Subthalamic Nucleus Stimulation Reduces Abnormal Motor Cortical Overactivity in Parkinson Disease

Payoux, Pierre; Rémy, Philippe; Damier, Philipe; Miloudi, Malika; Loubinoux, Isabelle; Pidoux, B.; Gaura, Véronique; Rascol, Olivier; Samson, Yves; Agid, Yves

doi:10.1001/archneur.61.8.1307

Cited by 107 publications

(106 citation statements)

References 31 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Discrete metabolic reductions in motor cortical and cerebellar areas distant from the stimulation site have been reported with STN DBS (Hershey et al, 2003;Hilker et al, 2004;Payoux et al, 2004). Our data are compatible with the notion of CSPTC hyperactivity in resting PD patients, which may be reduced by stimulation.…”

Section: Metabolic Changes With Stn Stimulationsupporting

confidence: 90%

Network modulation by the subthalamic nucleus in the treatment of Parkinson's disease

et al. 2006

View full text Add to dashboard Cite

Deep brain stimulation of the subthalamic nucleus (STN DBS) has become an accepted tool for the treatment of Parkinson's disease (PD). Although the precise mechanism of action of this intervention is unknown, its effectiveness has been attributed to the modulation of pathological network activity. We examined this notion using positron emission tomography (PET) to quantify stimulation-induced changes in the expression of a PD-related covariance pattern (PDRP) of regional metabolism. These metabolic changes were also compared with those observed in a similar cohort of patients undergoing STN lesioning.We found that PDRP activity declined significantly (P < 0.02) with STN stimulation. The degree of network modulation with DBS did not differ from that measured following lesioning (P = 0.58). Statistical parametric mapping (SPM) revealed that metabolic reductions in the internal globus pallidus (GPi) and caudal midbrain were common to both STN interventions (P < 0.01), although declines in GPi were more pronounced with lesion. By contrast, elevations in posterior parietal metabolism were common to the two procedures, albeit more pronounced with stimulation.These findings indicate that suppression of abnormal network activity is a feature of both STN stimulation and lesioning. Nonetheless, these two interventions may differ metabolically at a regional level.

show abstract

Section: Metabolic Changes With Stn Stimulationsupporting

confidence: 90%

Network modulation by the subthalamic nucleus in the treatment of Parkinson's disease

et al. 2006

View full text Add to dashboard Cite

show abstract

“…In patients with Parkinson's disease, STN stimulation augments the rCBF increase in SMA during motor tasks, but the main effect is a decrease of rCBF at rest rather than a rise during activation [Limousin et al, 1998;Hershey et al, 2003]. Thus Payoux et al [2004] agreed with Ceballos-Baumann et al [1999] that the effect of stimulation is reduction of an abnormally high resting activity in motor cortex and selective activation during motion. We suggest that a similar mechanism can explain how studies of a resting baseline subtracted from the active condition [e.g., Pinto et al, 2004] yield higher activity of the SMA when STN stimulation is on compared to off.…”

Section: Discussionsupporting

confidence: 77%

“…In summary, the bulk of the evidence indicates that GABAergic inhibition of the thalamus lowers thalamic activity and blood flow. To be consistent with the mechanism proposed by Alexander et al [1986], functional brain imaging results must reveal reduced blood flow in thalamus during DBS of the STN in patients with Parkinson's disease, if the DBS restores the normal resting striatal inhibition of the thalamocortical projections [Ceballos-Baumann et al, 1999, Payoux et al, 2004, Eckert and Eidelberg, 2005. STN-stimulation also reduced rCBF in the cerebellum.…”

Section: Discussionmentioning

confidence: 96%

“…The original explanation claimed that stimulation inhibits net output from the STN. A more recent view holds that the effect is the opposite, i.e., that the mechanism is facilitation of the output from this nucleus [Dostrovsky and Lozano, 2002;Haslinger et al, 2005;Vitek, 2002], which abolishes the abnormally elevated activity in the motor cortex of patients at rest by inhibiting the thalamocortical input [Payoux et al, 2004].…”

Section: Deep Brain Stimulation Of the Subthalamic Nucleus (Stn) Is Wmentioning

confidence: 99%

See 1 more Smart Citation

STN‐stimulation in Parkinson's disease restores striatal inhibition of thalamocortical projection

Geday

Østergaard

Johnsen

et al. 2007

Human Brain Mapping

View full text Add to dashboard Cite

“…For example, imaging studies report marked abnormal increases in cerebellar activity in PD patients and in subjects with idiopathic dystonia (20)(21)(22). In PD, deep brain stimulation of the STN improves the motor signs and normalizes cerebellar activation (22,23). In addition, one of the cardinal symptoms Fig.…”

Section: Discussionmentioning

confidence: 99%

The basal ganglia communicate with the cerebellum

Bostan

Dum

Strick

2010

Proc. Natl. Acad. Sci. U.S.A.

661

529

View full text Add to dashboard Cite

The basal ganglia and cerebellum are major subcortical structures that influence not only movement, but putatively also cognition and affect. Both structures receive input from and send output to the cerebral cortex. Thus, the basal ganglia and cerebellum form multisynaptic loops with the cerebral cortex. Basal ganglia and cerebellar loops have been assumed to be anatomically separate and to perform distinct functional operations. We investigated whether there is any direct route for basal ganglia output to influence cerebellar function that is independent of the cerebral cortex. We injected rabies virus (RV) into selected regions of the cerebellar cortex in cebus monkeys and used retrograde transneuronal transport of the virus to determine the origin of multisynaptic inputs to the injection sites. We found that the subthalamic nucleus of the basal ganglia has a substantial disynaptic projection to the cerebellar cortex. This pathway provides a means for both normal and abnormal signals from the basal ganglia to influence cerebellar function. We previously showed that the dentate nucleus of the cerebellum has a disynaptic projection to an input stage of basal ganglia processing, the striatum. Taken together these results provide the anatomical substrate for substantial two-way communication between the basal ganglia and cerebellum. Thus, the two subcortical structures may be linked together to form an integrated functional network. cerebellar cortex | subthalamic nucleus | virus tracing T he basal ganglia and cerebellum are major subcortical structures that influence not only movement, but putatively also cognition and affect (1, 2). Both structures receive input from and send output to the cerebral cortex. Thus, the basal ganglia and cerebellum form multisynaptic loops with the cerebral cortex. The major interactions between these loops were thought to occur largely at the cortical level (3). Recently, we showed that one of the output nuclei of the cerebellum, the dentate nucleus, has a disynaptic projection to an input stage of basal ganglia processing, the striatum (4). This pathway enables cerebellar output to influence basal ganglia function. Here, we investigated whether a comparable pathway allows basal ganglia output to influence cerebellar function. We injected rabies virus (RV) into regions of the cerebellar cortex in cebus monkeys and used retrograde transneuronal transport of the virus to determine the origin of multisynaptic inputs to the injection sites. Our results indicate that the subthalamic nucleus (STN) of the basal ganglia has substantial disynaptic projections to the cerebellar cortex. ResultsWe injected the N2c strain of RV into selected sites within the cerebellar cortex of three cebus monkeys ( Fig. 1 and Table S1). RV is transported transneuronally in the retrograde direction in a time-dependent fashion in nonhuman primates (4-8). We set the survival time at 42 h to allow two stages of transport: retrograde transport of RV to first-order neurons that project to the injection site and th...

show abstract

Subthalamic Nucleus Stimulation Reduces Abnormal Motor Cortical Overactivity in Parkinson Disease

Cited by 107 publications

References 31 publications

Network modulation by the subthalamic nucleus in the treatment of Parkinson's disease

Network modulation by the subthalamic nucleus in the treatment of Parkinson's disease

STN‐stimulation in Parkinson's disease restores striatal inhibition of thalamocortical projection

The basal ganglia communicate with the cerebellum

Contact Info

Product

Resources

About