Deep brain stimulation for Parkinson's disease dissociates mood and motor circuits: A functional MRI case study
Identifieur interne : 004137 ( Main/Exploration ); précédent : 004136; suivant : 004138Deep brain stimulation for Parkinson's disease dissociates mood and motor circuits: A functional MRI case study
Auteurs : Taresa Stefurak [Canada] ; David Mikulis [Canada] ; Helen Mayberg [Canada] ; Anthony E. Lang [Canada] ; Stephanie Hevenor [Canada] ; Peter Pahapill [États-Unis] ; Jean Saint-Cyr [Canada] ; Andres Lozano [Canada]Source :
- Movement Disorders [ 0885-3185 ] ; 2003-12.
Descripteurs français
- Pascal (Inist)
- Wicri :
- topic : Adulte.
English descriptors
- KwdEn :
- Adult, Case study, Cerebellum (metabolism), Cerebellum (physiopathology), Complication, Depression, Electric Stimulation Therapy (adverse effects), Electric Stimulation Therapy (instrumentation), Electrical stimulus, Electrodes, Electrodes, Implanted, Female, Functional Laterality (physiology), Humans, Instrumentation therapy, Localization, Magnetic Resonance Imaging, Mood Disorders (etiology), Mood Disorders (physiopathology), Mood Disorders (psychology), Motor Cortex (metabolism), Motor Cortex (physiopathology), Nerve Net (metabolism), Nerve Net (physiopathology), Nuclear magnetic resonance imaging, Parkinson Disease (therapy), Parkinson disease, Parkinson's disease, Putamen (metabolism), Putamen (physiopathology), Subthalamic nucleus, Ventral Thalamic Nuclei (metabolism), Ventral Thalamic Nuclei (physiopathology), deep brain stimulation, depression, functional magnetic resonance imaging, neural circuitry, subthalamic nucleus.
- MESH :
- adverse effects : Electric Stimulation Therapy.
- etiology : Mood Disorders.
- instrumentation : Electric Stimulation Therapy.
- metabolism : Cerebellum, Motor Cortex, Nerve Net, Putamen, Ventral Thalamic Nuclei.
- physiology : Functional Laterality.
- physiopathology : Cerebellum, Mood Disorders, Motor Cortex, Nerve Net, Putamen, Ventral Thalamic Nuclei.
- psychology : Mood Disorders.
- therapy : Parkinson Disease.
- Adult, Electrodes, Implanted, Female, Humans, Magnetic Resonance Imaging.
Abstract
Behavioral disturbances have been reported with subthalamic (STN) deep brain stimulation (DBS) treatment in Parkinson's disease (PD). We report correlative functional imaging (fMRI) of mood and motor responses induced by successive right and left DBS. A 36‐year‐old woman with medically refractory PD and a history of clinically remitted depression underwent uncomplicated implantation of bilateral STN DBS. High‐frequency stimulation of the left electrode improved motor symptoms. Unexpectedly, right DBS alone elicited several reproducible episodes of acute depressive dysphoria. Structural and functional magnetic resonance imaging (fMRI) imaging was carried out with sequential individual electrode stimulation. The electrode on the left was within the inferior STN, whereas the right electrode was marginally superior and lateral to the intended STN target within the Fields of Forel/zona incerta. fMRI image analysis (Analysis of Functional NeuroImages, AFNI) contrasting OFF versus ON stimulation identified significant lateralized blood oxygen level‐dependent (BOLD) signal changes with DBS (P < 0.001). Left DBS primarily showed changes in motor regions: increases in premotor and motor cortex, ventrolateral thalamus, putamen, and cerebellum as well as decreases in sensorimotor/supplementary motor cortex. Right DBS showed similar but less extensive change in motor regions. More prominent were the unique increases in superior prefrontal cortex, anterior cingulate (Brodmann's area [BA] 24), anterior thalamus, caudate, and brainstem, and marked widespread decreases in medial prefrontal cortex (BA 9/10). The mood disturbance resolved spontaneously in 4 weeks despite identical stimulation parameters. Transient depressive mood induced by subcortical DBS stimulation was correlated with changes in mesolimbic cortical structures. This case provides new evidence supporting cortical segregation of motor and nonmotor cortico‐basal ganglionic systems that may converge in close proximity at the level of the STN and the adjacent white matter tracts (Fields of Forel/zona incerta). © 2003 Movement Disorder Society
Url:
DOI: 10.1002/mds.10593
Affiliations:
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Disord.</title><idno type="ISSN">0885-3185</idno><idno type="eISSN">1531-8257</idno><imprint><publisher>Wiley Subscription Services, Inc., A Wiley Company</publisher><pubPlace>Hoboken</pubPlace><date type="published" when="2003-12">2003-12</date><biblScope unit="vol">18</biblScope><biblScope unit="issue">12</biblScope><biblScope unit="page" from="1508">1508</biblScope><biblScope unit="page" to="1516">1516</biblScope></imprint><idno type="ISSN">0885-3185</idno></series><idno type="istex">7B4B7E25FEF72E4341FCD3C01183082BD5EA8C92</idno><idno type="DOI">10.1002/mds.10593</idno><idno type="ArticleID">MDS10593</idno></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0885-3185</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adult</term><term>Case study</term><term>Cerebellum (metabolism)</term><term>Cerebellum (physiopathology)</term><term>Complication</term><term>Depression</term><term>Electric Stimulation Therapy (adverse effects)</term><term>Electric Stimulation Therapy (instrumentation)</term><term>Electrical stimulus</term><term>Electrodes</term><term>Electrodes, Implanted</term><term>Female</term><term>Functional Laterality (physiology)</term><term>Humans</term><term>Instrumentation therapy</term><term>Localization</term><term>Magnetic Resonance Imaging</term><term>Mood Disorders (etiology)</term><term>Mood Disorders (physiopathology)</term><term>Mood Disorders (psychology)</term><term>Motor Cortex (metabolism)</term><term>Motor Cortex (physiopathology)</term><term>Nerve Net (metabolism)</term><term>Nerve Net (physiopathology)</term><term>Nuclear magnetic resonance imaging</term><term>Parkinson Disease (therapy)</term><term>Parkinson disease</term><term>Parkinson's disease</term><term>Putamen (metabolism)</term><term>Putamen (physiopathology)</term><term>Subthalamic nucleus</term><term>Ventral Thalamic Nuclei (metabolism)</term><term>Ventral Thalamic Nuclei (physiopathology)</term><term>deep brain stimulation</term><term>depression</term><term>functional magnetic resonance imaging</term><term>neural circuitry</term><term>subthalamic nucleus</term></keywords><keywords scheme="MESH" qualifier="adverse effects" xml:lang="en"><term>Electric Stimulation Therapy</term></keywords><keywords scheme="MESH" qualifier="etiology" xml:lang="en"><term>Mood Disorders</term></keywords><keywords scheme="MESH" qualifier="instrumentation" xml:lang="en"><term>Electric Stimulation Therapy</term></keywords><keywords scheme="MESH" qualifier="metabolism" xml:lang="en"><term>Cerebellum</term><term>Motor Cortex</term><term>Nerve Net</term><term>Putamen</term><term>Ventral Thalamic Nuclei</term></keywords><keywords scheme="MESH" qualifier="physiology" xml:lang="en"><term>Functional Laterality</term></keywords><keywords scheme="MESH" qualifier="physiopathology" xml:lang="en"><term>Cerebellum</term><term>Mood Disorders</term><term>Motor Cortex</term><term>Nerve Net</term><term>Putamen</term><term>Ventral Thalamic Nuclei</term></keywords><keywords scheme="MESH" qualifier="psychology" xml:lang="en"><term>Mood Disorders</term></keywords><keywords scheme="MESH" qualifier="therapy" xml:lang="en"><term>Parkinson Disease</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adult</term><term>Electrodes, Implanted</term><term>Female</term><term>Humans</term><term>Magnetic Resonance Imaging</term></keywords><keywords scheme="Pascal" xml:lang="fr"><term>Adulte</term><term>Complication</term><term>Dysphorie</term><term>Electrode</term><term>Etat dépressif</term><term>Etude cas</term><term>Femelle</term><term>Imagerie RMN</term><term>Localisation</term><term>Noyau sousthalamique</term><term>Parkinson maladie</term><term>Stimulus électrique</term><term>Traitement instrumental</term></keywords><keywords scheme="Wicri" type="topic" xml:lang="fr"><term>Adulte</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Behavioral disturbances have been reported with subthalamic (STN) deep brain stimulation (DBS) treatment in Parkinson's disease (PD). We report correlative functional imaging (fMRI) of mood and motor responses induced by successive right and left DBS. A 36‐year‐old woman with medically refractory PD and a history of clinically remitted depression underwent uncomplicated implantation of bilateral STN DBS. High‐frequency stimulation of the left electrode improved motor symptoms. Unexpectedly, right DBS alone elicited several reproducible episodes of acute depressive dysphoria. Structural and functional magnetic resonance imaging (fMRI) imaging was carried out with sequential individual electrode stimulation. The electrode on the left was within the inferior STN, whereas the right electrode was marginally superior and lateral to the intended STN target within the Fields of Forel/zona incerta. fMRI image analysis (Analysis of Functional NeuroImages, AFNI) contrasting OFF versus ON stimulation identified significant lateralized blood oxygen level‐dependent (BOLD) signal changes with DBS (P < 0.001). Left DBS primarily showed changes in motor regions: increases in premotor and motor cortex, ventrolateral thalamus, putamen, and cerebellum as well as decreases in sensorimotor/supplementary motor cortex. Right DBS showed similar but less extensive change in motor regions. More prominent were the unique increases in superior prefrontal cortex, anterior cingulate (Brodmann's area [BA] 24), anterior thalamus, caudate, and brainstem, and marked widespread decreases in medial prefrontal cortex (BA 9/10). The mood disturbance resolved spontaneously in 4 weeks despite identical stimulation parameters. Transient depressive mood induced by subcortical DBS stimulation was correlated with changes in mesolimbic cortical structures. This case provides new evidence supporting cortical segregation of motor and nonmotor cortico‐basal ganglionic systems that may converge in close proximity at the level of the STN and the adjacent white matter tracts (Fields of Forel/zona incerta). © 2003 Movement Disorder Society</div></front></TEI><affiliations><list><country><li>Canada</li><li>États-Unis</li></country><region><li>Ontario</li><li>Pennsylvanie</li></region><settlement><li>Toronto</li></settlement><orgName><li>Université de Toronto</li></orgName></list><tree><country name="Canada"><region name="Ontario"><name sortKey="Stefurak, Taresa" sort="Stefurak, Taresa" uniqKey="Stefurak T" first="Taresa" last="Stefurak">Taresa Stefurak</name></region><name sortKey="Hevenor, Stephanie" sort="Hevenor, Stephanie" uniqKey="Hevenor S" first="Stephanie" last="Hevenor">Stephanie Hevenor</name><name sortKey="Lang, Anthony E" sort="Lang, Anthony E" uniqKey="Lang A" first="Anthony E." last="Lang">Anthony E. Lang</name><name sortKey="Lozano, Andres" sort="Lozano, Andres" uniqKey="Lozano A" first="Andres" last="Lozano">Andres Lozano</name><name sortKey="Mayberg, Helen" sort="Mayberg, Helen" uniqKey="Mayberg H" first="Helen" last="Mayberg">Helen Mayberg</name><name sortKey="Mayberg, Helen" sort="Mayberg, Helen" uniqKey="Mayberg H" first="Helen" last="Mayberg">Helen Mayberg</name><name sortKey="Mikulis, David" sort="Mikulis, David" uniqKey="Mikulis D" first="David" last="Mikulis">David Mikulis</name><name sortKey="Saint Yr, Jean" sort="Saint Yr, Jean" uniqKey="Saint Yr J" first="Jean" last="Saint-Cyr">Jean Saint-Cyr</name><name sortKey="Stefurak, Taresa" sort="Stefurak, Taresa" uniqKey="Stefurak T" first="Taresa" last="Stefurak">Taresa Stefurak</name></country><country name="États-Unis"><region name="Pennsylvanie"><name sortKey="Pahapill, Peter" sort="Pahapill, Peter" uniqKey="Pahapill P" first="Peter" last="Pahapill">Peter Pahapill</name></region></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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