Networks mediating the clinical effects of pallidal brain stimulation for Parkinson's disease
Identifieur interne : 003198 ( Main/Curation ); précédent : 003197; suivant : 003199Networks mediating the clinical effects of pallidal brain stimulation for Parkinson's disease
Auteurs : M. Fukuda ; M. J. Mentis ; Y. Ma ; V. Dhawan ; A. Antonini ; A. E. Lang [Canada] ; A. M. Lozano [Canada] ; J. Hammerstad ; K. Lyons [États-Unis] ; W. C. Koller [États-Unis] ; J. R. Moeller ; D. EidelbergSource :
- Brain [ 0006-8950 ] ; 2001-08.
Descripteurs français
- Pascal (Inist)
- Wicri :
English descriptors
- KwdEn :
- BA = Brodmann area, CSPTC = cortico-striato-pallido-thalamocortical, DBS = deep-brain stimulation, Emission tomography, Exploration, FDG = [18F]fluorodeoxyglucose, GPi = globus pallidus internus, Glucose, Human, Instrumental stimulation, Metabolism, PDRP = Parkinson's disease-related metabolic covariance pattern, PET, PMC = premotor cortex, PVP = posterior ventral pallidotomy, Pallidum, Parkinson disease, Parkinson's disease, Positron, SMA = supplementary motor area, SPM = Statistical Parametric Mapping, TPR = topographic profile rating, UPDRS = Unified Parkinson's Disease Rating Scale, [18F]fluorodeoxyglucose, brain networks, deep brain stimulation, rCBF = regional cerebral blood flow, rCMRGlc = regional cerebral metabolic rate for glucose.
Abstract
Employing [18F]fluorodeoxyglucose (FDG) and PET, we have found previously that stereotaxic ablation of the internal globus pallidus (GPi) for Parkinson's disease causes resting metabolic changes in brain regions remote from the lesion site. In this study we determined whether similar metabolic changes occur in Parkinson's disease patients treated with deep brain stimulation (DBS) of the GPi. We studied seven Parkinson's disease patients with FDG-PET to measure resting regional cerebral glucose utilization on and off GPi stimulation. We used statistical parametric mapping to identify significant changes in regional brain metabolism that occurred with this intervention. We also quantified stimulation-related changes in the expression of a specific abnormal Parkinson's disease-related pattern of metabolic covariation (PDRP) that had been identified in earlier FDG-PET studies. Metabolic changes with DBS were correlated with clinical improvement as measured by changes in Unified Parkinson's Disease Rating Scale (UPDRS) motor ratings off medication. GPi DBS improved UPDRS motor ratings (36%, P < 0.001) and significantly increased regional glucose metabolism in the premotor cortex ipsilateral to stimulation and in the cerebellum bilaterally. GPi DBS also resulted in a significant (P < 0.01) decline in PDRP activity ipsilateral to stimulation, which correlated significantly with clinical improvement in UPDRS motor ratings (P < 0.03). Clinical improvement with GPi DBS is associated with reduced expression of an abnormal Parkinson's disease-related metabolic network involving elements of the cortico-striato-pallido-thalamocortical and the cerebello-cortical motor loops.
Url:
DOI: 10.1093/brain/124.8.1601
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<term>Emission tomography</term>
<term>Exploration</term>
<term>FDG = [18F]fluorodeoxyglucose</term>
<term>GPi = globus pallidus internus</term>
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<term>PDRP = Parkinson's disease-related metabolic covariance pattern</term>
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<term>PMC = premotor cortex</term>
<term>PVP = posterior ventral pallidotomy</term>
<term>Pallidum</term>
<term>Parkinson disease</term>
<term>Parkinson's disease</term>
<term>Positron</term>
<term>SMA = supplementary motor area</term>
<term>SPM = Statistical Parametric Mapping</term>
<term>TPR = topographic profile rating</term>
<term>UPDRS = Unified Parkinson's Disease Rating Scale</term>
<term>[18F]fluorodeoxyglucose</term>
<term>brain networks</term>
<term>deep brain stimulation</term>
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<front><div type="abstract" xml:lang="en">Employing [18F]fluorodeoxyglucose (FDG) and PET, we have found previously that stereotaxic ablation of the internal globus pallidus (GPi) for Parkinson's disease causes resting metabolic changes in brain regions remote from the lesion site. In this study we determined whether similar metabolic changes occur in Parkinson's disease patients treated with deep brain stimulation (DBS) of the GPi. We studied seven Parkinson's disease patients with FDG-PET to measure resting regional cerebral glucose utilization on and off GPi stimulation. We used statistical parametric mapping to identify significant changes in regional brain metabolism that occurred with this intervention. We also quantified stimulation-related changes in the expression of a specific abnormal Parkinson's disease-related pattern of metabolic covariation (PDRP) that had been identified in earlier FDG-PET studies. Metabolic changes with DBS were correlated with clinical improvement as measured by changes in Unified Parkinson's Disease Rating Scale (UPDRS) motor ratings off medication. GPi DBS improved UPDRS motor ratings (36%, P < 0.001) and significantly increased regional glucose metabolism in the premotor cortex ipsilateral to stimulation and in the cerebellum bilaterally. GPi DBS also resulted in a significant (P < 0.01) decline in PDRP activity ipsilateral to stimulation, which correlated significantly with clinical improvement in UPDRS motor ratings (P < 0.03). Clinical improvement with GPi DBS is associated with reduced expression of an abnormal Parkinson's disease-related metabolic network involving elements of the cortico-striato-pallido-thalamocortical and the cerebello-cortical motor loops.</div>
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</placeName>
</affiliation>
</author>
<author><name sortKey="Ma, Y" sort="Ma, Y" uniqKey="Ma Y" first="Y." last="Ma">Y. Ma</name>
<affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Center for Neurosciences, North Shore-Long Island Jewish Research Institute</s1>
<s2>Manhasset</s2>
<s3>USA</s3>
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<s2>New York</s2>
<s3>USA</s3>
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</placeName>
</affiliation>
</author>
<author><name sortKey="Dhawan, V" sort="Dhawan, V" uniqKey="Dhawan V" first="V." last="Dhawan">V. Dhawan</name>
<affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Center for Neurosciences, North Shore-Long Island Jewish Research Institute</s1>
<s2>Manhasset</s2>
<s3>USA</s3>
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<s2>New York</s2>
<s3>USA</s3>
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</placeName>
</affiliation>
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<author><name sortKey="Antonini, A" sort="Antonini, A" uniqKey="Antonini A" first="A." last="Antonini">A. Antonini</name>
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<s2>Manhasset</s2>
<s3>USA</s3>
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<author><name sortKey="Lang, A E" sort="Lang, A E" uniqKey="Lang A" first="A. E." last="Lang">A. E. Lang</name>
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<s2>Toronto, Ontario</s2>
<s3>CAN</s3>
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</inist:fA14>
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<wicri:noRegion>Toronto Western Hospital</wicri:noRegion>
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<sZ>7 aut.</sZ>
</inist:fA14>
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<s2>Portland, Oregon</s2>
<s3>USA</s3>
<sZ>8 aut.</sZ>
</inist:fA14>
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<placeName><region type="state">Oregon</region>
</placeName>
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<affiliation wicri:level="2"><inist:fA14 i1="05"><s1>University of Miami Medical Center</s1>
<s2>Miami, Florida</s2>
<s3>USA</s3>
<sZ>9 aut.</sZ>
<sZ>10 aut.</sZ>
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<placeName><region type="state">Floride</region>
</placeName>
</affiliation>
</author>
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<affiliation wicri:level="2"><inist:fA14 i1="05"><s1>University of Miami Medical Center</s1>
<s2>Miami, Florida</s2>
<s3>USA</s3>
<sZ>9 aut.</sZ>
<sZ>10 aut.</sZ>
</inist:fA14>
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<placeName><region type="state">Floride</region>
</placeName>
</affiliation>
</author>
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<affiliation wicri:level="2"><inist:fA14 i1="06"><s1>Department of Psychiatry, Columbia College of Physicians and Surgeons</s1>
<s2>New York</s2>
<s3>USA</s3>
<sZ>11 aut.</sZ>
</inist:fA14>
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<placeName><region type="state">État de New York</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Eidelberg, D" sort="Eidelberg, D" uniqKey="Eidelberg D" first="D." last="Eidelberg">D. Eidelberg</name>
<affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Center for Neurosciences, North Shore-Long Island Jewish Research Institute</s1>
<s2>Manhasset</s2>
<s3>USA</s3>
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<affiliation wicri:level="2"><inist:fA14 i1="02"><s1>Department of Neurology, New York University School of Medicine</s1>
<s2>New York</s2>
<s3>USA</s3>
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</placeName>
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</analytic>
<series><title level="j" type="main">Brain</title>
<title level="j" type="abbreviated">Brain</title>
<idno type="ISSN">0006-8950</idno>
<imprint><date when="2001">2001</date>
</imprint>
</series>
</biblStruct>
</sourceDesc>
<seriesStmt><title level="j" type="main">Brain</title>
<title level="j" type="abbreviated">Brain</title>
<idno type="ISSN">0006-8950</idno>
</seriesStmt>
</fileDesc>
<profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Emission tomography</term>
<term>Exploration</term>
<term>Glucose</term>
<term>Human</term>
<term>Instrumental stimulation</term>
<term>Metabolism</term>
<term>Pallidum</term>
<term>Parkinson disease</term>
<term>Positron</term>
</keywords>
<keywords scheme="Pascal" xml:lang="fr"><term>Parkinson maladie</term>
<term>Tomoscintigraphie</term>
<term>Positon</term>
<term>Stimulation instrumentale</term>
<term>Pallidum</term>
<term>Métabolisme</term>
<term>Glucose</term>
<term>Exploration</term>
<term>Homme</term>
</keywords>
<keywords scheme="Wicri" type="topic" xml:lang="fr"><term>Glucose</term>
<term>Homme</term>
</keywords>
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<front><div type="abstract" xml:lang="en">Employing [<sup>18</sup>
F]fluorodeoxyglucose (FDG) and PET, we have found previously that stereotaxic ablation of the internal globus pallidus (GPi) for Parkinson's disease causes resting metabolic changes in brain regions remote from the lesion site. In this study we determined whether similar metabolic changes occur in Parkinson's disease patients treated with deep brain stimulation (DBS) of the GPi. We studied seven Parkinson's disease patients with FDG-PET to measure resting regional cerebral glucose utilization on and off GPi stimulation. We used statistical parametric mapping to identify significant changes in regional brain metabolism that occurred with this intervention. We also quantified stimulation-related changes in the expression of a specific abnormal Parkinson's disease-related pattern of metabolic covariation (PDRP) that had been identified in earlier FDG-PET studies. Metabolic changes with DBS were correlated with clinical improvement as measured by changes in Unified Parkinson's Disease Rating Scale (UPDRS) motor ratings off medication. GPi DBS improved UPDRS motor ratings (36%, P < 0.001) and significantly increased regional glucose metabolism in the premotor cortex ipsilateral to stimulation and in the cerebellum bilaterally. GPi DBS also resulted in a significant (P < 0.01) decline in PDRP activity ipsilateral to stimulation, which correlated significantly with clinical improvement in UPDRS motor ratings (P < 0.03). Clinical improvement with GPi DBS is associated with reduced expression of an abnormal Parkinson's disease-related metabolic network involving elements of the cortico-striato-pallido-thalamocortical and the cerebello-cortical motor loops.</div>
</front>
</TEI>
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<author><name sortKey="Mentis, M J" sort="Mentis, M J" uniqKey="Mentis M" first="M. J." last="Mentis">M. J. Mentis</name>
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<wicri:noRegion>Ontario</wicri:noRegion>
</affiliation>
</author>
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</placeName>
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<author><name sortKey="Koller, W C" sort="Koller, W C" uniqKey="Koller W" first="W. C." last="Koller">W. C. Koller</name>
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<placeName><region type="state">Floride</region>
</placeName>
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<author><name sortKey="Eidelberg, D" sort="Eidelberg, D" uniqKey="Eidelberg D" first="D." last="Eidelberg">D. Eidelberg</name>
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<series><title level="j">Brain</title>
<title level="j" type="abbrev">Brain</title>
<idno type="ISSN">0006-8950</idno>
<idno type="eISSN">1460-2156</idno>
<imprint><publisher>Oxford University Press</publisher>
<date type="published" when="2001-08">2001-08</date>
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<biblScope unit="page" from="1601">1601</biblScope>
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<profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>BA = Brodmann area</term>
<term>CSPTC = cortico-striato-pallido-thalamocortical</term>
<term>DBS = deep-brain stimulation</term>
<term>FDG = [18F]fluorodeoxyglucose</term>
<term>GPi = globus pallidus internus</term>
<term>PDRP = Parkinson's disease-related metabolic covariance pattern</term>
<term>PET</term>
<term>PMC = premotor cortex</term>
<term>PVP = posterior ventral pallidotomy</term>
<term>Parkinson's disease</term>
<term>SMA = supplementary motor area</term>
<term>SPM = Statistical Parametric Mapping</term>
<term>TPR = topographic profile rating</term>
<term>UPDRS = Unified Parkinson's Disease Rating Scale</term>
<term>[18F]fluorodeoxyglucose</term>
<term>brain networks</term>
<term>deep brain stimulation</term>
<term>rCBF = regional cerebral blood flow</term>
<term>rCMRGlc = regional cerebral metabolic rate for glucose</term>
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<front><div type="abstract" xml:lang="en">Employing [18F]fluorodeoxyglucose (FDG) and PET, we have found previously that stereotaxic ablation of the internal globus pallidus (GPi) for Parkinson's disease causes resting metabolic changes in brain regions remote from the lesion site. In this study we determined whether similar metabolic changes occur in Parkinson's disease patients treated with deep brain stimulation (DBS) of the GPi. We studied seven Parkinson's disease patients with FDG-PET to measure resting regional cerebral glucose utilization on and off GPi stimulation. We used statistical parametric mapping to identify significant changes in regional brain metabolism that occurred with this intervention. We also quantified stimulation-related changes in the expression of a specific abnormal Parkinson's disease-related pattern of metabolic covariation (PDRP) that had been identified in earlier FDG-PET studies. Metabolic changes with DBS were correlated with clinical improvement as measured by changes in Unified Parkinson's Disease Rating Scale (UPDRS) motor ratings off medication. GPi DBS improved UPDRS motor ratings (36%, P < 0.001) and significantly increased regional glucose metabolism in the premotor cortex ipsilateral to stimulation and in the cerebellum bilaterally. GPi DBS also resulted in a significant (P < 0.01) decline in PDRP activity ipsilateral to stimulation, which correlated significantly with clinical improvement in UPDRS motor ratings (P < 0.03). Clinical improvement with GPi DBS is associated with reduced expression of an abnormal Parkinson's disease-related metabolic network involving elements of the cortico-striato-pallido-thalamocortical and the cerebello-cortical motor loops.</div>
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