target and within motor cortex by STN DBS. Rather than a possible downstream effect, we propose to consider the tight correlations between DBS frequency and motor cortex activity in the context of an upstream modulation of direct efferents to the STN from primary motor and premotor cortices.
AB - According to the classical model of basal ganglia organization, deep brain stimulation (DBS) in the subthalamic nucleus (STN) for the treatment of Parkinson's disease (PD) blocks overactive excitatory projections to inhibitory basal ganglia output structures. This would release the break on thalamofrontal neurons alleviating the poverty of movement, the hallmark of PD. Such parallels to a functional lesion certainly simplify the mechanism of STN DBS. Here, we applied parametric analyses of H215O positron emission tomography (PET) scans at rest while systematically varying stimulation frequency in 6 patients with STN DBS for akinetic PD. A strong positive correlation of rCBF to increasing stimulation frequency was detected around the STN bilaterally. More importantly, we show that gradual increases in STN stimulation frequency are tightly correlated with decreases in motor cortex activity. This demonstrates an active modulation of resting activity within the subcortical stimulation target and within motor cortex by STN DBS. Rather than a possible downstream effect, we propose to consider the tight correlations between DBS frequency and motor cortex activity in the context of an upstream modulation of direct efferents to the STN from primary motor and premotor cortices.
UR - https://www.scopus.com/pages/publications/27544463191
U2 - 10.1016/j.neuroimage.2005.06.034
DO - 10.1016/j.neuroimage.2005.06.034
M3 - Article
C2 - 16081302
AN - SCOPUS:27544463191
SN - 1053-8119
VL - 28
SP - 598
EP - 606
JO - NeuroImage
JF - NeuroImage
IS - 3
ER -