MEDIAL FOREBRAIN BUNDLE STIMULATION AS A PATHOPHYSIOLOGICAL MECHANISM FOR HYPOMANIA IN SUBTHALAMIC NUCLEUS DEEP BRAIN STIMULATION FOR PARKINSON'S DISEASE
Identifieur interne : 002085 ( Main/Exploration ); précédent : 002084; suivant : 002086MEDIAL FOREBRAIN BUNDLE STIMULATION AS A PATHOPHYSIOLOGICAL MECHANISM FOR HYPOMANIA IN SUBTHALAMIC NUCLEUS DEEP BRAIN STIMULATION FOR PARKINSON'S DISEASE
Auteurs : Volker A. Coenen [Canada, Allemagne] ; Christopher R. Honey [Canada] ; Trevor Hurwitz [Allemagne] ; Ahmed A. Rahman [Canada] ; Jacqueline Mcmaster [Canada] ; Uli Bürgel [Allemagne] ; Burkhard M Dler [Pays-Bas] ; Robert E. Gross ; Philip A. Starr ; Clement Hamani ; Andres M. Lozano ; Robert R. GoodmanSource :
- Neurosurgery [ 0148-396X ] ; 2009.
Descripteurs français
- Pascal (Inist)
- Wicri :
- topic : Chirurgie.
English descriptors
- KwdEn :
Abstract
OBJECTIVE: Hypomania accounts for approximately 4% to 13% of psychotropic adverse events during subthalamic nucleus (STN) deep brain stimulation (DBS) for Parkinson's disease. Diffusion of current into the inferior and medial "limbic" STN is often reported to be the cause. We suggest a different explanation, in which the coactivation of the medial forebrain bundle (MFB), outside the STN, leads to hypomania during STN DBS. METHODS: Six patients with advanced Parkinson's disease (age, 54 ± 11 years) underwent bilateral STN DBS surgery. Preoperative diffusion tensor imaging scans for fiber tracking of the MFB were conducted on a 3T magnetic resonance imaging scanner. After implantation, the electrode positions were determined with computed tomography and integrated in a diffusion tensor imaging software environment. RESULTS: The medial STN was shown to send tributaries to the MFB using it as a pathway to connect to the reward circuitry. One patient, who had a transient, stimulation-induced acute hypomanic episode, showed a direct contact between 1 active electrode contact and these putative limbic STN tributaries to the MFB unilaterally on the left. In 5 asymptomatic patients, the active contacts were between 2.9 and 7.5 mm distant from the MFB or its limbic STN tributaries. CONCLUSION: We hypothesize that STN DBS-induced reversible acute hypomania might be elicited by inadvertent and unilateral coactivation of putative limbic STN tributaries to the MFB. These findings may provide insight into the neural pathways of hypomania and may facilitate future investigations of the pathophysiology of mood disorders.
Affiliations:
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Gross</name></author><author><name sortKey="Starr, Philip A" sort="Starr, Philip A" uniqKey="Starr P" first="Philip A." last="Starr">Philip A. Starr</name></author><author><name sortKey="Hamani, Clement" sort="Hamani, Clement" uniqKey="Hamani C" first="Clement" last="Hamani">Clement Hamani</name></author><author><name sortKey="Lozano, Andres M" sort="Lozano, Andres M" uniqKey="Lozano A" first="Andres M." last="Lozano">Andres M. Lozano</name></author><author><name sortKey="Goodman, Robert R" sort="Goodman, Robert R" uniqKey="Goodman R" first="Robert R." last="Goodman">Robert R. Goodman</name></author></titleStmt><publicationStmt><idno type="wicri:source">INIST</idno><idno type="inist">09-0260426</idno><date when="2009">2009</date><idno type="stanalyst">PASCAL 09-0260426 INIST</idno><idno type="RBID">Pascal:09-0260426</idno><idno type="wicri:Area/PascalFrancis/Corpus">000543</idno><idno type="wicri:Area/PascalFrancis/Curation">000749</idno><idno type="wicri:Area/PascalFrancis/Checkpoint">000442</idno><idno type="wicri:explorRef" wicri:stream="PascalFrancis" wicri:step="Checkpoint">000442</idno><idno type="wicri:doubleKey">0148-396X:2009:Coenen V:medial:forebrain:bundle</idno><idno type="wicri:Area/Main/Merge">002246</idno><idno type="wicri:Area/Main/Curation">002085</idno><idno type="wicri:Area/Main/Exploration">002085</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a">MEDIAL FOREBRAIN BUNDLE STIMULATION AS A PATHOPHYSIOLOGICAL MECHANISM FOR HYPOMANIA IN SUBTHALAMIC NUCLEUS DEEP BRAIN STIMULATION FOR PARKINSON'S DISEASE</title><author><name sortKey="Coenen, Volker A" sort="Coenen, Volker A" uniqKey="Coenen V" first="Volker A." last="Coenen">Volker A. Coenen</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Surgical Center for Movement Disorders, University of British Columbia</s1><s2>Vancouver</s2><s3>CAN</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ></inist:fA14><country>Canada</country><wicri:noRegion>Vancouver</wicri:noRegion></affiliation><affiliation wicri:level="3"><inist:fA14 i1="02"><s1>Department of Neurosurgery, University of Bonn</s1><s2>Bonn</s2><s3>DEU</s3><sZ>1 aut.</sZ><sZ>3 aut.</sZ><sZ>6 aut.</sZ></inist:fA14><country>Allemagne</country><placeName><region type="land" nuts="1">Rhénanie-du-Nord-Westphalie</region><region type="district" nuts="2">District de Cologne</region><settlement type="city">Bonn</settlement></placeName></affiliation></author><author><name sortKey="Honey, Christopher R" sort="Honey, Christopher R" uniqKey="Honey C" first="Christopher R." last="Honey">Christopher R. Honey</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Surgical Center for Movement Disorders, University of British Columbia</s1><s2>Vancouver</s2><s3>CAN</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ></inist:fA14><country>Canada</country><wicri:noRegion>Vancouver</wicri:noRegion></affiliation></author><author><name sortKey="Hurwitz, Trevor" sort="Hurwitz, Trevor" uniqKey="Hurwitz T" first="Trevor" last="Hurwitz">Trevor Hurwitz</name><affiliation wicri:level="3"><inist:fA14 i1="02"><s1>Department of Neurosurgery, University of Bonn</s1><s2>Bonn</s2><s3>DEU</s3><sZ>1 aut.</sZ><sZ>3 aut.</sZ><sZ>6 aut.</sZ></inist:fA14><country>Allemagne</country><placeName><region type="land" nuts="1">Rhénanie-du-Nord-Westphalie</region><region type="district" nuts="2">District de Cologne</region><settlement type="city">Bonn</settlement></placeName></affiliation></author><author><name sortKey="Rahman, Ahmed A" sort="Rahman, Ahmed A" uniqKey="Rahman A" first="Ahmed A." last="Rahman">Ahmed A. Rahman</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Surgical Center for Movement Disorders, University of British Columbia</s1><s2>Vancouver</s2><s3>CAN</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ></inist:fA14><country>Canada</country><wicri:noRegion>Vancouver</wicri:noRegion></affiliation></author><author><name sortKey="Mcmaster, Jacqueline" sort="Mcmaster, Jacqueline" uniqKey="Mcmaster J" first="Jacqueline" last="Mcmaster">Jacqueline Mcmaster</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Surgical Center for Movement Disorders, University of British Columbia</s1><s2>Vancouver</s2><s3>CAN</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ></inist:fA14><country>Canada</country><wicri:noRegion>Vancouver</wicri:noRegion></affiliation></author><author><name sortKey="Burgel, Uli" sort="Burgel, Uli" uniqKey="Burgel U" first="Uli" last="Bürgel">Uli Bürgel</name><affiliation wicri:level="3"><inist:fA14 i1="02"><s1>Department of Neurosurgery, University of Bonn</s1><s2>Bonn</s2><s3>DEU</s3><sZ>1 aut.</sZ><sZ>3 aut.</sZ><sZ>6 aut.</sZ></inist:fA14><country>Allemagne</country><placeName><region type="land" nuts="1">Rhénanie-du-Nord-Westphalie</region><region type="district" nuts="2">District de Cologne</region><settlement type="city">Bonn</settlement></placeName></affiliation></author><author><name sortKey="M Dler, Burkhard" sort="M Dler, Burkhard" uniqKey="M Dler B" first="Burkhard" last="M Dler">Burkhard M Dler</name><affiliation wicri:level="1"><inist:fA14 i1="03"><s1>Department of Physics and Astronomy, University of British Columbia, Vancouver, Canada, and Philips Health Care</s1><s2>Best</s2><s3>NLD</s3><sZ>7 aut.</sZ></inist:fA14><country>Pays-Bas</country><wicri:noRegion>Best</wicri:noRegion></affiliation></author><author><name sortKey="Gross, Robert E" sort="Gross, Robert E" uniqKey="Gross R" first="Robert E." last="Gross">Robert E. Gross</name></author><author><name sortKey="Starr, Philip A" sort="Starr, Philip A" uniqKey="Starr P" first="Philip A." last="Starr">Philip A. Starr</name></author><author><name sortKey="Hamani, Clement" sort="Hamani, Clement" uniqKey="Hamani C" first="Clement" last="Hamani">Clement Hamani</name></author><author><name sortKey="Lozano, Andres M" sort="Lozano, Andres M" uniqKey="Lozano A" first="Andres M." last="Lozano">Andres M. Lozano</name></author><author><name sortKey="Goodman, Robert R" sort="Goodman, Robert R" uniqKey="Goodman R" first="Robert R." last="Goodman">Robert R. Goodman</name></author></analytic><series><title level="j" type="main">Neurosurgery</title><title level="j" type="abbreviated">Neurosurgery</title><idno type="ISSN">0148-396X</idno><imprint><date when="2009">2009</date></imprint></series></biblStruct></sourceDesc><seriesStmt><title level="j" type="main">Neurosurgery</title><title level="j" type="abbreviated">Neurosurgery</title><idno type="ISSN">0148-396X</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Cerebral disorder</term><term>Diffusion imaging</term><term>Diffusion tensor</term><term>Hypomania</term><term>Nervous system diseases</term><term>Parkinson disease</term><term>Subthalamic nucleus</term><term>Surgery</term></keywords><keywords scheme="Pascal" xml:lang="fr"><term>Pathologie de l'encéphale</term><term>Maladie de Parkinson</term><term>Pathologie du système nerveux</term><term>Hypomanie</term><term>Noyau sousthalamique</term><term>Tenseur de diffusion</term><term>Chirurgie</term><term>Imagerie de diffusion</term></keywords><keywords scheme="Wicri" type="topic" xml:lang="fr"><term>Chirurgie</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">OBJECTIVE: Hypomania accounts for approximately 4% to 13% of psychotropic adverse events during subthalamic nucleus (STN) deep brain stimulation (DBS) for Parkinson's disease. Diffusion of current into the inferior and medial "limbic" STN is often reported to be the cause. We suggest a different explanation, in which the coactivation of the medial forebrain bundle (MFB), outside the STN, leads to hypomania during STN DBS. METHODS: Six patients with advanced Parkinson's disease (age, 54 ± 11 years) underwent bilateral STN DBS surgery. Preoperative diffusion tensor imaging scans for fiber tracking of the MFB were conducted on a 3T magnetic resonance imaging scanner. After implantation, the electrode positions were determined with computed tomography and integrated in a diffusion tensor imaging software environment. RESULTS: The medial STN was shown to send tributaries to the MFB using it as a pathway to connect to the reward circuitry. One patient, who had a transient, stimulation-induced acute hypomanic episode, showed a direct contact between 1 active electrode contact and these putative limbic STN tributaries to the MFB unilaterally on the left. In 5 asymptomatic patients, the active contacts were between 2.9 and 7.5 mm distant from the MFB or its limbic STN tributaries. CONCLUSION: We hypothesize that STN DBS-induced reversible acute hypomania might be elicited by inadvertent and unilateral coactivation of putative limbic STN tributaries to the MFB. These findings may provide insight into the neural pathways of hypomania and may facilitate future investigations of the pathophysiology of mood disorders.</div></front></TEI><affiliations><list><country><li>Allemagne</li><li>Canada</li><li>Pays-Bas</li></country><region><li>District de Cologne</li><li>Rhénanie-du-Nord-Westphalie</li></region><settlement><li>Bonn</li></settlement></list><tree><noCountry><name sortKey="Goodman, Robert R" sort="Goodman, Robert R" uniqKey="Goodman R" first="Robert R." last="Goodman">Robert R. Goodman</name><name sortKey="Gross, Robert E" sort="Gross, Robert E" uniqKey="Gross R" first="Robert E." last="Gross">Robert E. Gross</name><name sortKey="Hamani, Clement" sort="Hamani, Clement" uniqKey="Hamani C" first="Clement" last="Hamani">Clement Hamani</name><name sortKey="Lozano, Andres M" sort="Lozano, Andres M" uniqKey="Lozano A" first="Andres M." last="Lozano">Andres M. Lozano</name><name sortKey="Starr, Philip A" sort="Starr, Philip A" uniqKey="Starr P" first="Philip A." last="Starr">Philip A. Starr</name></noCountry><country name="Canada"><noRegion><name sortKey="Coenen, Volker A" sort="Coenen, Volker A" uniqKey="Coenen V" first="Volker A." last="Coenen">Volker A. Coenen</name></noRegion><name sortKey="Honey, Christopher R" sort="Honey, Christopher R" uniqKey="Honey C" first="Christopher R." last="Honey">Christopher R. Honey</name><name sortKey="Mcmaster, Jacqueline" sort="Mcmaster, Jacqueline" uniqKey="Mcmaster J" first="Jacqueline" last="Mcmaster">Jacqueline Mcmaster</name><name sortKey="Rahman, Ahmed A" sort="Rahman, Ahmed A" uniqKey="Rahman A" first="Ahmed A." last="Rahman">Ahmed A. Rahman</name></country><country name="Allemagne"><region name="Rhénanie-du-Nord-Westphalie"><name sortKey="Coenen, Volker A" sort="Coenen, Volker A" uniqKey="Coenen V" first="Volker A." last="Coenen">Volker A. Coenen</name></region><name sortKey="Burgel, Uli" sort="Burgel, Uli" uniqKey="Burgel U" first="Uli" last="Bürgel">Uli Bürgel</name><name sortKey="Hurwitz, Trevor" sort="Hurwitz, Trevor" uniqKey="Hurwitz T" first="Trevor" last="Hurwitz">Trevor Hurwitz</name></country><country name="Pays-Bas"><noRegion><name sortKey="M Dler, Burkhard" sort="M Dler, Burkhard" uniqKey="M Dler B" first="Burkhard" last="M Dler">Burkhard M Dler</name></noRegion></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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