Different cerebral cortical areas influence the effect of subthalamic nucleus stimulation on parkinsonian motor deficits and freezing of gait.
Identifieur interne : 001E06 ( Ncbi/Curation ); précédent : 001E05; suivant : 001E07Different cerebral cortical areas influence the effect of subthalamic nucleus stimulation on parkinsonian motor deficits and freezing of gait.
Auteurs : Chul Hyoung Lyoo [Corée du Sud] ; Sargo Aalto ; Juha O. Rinne ; Ki Ook Lee ; Seung Hun Oh ; Jin Woo Chang ; Myung Sik LeeSource :
- Movement disorders : official journal of the Movement Disorder Society [ 0885-3185 ] ; 2007.
English descriptors
- KwdEn :
- Adult, Aged, Antiparkinson Agents (therapeutic use), Brain Mapping, Cerebral Cortex (cytology), Cerebral Cortex (physiology), Cerebral Cortex (radionuclide imaging), Combined Modality Therapy, Deep Brain Stimulation, Female, Fluorodeoxyglucose F18 (diagnostic use), Gait Disorders, Neurologic (drug therapy), Gait Disorders, Neurologic (physiopathology), Gait Disorders, Neurologic (radionuclide imaging), Humans, Levodopa (therapeutic use), Male, Middle Aged, Neural Pathways, Parkinsonian Disorders (drug therapy), Parkinsonian Disorders (physiopathology), Parkinsonian Disorders (radionuclide imaging), Positron-Emission Tomography, Radiopharmaceuticals (diagnostic use), Subthalamic Nucleus (cytology), Subthalamic Nucleus (physiology), Subthalamic Nucleus (radionuclide imaging).
- MESH :
- chemical , diagnostic use : Fluorodeoxyglucose F18, Radiopharmaceuticals.
- chemical , therapeutic use : Antiparkinson Agents, Levodopa.
- cytology : Cerebral Cortex, Subthalamic Nucleus.
- drug therapy : Gait Disorders, Neurologic, Parkinsonian Disorders.
- physiology : Cerebral Cortex, Subthalamic Nucleus.
- physiopathology : Gait Disorders, Neurologic, Parkinsonian Disorders.
- radionuclide imaging : Cerebral Cortex, Gait Disorders, Neurologic, Parkinsonian Disorders, Subthalamic Nucleus.
- Adult, Aged, Brain Mapping, Combined Modality Therapy, Deep Brain Stimulation, Female, Humans, Male, Middle Aged, Neural Pathways, Positron-Emission Tomography.
Abstract
Inconsistent response in freezing of gait (FOG) with levodopa treatment or STN DBS makes the pathogenesis difficult to understand. We studied brain areas associated with the expression of STN DBS effect on parkinsonian motor deficits and FOG. Ten Parkinson's disease patients with typical FOG were included. One month before STN DBS, we performed [(18)F]-deoxyglucose PET scans and measured the UPDRS motor and modified FOG (mFOG) scores during levodopa off and on periods. At two months after STN DBS, same rating scores were measured. The percentage improvement of mFOG and UPDRS motor scores by STN DBS during levodopa off period was calculated. We searched for brain areas in which glucose metabolism correlated with the improvement of mFOG and UPDRS motor scores by DBS. During levodopa off period, STN DBS improved the UPDRS motor scores by 32.3% and the mFOG scores by 56.6%. There was no correlation between the improvements of both scores. The improvement of UPDRS motor score by DBS correlated with the metabolic activities of rostral supplementary motor area (Brodmann's area 8; BA8), anterior cingulate cortex (BA32), and prefrontal cortex (BA9). On the other hand, there was a positive correlation between the improvement of mFOG score by DBS and the metabolic activity of the parietal, occipital, and temporal sensory association cortices. In conclusion, dysfunction of different cerebral cortical areas limits the beneficial effects of DBS on parkinsonian motor deficits and FOG.
DOI: 10.1002/mds.21609
PubMed: 17712844
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<wicri:regionArea>Department of Neurology, Youngdong Severance Hospital, Yonsei University College of Medicine, Seoul</wicri:regionArea>
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<author><name sortKey="Lee, Ki Ook" sort="Lee, Ki Ook" uniqKey="Lee K" first="Ki Ook" last="Lee">Ki Ook Lee</name>
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<author><name sortKey="Oh, Seung Hun" sort="Oh, Seung Hun" uniqKey="Oh S" first="Seung Hun" last="Oh">Seung Hun Oh</name>
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<author><name sortKey="Chang, Jin Woo" sort="Chang, Jin Woo" uniqKey="Chang J" first="Jin Woo" last="Chang">Jin Woo Chang</name>
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<author><name sortKey="Lee, Myung Sik" sort="Lee, Myung Sik" uniqKey="Lee M" first="Myung Sik" last="Lee">Myung Sik Lee</name>
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<author><name sortKey="Oh, Seung Hun" sort="Oh, Seung Hun" uniqKey="Oh S" first="Seung Hun" last="Oh">Seung Hun Oh</name>
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<author><name sortKey="Chang, Jin Woo" sort="Chang, Jin Woo" uniqKey="Chang J" first="Jin Woo" last="Chang">Jin Woo Chang</name>
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<term>Cerebral Cortex (cytology)</term>
<term>Cerebral Cortex (physiology)</term>
<term>Cerebral Cortex (radionuclide imaging)</term>
<term>Combined Modality Therapy</term>
<term>Deep Brain Stimulation</term>
<term>Female</term>
<term>Fluorodeoxyglucose F18 (diagnostic use)</term>
<term>Gait Disorders, Neurologic (drug therapy)</term>
<term>Gait Disorders, Neurologic (physiopathology)</term>
<term>Gait Disorders, Neurologic (radionuclide imaging)</term>
<term>Humans</term>
<term>Levodopa (therapeutic use)</term>
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<term>Parkinsonian Disorders (physiopathology)</term>
<term>Parkinsonian Disorders (radionuclide imaging)</term>
<term>Positron-Emission Tomography</term>
<term>Radiopharmaceuticals (diagnostic use)</term>
<term>Subthalamic Nucleus (cytology)</term>
<term>Subthalamic Nucleus (physiology)</term>
<term>Subthalamic Nucleus (radionuclide imaging)</term>
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<term>Parkinsonian Disorders</term>
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<term>Gait Disorders, Neurologic</term>
<term>Parkinsonian Disorders</term>
<term>Subthalamic Nucleus</term>
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<term>Aged</term>
<term>Brain Mapping</term>
<term>Combined Modality Therapy</term>
<term>Deep Brain Stimulation</term>
<term>Female</term>
<term>Humans</term>
<term>Male</term>
<term>Middle Aged</term>
<term>Neural Pathways</term>
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<front><div type="abstract" xml:lang="en">Inconsistent response in freezing of gait (FOG) with levodopa treatment or STN DBS makes the pathogenesis difficult to understand. We studied brain areas associated with the expression of STN DBS effect on parkinsonian motor deficits and FOG. Ten Parkinson's disease patients with typical FOG were included. One month before STN DBS, we performed [(18)F]-deoxyglucose PET scans and measured the UPDRS motor and modified FOG (mFOG) scores during levodopa off and on periods. At two months after STN DBS, same rating scores were measured. The percentage improvement of mFOG and UPDRS motor scores by STN DBS during levodopa off period was calculated. We searched for brain areas in which glucose metabolism correlated with the improvement of mFOG and UPDRS motor scores by DBS. During levodopa off period, STN DBS improved the UPDRS motor scores by 32.3% and the mFOG scores by 56.6%. There was no correlation between the improvements of both scores. The improvement of UPDRS motor score by DBS correlated with the metabolic activities of rostral supplementary motor area (Brodmann's area 8; BA8), anterior cingulate cortex (BA32), and prefrontal cortex (BA9). On the other hand, there was a positive correlation between the improvement of mFOG score by DBS and the metabolic activity of the parietal, occipital, and temporal sensory association cortices. In conclusion, dysfunction of different cerebral cortical areas limits the beneficial effects of DBS on parkinsonian motor deficits and FOG.</div>
</front>
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