Stimulation of contacts in ventral but not dorsal subthalamic nucleus normalizes response switching in Parkinson's disease

Greenhouse, Ian; Gould, Sherrie; Houser, Melissa; Aron, Adam R.

doi:10.1016/j.neuropsychologia.2013.03.008

Cited by 32 publications

(25 citation statements)

References 54 publications

(83 reference statements)

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“…Variable effects reported after STN‐DBS may be related to the use of different cognitive tasks in the different published studies, small sample of patients, use of concomitant medication, direct effects produced by the intervention, or the expertise of medical teams. There are several anatomical and functional evidences showing involvement of STN in associative and limbic loops (Greenhouse, Gould, Houser, & Aron, 2013), consequently, precise electrode location is crucial according to the functional nonmotor somatotype of the STN (Campbell et al., 2008; Mikos et al., 2011). PET studies suggested that variability in the effects of STN‐DBS on cognitive performance relates to STN‐DBS‐induced cortical blood flow changes in the dorsolateral prefrontal cortex and the anterior cingulate cortex (Zangaglia et al., 2009).…”

Section: Discussionmentioning

confidence: 99%

l‐Dopa/carbidopa intestinal gel and subthalamic nucleus stimulation: Effects on cognition and behavior

et al. 2017

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ObjectiveIn Parkinson's disease (PD), effects on behavior and cognition of levodopa/carbidopa intestinal gel (LCIG) and subthalamic stimulation (STN‐DBS) and their practical consequences remain controversial. This study was designed to analyze the possible effects of these therapies on cognition and behavior after 1 year follow‐up.MethodsThis was an open‐label, nonrandomized prospective study for pre‐ and postintervention analyses. Twenty‐four patients were considered eligible to be candidates for complex therapies such as STN‐DBS or LCIG; 23 patients treated with standard medication were included as controls. Several cognitive, behavioral, and motor scales were administered before and at 6 and 12 months after the intervention.ResultsPatients treated with LCIG experienced significant improvement in specific neuropsychological functions when compared with patients receiving STN‐DBS and conventional medical treatment after 1 year from the onset of the intervention. In this study, no significant cognitive or behavioral changes occurred in patients treated with subthalamic stimulation when compared to patients receiving conventional medical treatment at 1 year follow‐up.ConclusionsPatients treated with LCIG may significantly improve some specific neuropsychological functions when compared with patients receiving STN‐DBS and with patients receiving conventional medical treatment after 1 year from the intervention; there are not significant cognitive or behavioral changes in patients treated with STN‐DBS when compared to PD patients receiving conventional medical treatment after 1 year from the intervention. The outcomes showed in the study can help to the selection of the appropriate candidates for STN‐DBS and LCIG.

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Section: Discussionmentioning

confidence: 99%

l‐Dopa/carbidopa intestinal gel and subthalamic nucleus stimulation: Effects on cognition and behavior

et al. 2017

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“…Others have questioned the fidelity of topographically defined STN subregions by pointing to the diffuse overlap of prefrontal inputs across the STN structure (Keuken et al, 2012). Contributing to this debate are a limited set of pioneering studies in Parkinson’s disease that tested the functional architecture of STN substructures by contrasting behavioral effects of stimulating electrode contacts situated relatively more dorsal or more ventral along the lead wire targeting STN (Greenhouse et al, 2011, 2013; Hershey et al, 2010). While these studies have disclosed dissociable behavioral effects along the dorsal-ventral axis, most have been restricted by the confounding influence of dopaminergic medications in Parkinson’s disease, use of electrodes and stimulation parameters chosen clinically for motor symptom control that inevitably produce large fields of tissue activation, and limited specification of electrode positioning, including electrodes often positioned outside of the STN.…”

Section: Introductionmentioning

confidence: 99%

Focused stimulation of dorsal subthalamic nucleus improves reactive inhibitory control of action impulses

et al. 2017

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Frontal-basal ganglia circuitry dysfunction caused by Parkinson’s disease impairs important executive cognitive processes, such as the ability to inhibit impulsive action tendencies. Subthalamic Nucleus Deep Brain Stimulation in Parkinson’s disease improves the reactive inhibition of impulsive actions that interfere with goal-directed behavior. An unresolved question is whether this effect depends on stimulation of a particular Subthalamic Nucleus subregion. The current study aimed to 1) replicate previous findings and additionally investigate the effect of chronic versus acute Subthalamic Nucleus stimulation on inhibitory control in Parkinson’s disease patients off dopaminergic medication 2) test whether stimulating Subthalamic Nucleus subregions differentially modulate proactive response control and the proficiency of reactive inhibitory control. In the first experiment, twelve Parkinson’s disease patients completed three sessions of the Simon task, Off Deep brain stimulation and medication, on acute Deep Brain Stimulation and on chronic Deep Brain Stimulation. Experiment 2 consisted of 11 Parkinson’s disease patients with Subthalamic Nucleus Deep Brain Stimulation (off medication) who completed two testing sessions involving of a Simon task either with stimulation of the dorsal or the ventral contact in the Subthalamic Nucleus. Our findings show that Deep Brain Stimulation improves reactive inhibitory control, regardless of medication and regardless of whether it concerns chronic or acute Subthalamic Nucleus stimulation. More importantly, selective stimulation of dorsal and ventral subregions of the Subthalamic Nucleus indicates that especially the dorsal Subthalamic Nucleus circuitries are crucial for modulating the reactive inhibitory control of motor actions.

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“…Motor impairment is the main clinical feature of PD, but cognitive deficits, particularly those involving mental flexibility, conflict resolution, and executive control (e.g., planning, initiation and monitoring of actions) (Aarsland et al, 2003; Caballol et al, 2007; Dubois and Pillon, 1997; Vandenbossche et al, 2011), are frequently observed in the advanced stages of PD, and can emerge even at the early mild disease stages (Aarsland et al, 2010) and before treatment commences (Cooper et al, 1992). Disturbances of executive functions in PD that involve conflict resolution and task switching (Greenhouse et al, 2013; Obeso et al, 2011) can affect planning and carrying through tasks in daily life (Dirnberger and Jahanshahi, 2013); little is known about their neurofunctional correlates (Aarsland et al 2003; Caballol et al, 2007; Dubois and Pillon, 1997). …”

Section: Introductionmentioning

confidence: 99%

Task-rest modulation of basal ganglia connectivity in mild to moderate Parkinson’s disease

Müller‐Oehring

Sullivan

Pfefferbaum

et al. 2014

Brain Imaging and Behavior

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Parkinson’s disease (PD) is associated with abnormal synchronization in basal ganglia-thalamo-cortical loops. We tested whether early PD patients without demonstrable cognitive impairment exhibit abnormal modulation of functional connectivity at rest, while engaged in a task, or both. PD and healthy controls underwent two functional MRI scans: a resting-state scan and a Stroop Match-to-Sample task scan. Rest-task modulation of basal ganglia (BG) connectivity was tested using seed-to-voxel connectivity analysis with task and rest time series as conditions. Despite substantial overlap of BG–cortical connectivity patterns in both groups, connectivity differences between groups had clinical and behavioral correlates. During rest, stronger putamen–medial parietal and pallidum–occipital connectivity in PD than controls was associated with worse task performance and more severe PD symptoms suggesting that abnormalities in resting-state connectivity denote neural network dedifferentiation. During the executive task, PD patients showed weaker BG-cortical connectivity than controls, i.e., between caudate–supramarginal gyrus and pallidum–inferior prefrontal regions, that was related to more severe PD symptoms and worse task performance. Yet, task processing also evoked stronger striatal–cortical connectivity, specifically between caudate–prefrontal, caudate–precuneus, and putamen–motor/premotor regions in PD relative to controls, which was related to less severe PD symptoms and better performance on the Stroop task. Thus, stronger task-evoked striatal connectivity in PD demonstrated compensatory neural network enhancement to meet task demands and improve performance levels. fMRI-based network analysis revealed that despite resting-state BG network compromise in PD, BG connectivity to prefrontal, premotor, and precuneus regions can be adequately invoked during executive control demands enabling near normal task performance.

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Stimulation of contacts in ventral but not dorsal subthalamic nucleus normalizes response switching in Parkinson's disease

Cited by 32 publications

References 54 publications

l‐Dopa/carbidopa intestinal gel and subthalamic nucleus stimulation: Effects on cognition and behavior

l‐Dopa/carbidopa intestinal gel and subthalamic nucleus stimulation: Effects on cognition and behavior

Focused stimulation of dorsal subthalamic nucleus improves reactive inhibitory control of action impulses

Task-rest modulation of basal ganglia connectivity in mild to moderate Parkinson’s disease

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