TY - JOUR

T1 - STN-stimulation in Parkinson's disease restores striatal inhibition of thalamocortical projection

AU - Geday, Jacob

AU - Østergaard, Karen

AU - Johnsen, Erik

AU - Gjedde, Albert

N1 - Keywords: Adult; Aged; Cerebrovascular Circulation; Corpus Striatum; Electric Stimulation Therapy; Female; Functional Laterality; Globus Pallidus; Humans; Magnetic Resonance Imaging; Male; Middle Aged; Motor Cortex; Neural Inhibition; Neural Pathways; Parkinson Disease; Subthalamic Nucleus; Treatment Outcome; Up-Regulation; Ventral Thalamic Nuclei

PY - 2009

Y1 - 2009

N2 - To test the hypothesis that deep brain stimulation of the subthalamic nucleus (STN) restores the inhibitory output to the striatothalamocortical loop in Parkinson's disease, we obtained functional brain images of blood flow in 10 STN-stimulated patients with Parkinson's disease. Patients were immobile and off antiparkinsonian medication for 12 h. They were scanned with and without bilateral STN-stimulation with a 4-h interval between the two conditions. The order of DBS stimulation (ON or OFF) was randomized. Stimulation significantly raised regional cerebral blood flow (rCBF) bilaterally in the STN and in the left nucleus lentiformis. Conversely, flow declined in the left supplementary motor area (BA 6), ventrolateral nucleus of the left thalamus, and right cerebellum. Activation of the basal ganglia and deactivation of supplementary motor area and thalamus were both correlated with the improvement of motor function. The result is consistent with the explanation that stimulation in resting patients raises output from the STN with activation of the inhibitory basal ganglia output nuclei and subsequent deactivation of the thalamic anteroventral and ventrolateral nuclei and the supplementary motor area.

AB - To test the hypothesis that deep brain stimulation of the subthalamic nucleus (STN) restores the inhibitory output to the striatothalamocortical loop in Parkinson's disease, we obtained functional brain images of blood flow in 10 STN-stimulated patients with Parkinson's disease. Patients were immobile and off antiparkinsonian medication for 12 h. They were scanned with and without bilateral STN-stimulation with a 4-h interval between the two conditions. The order of DBS stimulation (ON or OFF) was randomized. Stimulation significantly raised regional cerebral blood flow (rCBF) bilaterally in the STN and in the left nucleus lentiformis. Conversely, flow declined in the left supplementary motor area (BA 6), ventrolateral nucleus of the left thalamus, and right cerebellum. Activation of the basal ganglia and deactivation of supplementary motor area and thalamus were both correlated with the improvement of motor function. The result is consistent with the explanation that stimulation in resting patients raises output from the STN with activation of the inhibitory basal ganglia output nuclei and subsequent deactivation of the thalamic anteroventral and ventrolateral nuclei and the supplementary motor area.

U2 - 10.1002/hbm.20486

DO - 10.1002/hbm.20486

M3 - Journal article

C2 - 18041743

VL - 30

SP - 112

EP - 121

JO - Human Brain Mapping

JF - Human Brain Mapping

SN - 1065-9471

IS - 1

ER -