Improved sensory gating of urinary bladder afferents in Parkinson's disease following subthalamic stimulation
Identifieur interne : 000F01 ( Main/Exploration ); précédent : 000F00; suivant : 000F02Improved sensory gating of urinary bladder afferents in Parkinson's disease following subthalamic stimulation
Auteurs : Jan Herzog [Allemagne] ; Peter H. Weiss [Allemagne] ; Ann Assmus [Allemagne] ; Björn Wefer [Allemagne] ; Christoph Seif [Allemagne] ; Peter M. Braun [Allemagne] ; Marcus O. Pinsker [Allemagne] ; Hans Herzog [Allemagne] ; Jens Volkmann [Allemagne] ; Günther Deuschl [Allemagne] ; Gereon R. Fink [Allemagne]Source :
- Brain [ 0006-8950 ] ; 2008-01.
Abstract
In addition to motor symptoms, patients with Parkinson's disease (PD) show deficits in sensory processing. These deficits are thought to result from deficient gating of sensory information due to basal ganglia dysfunction in PD. Deep brain stimulation of the subthalamic nucleus (STN-DBS) has been shown to improve sensory deficits in PD, e.g. STN-DBS normalizes the perception of urinary bladder filling in patients with PD. This study aimed at investigating how STN-DBS modulates the processing of urinary bladder information to elucidate the (patho-)physiology of sensory gating mechanisms in PD. Nine PD patients with bilateral STN-DBS switched on (STN-DBS ON) or off (STN-DBS OFF) were studied during dynamic bladder filling and an empty bladder condition (for control), while changes in regional cerebral blood flow (rCBF) were measured by PET. Urinary bladder filling led to an increased rCBF in the periaqueductal grey (PAG), the posterior thalamus, the insular cortex as well as in the right frontal cortex and the cerebellum bilaterally. A significant interaction between bladder condition and STN-DBS was observed in the posterior thalamus and the insular cortex, with enhanced modulation of these areas during STN-DBS ON compared to STN-DBS OFF. Furthermore, regression analyses revealed a modulation of the neural activity in the thalamus and the insular cortex by the PAG activity during STN-DBS ON only. Thus, STN-DBS led to a significant enhancement of afferent urinary bladder information processing. The data suggest that STN-DBS facilitates the discrimination of different bodily states by supporting sensory perception and the underlying neural mechanisms. Furthermore, this is the first imaging study, which shows an effect of STN-DBS on sensory gating in PD patients and its neural basis.
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DOI: 10.1093/brain/awm254
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Fink</name><affiliation wicri:level="3"><country xml:lang="fr">Allemagne</country><wicri:regionArea>Department of Neurology, Christian-Albrechts-University Kiel, Schittenhelmstrasse 10, 24105 Kiel, Institute of Neurosciences and Biophysics, Research Center Jülich, Brain Imaging Centre West (BICW), Research Center Jülich, Leo- Brandt- Str. 5, 52425 Jülich, Department of Urology, Christian-Albrechts-University Kiel, Arnold- Heller- Street 7, Department of Neurosurgery, Christian-Albrechts-University Kiel, Schittenhelmstr. 10, 24105 Kiel and Department of Neurology, University Hospital, University of Cologne, Kerpener Straße 62, 50924 Köln</wicri:regionArea><placeName><region type="land" nuts="1">Rhénanie-du-Nord-Westphalie</region><region type="district" nuts="2">District de Cologne</region><settlement type="city">Cologne</settlement></placeName></affiliation><affiliation wicri:level="1"><country wicri:rule="url">Allemagne</country></affiliation></author></analytic><monogr></monogr><series><title level="j">Brain</title><idno type="ISSN">0006-8950</idno><idno type="eISSN">1460-2156</idno><imprint><publisher>Oxford University Press</publisher><date type="published" when="2008-01">2008-01</date><biblScope unit="volume">131</biblScope><biblScope unit="issue">1</biblScope><biblScope unit="page" from="132">132</biblScope><biblScope unit="page" to="145">145</biblScope></imprint><idno type="ISSN">0006-8950</idno></series><idno type="istex">335FF06443602C89CC4A753EDE9BC7A7369675A6</idno><idno type="DOI">10.1093/brain/awm254</idno></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0006-8950</idno></seriesStmt></fileDesc><profileDesc><textClass></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract">In addition to motor symptoms, patients with Parkinson's disease (PD) show deficits in sensory processing. These deficits are thought to result from deficient gating of sensory information due to basal ganglia dysfunction in PD. Deep brain stimulation of the subthalamic nucleus (STN-DBS) has been shown to improve sensory deficits in PD, e.g. STN-DBS normalizes the perception of urinary bladder filling in patients with PD. This study aimed at investigating how STN-DBS modulates the processing of urinary bladder information to elucidate the (patho-)physiology of sensory gating mechanisms in PD. Nine PD patients with bilateral STN-DBS switched on (STN-DBS ON) or off (STN-DBS OFF) were studied during dynamic bladder filling and an empty bladder condition (for control), while changes in regional cerebral blood flow (rCBF) were measured by PET. Urinary bladder filling led to an increased rCBF in the periaqueductal grey (PAG), the posterior thalamus, the insular cortex as well as in the right frontal cortex and the cerebellum bilaterally. A significant interaction between bladder condition and STN-DBS was observed in the posterior thalamus and the insular cortex, with enhanced modulation of these areas during STN-DBS ON compared to STN-DBS OFF. Furthermore, regression analyses revealed a modulation of the neural activity in the thalamus and the insular cortex by the PAG activity during STN-DBS ON only. Thus, STN-DBS led to a significant enhancement of afferent urinary bladder information processing. The data suggest that STN-DBS facilitates the discrimination of different bodily states by supporting sensory perception and the underlying neural mechanisms. Furthermore, this is the first imaging study, which shows an effect of STN-DBS on sensory gating in PD patients and its neural basis.</div></front></TEI><affiliations><list><country><li>Allemagne</li></country><region><li>District de Cologne</li><li>Rhénanie-du-Nord-Westphalie</li></region><settlement><li>Cologne</li></settlement></list><tree><country name="Allemagne"><region name="Rhénanie-du-Nord-Westphalie"><name sortKey="Herzog, Jan" sort="Herzog, Jan" uniqKey="Herzog J" first="Jan" last="Herzog">Jan Herzog</name></region><name sortKey="Assmus, Ann" sort="Assmus, Ann" uniqKey="Assmus A" first="Ann" last="Assmus">Ann Assmus</name><name sortKey="Braun, Peter M" sort="Braun, Peter M" uniqKey="Braun P" first="Peter M." last="Braun">Peter M. Braun</name><name sortKey="Deuschl, Gunther" sort="Deuschl, Gunther" uniqKey="Deuschl G" first="Günther" last="Deuschl">Günther Deuschl</name><name sortKey="Fink, Gereon R" sort="Fink, Gereon R" uniqKey="Fink G" first="Gereon R." last="Fink">Gereon R. Fink</name><name sortKey="Fink, Gereon R" sort="Fink, Gereon R" uniqKey="Fink G" first="Gereon R." last="Fink">Gereon R. Fink</name><name sortKey="Herzog, Hans" sort="Herzog, Hans" uniqKey="Herzog H" first="Hans" last="Herzog">Hans Herzog</name><name sortKey="Pinsker, Marcus O" sort="Pinsker, Marcus O" uniqKey="Pinsker M" first="Marcus O." last="Pinsker">Marcus O. Pinsker</name><name sortKey="Seif, Christoph" sort="Seif, Christoph" uniqKey="Seif C" first="Christoph" last="Seif">Christoph Seif</name><name sortKey="Volkmann, Jens" sort="Volkmann, Jens" uniqKey="Volkmann J" first="Jens" last="Volkmann">Jens Volkmann</name><name sortKey="Wefer, Bjorn" sort="Wefer, Bjorn" uniqKey="Wefer B" first="Björn" last="Wefer">Björn Wefer</name><name sortKey="Weiss, Peter H" sort="Weiss, Peter H" uniqKey="Weiss P" first="Peter H." last="Weiss">Peter H. Weiss</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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