Contrasting changes in cortical activation induced by acute high-frequency stimulation within the globus pallidus in Parkinson's disease.
Identifieur interne : 000B80 ( PubMed/Curation ); précédent : 000B79; suivant : 000B81Contrasting changes in cortical activation induced by acute high-frequency stimulation within the globus pallidus in Parkinson's disease.
Auteurs : Pierre Payoux [France] ; Philippe Remy ; Malika Miloudi ; Jean-Luc Houeto ; Claudio Stadler ; Boulos-Paul Bejjani ; Jérome Yelnik ; Yves Samson ; Olivier Rascol ; Yves Agid ; Philippe DamierSource :
- Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism [ 1559-7016 ] ; 2009.
English descriptors
- KwdEn :
- Aged, Cerebral Cortex (blood supply), Cerebral Cortex (physiology), Cerebrovascular Circulation, Deep Brain Stimulation, Electrodes, Female, Globus Pallidus (blood supply), Globus Pallidus (physiology), Hand (physiology), Humans, Male, Middle Aged, Movement, Parkinson Disease (physiopathology), Parkinson Disease (therapy), Positron-Emission Tomography, Rest (physiology), Time Factors.
- MESH :
- blood supply : Cerebral Cortex, Globus Pallidus.
- physiology : Cerebral Cortex, Globus Pallidus, Hand, Rest.
- physiopathology : Parkinson Disease.
- therapy : Parkinson Disease.
- Aged, Cerebrovascular Circulation, Deep Brain Stimulation, Electrodes, Female, Humans, Male, Middle Aged, Movement, Positron-Emission Tomography, Time Factors.
Abstract
Continuous stimulation of the globus pallidus (GP) has been shown to be an effective treatment for Parkinson's disease (PD). We used the fact that the implanted quadripolar leads contain electrodes within the GPi and GPe to investigate the clinical effects of acute high-frequency stimulation applied in these nuclei and changes in regional cerebral blood flow (rCBF) as an index of synaptic activity. In five patients treated by chronic GP stimulation, we compared the effects on PD symptoms and the changes in rCBF at rest and during paced right-hand movements, with and without left GPe or GPi stimulation. Although improving contralateral rigidity and akinesia, left GPe stimulation decreased rCBF in the left cerebellum and lateral premotor cortex at rest and significantly increased it in the left primary sensorimotor cortex (SM1) during movement. In contrast, left ventral GPi stimulation, which improved rigidity and worsened akinesia, decreased rCBF in the left SM1, premotor area, anterior cingulum, and supplementary motor area but did not modify the movement-related activation. GPe stimulation seems to result in a reduced activity of motor-related areas and the facilitation of motor cortex activation during movement, the latter component being absent during GPi stimulation, and this may explain the observed worsening of akinesia.
DOI: 10.1038/jcbfm.2008.107
PubMed: 18781162
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pubmed:18781162Le document en format XML
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<front><div type="abstract" xml:lang="en">Continuous stimulation of the globus pallidus (GP) has been shown to be an effective treatment for Parkinson's disease (PD). We used the fact that the implanted quadripolar leads contain electrodes within the GPi and GPe to investigate the clinical effects of acute high-frequency stimulation applied in these nuclei and changes in regional cerebral blood flow (rCBF) as an index of synaptic activity. In five patients treated by chronic GP stimulation, we compared the effects on PD symptoms and the changes in rCBF at rest and during paced right-hand movements, with and without left GPe or GPi stimulation. Although improving contralateral rigidity and akinesia, left GPe stimulation decreased rCBF in the left cerebellum and lateral premotor cortex at rest and significantly increased it in the left primary sensorimotor cortex (SM1) during movement. In contrast, left ventral GPi stimulation, which improved rigidity and worsened akinesia, decreased rCBF in the left SM1, premotor area, anterior cingulum, and supplementary motor area but did not modify the movement-related activation. GPe stimulation seems to result in a reduced activity of motor-related areas and the facilitation of motor cortex activation during movement, the latter component being absent during GPi stimulation, and this may explain the observed worsening of akinesia.</div>
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