rCBF changes associated with PPN stimulation in a patient with Parkinson's disease: a PET study.
Identifieur interne : 002107 ( Ncbi/Checkpoint ); précédent : 002106; suivant : 002108rCBF changes associated with PPN stimulation in a patient with Parkinson's disease: a PET study.
Auteurs : Antonio P. Strafella [Canada] ; Andres M. Lozano ; Benedicte Ballanger ; Yu-Yan Poon ; Anthony E. Lang ; Elena MoroSource :
- Movement disorders : official journal of the Movement Disorder Society [ 1531-8257 ] ; 2008.
English descriptors
- KwdEn :
- Brain (blood supply), Brain (pathology), Cerebrovascular Circulation (physiology), Deep Brain Stimulation (methods), Humans, Magnetic Resonance Imaging, Male, Middle Aged, Parkinson Disease (diagnosis), Parkinson Disease (therapy), Pedunculopontine Tegmental Nucleus (blood supply), Positron-Emission Tomography.
- MESH :
- blood supply : Brain, Pedunculopontine Tegmental Nucleus.
- diagnosis : Parkinson Disease.
- methods : Deep Brain Stimulation.
- pathology : Brain.
- physiology : Cerebrovascular Circulation.
- therapy : Parkinson Disease.
- Humans, Magnetic Resonance Imaging, Male, Middle Aged, Positron-Emission Tomography.
Abstract
Gait disturbances and akinesia are disabling symptoms in advanced Parkinson's disease (PD). The pedunculopontine nucleus (PPN) is involved in locomotion, control of posture, and behavioral states [i.e. wakefulness, rapid eye movement (REM) sleep]. Some reports have suggested that modulation of the activity of the PPN with deep brain stimulation (DBS) may be beneficial in the treatment of gait dysfunction and akinesia. To gain some insights on effects of PPN-DBS in the human brain, we used [(15)O] H(2)O positron emission tomography (PET) to measure changes in regional cerebral blood flow (rCBF) at rest during Off and On stimulation in an advanced PD patient with unilateral PPN-DBS. PPN-DBS increased rCBF in different subcortical areas most notably the thalamus, bilaterally. Double-blinded clinical evaluation revealed an improvement in motor function by approximately 20%. The PET changes provide for the first time evidence in the human brain that PPN-DBS may be able to influence and modify rCBF of closely connected subcortical structures. Given the importance of the PPN in locomotion, control of posture, and behavioral states, DBS may have significant implication for more complicated forms of movement disorders where deterioration of gait, postural instability, and REM sleep behavior disorders are very disabling.
DOI: 10.1002/mds.22055
PubMed: 18412282
Affiliations:
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Strafella</name><affiliation wicri:level="4"><nlm:affiliation>Movement Disorders Center, Toronto Western Hospital, Division of Neurology, University of Toronto, Toronto, Ontario, Canada. antonio.strafella@uhnres.utoronto.ca</nlm:affiliation><country xml:lang="fr">Canada</country><wicri:regionArea>Movement Disorders Center, Toronto Western Hospital, Division of Neurology, University of Toronto, Toronto, Ontario</wicri:regionArea><orgName type="university">Université de Toronto</orgName><placeName><settlement type="city">Toronto</settlement><region type="state">Ontario</region></placeName></affiliation></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="Ballanger, Benedicte" sort="Ballanger, Benedicte" uniqKey="Ballanger B" first="Benedicte" last="Ballanger">Benedicte Ballanger</name></author><author><name sortKey="Poon, Yu Yan" sort="Poon, Yu Yan" uniqKey="Poon Y" first="Yu-Yan" last="Poon">Yu-Yan Poon</name></author><author><name sortKey="Lang, Anthony E" sort="Lang, Anthony E" uniqKey="Lang A" first="Anthony E" last="Lang">Anthony E. 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Strafella</name><affiliation wicri:level="4"><nlm:affiliation>Movement Disorders Center, Toronto Western Hospital, Division of Neurology, University of Toronto, Toronto, Ontario, Canada. antonio.strafella@uhnres.utoronto.ca</nlm:affiliation><country xml:lang="fr">Canada</country><wicri:regionArea>Movement Disorders Center, Toronto Western Hospital, Division of Neurology, University of Toronto, Toronto, Ontario</wicri:regionArea><orgName type="university">Université de Toronto</orgName><placeName><settlement type="city">Toronto</settlement><region type="state">Ontario</region></placeName></affiliation></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="Ballanger, Benedicte" sort="Ballanger, Benedicte" uniqKey="Ballanger B" first="Benedicte" last="Ballanger">Benedicte Ballanger</name></author><author><name sortKey="Poon, Yu Yan" sort="Poon, Yu Yan" uniqKey="Poon Y" first="Yu-Yan" last="Poon">Yu-Yan Poon</name></author><author><name sortKey="Lang, Anthony E" sort="Lang, Anthony E" uniqKey="Lang A" first="Anthony E" last="Lang">Anthony E. Lang</name></author><author><name sortKey="Moro, Elena" sort="Moro, Elena" uniqKey="Moro E" first="Elena" last="Moro">Elena Moro</name></author></analytic><series><title level="j">Movement disorders : official journal of the Movement Disorder Society</title><idno type="eISSN">1531-8257</idno><imprint><date when="2008" type="published">2008</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Brain (blood supply)</term><term>Brain (pathology)</term><term>Cerebrovascular Circulation (physiology)</term><term>Deep Brain Stimulation (methods)</term><term>Humans</term><term>Magnetic Resonance Imaging</term><term>Male</term><term>Middle Aged</term><term>Parkinson Disease (diagnosis)</term><term>Parkinson Disease (therapy)</term><term>Pedunculopontine Tegmental Nucleus (blood supply)</term><term>Positron-Emission Tomography</term></keywords><keywords scheme="MESH" qualifier="blood supply" xml:lang="en"><term>Brain</term><term>Pedunculopontine Tegmental Nucleus</term></keywords><keywords scheme="MESH" qualifier="diagnosis" xml:lang="en"><term>Parkinson Disease</term></keywords><keywords scheme="MESH" qualifier="methods" xml:lang="en"><term>Deep Brain Stimulation</term></keywords><keywords scheme="MESH" qualifier="pathology" xml:lang="en"><term>Brain</term></keywords><keywords scheme="MESH" qualifier="physiology" xml:lang="en"><term>Cerebrovascular Circulation</term></keywords><keywords scheme="MESH" qualifier="therapy" xml:lang="en"><term>Parkinson Disease</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Humans</term><term>Magnetic Resonance Imaging</term><term>Male</term><term>Middle Aged</term><term>Positron-Emission Tomography</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Gait disturbances and akinesia are disabling symptoms in advanced Parkinson's disease (PD). The pedunculopontine nucleus (PPN) is involved in locomotion, control of posture, and behavioral states [i.e. wakefulness, rapid eye movement (REM) sleep]. Some reports have suggested that modulation of the activity of the PPN with deep brain stimulation (DBS) may be beneficial in the treatment of gait dysfunction and akinesia. To gain some insights on effects of PPN-DBS in the human brain, we used [(15)O] H(2)O positron emission tomography (PET) to measure changes in regional cerebral blood flow (rCBF) at rest during Off and On stimulation in an advanced PD patient with unilateral PPN-DBS. PPN-DBS increased rCBF in different subcortical areas most notably the thalamus, bilaterally. Double-blinded clinical evaluation revealed an improvement in motor function by approximately 20%. The PET changes provide for the first time evidence in the human brain that PPN-DBS may be able to influence and modify rCBF of closely connected subcortical structures. Given the importance of the PPN in locomotion, control of posture, and behavioral states, DBS may have significant implication for more complicated forms of movement disorders where deterioration of gait, postural instability, and REM sleep behavior disorders are very disabling.</div></front></TEI><affiliations><list><country><li>Canada</li></country><region><li>Ontario</li></region><settlement><li>Toronto</li></settlement><orgName><li>Université de Toronto</li></orgName></list><tree><noCountry><name sortKey="Ballanger, Benedicte" sort="Ballanger, Benedicte" uniqKey="Ballanger B" first="Benedicte" last="Ballanger">Benedicte Ballanger</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 M" sort="Lozano, Andres M" uniqKey="Lozano A" first="Andres M" last="Lozano">Andres M. Lozano</name><name sortKey="Moro, Elena" sort="Moro, Elena" uniqKey="Moro E" first="Elena" last="Moro">Elena Moro</name><name sortKey="Poon, Yu Yan" sort="Poon, Yu Yan" uniqKey="Poon Y" first="Yu-Yan" last="Poon">Yu-Yan Poon</name></noCountry><country name="Canada"><region name="Ontario"><name sortKey="Strafella, Antonio P" sort="Strafella, Antonio P" uniqKey="Strafella A" first="Antonio P" last="Strafella">Antonio P. Strafella</name></region></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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