Deep brain stimulation of the subthalamic nucleus versus levodopa challenge in Parkinson's disease: measuring the on- and off-conditions with FDG-PET

Hilker, Rüdiger; Voges, J.; Thiel, Alexander; Ghaemi, Mehran; Herholz, K.; Sturm, Volker; Heiss, Wolf‐Dieter

doi:10.1007/s00702-002-0696-5

Cited by 50 publications

(29 citation statements)

References 11 publications

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“…These findings are compatible with prior studies describing metabolic decreases in the primary motor area and cerebellar vermis with levodopa administration (Feigin et al, 2001;Hilker et al, 2002), and suggest a common final pathway for the therapeutic actions of dopaminergic therapy and STN stimulation. Although reductions in putamen and pallido-thalamic hypermetabolism have been noted with levodopa therapy (Blesa et al, 1991;Feigin et al, 2001), these local effects have not been reported in prior resting state comparisons of the ON and OFF STN stimulation conditions (Ceballos-Baumann et al, 1999;Hilker et al, 2002;Payoux et al, 2004). Subtle changes in GPi metabolism with STN stimulation have however been detected using conjunction analysis (Trošt et al, 2006), which can capture such small effects if they are shared across interventions.…”

Section: Comparison Of the Metabolic Effects Of Stn Dbs And Levodopa supporting

confidence: 91%

Network modulation in the treatment of Parkinson's disease

Asanuma

Tang

et al. 2006

Brain

323

328

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It has been proposed that deep brain stimulation (DBS) of the subthalamic nucleus (STN DBS) and dopaminergic therapy ameliorate the symptoms of Parkinson's disease through similar functional mechanisms. We examined this notion using PET to compare the metabolic effects of these treatment approaches. Nine Parkinson's disease patients (age 61.7 ± 11.1 years) were scanned ON and OFF STN stimulation and nine others (age 60.0 ± 9.3 years) were scanned ON and OFF an individual titrated intravenous levodopa infusion. The two treatment groups were matched for baseline disease severity as well as clinical response to therapy. Similarities and differences in the effects of treatment on regional metabolism were assessed using statistical parametric mapping (SPM). In addition, we used network analysis to assess the effect of therapy on the expression of an abnormal Parkinson's disease-related spatial covariance pattern (PDRP). We found that both STN DBS and levodopa therapy were associated with significant (P < 0.001) metabolic reductions in the putamen/globus pallidus, sensorimotor cortex and cerebellar vermis, as well as increases in the precuneus (BA 7). The metabolic effects of the two interventions differed in the STN and medial prefrontal cortex, with relative increases with stimulation in the former structure and decreases in the latter. Network quantification disclosed reductions in PDRP activity with both interventions, which correlated with clinical improvement (P < 0.05). The degree of network modulation by therapy did not differ significantly for the two treatment approaches (P > 0.6). These findings support the results of previous imaging studies indicating that effective symptomatic therapies for Parkinson's disease involve a common mechanism. The modulation of pathological brain networks is a critical feature of the treatment response in parkinsonism. KeywordsParkinson s disease; subthalamic nucleus; deep brain stimulation; brain metabolism; PET

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Section: Comparison Of the Metabolic Effects Of Stn Dbs And Levodopa supporting

confidence: 91%

Network modulation in the treatment of Parkinson's disease

Asanuma

Tang

et al. 2006

Brain

323

328

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“…Previous studies have reported that various neurotransmitters, including glutamic acid and dopamine, are released following DBS (23,24). Functional neuroimaging data also indicate that DBS alters the brain activity beyond the target area to a large extent, suggesting that DBS may have a sophisticated neural network control function (9,(25)(26)(27).…”

Section: Mechanisms Of Dbsmentioning

confidence: 96%

Advanced research on deep brain stimulation in treating mental disorders (Review)

et al. 2017

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“…Moreover, STN DBS could produce its clinical effects by artificially mimicking the pacing action of the 300-Hz subthalamic rhythm which is lost in PD [56,57] . In neurophysiological study, STN DBS activated not only the STN and its direct efferents but also the thalamus, the basal ganglia, the somatosensory cortex, the motor cortex, and the supplementary motor area as disclosed also by functional imaging [58,59] . DBS generates efferent output transmitted to non-stimulated nuclei, supporting the hypothesis that STN-DBS acts in the entire cortexbasal ganglia-cortex network [13,18,[60][61][62] .…”

Section: Discussionmentioning

confidence: 99%

Subthalamic Local Field Beta Oscillations during Ongoing Deep Brain Stimulation in Parkinson’s Disease in Hyperacute and Chronic Phases

et al. 2011

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In the past years, local field potential (LFP) signals recorded from the subthalamic nucleus (STN) in patients undergoing deep brain stimulation (DBS) for Parkinson’s disease (PD) disclosed that DBS has a controversial effect on STN beta oscillations recorded 2–7 days after surgery for macroelectrode implantation. Nothing is known about these DBS-induced oscillatory changes 30 days after surgery. We recorded STN LFPs during ongoing DBS in 7 patients with PD, immediately (hyperacute phase) and 30 days (chronic phase) after surgery. STN LFP recordings showed stationary intranuclear STN beta LFP activity in hyperacute and chronic phases, confirming that beta peaks were also present in chronic recordings. Power spectra of nuclei with significant beta activity (54% of the sample) showed that it decreased significantly during DBS (p = 0.021) under both recording conditions. The time course of beta activity showed more evident DBS-induced changes in the chronic than in the hyperacute phase (p = 0.014). DBS-induced changes in STN beta LFPs in patients undergoing DBS in chronic phase provide useful information for developing a new neurosignal-controlled adaptive DBS system.

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Deep brain stimulation of the subthalamic nucleus versus levodopa challenge in Parkinson's disease: measuring the on- and off-conditions with FDG-PET

Cited by 50 publications

References 11 publications

Network modulation in the treatment of Parkinson's disease

Network modulation in the treatment of Parkinson's disease

Advanced research on deep brain stimulation in treating mental disorders (Review)

Subthalamic Local Field Beta Oscillations during Ongoing Deep Brain Stimulation in Parkinson’s Disease in Hyperacute and Chronic Phases

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