Deep Brain Stimulation of the Subthalamic Nucleus, but not Dopaminergic Medication, Improves Proactive Inhibitory Control of Movement Initiation in Parkinson's Disease
Identifieur interne : 001019 ( Ncbi/Checkpoint ); précédent : 001018; suivant : 001020Deep Brain Stimulation of the Subthalamic Nucleus, but not Dopaminergic Medication, Improves Proactive Inhibitory Control of Movement Initiation in Parkinson's Disease
Auteurs : Emilie Favre [France] ; Bénédicte Ballanger [France] ; Stéphane Thobois [France] ; Emmanuel Broussolle [France] ; Philippe Boulinguez [France]Source :
- Neurotherapeutics [ 1933-7213 ] ; 2012.
English descriptors
- KwdEn :
- MESH :
- chemical , therapeutic use : Dopamine Agents.
- chemical : Antiparkinson Agents.
- drug therapy : Parkinson Disease.
- physiology : Subthalamic Nucleus.
- physiopathology : Parkinson Disease.
- surgery : Parkinson Disease.
- Cues, Deep Brain Stimulation, Female, Humans, Male, Middle Aged, Reaction Time.
Abstract
Slowness in movement initiation is a cardinal feature of Parkinson’s disease (PD) that is still poorly understood and unsuccessfully alleviated by standard therapies. Here, we raise this major clinical issue within the framework of a novel theoretical model that allows a better understanding of the basic mechanisms involved in movement initiation. This model assumes that movement triggering is inhibited by default to prevent automatic responses to unpredictable events. We investigated to which extent the top-down control necessary to release this locking state before initiating actions is impaired in PD and restored by standard therapies. We used a cue–target reaction time task to test both the ability to initiate fast responses to targets and the ability to refrain from reacting to cues. Fourteen patients with dopaminergic (DA) medication and 11 with subthalamic nucleus (STN) stimulation were tested on and off treatment, and compared with 14 healthy controls. We found evidence that patients withdrawn from treatment have trouble voluntarily releasing proactive inhibitory control; while DA medication broadly reduces movement initiation latency, it does not reinstate a normal pattern of movement initiation; and stimulation of the STN specifically re-establishes the efficiency of the top-down control of proactive inhibition. These results suggest that movement initiation disorders that resist DA medication are due to executive, not motor, dysfunctions. This conclusion is discussed with regard to the role the STN may play as an interface between non-DA executive and DA motor systems in cortico-basal ganglia loops.
The online version of this article (doi:10.1007/s13311-012-0166-1) contains supplementary material, which is available to authorized users.
Url:
DOI: 10.1007/s13311-012-0166-1
PubMed: 23184315
PubMed Central: 3557357
Affiliations:
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Stimulation of the Subthalamic Nucleus, but not Dopaminergic Medication, Improves Proactive Inhibitory Control of Movement Initiation in Parkinson's Disease</title><author><name sortKey="Favre, Emilie" sort="Favre, Emilie" uniqKey="Favre E" first="Emilie" last="Favre">Emilie Favre</name><affiliation wicri:level="3"><nlm:aff id="Aff1">Université de Lyon, 69622 Lyon, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Université de Lyon, 69622 Lyon</wicri:regionArea><placeName><region type="region" nuts="2">Auvergne-Rhône-Alpes</region><region type="old region" nuts="2">Rhône-Alpes</region><settlement type="city">Lyon</settlement></placeName></affiliation><affiliation wicri:level="3"><nlm:aff id="Aff2">Université Lyon 1, Villeurbanne, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Université Lyon 1, Villeurbanne</wicri:regionArea><placeName><region type="region" nuts="2">Auvergne-Rhône-Alpes</region><region type="old region" 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Benedicte" sort="Ballanger, Benedicte" uniqKey="Ballanger B" first="Bénédicte" last="Ballanger">Bénédicte Ballanger</name><affiliation wicri:level="3"><nlm:aff id="Aff1">Université de Lyon, 69622 Lyon, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Université de Lyon, 69622 Lyon</wicri:regionArea><placeName><region type="region" nuts="2">Auvergne-Rhône-Alpes</region><region type="old region" nuts="2">Rhône-Alpes</region><settlement type="city">Lyon</settlement></placeName></affiliation><affiliation wicri:level="3"><nlm:aff id="Aff2">Université Lyon 1, Villeurbanne, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Université Lyon 1, Villeurbanne</wicri:regionArea><placeName><region type="region" nuts="2">Auvergne-Rhône-Alpes</region><region type="old region" nuts="2">Rhône-Alpes</region><settlement type="city">Villeurbanne</settlement><settlement type="city" wicri:auto="agglo">Lyon</settlement></placeName></affiliation><affiliation wicri:level="1"><nlm:aff id="Aff3">CNRS, UMR5229, Centre de Neuroscience Cognitive, Bron, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>CNRS, UMR5229, Centre de Neuroscience Cognitive, Bron</wicri:regionArea><wicri:noRegion>Bron</wicri:noRegion><wicri:noRegion>Bron</wicri:noRegion></affiliation></author><author><name sortKey="Thobois, Stephane" sort="Thobois, Stephane" uniqKey="Thobois S" first="Stéphane" last="Thobois">Stéphane Thobois</name><affiliation wicri:level="3"><nlm:aff id="Aff1">Université de Lyon, 69622 Lyon, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Université de Lyon, 69622 Lyon</wicri:regionArea><placeName><region type="region" nuts="2">Auvergne-Rhône-Alpes</region><region type="old region" nuts="2">Rhône-Alpes</region><settlement type="city">Lyon</settlement></placeName></affiliation><affiliation wicri:level="3"><nlm:aff id="Aff2">Université Lyon 1, Villeurbanne, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Université Lyon 1, Villeurbanne</wicri:regionArea><placeName><region type="region" nuts="2">Auvergne-Rhône-Alpes</region><region type="old region" nuts="2">Rhône-Alpes</region><settlement type="city">Villeurbanne</settlement><settlement type="city" wicri:auto="agglo">Lyon</settlement></placeName></affiliation><affiliation wicri:level="1"><nlm:aff id="Aff3">CNRS, UMR5229, Centre de Neuroscience Cognitive, Bron, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>CNRS, UMR5229, Centre de Neuroscience Cognitive, Bron</wicri:regionArea><wicri:noRegion>Bron</wicri:noRegion><wicri:noRegion>Bron</wicri:noRegion></affiliation><affiliation wicri:level="3"><nlm:aff id="Aff4">Hopital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Lyon, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Hopital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Lyon</wicri:regionArea><placeName><region type="region">Auvergne-Rhône-Alpes</region><region type="old region">Rhône-Alpes</region><settlement type="city">Lyon</settlement></placeName></affiliation></author><author><name sortKey="Broussolle, Emmanuel" sort="Broussolle, Emmanuel" uniqKey="Broussolle E" first="Emmanuel" last="Broussolle">Emmanuel Broussolle</name><affiliation wicri:level="3"><nlm:aff id="Aff1">Université de Lyon, 69622 Lyon, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Université de Lyon, 69622 Lyon</wicri:regionArea><placeName><region type="region" nuts="2">Auvergne-Rhône-Alpes</region><region type="old region" nuts="2">Rhône-Alpes</region><settlement type="city">Lyon</settlement></placeName></affiliation><affiliation wicri:level="3"><nlm:aff id="Aff2">Université Lyon 1, Villeurbanne, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Université Lyon 1, Villeurbanne</wicri:regionArea><placeName><region type="region" nuts="2">Auvergne-Rhône-Alpes</region><region type="old region" nuts="2">Rhône-Alpes</region><settlement type="city">Villeurbanne</settlement><settlement type="city" wicri:auto="agglo">Lyon</settlement></placeName></affiliation><affiliation wicri:level="1"><nlm:aff id="Aff3">CNRS, UMR5229, Centre de Neuroscience Cognitive, Bron, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>CNRS, UMR5229, Centre de Neuroscience Cognitive, Bron</wicri:regionArea><wicri:noRegion>Bron</wicri:noRegion><wicri:noRegion>Bron</wicri:noRegion></affiliation><affiliation wicri:level="3"><nlm:aff id="Aff4">Hopital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Lyon, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Hopital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Lyon</wicri:regionArea><placeName><region type="region">Auvergne-Rhône-Alpes</region><region type="old region">Rhône-Alpes</region><settlement type="city">Lyon</settlement></placeName></affiliation></author><author><name sortKey="Boulinguez, Philippe" sort="Boulinguez, Philippe" uniqKey="Boulinguez P" first="Philippe" last="Boulinguez">Philippe Boulinguez</name><affiliation wicri:level="3"><nlm:aff id="Aff1">Université de Lyon, 69622 Lyon, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Université de Lyon, 69622 Lyon</wicri:regionArea><placeName><region type="region" nuts="2">Auvergne-Rhône-Alpes</region><region type="old region" nuts="2">Rhône-Alpes</region><settlement type="city">Lyon</settlement></placeName></affiliation><affiliation wicri:level="3"><nlm:aff id="Aff2">Université Lyon 1, Villeurbanne, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Université Lyon 1, Villeurbanne</wicri:regionArea><placeName><region type="region" nuts="2">Auvergne-Rhône-Alpes</region><region type="old region" nuts="2">Rhône-Alpes</region><settlement type="city">Villeurbanne</settlement><settlement type="city" wicri:auto="agglo">Lyon</settlement></placeName></affiliation><affiliation wicri:level="1"><nlm:aff id="Aff3">CNRS, UMR5229, Centre de Neuroscience Cognitive, Bron, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>CNRS, UMR5229, Centre de Neuroscience Cognitive, Bron</wicri:regionArea><wicri:noRegion>Bron</wicri:noRegion><wicri:noRegion>Bron</wicri:noRegion></affiliation></author></analytic><series><title level="j">Neurotherapeutics</title><idno type="ISSN">1933-7213</idno><idno type="eISSN">1878-7479</idno><imprint><date when="2012">2012</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Antiparkinson Agents</term><term>Cues</term><term>Deep Brain Stimulation</term><term>Dopamine Agents (therapeutic use)</term><term>Female</term><term>Humans</term><term>Male</term><term>Middle Aged</term><term>Parkinson Disease (drug therapy)</term><term>Parkinson Disease (physiopathology)</term><term>Parkinson Disease (surgery)</term><term>Reaction Time</term><term>Subthalamic Nucleus (physiology)</term></keywords><keywords scheme="MESH" type="chemical" qualifier="therapeutic use" xml:lang="en"><term>Dopamine Agents</term></keywords><keywords scheme="MESH" type="chemical" xml:lang="en"><term>Antiparkinson Agents</term></keywords><keywords scheme="MESH" qualifier="drug therapy" xml:lang="en"><term>Parkinson Disease</term></keywords><keywords scheme="MESH" qualifier="physiology" xml:lang="en"><term>Subthalamic Nucleus</term></keywords><keywords scheme="MESH" qualifier="physiopathology" xml:lang="en"><term>Parkinson Disease</term></keywords><keywords scheme="MESH" qualifier="surgery" xml:lang="en"><term>Parkinson Disease</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Cues</term><term>Deep Brain Stimulation</term><term>Female</term><term>Humans</term><term>Male</term><term>Middle Aged</term><term>Reaction Time</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p>Slowness in movement initiation is a cardinal feature of Parkinson’s disease (PD) that is still poorly understood and unsuccessfully alleviated by standard therapies. Here, we raise this major clinical issue within the framework of a novel theoretical model that allows a better understanding of the basic mechanisms involved in movement initiation. This model assumes that movement triggering is inhibited by default to prevent automatic responses to unpredictable events. We investigated to which extent the top-down control necessary to release this locking state before initiating actions is impaired in PD and restored by standard therapies. We used a cue–target reaction time task to test both the ability to initiate fast responses to targets and the ability to refrain from reacting to cues. Fourteen patients with dopaminergic (DA) medication and 11 with subthalamic nucleus (STN) stimulation were tested on and off treatment, and compared with 14 healthy controls. We found evidence that patients withdrawn from treatment have trouble voluntarily releasing proactive inhibitory control; while DA medication broadly reduces movement initiation latency, it does not reinstate a normal pattern of movement initiation; and stimulation of the STN specifically re-establishes the efficiency of the top-down control of proactive inhibition. These results suggest that movement initiation disorders that resist DA medication are due to executive, not motor, dysfunctions. This conclusion is discussed with regard to the role the STN may play as an interface between non-DA executive and DA motor systems in cortico-basal ganglia loops.</p><sec><title>Electronic supplementary material</title><p>The online version of this article (doi:10.1007/s13311-012-0166-1) contains supplementary material, which is available to authorized users.</p></sec></div></front></TEI><affiliations><list><country><li>France</li></country><region><li>Auvergne-Rhône-Alpes</li><li>Rhône-Alpes</li></region><settlement><li>Lyon</li><li>Villeurbanne</li></settlement></list><tree><country name="France"><region name="Auvergne-Rhône-Alpes"><name sortKey="Favre, Emilie" sort="Favre, Emilie" uniqKey="Favre E" first="Emilie" last="Favre">Emilie Favre</name></region><name sortKey="Ballanger, Benedicte" sort="Ballanger, Benedicte" uniqKey="Ballanger B" first="Bénédicte" last="Ballanger">Bénédicte Ballanger</name><name sortKey="Ballanger, Benedicte" sort="Ballanger, Benedicte" uniqKey="Ballanger B" first="Bénédicte" last="Ballanger">Bénédicte Ballanger</name><name sortKey="Ballanger, Benedicte" sort="Ballanger, Benedicte" uniqKey="Ballanger B" first="Bénédicte" last="Ballanger">Bénédicte Ballanger</name><name sortKey="Boulinguez, Philippe" sort="Boulinguez, Philippe" uniqKey="Boulinguez P" first="Philippe" last="Boulinguez">Philippe Boulinguez</name><name sortKey="Boulinguez, Philippe" sort="Boulinguez, Philippe" uniqKey="Boulinguez P" first="Philippe" last="Boulinguez">Philippe Boulinguez</name><name sortKey="Boulinguez, Philippe" sort="Boulinguez, Philippe" uniqKey="Boulinguez P" first="Philippe" last="Boulinguez">Philippe Boulinguez</name><name sortKey="Broussolle, Emmanuel" sort="Broussolle, Emmanuel" uniqKey="Broussolle E" first="Emmanuel" last="Broussolle">Emmanuel Broussolle</name><name sortKey="Broussolle, Emmanuel" sort="Broussolle, Emmanuel" uniqKey="Broussolle E" first="Emmanuel" last="Broussolle">Emmanuel Broussolle</name><name sortKey="Broussolle, Emmanuel" sort="Broussolle, Emmanuel" uniqKey="Broussolle E" first="Emmanuel" last="Broussolle">Emmanuel Broussolle</name><name sortKey="Broussolle, Emmanuel" sort="Broussolle, Emmanuel" uniqKey="Broussolle E" first="Emmanuel" last="Broussolle">Emmanuel Broussolle</name><name sortKey="Favre, Emilie" sort="Favre, Emilie" uniqKey="Favre E" first="Emilie" last="Favre">Emilie Favre</name><name sortKey="Favre, Emilie" sort="Favre, Emilie" uniqKey="Favre E" first="Emilie" last="Favre">Emilie Favre</name><name sortKey="Favre, Emilie" sort="Favre, Emilie" uniqKey="Favre E" first="Emilie" last="Favre">Emilie Favre</name><name sortKey="Thobois, Stephane" sort="Thobois, Stephane" uniqKey="Thobois S" first="Stéphane" last="Thobois">Stéphane Thobois</name><name sortKey="Thobois, Stephane" sort="Thobois, Stephane" uniqKey="Thobois S" first="Stéphane" last="Thobois">Stéphane Thobois</name><name sortKey="Thobois, Stephane" sort="Thobois, Stephane" uniqKey="Thobois S" first="Stéphane" last="Thobois">Stéphane Thobois</name><name sortKey="Thobois, Stephane" sort="Thobois, Stephane" uniqKey="Thobois S" first="Stéphane" last="Thobois">Stéphane Thobois</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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