SPECT and PET analysis of subthalamic stimulation in Parkinson's disease: analysis using a manual segmentation
Identifieur interne : 001D18 ( Main/Curation ); précédent : 001D17; suivant : 001D19SPECT and PET analysis of subthalamic stimulation in Parkinson's disease: analysis using a manual segmentation
Auteurs : Claire Haegelen [France] ; Daniel Garcia-Lorenzo [France] ; Florence Le Jeune [France] ; Julie Peron [France] ; Bernard Gibaud [France] ; Laurent Riffaud [France] ; Gilles Brassier [France] ; Christian Barillot [France] ; Marc Verin [France] ; Xavier Morandi [France]Source :
- Journal of neurology [ 0340-5354 ] ; 2010.
Descripteurs français
- Pascal (Inist)
English descriptors
- KwdEn :
- Aged, Amygdala (anatomy & histology), Amygdala (diagnostic imaging), Amygdala (physiopathology), Basal Ganglia (anatomy & histology), Basal Ganglia (diagnostic imaging), Basal Ganglia (physiopathology), Brain Mapping (methods), Cognition (physiology), Cognition Disorders (diagnostic imaging), Cognition Disorders (etiology), Cognition Disorders (physiopathology), Deep Brain Stimulation (adverse effects), Deep brain stimulation, Emotions (physiology), Female, Functional imaging, Hippocampus (anatomy & histology), Hippocampus (diagnostic imaging), Hippocampus (physiopathology), Humans, Image Processing, Computer-Assisted (methods), Image processing, Limbic System (anatomy & histology), Limbic System (diagnostic imaging), Limbic System (physiopathology), Limbic system, Male, Manuals, Middle Aged, Mood Disorders (diagnostic imaging), Mood Disorders (etiology), Mood Disorders (physiopathology), Nervous system diseases, Neural Pathways (anatomy & histology), Neural Pathways (diagnostic imaging), Neural Pathways (physiopathology), Parkinson Disease (physiopathology), Parkinson Disease (therapy), Parkinson disease, Photon, Positron emission tomography, Positron-Emission Tomography (methods), Prefrontal Cortex (anatomy & histology), Prefrontal Cortex (diagnostic imaging), Prefrontal Cortex (physiopathology), Segmentation, Single photon emission tomography, Subthalamic Nucleus (anatomy & histology), Subthalamic Nucleus (physiology), Subthalamic nucleus, Tomography, Emission-Computed, Single-Photon (methods).
- MESH :
- adverse effects : Deep Brain Stimulation.
- anatomy & histology : Amygdala, Basal Ganglia, Hippocampus, Limbic System, Neural Pathways, Prefrontal Cortex, Subthalamic Nucleus.
- diagnostic imaging : Amygdala, Basal Ganglia, Cognition Disorders, Hippocampus, Limbic System, Mood Disorders, Neural Pathways, Prefrontal Cortex.
- etiology : Cognition Disorders, Mood Disorders.
- methods : Brain Mapping, Image Processing, Computer-Assisted, Positron-Emission Tomography, Tomography, Emission-Computed, Single-Photon.
- physiology : Cognition, Emotions, Subthalamic Nucleus.
- physiopathology : Amygdala, Basal Ganglia, Cognition Disorders, Hippocampus, Limbic System, Mood Disorders, Neural Pathways, Parkinson Disease, Prefrontal Cortex.
- therapy : Parkinson Disease.
- Aged, Female, Humans, Male, Middle Aged.
Abstract
The subthalamic nucleus (STN) has become an effective target of deep-brain stimulation (DBS) in severely disabled patients with advanced Parkinson's disease (PD). Clinical studies have reported DBS-induced adverse effects on cognitive functions, mood, emotion and behavior. STN DBS seems to interfere with the limbic functions of the basal ganglia, but the limbic effects of STN DBS are controversial. We measured prospectively resting regional cerebral metabolism (rCMb) with 18-fluorodeoxyglucose and PET, and resting regional cerebral blood flow (rCBF) with HMPAO and SPECT in six patients with Parkinson's disease. We compared PET and SPECT 1 month before and 3 months after STN DBS. On cerebral MRI, 13 regions of interest (ROI) were manually delineated slice by slice in frontal and limbic lobes. We obtained mean rCBF and rCMb values for each ROI and the whole brain. We normalized rCBF and rCMB values to ones for the whole brain volume, which we compared before and following STN DBS. No significant difference emerged in the SPECT analysis. PET analysis revealed a significant decrease in rCMb following STN DBS in the superior frontal gyri and left and right dorsolateral prefrontal cortex (p < 0.05). A non-significant decrease in rCMb in the left anterior cingulate gyrus appeared following STN DBS (p = 0.075). Our prospective SPECT and PET study revealed significantly decreased glucose metabolism of the two superior frontal gyri without any attendant perfusion changes following STN DBS. These results suggest that STN DBS may change medial prefrontal function and therefore the integration of limbic information, either by disrupting emotional processes within the STN, or by hampering the normal function of a limbic circuit.
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<sourceDesc><biblStruct><analytic><title xml:lang="en" level="a">SPECT and PET analysis of subthalamic stimulation in Parkinson's disease: analysis using a manual segmentation</title>
<author><name sortKey="Haegelen, Claire" sort="Haegelen, Claire" uniqKey="Haegelen C" first="Claire" last="Haegelen">Claire Haegelen</name>
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<author><name sortKey="Garcia Lorenzo, Daniel" sort="Garcia Lorenzo, Daniel" uniqKey="Garcia Lorenzo D" first="Daniel" last="Garcia-Lorenzo">Daniel Garcia-Lorenzo</name>
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<author><name sortKey="Le Jeune, Florence" sort="Le Jeune, Florence" uniqKey="Le Jeune F" first="Florence" last="Le Jeune">Florence Le Jeune</name>
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<author><name sortKey="Peron, Julie" sort="Peron, Julie" uniqKey="Peron J" first="Julie" last="Peron">Julie Peron</name>
<affiliation wicri:level="3"><inist:fA14 i1="06"><s1>Department of Neurology, Pontchaillou Hospital, 2 rue Henri Le Guilloux</s1>
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<author><name sortKey="Gibaud, Bernard" sort="Gibaud, Bernard" uniqKey="Gibaud B" first="Bernard" last="Gibaud">Bernard Gibaud</name>
<affiliation wicri:level="3"><inist:fA14 i1="01"><s1>Department of Neurosurgery, Pontchaillou Hospital, 2 rue Henri Le Guilloux</s1>
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<author><name sortKey="Riffaud, Laurent" sort="Riffaud, Laurent" uniqKey="Riffaud L" first="Laurent" last="Riffaud">Laurent Riffaud</name>
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<author><name sortKey="Brassier, Gilles" sort="Brassier, Gilles" uniqKey="Brassier G" first="Gilles" last="Brassier">Gilles Brassier</name>
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<author><name sortKey="Barillot, Christian" sort="Barillot, Christian" uniqKey="Barillot C" first="Christian" last="Barillot">Christian Barillot</name>
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<author><name sortKey="Verin, Marc" sort="Verin, Marc" uniqKey="Verin M" first="Marc" last="Verin">Marc Verin</name>
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<author><name sortKey="Morandi, Xavier" sort="Morandi, Xavier" uniqKey="Morandi X" first="Xavier" last="Morandi">Xavier Morandi</name>
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<series><title level="j" type="main">Journal of neurology</title>
<title level="j" type="abbreviated">J. neurol.</title>
<idno type="ISSN">0340-5354</idno>
<imprint><date when="2010">2010</date>
</imprint>
</series>
</biblStruct>
</sourceDesc>
<seriesStmt><title level="j" type="main">Journal of neurology</title>
<title level="j" type="abbreviated">J. neurol.</title>
<idno type="ISSN">0340-5354</idno>
</seriesStmt>
</fileDesc>
<profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Aged</term>
<term>Amygdala (anatomy & histology)</term>
<term>Amygdala (diagnostic imaging)</term>
<term>Amygdala (physiopathology)</term>
<term>Basal Ganglia (anatomy & histology)</term>
<term>Basal Ganglia (diagnostic imaging)</term>
<term>Basal Ganglia (physiopathology)</term>
<term>Brain Mapping (methods)</term>
<term>Cognition (physiology)</term>
<term>Cognition Disorders (diagnostic imaging)</term>
<term>Cognition Disorders (etiology)</term>
<term>Cognition Disorders (physiopathology)</term>
<term>Deep Brain Stimulation (adverse effects)</term>
<term>Deep brain stimulation</term>
<term>Emotions (physiology)</term>
<term>Female</term>
<term>Functional imaging</term>
<term>Hippocampus (anatomy & histology)</term>
<term>Hippocampus (diagnostic imaging)</term>
<term>Hippocampus (physiopathology)</term>
<term>Humans</term>
<term>Image Processing, Computer-Assisted (methods)</term>
<term>Image processing</term>
<term>Limbic System (anatomy & histology)</term>
<term>Limbic System (diagnostic imaging)</term>
<term>Limbic System (physiopathology)</term>
<term>Limbic system</term>
<term>Male</term>
<term>Manuals</term>
<term>Middle Aged</term>
<term>Mood Disorders (diagnostic imaging)</term>
<term>Mood Disorders (etiology)</term>
<term>Mood Disorders (physiopathology)</term>
<term>Nervous system diseases</term>
<term>Neural Pathways (anatomy & histology)</term>
<term>Neural Pathways (diagnostic imaging)</term>
<term>Neural Pathways (physiopathology)</term>
<term>Parkinson Disease (physiopathology)</term>
<term>Parkinson Disease (therapy)</term>
<term>Parkinson disease</term>
<term>Photon</term>
<term>Positron emission tomography</term>
<term>Positron-Emission Tomography (methods)</term>
<term>Prefrontal Cortex (anatomy & histology)</term>
<term>Prefrontal Cortex (diagnostic imaging)</term>
<term>Prefrontal Cortex (physiopathology)</term>
<term>Segmentation</term>
<term>Single photon emission tomography</term>
<term>Subthalamic Nucleus (anatomy & histology)</term>
<term>Subthalamic Nucleus (physiology)</term>
<term>Subthalamic nucleus</term>
<term>Tomography, Emission-Computed, Single-Photon (methods)</term>
</keywords>
<keywords scheme="MESH" qualifier="adverse effects" xml:lang="en"><term>Deep Brain Stimulation</term>
</keywords>
<keywords scheme="MESH" qualifier="anatomy & histology" xml:lang="en"><term>Amygdala</term>
<term>Basal Ganglia</term>
<term>Hippocampus</term>
<term>Limbic System</term>
<term>Neural Pathways</term>
<term>Prefrontal Cortex</term>
<term>Subthalamic Nucleus</term>
</keywords>
<keywords scheme="MESH" qualifier="diagnostic imaging" xml:lang="en"><term>Amygdala</term>
<term>Basal Ganglia</term>
<term>Cognition Disorders</term>
<term>Hippocampus</term>
<term>Limbic System</term>
<term>Mood Disorders</term>
<term>Neural Pathways</term>
<term>Prefrontal Cortex</term>
</keywords>
<keywords scheme="MESH" qualifier="etiology" xml:lang="en"><term>Cognition Disorders</term>
<term>Mood Disorders</term>
</keywords>
<keywords scheme="MESH" qualifier="methods" xml:lang="en"><term>Brain Mapping</term>
<term>Image Processing, Computer-Assisted</term>
<term>Positron-Emission Tomography</term>
<term>Tomography, Emission-Computed, Single-Photon</term>
</keywords>
<keywords scheme="MESH" qualifier="physiology" xml:lang="en"><term>Cognition</term>
<term>Emotions</term>
<term>Subthalamic Nucleus</term>
</keywords>
<keywords scheme="MESH" qualifier="physiopathology" xml:lang="en"><term>Amygdala</term>
<term>Basal Ganglia</term>
<term>Cognition Disorders</term>
<term>Hippocampus</term>
<term>Limbic System</term>
<term>Mood Disorders</term>
<term>Neural Pathways</term>
<term>Parkinson Disease</term>
<term>Prefrontal Cortex</term>
</keywords>
<keywords scheme="MESH" qualifier="therapy" xml:lang="en"><term>Parkinson Disease</term>
</keywords>
<keywords scheme="MESH" xml:lang="en"><term>Aged</term>
<term>Female</term>
<term>Humans</term>
<term>Male</term>
<term>Middle Aged</term>
</keywords>
<keywords scheme="Pascal" xml:lang="fr"><term>Maladie de Parkinson</term>
<term>Pathologie du système nerveux</term>
<term>Tomoscintigraphie émission monophotonique</term>
<term>Photon</term>
<term>Tomographie par émission de positons</term>
<term>Manuel</term>
<term>Segmentation</term>
<term>Traitement image</term>
<term>Imagerie fonctionnelle</term>
<term>Système limbique</term>
<term>Noyau sousthalamique</term>
<term>Stimulation cérébrale profonde</term>
</keywords>
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<front><div type="abstract" xml:lang="en">The subthalamic nucleus (STN) has become an effective target of deep-brain stimulation (DBS) in severely disabled patients with advanced Parkinson's disease (PD). Clinical studies have reported DBS-induced adverse effects on cognitive functions, mood, emotion and behavior. STN DBS seems to interfere with the limbic functions of the basal ganglia, but the limbic effects of STN DBS are controversial. We measured prospectively resting regional cerebral metabolism (rCMb) with 18-fluorodeoxyglucose and PET, and resting regional cerebral blood flow (rCBF) with HMPAO and SPECT in six patients with Parkinson's disease. We compared PET and SPECT 1 month before and 3 months after STN DBS. On cerebral MRI, 13 regions of interest (ROI) were manually delineated slice by slice in frontal and limbic lobes. We obtained mean rCBF and rCMb values for each ROI and the whole brain. We normalized rCBF and rCMB values to ones for the whole brain volume, which we compared before and following STN DBS. No significant difference emerged in the SPECT analysis. PET analysis revealed a significant decrease in rCMb following STN DBS in the superior frontal gyri and left and right dorsolateral prefrontal cortex (p < 0.05). A non-significant decrease in rCMb in the left anterior cingulate gyrus appeared following STN DBS (p = 0.075). Our prospective SPECT and PET study revealed significantly decreased glucose metabolism of the two superior frontal gyri without any attendant perfusion changes following STN DBS. These results suggest that STN DBS may change medial prefrontal function and therefore the integration of limbic information, either by disrupting emotional processes within the STN, or by hampering the normal function of a limbic circuit.</div>
</front>
</TEI>
<double idat="0340-5354:2010:Haegelen C:spect:and:pet"><INIST><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en" level="a">SPECT and PET analysis of subthalamic stimulation in Parkinson's disease: analysis using a manual segmentation</title>
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<author><name sortKey="Garcia Lorenzo, Daniel" sort="Garcia Lorenzo, Daniel" uniqKey="Garcia Lorenzo D" first="Daniel" last="Garcia-Lorenzo">Daniel Garcia-Lorenzo</name>
<affiliation wicri:level="3"><inist:fA14 i1="01"><s1>Department of Neurosurgery, Pontchaillou Hospital, 2 rue Henri Le Guilloux</s1>
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<author><name sortKey="Le Jeune, Florence" sort="Le Jeune, Florence" uniqKey="Le Jeune F" first="Florence" last="Le Jeune">Florence Le Jeune</name>
<affiliation wicri:level="3"><inist:fA14 i1="05"><s1>Department of Nuclear Medicine, Centre Eugène Marquis, Rue de la Bataille Flandres Dunkerque</s1>
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<country>France</country>
<placeName><region type="region" nuts="2">Région Bretagne</region>
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<author><name sortKey="Peron, Julie" sort="Peron, Julie" uniqKey="Peron J" first="Julie" last="Peron">Julie Peron</name>
<affiliation wicri:level="3"><inist:fA14 i1="06"><s1>Department of Neurology, Pontchaillou Hospital, 2 rue Henri Le Guilloux</s1>
<s2>35033 Rennes</s2>
<s3>FRA</s3>
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<country>France</country>
<placeName><region type="region" nuts="2">Région Bretagne</region>
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<author><name sortKey="Gibaud, Bernard" sort="Gibaud, Bernard" uniqKey="Gibaud B" first="Bernard" last="Gibaud">Bernard Gibaud</name>
<affiliation wicri:level="3"><inist:fA14 i1="01"><s1>Department of Neurosurgery, Pontchaillou Hospital, 2 rue Henri Le Guilloux</s1>
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<country>France</country>
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<country>France</country>
<placeName><region type="region" nuts="2">Région Bretagne</region>
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<author><name sortKey="Riffaud, Laurent" sort="Riffaud, Laurent" uniqKey="Riffaud L" first="Laurent" last="Riffaud">Laurent Riffaud</name>
<affiliation wicri:level="3"><inist:fA14 i1="01"><s1>Department of Neurosurgery, Pontchaillou Hospital, 2 rue Henri Le Guilloux</s1>
<s2>35033 Rennes</s2>
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<country>France</country>
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<settlement type="city">Rennes</settlement>
</placeName>
</affiliation>
<affiliation wicri:level="3"><inist:fA14 i1="03"><s1>INRIA, VisAGeS Unit/Project</s1>
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<country>France</country>
<placeName><region type="region" nuts="2">Région Bretagne</region>
<settlement type="city">Rennes</settlement>
</placeName>
</affiliation>
<affiliation wicri:level="3"><inist:fA14 i1="04"><s1>CNRS, UMR 6074, IRISA</s1>
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<country>France</country>
<placeName><region type="region" nuts="2">Région Bretagne</region>
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</author>
<author><name sortKey="Brassier, Gilles" sort="Brassier, Gilles" uniqKey="Brassier G" first="Gilles" last="Brassier">Gilles Brassier</name>
<affiliation wicri:level="3"><inist:fA14 i1="01"><s1>Department of Neurosurgery, Pontchaillou Hospital, 2 rue Henri Le Guilloux</s1>
<s2>35033 Rennes</s2>
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<country>France</country>
<placeName><region type="region" nuts="2">Région Bretagne</region>
<settlement type="city">Rennes</settlement>
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</affiliation>
<affiliation wicri:level="3"><inist:fA14 i1="02"><s1>INSERM, U746, CS 34317</s1>
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<affiliation wicri:level="3"><inist:fA14 i1="03"><s1>INRIA, VisAGeS Unit/Project</s1>
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<country>France</country>
<placeName><region type="region" nuts="2">Région Bretagne</region>
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</placeName>
</affiliation>
<affiliation wicri:level="3"><inist:fA14 i1="04"><s1>CNRS, UMR 6074, IRISA</s1>
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<author><name sortKey="Barillot, Christian" sort="Barillot, Christian" uniqKey="Barillot C" first="Christian" last="Barillot">Christian Barillot</name>
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<author><name sortKey="Verin, Marc" sort="Verin, Marc" uniqKey="Verin M" first="Marc" last="Verin">Marc Verin</name>
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<author><name sortKey="Morandi, Xavier" sort="Morandi, Xavier" uniqKey="Morandi X" first="Xavier" last="Morandi">Xavier Morandi</name>
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<publicationStmt><idno type="wicri:source">INIST</idno>
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<sourceDesc><biblStruct><analytic><title xml:lang="en" level="a">SPECT and PET analysis of subthalamic stimulation in Parkinson's disease: analysis using a manual segmentation</title>
<author><name sortKey="Haegelen, Claire" sort="Haegelen, Claire" uniqKey="Haegelen C" first="Claire" last="Haegelen">Claire Haegelen</name>
<affiliation wicri:level="3"><inist:fA14 i1="01"><s1>Department of Neurosurgery, Pontchaillou Hospital, 2 rue Henri Le Guilloux</s1>
<s2>35033 Rennes</s2>
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</affiliation>
</author>
<author><name sortKey="Garcia Lorenzo, Daniel" sort="Garcia Lorenzo, Daniel" uniqKey="Garcia Lorenzo D" first="Daniel" last="Garcia-Lorenzo">Daniel Garcia-Lorenzo</name>
<affiliation wicri:level="3"><inist:fA14 i1="01"><s1>Department of Neurosurgery, Pontchaillou Hospital, 2 rue Henri Le Guilloux</s1>
<s2>35033 Rennes</s2>
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<placeName><region type="region" nuts="2">Région Bretagne</region>
<settlement type="city">Rennes</settlement>
</placeName>
</affiliation>
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<country>France</country>
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</author>
<author><name sortKey="Le Jeune, Florence" sort="Le Jeune, Florence" uniqKey="Le Jeune F" first="Florence" last="Le Jeune">Florence Le Jeune</name>
<affiliation wicri:level="3"><inist:fA14 i1="05"><s1>Department of Nuclear Medicine, Centre Eugène Marquis, Rue de la Bataille Flandres Dunkerque</s1>
<s2>35042 Rennes</s2>
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<author><name sortKey="Peron, Julie" sort="Peron, Julie" uniqKey="Peron J" first="Julie" last="Peron">Julie Peron</name>
<affiliation wicri:level="3"><inist:fA14 i1="06"><s1>Department of Neurology, Pontchaillou Hospital, 2 rue Henri Le Guilloux</s1>
<s2>35033 Rennes</s2>
<s3>FRA</s3>
<sZ>4 aut.</sZ>
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<country>France</country>
<placeName><region type="region" nuts="2">Région Bretagne</region>
<settlement type="city">Rennes</settlement>
</placeName>
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<author><name sortKey="Gibaud, Bernard" sort="Gibaud, Bernard" uniqKey="Gibaud B" first="Bernard" last="Gibaud">Bernard Gibaud</name>
<affiliation wicri:level="3"><inist:fA14 i1="01"><s1>Department of Neurosurgery, Pontchaillou Hospital, 2 rue Henri Le Guilloux</s1>
<s2>35033 Rennes</s2>
<s3>FRA</s3>
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</author>
<author><name sortKey="Riffaud, Laurent" sort="Riffaud, Laurent" uniqKey="Riffaud L" first="Laurent" last="Riffaud">Laurent Riffaud</name>
<affiliation wicri:level="3"><inist:fA14 i1="01"><s1>Department of Neurosurgery, Pontchaillou Hospital, 2 rue Henri Le Guilloux</s1>
<s2>35033 Rennes</s2>
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<author><name sortKey="Brassier, Gilles" sort="Brassier, Gilles" uniqKey="Brassier G" first="Gilles" last="Brassier">Gilles Brassier</name>
<affiliation wicri:level="3"><inist:fA14 i1="01"><s1>Department of Neurosurgery, Pontchaillou Hospital, 2 rue Henri Le Guilloux</s1>
<s2>35033 Rennes</s2>
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<author><name sortKey="Barillot, Christian" sort="Barillot, Christian" uniqKey="Barillot C" first="Christian" last="Barillot">Christian Barillot</name>
<affiliation wicri:level="3"><inist:fA14 i1="01"><s1>Department of Neurosurgery, Pontchaillou Hospital, 2 rue Henri Le Guilloux</s1>
<s2>35033 Rennes</s2>
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<series><title level="j" type="main">Journal of neurology</title>
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<term>Functional imaging</term>
<term>Image processing</term>
<term>Limbic system</term>
<term>Manuals</term>
<term>Nervous system diseases</term>
<term>Parkinson disease</term>
<term>Photon</term>
<term>Positron emission tomography</term>
<term>Segmentation</term>
<term>Single photon emission tomography</term>
<term>Subthalamic nucleus</term>
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<keywords scheme="Pascal" xml:lang="fr"><term>Maladie de Parkinson</term>
<term>Pathologie du système nerveux</term>
<term>Tomoscintigraphie émission monophotonique</term>
<term>Photon</term>
<term>Tomographie par émission de positons</term>
<term>Manuel</term>
<term>Segmentation</term>
<term>Traitement image</term>
<term>Imagerie fonctionnelle</term>
<term>Système limbique</term>
<term>Noyau sousthalamique</term>
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<front><div type="abstract" xml:lang="en">The subthalamic nucleus (STN) has become an effective target of deep-brain stimulation (DBS) in severely disabled patients with advanced Parkinson's disease (PD). Clinical studies have reported DBS-induced adverse effects on cognitive functions, mood, emotion and behavior. STN DBS seems to interfere with the limbic functions of the basal ganglia, but the limbic effects of STN DBS are controversial. We measured prospectively resting regional cerebral metabolism (rCMb) with 18-fluorodeoxyglucose and PET, and resting regional cerebral blood flow (rCBF) with HMPAO and SPECT in six patients with Parkinson's disease. We compared PET and SPECT 1 month before and 3 months after STN DBS. On cerebral MRI, 13 regions of interest (ROI) were manually delineated slice by slice in frontal and limbic lobes. We obtained mean rCBF and rCMb values for each ROI and the whole brain. We normalized rCBF and rCMB values to ones for the whole brain volume, which we compared before and following STN DBS. No significant difference emerged in the SPECT analysis. PET analysis revealed a significant decrease in rCMb following STN DBS in the superior frontal gyri and left and right dorsolateral prefrontal cortex (p < 0.05). A non-significant decrease in rCMb in the left anterior cingulate gyrus appeared following STN DBS (p = 0.075). Our prospective SPECT and PET study revealed significantly decreased glucose metabolism of the two superior frontal gyri without any attendant perfusion changes following STN DBS. These results suggest that STN DBS may change medial prefrontal function and therefore the integration of limbic information, either by disrupting emotional processes within the STN, or by hampering the normal function of a limbic circuit.</div>
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<author><name sortKey="Garcia Lorenzo, Daniel" sort="Garcia Lorenzo, Daniel" uniqKey="Garcia Lorenzo D" first="Daniel" last="García-Lorenzo">Daniel García-Lorenzo</name>
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<author><name sortKey="Gibaud, Bernard" sort="Gibaud, Bernard" uniqKey="Gibaud B" first="Bernard" last="Gibaud">Bernard Gibaud</name>
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<author><name sortKey="Riffaud, Laurent" sort="Riffaud, Laurent" uniqKey="Riffaud L" first="Laurent" last="Riffaud">Laurent Riffaud</name>
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<author><name sortKey="Barillot, Christian" sort="Barillot, Christian" uniqKey="Barillot C" first="Christian" last="Barillot">Christian Barillot</name>
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<author><name sortKey="Verin, Marc" sort="Verin, Marc" uniqKey="Verin M" first="Marc" last="Vérin">Marc Vérin</name>
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<author><name sortKey="Morandi, Xavier" sort="Morandi, Xavier" uniqKey="Morandi X" first="Xavier" last="Morandi">Xavier Morandi</name>
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<series><title level="j">Journal of neurology</title>
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<term>Amygdala (anatomy & histology)</term>
<term>Amygdala (diagnostic imaging)</term>
<term>Amygdala (physiopathology)</term>
<term>Basal Ganglia (anatomy & histology)</term>
<term>Basal Ganglia (diagnostic imaging)</term>
<term>Basal Ganglia (physiopathology)</term>
<term>Brain Mapping (methods)</term>
<term>Cognition (physiology)</term>
<term>Cognition Disorders (diagnostic imaging)</term>
<term>Cognition Disorders (etiology)</term>
<term>Cognition Disorders (physiopathology)</term>
<term>Deep Brain Stimulation (adverse effects)</term>
<term>Emotions (physiology)</term>
<term>Female</term>
<term>Hippocampus (anatomy & histology)</term>
<term>Hippocampus (diagnostic imaging)</term>
<term>Hippocampus (physiopathology)</term>
<term>Humans</term>
<term>Image Processing, Computer-Assisted (methods)</term>
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<term>Male</term>
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<term>Neural Pathways (diagnostic imaging)</term>
<term>Neural Pathways (physiopathology)</term>
<term>Parkinson Disease (physiopathology)</term>
<term>Parkinson Disease (therapy)</term>
<term>Positron-Emission Tomography (methods)</term>
<term>Prefrontal Cortex (anatomy & histology)</term>
<term>Prefrontal Cortex (diagnostic imaging)</term>
<term>Prefrontal Cortex (physiopathology)</term>
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<term>Limbic System</term>
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<front><div type="abstract" xml:lang="en">The subthalamic nucleus (STN) has become an effective target of deep-brain stimulation (DBS) in severely disabled patients with advanced Parkinson's disease (PD). Clinical studies have reported DBS-induced adverse effects on cognitive functions, mood, emotion and behavior. STN DBS seems to interfere with the limbic functions of the basal ganglia, but the limbic effects of STN DBS are controversial. We measured prospectively resting regional cerebral metabolism (rCMb) with 18-fluorodeoxyglucose and PET, and resting regional cerebral blood flow (rCBF) with HMPAO and SPECT in six patients with Parkinson's disease. We compared PET and SPECT 1 month before and 3 months after STN DBS. On cerebral MRI, 13 regions of interest (ROI) were manually delineated slice by slice in frontal and limbic lobes. We obtained mean rCBF and rCMb values for each ROI and the whole brain. We normalized rCBF and rCMB values to ones for the whole brain volume, which we compared before and following STN DBS. No significant difference emerged in the SPECT analysis. PET analysis revealed a significant decrease in rCMb following STN DBS in the superior frontal gyri and left and right dorsolateral prefrontal cortex (p < 0.05). A non-significant decrease in rCMb in the left anterior cingulate gyrus appeared following STN DBS (p = 0.075). Our prospective SPECT and PET study revealed significantly decreased glucose metabolism of the two superior frontal gyri without any attendant perfusion changes following STN DBS. These results suggest that STN DBS may change medial prefrontal function and therefore the integration of limbic information, either by disrupting emotional processes within the STN, or by hampering the normal function of a limbic circuit.</div>
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