A Positron Emission Tomographic Study of Subthalamic Nucleus Stimulation in Parkinson Disease

Abstract

Stimulation of the STN reduces the movement-related impairment of frontal motor association areas and the inappropriate motor cortex resting activity in Parkinson disease.

Deep Brain Stimulation restores information processing in parkinsonian cortical networks

“…Interestingly, closely aligned to our information indicators, STN-DBS improves not only movement initiation and motor sequence execution, but also somatosensory and proprioceptive discrimination in PD patients (60,61). In line with our hypothesis, the STN-DBS-induced improvement in information processing was accompanied by a restoration of more physiological activity patterns: a decrease in the firing rate of pyramidal neurons was observed in most network configurations, mediated in part by the recruitment of SST interneurons, consistent with previous experimental work in rodents demonstrating the activation of cortical L5 SST interneurons and inhibition of pyramidal neurons under STN-DBS (12,13), and clinical studies (33,34,38,39). When applied to a low-entropy state, the decrease in firing rate further allowed a reduction in the level of synchronization of pyramidal cells spiking activity and the restoration of temporally richer dynamics, in accordance with experimental (18) and clinical findings (36,37).…”

Deep Brain Stimulation restores information processing in parkinsonian cortical networks

“…Interestingly, closely aligned to our information indicators, STN-DBS improves not only movement initiation and motor sequence execution, but also somatosensory and proprioceptive discrimination in PD patients (60,61). In line with our hypothesis, the STN-DBS-induced improvement in information processing was accompanied by a restoration of more physiological activity patterns: a decrease in the firing rate of pyramidal neurons was observed in most network configurations, mediated in part by the recruitment of SST interneurons, consistent with previous experimental work in rodents demonstrating the activation of cortical L5 SST interneurons and inhibition of pyramidal neurons under STN-DBS (12,13), and clinical studies (33,34,38,39). When applied to a low-entropy state, the decrease in firing rate further allowed a reduction in the level of synchronization of pyramidal cells spiking activity and the restoration of temporally richer dynamics, in accordance with experimental (18) and clinical findings (36,37).…”

Virtual deep brain stimulation: Multiscale co-simulation of a spiking basal ganglia model and a whole-brain mean-field model with The Virtual Brain

“…Direct stimulation of supplementary motor areas with transcranial magnetic stimulation leads to improved freezing of gait symptoms in PD (Kim et al, 2018;Shirota et al, 2013), while dopaminergic medication can be related to improved supplementary motor area activation and improved motoric functions (Jenkins et al, 1992;Rascol et al, 1994). STN DBS in PD has been shown in fMRI (Stefurak et al, 2003) and positron emission tomography (Ceballos-Baumann et al, 1999) studies to activate motor as well as premotor areas, concordant with the simulated patterns in this work.…”

Effects of subthalamic nucleus stimulation on actual and imagined movement in Parkinson's disease : a PET study

“…This finding underlines the restoration of a more physiological frontal-striatal-thalamic circuit by STN stimulation although the precise mechanims of such stimulation remains debated [4]. This effect may be explained by an improved functioning of the thalamocortical excitatory pathway and is in accordance with recent studies [7,27].…”

“…In a recent PET study, the right DLPFC, and not the left one, appeared hypoactivated, compared with controls, while PD patients performed a joystick motor task in freely selected directions with the right hand [40]. Several authors have reported an increased rCBF in the SMA following STN or GPi stimulation, pallidotomy or apomorphine challenge [7,17,19,24,27,39]. In contrast, in our work, STN stimulation induces a reduction Fig.…”

Deep Brain Stimulation restores information processing in parkinsonian cortical networks

“…Interestingly, closely aligned to our information indicators, STN-DBS improves not only movement initiation and motor sequence execution, but also somatosensory and proprioceptive discrimination in PD patients (60,61). In line with our hypothesis, the STN-DBS-induced improvement in information processing was accompanied by a restoration of more physiological activity patterns: a decrease in the firing rate of pyramidal neurons was observed in most network configurations, mediated in part by the recruitment of SST interneurons, consistent with previous experimental work in rodents demonstrating the activation of cortical L5 SST interneurons and inhibition of pyramidal neurons under STN-DBS (12,13), and clinical studies (33,34,38,39). When applied to a low-entropy state, the decrease in firing rate further allowed a reduction in the level of synchronization of pyramidal cells spiking activity and the restoration of temporally richer dynamics, in accordance with experimental (18) and clinical findings (36,37).…”

Virtual deep brain stimulation: Multiscale co-simulation of a spiking basal ganglia model and a whole-brain mean-field model with The Virtual Brain

“…Direct stimulation of supplementary motor areas with transcranial magnetic stimulation leads to improved freezing of gait symptoms in PD (Kim et al, 2018;Shirota et al, 2013), while dopaminergic medication can be related to improved supplementary motor area activation and improved motoric functions (Jenkins et al, 1992;Rascol et al, 1994). STN DBS in PD has been shown in fMRI (Stefurak et al, 2003) and positron emission tomography (Ceballos-Baumann et al, 1999) studies to activate motor as well as premotor areas, concordant with the simulated patterns in this work.…”

Effects of subthalamic nucleus stimulation on actual and imagined movement in Parkinson's disease : a PET study

“…This finding underlines the restoration of a more physiological frontal-striatal-thalamic circuit by STN stimulation although the precise mechanims of such stimulation remains debated [4]. This effect may be explained by an improved functioning of the thalamocortical excitatory pathway and is in accordance with recent studies [7,27].…”

“…In a recent PET study, the right DLPFC, and not the left one, appeared hypoactivated, compared with controls, while PD patients performed a joystick motor task in freely selected directions with the right hand [40]. Several authors have reported an increased rCBF in the SMA following STN or GPi stimulation, pallidotomy or apomorphine challenge [7,17,19,24,27,39]. In contrast, in our work, STN stimulation induces a reduction Fig.…”

Deep Brain Stimulation restores information processing in parkinsonian cortical networks

“…Interestingly, closely aligned to our information indicators, STN-DBS improves not only movement initiation and motor sequence execution, but also somatosensory and proprioceptive discrimination in PD patients (60,61). In line with our hypothesis, the STN-DBS-induced improvement in information processing was accompanied by a restoration of more physiological activity patterns: a decrease in the firing rate of pyramidal neurons was observed in most network configurations, mediated in part by the recruitment of SST interneurons, consistent with previous experimental work in rodents demonstrating the activation of cortical L5 SST interneurons and inhibition of pyramidal neurons under STN-DBS (12,13), and clinical studies (33,34,38,39). When applied to a low-entropy state, the decrease in firing rate further allowed a reduction in the level of synchronization of pyramidal cells spiking activity and the restoration of temporally richer dynamics, in accordance with experimental (18) and clinical findings (36,37).…”

Virtual deep brain stimulation: Multiscale co-simulation of a spiking basal ganglia model and a whole-brain mean-field model with The Virtual Brain

“…Direct stimulation of supplementary motor areas with transcranial magnetic stimulation leads to improved freezing of gait symptoms in PD (Kim et al, 2018;Shirota et al, 2013), while dopaminergic medication can be related to improved supplementary motor area activation and improved motoric functions (Jenkins et al, 1992;Rascol et al, 1994). STN DBS in PD has been shown in fMRI (Stefurak et al, 2003) and positron emission tomography (Ceballos-Baumann et al, 1999) studies to activate motor as well as premotor areas, concordant with the simulated patterns in this work.…”

Effects of subthalamic nucleus stimulation on actual and imagined movement in Parkinson's disease : a PET study

“…This finding underlines the restoration of a more physiological frontal-striatal-thalamic circuit by STN stimulation although the precise mechanims of such stimulation remains debated [4]. This effect may be explained by an improved functioning of the thalamocortical excitatory pathway and is in accordance with recent studies [7,27].…”

“…In a recent PET study, the right DLPFC, and not the left one, appeared hypoactivated, compared with controls, while PD patients performed a joystick motor task in freely selected directions with the right hand [40]. Several authors have reported an increased rCBF in the SMA following STN or GPi stimulation, pallidotomy or apomorphine challenge [7,17,19,24,27,39]. In contrast, in our work, STN stimulation induces a reduction Fig.…”