SPECT and PET analysis of subthalamic stimulation in Parkinson's disease: analysis using a manual segmentation
Identifieur interne : 000454 ( PascalFrancis/Checkpoint ); précédent : 000453; suivant : 000455SPECT 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.
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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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type="city">Rennes</settlement></placeName></affiliation></author><author><name sortKey="Verin, Marc" sort="Verin, Marc" uniqKey="Verin M" first="Marc" last="Verin">Marc Verin</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><sZ>9 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region" nuts="2">Région Bretagne</region><settlement type="city">Rennes</settlement></placeName></affiliation></author><author><name sortKey="Morandi, Xavier" sort="Morandi, Xavier" uniqKey="Morandi X" first="Xavier" last="Morandi">Xavier Morandi</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><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>7 aut.</sZ><sZ>8 aut.</sZ><sZ>10 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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><s3>FRA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>7 aut.</sZ><sZ>8 aut.</sZ><sZ>10 aut.</sZ></inist:fA14><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="02"><s1>INSERM, U746, CS 34317</s1><s2>35043 Rennes</s2><s3>FRA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>7 aut.</sZ><sZ>8 aut.</sZ><sZ>10 aut.</sZ></inist:fA14><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="03"><s1>INRIA, VisAGeS Unit/Project</s1><s2>35042 Rennes</s2><s3>FRA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>7 aut.</sZ><sZ>8 aut.</sZ><sZ>10 aut.</sZ></inist:fA14><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><s2>35042 Rennes</s2><s3>FRA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>7 aut.</sZ><sZ>8 aut.</sZ><sZ>10 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region" nuts="2">Région Bretagne</region><settlement type="city">Rennes</settlement></placeName></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><s3>FRA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>7 aut.</sZ><sZ>8 aut.</sZ><sZ>10 aut.</sZ></inist:fA14><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="02"><s1>INSERM, U746, CS 34317</s1><s2>35043 Rennes</s2><s3>FRA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>7 aut.</sZ><sZ>8 aut.</sZ><sZ>10 aut.</sZ></inist:fA14><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="03"><s1>INRIA, VisAGeS Unit/Project</s1><s2>35042 Rennes</s2><s3>FRA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>7 aut.</sZ><sZ>8 aut.</sZ><sZ>10 aut.</sZ></inist:fA14><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><s2>35042 Rennes</s2><s3>FRA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>7 aut.</sZ><sZ>8 aut.</sZ><sZ>10 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region" nuts="2">Région Bretagne</region><settlement type="city">Rennes</settlement></placeName></affiliation></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><s3>FRA</s3><sZ>3 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region" nuts="2">Région Bretagne</region><settlement type="city">Rennes</settlement></placeName></affiliation></author><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><sZ>9 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region" nuts="2">Région Bretagne</region><settlement type="city">Rennes</settlement></placeName></affiliation></author><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><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>7 aut.</sZ><sZ>8 aut.</sZ><sZ>10 aut.</sZ></inist:fA14><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="02"><s1>INSERM, U746, CS 34317</s1><s2>35043 Rennes</s2><s3>FRA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>7 aut.</sZ><sZ>8 aut.</sZ><sZ>10 aut.</sZ></inist:fA14><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="03"><s1>INRIA, VisAGeS Unit/Project</s1><s2>35042 Rennes</s2><s3>FRA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>7 aut.</sZ><sZ>8 aut.</sZ><sZ>10 aut.</sZ></inist:fA14><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><s2>35042 Rennes</s2><s3>FRA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>7 aut.</sZ><sZ>8 aut.</sZ><sZ>10 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region" nuts="2">Région Bretagne</region><settlement type="city">Rennes</settlement></placeName></affiliation></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><s3>FRA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>7 aut.</sZ><sZ>8 aut.</sZ><sZ>10 aut.</sZ></inist:fA14><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="02"><s1>INSERM, U746, CS 34317</s1><s2>35043 Rennes</s2><s3>FRA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>7 aut.</sZ><sZ>8 aut.</sZ><sZ>10 aut.</sZ></inist:fA14><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="03"><s1>INRIA, VisAGeS Unit/Project</s1><s2>35042 Rennes</s2><s3>FRA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>7 aut.</sZ><sZ>8 aut.</sZ><sZ>10 aut.</sZ></inist:fA14><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><s2>35042 Rennes</s2><s3>FRA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>7 aut.</sZ><sZ>8 aut.</sZ><sZ>10 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region" nuts="2">Région Bretagne</region><settlement type="city">Rennes</settlement></placeName></affiliation></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><s3>FRA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>7 aut.</sZ><sZ>8 aut.</sZ><sZ>10 aut.</sZ></inist:fA14><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="02"><s1>INSERM, U746, CS 34317</s1><s2>35043 Rennes</s2><s3>FRA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>7 aut.</sZ><sZ>8 aut.</sZ><sZ>10 aut.</sZ></inist:fA14><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="03"><s1>INRIA, VisAGeS Unit/Project</s1><s2>35042 Rennes</s2><s3>FRA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>7 aut.</sZ><sZ>8 aut.</sZ><sZ>10 aut.</sZ></inist:fA14><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><s2>35042 Rennes</s2><s3>FRA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>7 aut.</sZ><sZ>8 aut.</sZ><sZ>10 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region" nuts="2">Région Bretagne</region><settlement type="city">Rennes</settlement></placeName></affiliation></author><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><s3>FRA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>7 aut.</sZ><sZ>8 aut.</sZ><sZ>10 aut.</sZ></inist:fA14><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="02"><s1>INSERM, U746, CS 34317</s1><s2>35043 Rennes</s2><s3>FRA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>7 aut.</sZ><sZ>8 aut.</sZ><sZ>10 aut.</sZ></inist:fA14><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="03"><s1>INRIA, VisAGeS Unit/Project</s1><s2>35042 Rennes</s2><s3>FRA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>7 aut.</sZ><sZ>8 aut.</sZ><sZ>10 aut.</sZ></inist:fA14><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><s2>35042 Rennes</s2><s3>FRA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>7 aut.</sZ><sZ>8 aut.</sZ><sZ>10 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region" nuts="2">Région Bretagne</region><settlement type="city">Rennes</settlement></placeName></affiliation></author><author><name sortKey="Verin, Marc" sort="Verin, Marc" uniqKey="Verin M" first="Marc" last="Verin">Marc Verin</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><sZ>9 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region" nuts="2">Région Bretagne</region><settlement type="city">Rennes</settlement></placeName></affiliation></author><author><name sortKey="Morandi, Xavier" sort="Morandi, Xavier" uniqKey="Morandi X" first="Xavier" last="Morandi">Xavier Morandi</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><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>7 aut.</sZ><sZ>8 aut.</sZ><sZ>10 aut.</sZ></inist:fA14><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="02"><s1>INSERM, U746, CS 34317</s1><s2>35043 Rennes</s2><s3>FRA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>7 aut.</sZ><sZ>8 aut.</sZ><sZ>10 aut.</sZ></inist:fA14><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="03"><s1>INRIA, VisAGeS Unit/Project</s1><s2>35042 Rennes</s2><s3>FRA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>7 aut.</sZ><sZ>8 aut.</sZ><sZ>10 aut.</sZ></inist:fA14><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><s2>35042 Rennes</s2><s3>FRA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>7 aut.</sZ><sZ>8 aut.</sZ><sZ>10 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region" nuts="2">Région Bretagne</region><settlement type="city">Rennes</settlement></placeName></affiliation></author></analytic><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>Deep brain stimulation</term><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></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></textClass></profileDesc></teiHeader><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><inist><standard h6="B"><pA><fA01 i1="01" i2="1"><s0>0340-5354</s0></fA01><fA02 i1="01"><s0>JNRYA9</s0></fA02><fA03 i2="1"><s0>J. neurol.</s0></fA03><fA05><s2>257</s2></fA05><fA06><s2>3</s2></fA06><fA08 i1="01" i2="1" l="ENG"><s1>SPECT and PET analysis of subthalamic stimulation in Parkinson's disease: analysis using a manual segmentation</s1></fA08><fA11 i1="01" i2="1"><s1>HAEGELEN (Claire)</s1></fA11><fA11 i1="02" i2="1"><s1>GARCIA-LORENZO (Daniel)</s1></fA11><fA11 i1="03" i2="1"><s1>LE JEUNE (Florence)</s1></fA11><fA11 i1="04" i2="1"><s1>PERON (Julie)</s1></fA11><fA11 i1="05" i2="1"><s1>GIBAUD (Bernard)</s1></fA11><fA11 i1="06" i2="1"><s1>RIFFAUD (Laurent)</s1></fA11><fA11 i1="07" i2="1"><s1>BRASSIER (Gilles)</s1></fA11><fA11 i1="08" i2="1"><s1>BARILLOT (Christian)</s1></fA11><fA11 i1="09" i2="1"><s1>VERIN (Marc)</s1></fA11><fA11 i1="10" i2="1"><s1>MORANDI (Xavier)</s1></fA11><fA14 i1="01"><s1>Department of Neurosurgery, Pontchaillou Hospital, 2 rue Henri Le Guilloux</s1><s2>35033 Rennes</s2><s3>FRA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>7 aut.</sZ><sZ>8 aut.</sZ><sZ>10 aut.</sZ></fA14><fA14 i1="02"><s1>INSERM, U746, CS 34317</s1><s2>35043 Rennes</s2><s3>FRA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>7 aut.</sZ><sZ>8 aut.</sZ><sZ>10 aut.</sZ></fA14><fA14 i1="03"><s1>INRIA, VisAGeS Unit/Project</s1><s2>35042 Rennes</s2><s3>FRA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>7 aut.</sZ><sZ>8 aut.</sZ><sZ>10 aut.</sZ></fA14><fA14 i1="04"><s1>CNRS, UMR 6074, IRISA</s1><s2>35042 Rennes</s2><s3>FRA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>7 aut.</sZ><sZ>8 aut.</sZ><sZ>10 aut.</sZ></fA14><fA14 i1="05"><s1>Department of Nuclear Medicine, Centre Eugène Marquis, Rue de la Bataille Flandres Dunkerque</s1><s2>35042 Rennes</s2><s3>FRA</s3><sZ>3 aut.</sZ></fA14><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><sZ>9 aut.</sZ></fA14><fA20><s1>375-382</s1></fA20><fA21><s1>2010</s1></fA21><fA23 i1="01"><s0>ENG</s0></fA23><fA43 i1="01"><s1>INIST</s1><s2>4826</s2><s5>354000181898380110</s5></fA43><fA44><s0>0000</s0><s1>© 2010 INIST-CNRS. All rights reserved.</s1></fA44><fA45><s0>47 ref.</s0></fA45><fA47 i1="01" i2="1"><s0>10-0175598</s0></fA47><fA60><s1>P</s1></fA60><fA61><s0>A</s0></fA61><fA64 i1="01" i2="1"><s0>Journal of neurology</s0></fA64><fA66 i1="01"><s0>DEU</s0></fA66><fC01 i1="01" l="ENG"><s0>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.</s0></fC01><fC02 i1="01" i2="X"><s0>002B17</s0></fC02><fC02 i1="02" i2="X"><s0>002B17G</s0></fC02><fC03 i1="01" i2="X" l="FRE"><s0>Maladie de Parkinson</s0><s2>NM</s2><s5>01</s5></fC03><fC03 i1="01" i2="X" l="ENG"><s0>Parkinson disease</s0><s2>NM</s2><s5>01</s5></fC03><fC03 i1="01" i2="X" l="SPA"><s0>Parkinson enfermedad</s0><s2>NM</s2><s5>01</s5></fC03><fC03 i1="02" i2="X" l="FRE"><s0>Pathologie du système nerveux</s0><s5>02</s5></fC03><fC03 i1="02" i2="X" l="ENG"><s0>Nervous system diseases</s0><s5>02</s5></fC03><fC03 i1="02" i2="X" l="SPA"><s0>Sistema nervioso patología</s0><s5>02</s5></fC03><fC03 i1="03" i2="X" l="FRE"><s0>Tomoscintigraphie émission monophotonique</s0><s5>09</s5></fC03><fC03 i1="03" i2="X" l="ENG"><s0>Single photon emission tomography</s0><s5>09</s5></fC03><fC03 i1="03" i2="X" l="SPA"><s0>Tomografía emisión fotón único</s0><s5>09</s5></fC03><fC03 i1="04" i2="X" l="FRE"><s0>Photon</s0><s5>10</s5></fC03><fC03 i1="04" i2="X" l="ENG"><s0>Photon</s0><s5>10</s5></fC03><fC03 i1="04" i2="X" l="SPA"><s0>Fotón</s0><s5>10</s5></fC03><fC03 i1="05" i2="X" l="FRE"><s0>Tomographie par émission de positons</s0><s5>11</s5></fC03><fC03 i1="05" i2="X" l="ENG"><s0>Positron emission tomography</s0><s5>11</s5></fC03><fC03 i1="05" i2="X" l="SPA"><s0>Tomografía emisión positrones</s0><s5>11</s5></fC03><fC03 i1="06" i2="X" l="FRE"><s0>Manuel</s0><s5>12</s5></fC03><fC03 i1="06" i2="X" l="ENG"><s0>Manuals</s0><s5>12</s5></fC03><fC03 i1="06" i2="X" l="SPA"><s0>Manual</s0><s5>12</s5></fC03><fC03 i1="07" i2="X" l="FRE"><s0>Segmentation</s0><s5>13</s5></fC03><fC03 i1="07" i2="X" l="ENG"><s0>Segmentation</s0><s5>13</s5></fC03><fC03 i1="07" i2="X" l="SPA"><s0>Segmentación</s0><s5>13</s5></fC03><fC03 i1="08" i2="X" l="FRE"><s0>Traitement image</s0><s5>14</s5></fC03><fC03 i1="08" i2="X" l="ENG"><s0>Image processing</s0><s5>14</s5></fC03><fC03 i1="08" i2="X" l="SPA"><s0>Procesamiento imagen</s0><s5>14</s5></fC03><fC03 i1="09" i2="X" l="FRE"><s0>Imagerie fonctionnelle</s0><s5>15</s5></fC03><fC03 i1="09" i2="X" l="ENG"><s0>Functional imaging</s0><s5>15</s5></fC03><fC03 i1="09" i2="X" l="SPA"><s0>Imaginería funcional</s0><s5>15</s5></fC03><fC03 i1="10" i2="X" l="FRE"><s0>Système limbique</s0><s5>16</s5></fC03><fC03 i1="10" i2="X" l="ENG"><s0>Limbic system</s0><s5>16</s5></fC03><fC03 i1="10" i2="X" l="SPA"><s0>Sistema límbico</s0><s5>16</s5></fC03><fC03 i1="11" i2="X" l="FRE"><s0>Noyau sousthalamique</s0><s5>17</s5></fC03><fC03 i1="11" i2="X" l="ENG"><s0>Subthalamic nucleus</s0><s5>17</s5></fC03><fC03 i1="11" i2="X" l="SPA"><s0>Núcleo subtalámico</s0><s5>17</s5></fC03><fC03 i1="12" i2="X" l="FRE"><s0>Stimulation cérébrale profonde</s0><s4>CD</s4><s5>96</s5></fC03><fC03 i1="12" i2="X" l="ENG"><s0>Deep brain stimulation</s0><s4>CD</s4><s5>96</s5></fC03><fC07 i1="01" i2="X" l="FRE"><s0>Pathologie de l'encéphale</s0><s5>37</s5></fC07><fC07 i1="01" i2="X" l="ENG"><s0>Cerebral disorder</s0><s5>37</s5></fC07><fC07 i1="01" i2="X" l="SPA"><s0>Encéfalo patología</s0><s5>37</s5></fC07><fC07 i1="02" i2="X" l="FRE"><s0>Syndrome extrapyramidal</s0><s5>38</s5></fC07><fC07 i1="02" i2="X" l="ENG"><s0>Extrapyramidal syndrome</s0><s5>38</s5></fC07><fC07 i1="02" i2="X" l="SPA"><s0>Extrapiramidal síndrome</s0><s5>38</s5></fC07><fC07 i1="03" i2="X" l="FRE"><s0>Maladie dégénérative</s0><s5>39</s5></fC07><fC07 i1="03" i2="X" l="ENG"><s0>Degenerative disease</s0><s5>39</s5></fC07><fC07 i1="03" i2="X" l="SPA"><s0>Enfermedad degenerativa</s0><s5>39</s5></fC07><fC07 i1="04" i2="X" l="FRE"><s0>Pathologie du système nerveux central</s0><s5>40</s5></fC07><fC07 i1="04" i2="X" l="ENG"><s0>Central nervous system disease</s0><s5>40</s5></fC07><fC07 i1="04" i2="X" l="SPA"><s0>Sistema nervosio central patología</s0><s5>40</s5></fC07><fC07 i1="05" i2="X" l="FRE"><s0>Encéphale</s0><s5>42</s5></fC07><fC07 i1="05" i2="X" l="ENG"><s0>Encephalon</s0><s5>42</s5></fC07><fC07 i1="05" i2="X" l="SPA"><s0>Encéfalo</s0><s5>42</s5></fC07><fC07 i1="06" i2="X" l="FRE"><s0>Système nerveux central</s0><s5>43</s5></fC07><fC07 i1="06" i2="X" l="ENG"><s0>Central nervous system</s0><s5>43</s5></fC07><fC07 i1="06" i2="X" l="SPA"><s0>Sistema nervioso central</s0><s5>43</s5></fC07><fN21><s1>116</s1></fN21><fN44 i1="01"><s1>OTO</s1></fN44><fN82><s1>OTO</s1></fN82></pA></standard></inist><affiliations><list><country><li>France</li></country><region><li>Région Bretagne</li></region><settlement><li>Rennes</li></settlement></list><tree><country name="France"><region name="Région Bretagne"><name sortKey="Haegelen, Claire" sort="Haegelen, Claire" uniqKey="Haegelen C" first="Claire" last="Haegelen">Claire Haegelen</name></region><name sortKey="Barillot, Christian" sort="Barillot, Christian" uniqKey="Barillot C" first="Christian" last="Barillot">Christian Barillot</name><name sortKey="Barillot, Christian" sort="Barillot, Christian" uniqKey="Barillot C" first="Christian" last="Barillot">Christian Barillot</name><name sortKey="Barillot, Christian" sort="Barillot, Christian" uniqKey="Barillot C" first="Christian" last="Barillot">Christian Barillot</name><name sortKey="Barillot, Christian" sort="Barillot, Christian" uniqKey="Barillot C" first="Christian" last="Barillot">Christian Barillot</name><name sortKey="Brassier, Gilles" sort="Brassier, Gilles" uniqKey="Brassier G" first="Gilles" last="Brassier">Gilles Brassier</name><name sortKey="Brassier, Gilles" sort="Brassier, Gilles" uniqKey="Brassier G" first="Gilles" last="Brassier">Gilles Brassier</name><name sortKey="Brassier, Gilles" sort="Brassier, Gilles" uniqKey="Brassier G" first="Gilles" last="Brassier">Gilles Brassier</name><name sortKey="Brassier, Gilles" sort="Brassier, Gilles" uniqKey="Brassier G" first="Gilles" last="Brassier">Gilles Brassier</name><name sortKey="Garcia Lorenzo, Daniel" sort="Garcia Lorenzo, Daniel" uniqKey="Garcia Lorenzo D" first="Daniel" last="Garcia-Lorenzo">Daniel Garcia-Lorenzo</name><name sortKey="Garcia Lorenzo, Daniel" sort="Garcia Lorenzo, Daniel" uniqKey="Garcia Lorenzo D" first="Daniel" last="Garcia-Lorenzo">Daniel Garcia-Lorenzo</name><name sortKey="Garcia Lorenzo, Daniel" sort="Garcia Lorenzo, Daniel" uniqKey="Garcia Lorenzo D" first="Daniel" last="Garcia-Lorenzo">Daniel Garcia-Lorenzo</name><name sortKey="Garcia Lorenzo, Daniel" sort="Garcia Lorenzo, Daniel" uniqKey="Garcia Lorenzo D" first="Daniel" last="Garcia-Lorenzo">Daniel Garcia-Lorenzo</name><name sortKey="Gibaud, Bernard" sort="Gibaud, Bernard" uniqKey="Gibaud B" first="Bernard" last="Gibaud">Bernard Gibaud</name><name sortKey="Gibaud, Bernard" sort="Gibaud, Bernard" uniqKey="Gibaud B" first="Bernard" last="Gibaud">Bernard Gibaud</name><name sortKey="Gibaud, Bernard" sort="Gibaud, Bernard" uniqKey="Gibaud B" first="Bernard" last="Gibaud">Bernard Gibaud</name><name sortKey="Gibaud, Bernard" sort="Gibaud, Bernard" uniqKey="Gibaud B" first="Bernard" last="Gibaud">Bernard Gibaud</name><name sortKey="Haegelen, Claire" sort="Haegelen, Claire" uniqKey="Haegelen C" first="Claire" last="Haegelen">Claire Haegelen</name><name sortKey="Haegelen, Claire" sort="Haegelen, Claire" uniqKey="Haegelen C" first="Claire" last="Haegelen">Claire Haegelen</name><name sortKey="Haegelen, Claire" sort="Haegelen, Claire" uniqKey="Haegelen C" first="Claire" last="Haegelen">Claire Haegelen</name><name sortKey="Le Jeune, Florence" sort="Le Jeune, Florence" uniqKey="Le Jeune F" first="Florence" last="Le Jeune">Florence Le Jeune</name><name sortKey="Morandi, Xavier" sort="Morandi, Xavier" uniqKey="Morandi X" first="Xavier" last="Morandi">Xavier Morandi</name><name sortKey="Morandi, Xavier" sort="Morandi, Xavier" uniqKey="Morandi X" first="Xavier" last="Morandi">Xavier Morandi</name><name sortKey="Morandi, Xavier" sort="Morandi, Xavier" uniqKey="Morandi X" first="Xavier" last="Morandi">Xavier Morandi</name><name sortKey="Morandi, Xavier" sort="Morandi, Xavier" uniqKey="Morandi X" first="Xavier" last="Morandi">Xavier Morandi</name><name sortKey="Peron, Julie" sort="Peron, Julie" uniqKey="Peron J" first="Julie" last="Peron">Julie Peron</name><name sortKey="Riffaud, Laurent" sort="Riffaud, Laurent" uniqKey="Riffaud L" first="Laurent" last="Riffaud">Laurent Riffaud</name><name sortKey="Riffaud, Laurent" sort="Riffaud, Laurent" uniqKey="Riffaud L" first="Laurent" last="Riffaud">Laurent Riffaud</name><name sortKey="Riffaud, Laurent" sort="Riffaud, Laurent" uniqKey="Riffaud L" first="Laurent" last="Riffaud">Laurent Riffaud</name><name sortKey="Riffaud, Laurent" sort="Riffaud, Laurent" uniqKey="Riffaud L" first="Laurent" last="Riffaud">Laurent Riffaud</name><name sortKey="Verin, Marc" sort="Verin, Marc" uniqKey="Verin M" first="Marc" last="Verin">Marc Verin</name></country></tree></affiliations></record>Pour manipuler ce 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