Does subthalamic nucleus stimulation affect the frontal limbic areas? A single-photon emission computed tomography study using a manual anatomical segmentation method
Identifieur interne : 002D78 ( Main/Exploration ); précédent : 002D77; suivant : 002D79Does subthalamic nucleus stimulation affect the frontal limbic areas? A single-photon emission computed tomography study using a manual anatomical segmentation method
Auteurs : C. Haegelen [France] ; M. Verin [France] ; B. Aubert Broche [France] ; F. Prigent [France] ; P. Jannin [France] ; B. Gibaud [France] ; X. Morandi [France]Source :
- Surgical and radiologic anatomy : (Print) [ 0930-1038 ] ; 2005.
Descripteurs français
- Pascal (Inist)
- Wicri :
English descriptors
- KwdEn :
- Antiparkinson Agents (therapeutic use), Brain, Cerebrovascular Circulation (physiology), Cognition (physiology), Deep Brain Stimulation, Encephalon, Female, Frontal, Frontal Lobe (physiopathology), Gyrus Cinguli (physiopathology), Humans, Image Processing, Computer-Assisted (methods), Imaging, Three-Dimensional (methods), Levodopa (therapeutic use), Limbic System (physiopathology), Limbic system, Magnetic Resonance Imaging (methods), Male, Manuals, Medicine, Method, Methodology, Middle Aged, Neural Pathways (physiopathology), Nuclear magnetic resonance imaging, Parkinson Disease (physiopathology), Parkinson Disease (therapy), Prefrontal Cortex (physiopathology), Prospective Studies, Segmentation, Single photon emission tomography, Stimulation, Subthalamic Nucleus (physiopathology), Subthalamic nucleus, Surgery, Tomography, Emission-Computed, Single-Photon (methods), Treatment.
- MESH :
- chemical , therapeutic use : Antiparkinson Agents, Levodopa.
- methods : Image Processing, Computer-Assisted, Imaging, Three-Dimensional, Magnetic Resonance Imaging, Tomography, Emission-Computed, Single-Photon.
- physiology : Cerebrovascular Circulation, Cognition.
- physiopathology : Frontal Lobe, Gyrus Cinguli, Limbic System, Neural Pathways, Parkinson Disease, Prefrontal Cortex, Subthalamic Nucleus.
- therapy : Parkinson Disease.
- Deep Brain Stimulation, Female, Humans, Male, Middle Aged, Prospective Studies.
Abstract
Among the basal ganglia nuclei, the subthalamic nucleus (STN) is considered to play a major role in output modulation. The STN represents a relay of the motor cortico-basal ganglia-thalamo-cortical circuit and has become the standard surgical target for treating Parkinson's patients with long-term motor fluctuations and dyskinesia. But chronic bilateral stimulation of the STN produces cognitive effects. According to animal and clinical studies, the STN also appears to have direct or indirect connections with the frontal associative and limbic areas. This prospective study was conducted to analyse regional cerebral blood flow changes in single-photon emission computed tomography imaging of six Parkinson's patients before and after STN stimulation. We particularly focused on the dorsolateral prefrontal cortex and the frontal limbic areas using a manual anatomical MRI segmentation method. We defined nine regions of interest, segmenting each MR slice to quantify the regional cerebral blood flow on pre- and postoperative SPECT images. We normalised the region-of-interest-based measurements to the entire brain volume. The, patients showed increased activation during STN stimulation in the dorsolateral prefrontal cortex bilaterally and no change in the anterior cingulate and orbitofrontal cortices. In our study, STN stimulation induced activation of premotor and associative frontal areas. Further studies are needed to underline involvement of the STN with the so-called limbic system.
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Le document en format XML
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<term>Cognition (physiology)</term>
<term>Deep Brain Stimulation</term>
<term>Encephalon</term>
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<term>Neural Pathways</term>
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<front><div type="abstract" xml:lang="en">Among the basal ganglia nuclei, the subthalamic nucleus (STN) is considered to play a major role in output modulation. The STN represents a relay of the motor cortico-basal ganglia-thalamo-cortical circuit and has become the standard surgical target for treating Parkinson's patients with long-term motor fluctuations and dyskinesia. But chronic bilateral stimulation of the STN produces cognitive effects. According to animal and clinical studies, the STN also appears to have direct or indirect connections with the frontal associative and limbic areas. This prospective study was conducted to analyse regional cerebral blood flow changes in single-photon emission computed tomography imaging of six Parkinson's patients before and after STN stimulation. We particularly focused on the dorsolateral prefrontal cortex and the frontal limbic areas using a manual anatomical MRI segmentation method. We defined nine regions of interest, segmenting each MR slice to quantify the regional cerebral blood flow on pre- and postoperative SPECT images. We normalised the region-of-interest-based measurements to the entire brain volume. The, patients showed increased activation during STN stimulation in the dorsolateral prefrontal cortex bilaterally and no change in the anterior cingulate and orbitofrontal cortices. In our study, STN stimulation induced activation of premotor and associative frontal areas. Further studies are needed to underline involvement of the STN with the so-called limbic system.</div>
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