Networks mediating the clinical effects of pallidal brain stimulation for Parkinson's disease
Identifieur interne : 001A42 ( Main/Exploration ); précédent : 001A41; suivant : 001A43Networks mediating the clinical effects of pallidal brain stimulation for Parkinson's disease
Auteurs : M. Fukuda ; M. J. Mentis ; Y. Ma ; V. Dhawan ; A. Antonini ; A. E. Lang ; A. M. Lozano ; J. Hammerstad ; K. Lyons ; W. C. Koller ; J. R. Moeller ; D. EidelbergSource :
- Brain [ 0006-8950 ] ; 2001-08.
English descriptors
- KwdEn :
- BA = Brodmann area, CSPTC = cortico-striato-pallido-thalamocortical, DBS = deep-brain stimulation, FDG = [18F]fluorodeoxyglucose, GPi = globus pallidus internus, PDRP = Parkinson's disease-related metabolic covariance pattern, PET, PMC = premotor cortex, PVP = posterior ventral pallidotomy, Parkinson's disease, SMA = supplementary motor area, SPM = Statistical Parametric Mapping, TPR = topographic profile rating, UPDRS = Unified Parkinson's Disease Rating Scale, [18F]fluorodeoxyglucose, brain networks, deep brain stimulation, rCBF = regional cerebral blood flow, rCMRGlc = regional cerebral metabolic rate for glucose.
Abstract
Employing [18F]fluorodeoxyglucose (FDG) and PET, we have found previously that stereotaxic ablation of the internal globus pallidus (GPi) for Parkinson's disease causes resting metabolic changes in brain regions remote from the lesion site. In this study we determined whether similar metabolic changes occur in Parkinson's disease patients treated with deep brain stimulation (DBS) of the GPi. We studied seven Parkinson's disease patients with FDG-PET to measure resting regional cerebral glucose utilization on and off GPi stimulation. We used statistical parametric mapping to identify significant changes in regional brain metabolism that occurred with this intervention. We also quantified stimulation-related changes in the expression of a specific abnormal Parkinson's disease-related pattern of metabolic covariation (PDRP) that had been identified in earlier FDG-PET studies. Metabolic changes with DBS were correlated with clinical improvement as measured by changes in Unified Parkinson's Disease Rating Scale (UPDRS) motor ratings off medication. GPi DBS improved UPDRS motor ratings (36%, P < 0.001) and significantly increased regional glucose metabolism in the premotor cortex ipsilateral to stimulation and in the cerebellum bilaterally. GPi DBS also resulted in a significant (P < 0.01) decline in PDRP activity ipsilateral to stimulation, which correlated significantly with clinical improvement in UPDRS motor ratings (P < 0.03). Clinical improvement with GPi DBS is associated with reduced expression of an abnormal Parkinson's disease-related metabolic network involving elements of the cortico-striato-pallido-thalamocortical and the cerebello-cortical motor loops.
Url:
DOI: 10.1093/brain/124.8.1601
Affiliations:
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Hammerstad</name><affiliation><wicri:noCountry code="syntax">???</wicri:noCountry></affiliation></author><author><name sortKey="Lyons, K" sort="Lyons, K" uniqKey="Lyons K" first="K." last="Lyons">K. Lyons</name><affiliation><wicri:noCountry code="syntax">???</wicri:noCountry></affiliation></author><author><name sortKey="Koller, W C" sort="Koller, W C" uniqKey="Koller W" first="W. C." last="Koller">W. C. Koller</name><affiliation><wicri:noCountry code="syntax">???</wicri:noCountry></affiliation></author><author><name sortKey="Moeller, J R" sort="Moeller, J R" uniqKey="Moeller J" first="J. R." last="Moeller">J. R. Moeller</name><affiliation><wicri:noCountry code="syntax">???</wicri:noCountry></affiliation></author><author><name sortKey="Eidelberg, D" sort="Eidelberg, D" uniqKey="Eidelberg D" first="D." last="Eidelberg">D. Eidelberg</name><affiliation><wicri:noCountry code="syntax">???</wicri:noCountry></affiliation><affiliation><wicri:noCountry code="syntax">???</wicri:noCountry></affiliation></author></analytic><monogr></monogr><series><title level="j">Brain</title><title level="j" type="abbrev">Brain</title><idno type="ISSN">0006-8950</idno><idno type="eISSN">1460-2156</idno><imprint><publisher>Oxford University Press</publisher><date type="published" when="2001-08">2001-08</date><biblScope unit="volume">124</biblScope><biblScope unit="issue">8</biblScope><biblScope unit="page" from="1601">1601</biblScope><biblScope unit="page" to="1609">1609</biblScope></imprint><idno type="ISSN">0006-8950</idno></series><idno type="istex">204BAF34FFE79A7AA65FE086D8150F7D97F8A8D7</idno><idno type="DOI">10.1093/brain/124.8.1601</idno><idno type="PII">1460-2156</idno><idno type="local">1241601</idno></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0006-8950</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>BA = Brodmann area</term><term>CSPTC = cortico-striato-pallido-thalamocortical</term><term>DBS = deep-brain stimulation</term><term>FDG = [18F]fluorodeoxyglucose</term><term>GPi = globus pallidus internus</term><term>PDRP = Parkinson's disease-related metabolic covariance pattern</term><term>PET</term><term>PMC = premotor cortex</term><term>PVP = posterior ventral pallidotomy</term><term>Parkinson's disease</term><term>SMA = supplementary motor area</term><term>SPM = Statistical Parametric Mapping</term><term>TPR = topographic profile rating</term><term>UPDRS = Unified Parkinson's Disease Rating Scale</term><term>[18F]fluorodeoxyglucose</term><term>brain networks</term><term>deep brain stimulation</term><term>rCBF = regional cerebral blood flow</term><term>rCMRGlc = regional cerebral metabolic rate for glucose</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Employing [18F]fluorodeoxyglucose (FDG) and PET, we have found previously that stereotaxic ablation of the internal globus pallidus (GPi) for Parkinson's disease causes resting metabolic changes in brain regions remote from the lesion site. In this study we determined whether similar metabolic changes occur in Parkinson's disease patients treated with deep brain stimulation (DBS) of the GPi. We studied seven Parkinson's disease patients with FDG-PET to measure resting regional cerebral glucose utilization on and off GPi stimulation. We used statistical parametric mapping to identify significant changes in regional brain metabolism that occurred with this intervention. We also quantified stimulation-related changes in the expression of a specific abnormal Parkinson's disease-related pattern of metabolic covariation (PDRP) that had been identified in earlier FDG-PET studies. Metabolic changes with DBS were correlated with clinical improvement as measured by changes in Unified Parkinson's Disease Rating Scale (UPDRS) motor ratings off medication. GPi DBS improved UPDRS motor ratings (36%, P < 0.001) and significantly increased regional glucose metabolism in the premotor cortex ipsilateral to stimulation and in the cerebellum bilaterally. GPi DBS also resulted in a significant (P < 0.01) decline in PDRP activity ipsilateral to stimulation, which correlated significantly with clinical improvement in UPDRS motor ratings (P < 0.03). Clinical improvement with GPi DBS is associated with reduced expression of an abnormal Parkinson's disease-related metabolic network involving elements of the cortico-striato-pallido-thalamocortical and the cerebello-cortical motor loops.</div></front></TEI><affiliations><list></list><tree><noCountry><name sortKey="Antonini, A" sort="Antonini, A" uniqKey="Antonini A" first="A." last="Antonini">A. Antonini</name><name sortKey="Dhawan, V" sort="Dhawan, V" uniqKey="Dhawan V" first="V." last="Dhawan">V. Dhawan</name><name sortKey="Eidelberg, D" sort="Eidelberg, D" uniqKey="Eidelberg D" first="D." last="Eidelberg">D. Eidelberg</name><name sortKey="Fukuda, M" sort="Fukuda, M" uniqKey="Fukuda M" first="M." last="Fukuda">M. Fukuda</name><name sortKey="Hammerstad, J" sort="Hammerstad, J" uniqKey="Hammerstad J" first="J." last="Hammerstad">J. Hammerstad</name><name sortKey="Koller, W C" sort="Koller, W C" uniqKey="Koller W" first="W. C." last="Koller">W. C. Koller</name><name sortKey="Lang, A E" sort="Lang, A E" uniqKey="Lang A" first="A. E." last="Lang">A. E. Lang</name><name sortKey="Lozano, A M" sort="Lozano, A M" uniqKey="Lozano A" first="A. M." last="Lozano">A. M. Lozano</name><name sortKey="Lyons, K" sort="Lyons, K" uniqKey="Lyons K" first="K." last="Lyons">K. Lyons</name><name sortKey="Ma, Y" sort="Ma, Y" uniqKey="Ma Y" first="Y." last="Ma">Y. Ma</name><name sortKey="Mentis, M J" sort="Mentis, M J" uniqKey="Mentis M" first="M. J." last="Mentis">M. J. Mentis</name><name sortKey="Moeller, J R" sort="Moeller, J R" uniqKey="Moeller J" first="J. R." last="Moeller">J. R. Moeller</name></noCountry></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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