Changes in Regional Cerebral Blood Flow Caused by Deep-Brain Stimulation of the Subthalamic Nucleus in Parkinson's Disease
The aim of this study was to investigate the effect of deep-brain stimulation of the subthalamic nucleus (STN) on regional cerebral blood flow (rCBF) throughout the entire brain volume in patients with Parkinson's disease and to evaluate which of the brain areas showing an rCBF increase during...
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| Veröffentlicht in: | The Journal of nuclear medicine (1978) 2002-06, Vol.43 (6), p.725-732 |
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| creator | Sestini, Stelvio Scotto di Luzio, Anita Ammannati, Franco De Cristofaro, Maria Teresa R Passeri, Alessandro Martini, Sara Pupi, Alberto |
| description | The aim of this study was to investigate the effect of deep-brain stimulation of the subthalamic nucleus (STN) on regional cerebral blood flow (rCBF) throughout the entire brain volume in patients with Parkinson's disease and to evaluate which of the brain areas showing an rCBF increase during STN stimulation related significantly to the improvement in motor function.
Ten consecutive Parkinson's disease patients (6 men, 4 women; mean age +/- SD, 59 +/- 8 y) with bilateral STN stimulators underwent 3 rCBF SPECT examinations at rest: the first preoperatively and the second and third postoperatively (follow-up, 4.8 +/- 1.4 mo) with STN stimulators on and off, respectively. The motor unified Parkinson's disease rating scale, the Hoehn and Yahr disability scale, and the Schwab and England activities-of-daily-living scale were used to evaluate the clinical state under each condition. Statistical parametric mapping was used to investigate rCBF during STN stimulation in comparison with rCBF preoperatively and with STN stimulators off. Also evaluated with statistical parametric mapping was the relationship between rCBF and individual motor scores used as covariates of interest.
STN stimulation significantly changed rCBF in the right pre-supplementary motor area (pre-SMA), anterior cingulate cortex, and dorsolateral prefrontal cortex and in the medial Brodmann's area 8 (BA8) as defined in the atlas of Talairach and Tournoux (P < 0.05 corrected for multiple comparisons). The rCBF in these areas increased from the preoperative condition to the stimulators-on condition and decreased again after the stimulators were switched off. A significant correlation was detected between the improvement in motor scores and the rCBF increase only in the right pre-SMA and in the anterior cingulate motor area (P < 0.005, uncorrected).
According to the topographic organization of the primate STN, our study shows that stimulation of the STN leads to rCBF increases in the motor (pre-SMA), associative, and limbic territories (anterior cingulate) in the frontal cortex. The significant correlation between motor improvement and rCBF increase in the pre-SMA and the anterior cingulate motor area reinforces the hypothesis that STN stimulation in parkinsonian patients can potentiate the cortical areas participating in higher-order aspects of motor control. |
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Ten consecutive Parkinson's disease patients (6 men, 4 women; mean age +/- SD, 59 +/- 8 y) with bilateral STN stimulators underwent 3 rCBF SPECT examinations at rest: the first preoperatively and the second and third postoperatively (follow-up, 4.8 +/- 1.4 mo) with STN stimulators on and off, respectively. The motor unified Parkinson's disease rating scale, the Hoehn and Yahr disability scale, and the Schwab and England activities-of-daily-living scale were used to evaluate the clinical state under each condition. Statistical parametric mapping was used to investigate rCBF during STN stimulation in comparison with rCBF preoperatively and with STN stimulators off. Also evaluated with statistical parametric mapping was the relationship between rCBF and individual motor scores used as covariates of interest.
STN stimulation significantly changed rCBF in the right pre-supplementary motor area (pre-SMA), anterior cingulate cortex, and dorsolateral prefrontal cortex and in the medial Brodmann's area 8 (BA8) as defined in the atlas of Talairach and Tournoux (P < 0.05 corrected for multiple comparisons). The rCBF in these areas increased from the preoperative condition to the stimulators-on condition and decreased again after the stimulators were switched off. A significant correlation was detected between the improvement in motor scores and the rCBF increase only in the right pre-SMA and in the anterior cingulate motor area (P < 0.005, uncorrected).
According to the topographic organization of the primate STN, our study shows that stimulation of the STN leads to rCBF increases in the motor (pre-SMA), associative, and limbic territories (anterior cingulate) in the frontal cortex. The significant correlation between motor improvement and rCBF increase in the pre-SMA and the anterior cingulate motor area reinforces the hypothesis that STN stimulation in parkinsonian patients can potentiate the cortical areas participating in higher-order aspects of motor control.</description><identifier>ISSN: 0161-5505</identifier><identifier>EISSN: 1535-5667</identifier><identifier>PMID: 12050315</identifier><identifier>CODEN: JNMEAQ</identifier><language>eng</language><publisher>Reston, VA: Soc Nuclear Med</publisher><subject>Biological and medical sciences ; Brain - diagnostic imaging ; Cerebrovascular Circulation - physiology ; Degenerative and inherited degenerative diseases of the nervous system. Leukodystrophies. Prion diseases ; Electric Stimulation Therapy ; Electrodes, Implanted ; Female ; Humans ; Image Processing, Computer-Assisted ; Investigative techniques, diagnostic techniques (general aspects) ; Male ; Medical sciences ; Middle Aged ; Motor Cortex - physiology ; Nervous system ; Neurology ; Parkinson Disease - diagnostic imaging ; Parkinson Disease - physiopathology ; Parkinson Disease - therapy ; Prospective Studies ; Radionuclide investigations ; Subthalamic Nucleus - physiology ; Tomography, Emission-Computed, Single-Photon</subject><ispartof>The Journal of nuclear medicine (1978), 2002-06, Vol.43 (6), p.725-732</ispartof><rights>2002 INIST-CNRS</rights><rights>Copyright Society of Nuclear Medicine Jun 2002</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=13715964$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/12050315$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Sestini, Stelvio</creatorcontrib><creatorcontrib>Scotto di Luzio, Anita</creatorcontrib><creatorcontrib>Ammannati, Franco</creatorcontrib><creatorcontrib>De Cristofaro, Maria Teresa R</creatorcontrib><creatorcontrib>Passeri, Alessandro</creatorcontrib><creatorcontrib>Martini, Sara</creatorcontrib><creatorcontrib>Pupi, Alberto</creatorcontrib><title>Changes in Regional Cerebral Blood Flow Caused by Deep-Brain Stimulation of the Subthalamic Nucleus in Parkinson's Disease</title><title>The Journal of nuclear medicine (1978)</title><addtitle>J Nucl Med</addtitle><description>The aim of this study was to investigate the effect of deep-brain stimulation of the subthalamic nucleus (STN) on regional cerebral blood flow (rCBF) throughout the entire brain volume in patients with Parkinson's disease and to evaluate which of the brain areas showing an rCBF increase during STN stimulation related significantly to the improvement in motor function.
Ten consecutive Parkinson's disease patients (6 men, 4 women; mean age +/- SD, 59 +/- 8 y) with bilateral STN stimulators underwent 3 rCBF SPECT examinations at rest: the first preoperatively and the second and third postoperatively (follow-up, 4.8 +/- 1.4 mo) with STN stimulators on and off, respectively. The motor unified Parkinson's disease rating scale, the Hoehn and Yahr disability scale, and the Schwab and England activities-of-daily-living scale were used to evaluate the clinical state under each condition. Statistical parametric mapping was used to investigate rCBF during STN stimulation in comparison with rCBF preoperatively and with STN stimulators off. Also evaluated with statistical parametric mapping was the relationship between rCBF and individual motor scores used as covariates of interest.
STN stimulation significantly changed rCBF in the right pre-supplementary motor area (pre-SMA), anterior cingulate cortex, and dorsolateral prefrontal cortex and in the medial Brodmann's area 8 (BA8) as defined in the atlas of Talairach and Tournoux (P < 0.05 corrected for multiple comparisons). The rCBF in these areas increased from the preoperative condition to the stimulators-on condition and decreased again after the stimulators were switched off. A significant correlation was detected between the improvement in motor scores and the rCBF increase only in the right pre-SMA and in the anterior cingulate motor area (P < 0.005, uncorrected).
According to the topographic organization of the primate STN, our study shows that stimulation of the STN leads to rCBF increases in the motor (pre-SMA), associative, and limbic territories (anterior cingulate) in the frontal cortex. The significant correlation between motor improvement and rCBF increase in the pre-SMA and the anterior cingulate motor area reinforces the hypothesis that STN stimulation in parkinsonian patients can potentiate the cortical areas participating in higher-order aspects of motor control.</description><subject>Biological and medical sciences</subject><subject>Brain - diagnostic imaging</subject><subject>Cerebrovascular Circulation - physiology</subject><subject>Degenerative and inherited degenerative diseases of the nervous system. Leukodystrophies. Prion diseases</subject><subject>Electric Stimulation Therapy</subject><subject>Electrodes, Implanted</subject><subject>Female</subject><subject>Humans</subject><subject>Image Processing, Computer-Assisted</subject><subject>Investigative techniques, diagnostic techniques (general aspects)</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Motor Cortex - physiology</subject><subject>Nervous system</subject><subject>Neurology</subject><subject>Parkinson Disease - diagnostic imaging</subject><subject>Parkinson Disease - physiopathology</subject><subject>Parkinson Disease - therapy</subject><subject>Prospective Studies</subject><subject>Radionuclide investigations</subject><subject>Subthalamic Nucleus - physiology</subject><subject>Tomography, Emission-Computed, Single-Photon</subject><issn>0161-5505</issn><issn>1535-5667</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2002</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNpdkMFu1DAQhiNERZfCKyALCThFsuPYjo80bQGpgqqFczRxJhsvjr3Ysar26cnCokqcZg7f_2nmf1ZsmOCiFFKq58WGMslKIag4LV6mtKOUyqZpXhSnrKKCciY2xWM7gd9iItaTW9za4MGRFiP2cV3OXQgDuXLhnrSQEw6kfyAXiPvyPMKauFvsnB0sa4yEkSwTkrvcLxM4mK0hX7NxmP-4byD-tD4F_yGRC5sQEr4qTkZwCV8f51nx4-rye_u5vP726Uv78bqcKi2WUmouqrrvGdOIxigmK8GN6Mdaw6A4Ug6jrivGRaNHLmWt6DiMDeV90xvQkp8V7_969zH8ypiWbrbJoHPgMeTUKaa0pEyv4Nv_wF3IcS0kdRXTlZKUH6A3Ryj3Mw7dPtoZ4kP3r9IVeHcEIBlwYwRvbHriuGJCy_rprMlup3sbsfOHuiAerDs_17yTnVp__Q0454zY</recordid><startdate>20020601</startdate><enddate>20020601</enddate><creator>Sestini, Stelvio</creator><creator>Scotto di Luzio, Anita</creator><creator>Ammannati, Franco</creator><creator>De Cristofaro, Maria Teresa R</creator><creator>Passeri, Alessandro</creator><creator>Martini, Sara</creator><creator>Pupi, Alberto</creator><general>Soc Nuclear Med</general><general>Society of Nuclear Medicine</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>3V.</scope><scope>4T-</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88I</scope><scope>8AF</scope><scope>8AO</scope><scope>8FD</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB0</scope><scope>LK8</scope><scope>M0S</scope><scope>M1P</scope><scope>M2P</scope><scope>M7P</scope><scope>M7Z</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>P64</scope><scope>PHGZM</scope><scope>PHGZT</scope><scope>PJZUB</scope><scope>PKEHL</scope><scope>PPXIY</scope><scope>PQEST</scope><scope>PQGLB</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>S0X</scope><scope>7X8</scope></search><sort><creationdate>20020601</creationdate><title>Changes in Regional Cerebral Blood Flow Caused by Deep-Brain Stimulation of the Subthalamic Nucleus in Parkinson's Disease</title><author>Sestini, Stelvio ; Scotto di Luzio, Anita ; Ammannati, Franco ; De Cristofaro, Maria Teresa R ; Passeri, Alessandro ; Martini, Sara ; Pupi, Alberto</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-h295t-693524bb119eecc716253c5bf49ad73e03af94213589f366470fdf803b8bca963</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2002</creationdate><topic>Biological and medical sciences</topic><topic>Brain - diagnostic imaging</topic><topic>Cerebrovascular Circulation - physiology</topic><topic>Degenerative and inherited degenerative diseases of the nervous system. Leukodystrophies. Prion diseases</topic><topic>Electric Stimulation Therapy</topic><topic>Electrodes, Implanted</topic><topic>Female</topic><topic>Humans</topic><topic>Image Processing, Computer-Assisted</topic><topic>Investigative techniques, diagnostic techniques (general aspects)</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Motor Cortex - physiology</topic><topic>Nervous system</topic><topic>Neurology</topic><topic>Parkinson Disease - diagnostic imaging</topic><topic>Parkinson Disease - physiopathology</topic><topic>Parkinson Disease - therapy</topic><topic>Prospective Studies</topic><topic>Radionuclide investigations</topic><topic>Subthalamic Nucleus - physiology</topic><topic>Tomography, Emission-Computed, Single-Photon</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Sestini, Stelvio</creatorcontrib><creatorcontrib>Scotto di Luzio, Anita</creatorcontrib><creatorcontrib>Ammannati, Franco</creatorcontrib><creatorcontrib>De Cristofaro, Maria Teresa R</creatorcontrib><creatorcontrib>Passeri, Alessandro</creatorcontrib><creatorcontrib>Martini, Sara</creatorcontrib><creatorcontrib>Pupi, Alberto</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>ProQuest Central (Corporate)</collection><collection>Docstoc</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Science Database (Alumni Edition)</collection><collection>STEM Database</collection><collection>ProQuest Pharma Collection</collection><collection>Technology Research Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Technology Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>Advanced Technologies & Aerospace Collection</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Technology Collection</collection><collection>Natural Science Collection</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>ProQuest Biological Science Collection</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Science Database</collection><collection>Biological Science Database</collection><collection>Biochemistry Abstracts 1</collection><collection>Nursing & Allied Health Premium</collection><collection>Advanced Technologies & Aerospace Database</collection><collection>ProQuest Advanced Technologies & Aerospace Collection</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest Central (New)</collection><collection>ProQuest One Academic (New)</collection><collection>ProQuest Health & Medical Research Collection</collection><collection>ProQuest One Academic Middle East (New)</collection><collection>ProQuest One Health & Nursing</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Applied & Life Sciences</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>SIRS Editorial</collection><collection>MEDLINE - Academic</collection><jtitle>The Journal of nuclear medicine (1978)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Sestini, Stelvio</au><au>Scotto di Luzio, Anita</au><au>Ammannati, Franco</au><au>De Cristofaro, Maria Teresa R</au><au>Passeri, Alessandro</au><au>Martini, Sara</au><au>Pupi, Alberto</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Changes in Regional Cerebral Blood Flow Caused by Deep-Brain Stimulation of the Subthalamic Nucleus in Parkinson's Disease</atitle><jtitle>The Journal of nuclear medicine (1978)</jtitle><addtitle>J Nucl Med</addtitle><date>2002-06-01</date><risdate>2002</risdate><volume>43</volume><issue>6</issue><spage>725</spage><epage>732</epage><pages>725-732</pages><issn>0161-5505</issn><eissn>1535-5667</eissn><coden>JNMEAQ</coden><abstract>The aim of this study was to investigate the effect of deep-brain stimulation of the subthalamic nucleus (STN) on regional cerebral blood flow (rCBF) throughout the entire brain volume in patients with Parkinson's disease and to evaluate which of the brain areas showing an rCBF increase during STN stimulation related significantly to the improvement in motor function.
Ten consecutive Parkinson's disease patients (6 men, 4 women; mean age +/- SD, 59 +/- 8 y) with bilateral STN stimulators underwent 3 rCBF SPECT examinations at rest: the first preoperatively and the second and third postoperatively (follow-up, 4.8 +/- 1.4 mo) with STN stimulators on and off, respectively. The motor unified Parkinson's disease rating scale, the Hoehn and Yahr disability scale, and the Schwab and England activities-of-daily-living scale were used to evaluate the clinical state under each condition. Statistical parametric mapping was used to investigate rCBF during STN stimulation in comparison with rCBF preoperatively and with STN stimulators off. Also evaluated with statistical parametric mapping was the relationship between rCBF and individual motor scores used as covariates of interest.
STN stimulation significantly changed rCBF in the right pre-supplementary motor area (pre-SMA), anterior cingulate cortex, and dorsolateral prefrontal cortex and in the medial Brodmann's area 8 (BA8) as defined in the atlas of Talairach and Tournoux (P < 0.05 corrected for multiple comparisons). The rCBF in these areas increased from the preoperative condition to the stimulators-on condition and decreased again after the stimulators were switched off. A significant correlation was detected between the improvement in motor scores and the rCBF increase only in the right pre-SMA and in the anterior cingulate motor area (P < 0.005, uncorrected).
According to the topographic organization of the primate STN, our study shows that stimulation of the STN leads to rCBF increases in the motor (pre-SMA), associative, and limbic territories (anterior cingulate) in the frontal cortex. The significant correlation between motor improvement and rCBF increase in the pre-SMA and the anterior cingulate motor area reinforces the hypothesis that STN stimulation in parkinsonian patients can potentiate the cortical areas participating in higher-order aspects of motor control.</abstract><cop>Reston, VA</cop><pub>Soc Nuclear Med</pub><pmid>12050315</pmid><tpages>8</tpages></addata></record> |
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| subjects | Biological and medical sciences Brain - diagnostic imaging Cerebrovascular Circulation - physiology Degenerative and inherited degenerative diseases of the nervous system. Leukodystrophies. Prion diseases Electric Stimulation Therapy Electrodes, Implanted Female Humans Image Processing, Computer-Assisted Investigative techniques, diagnostic techniques (general aspects) Male Medical sciences Middle Aged Motor Cortex - physiology Nervous system Neurology Parkinson Disease - diagnostic imaging Parkinson Disease - physiopathology Parkinson Disease - therapy Prospective Studies Radionuclide investigations Subthalamic Nucleus - physiology Tomography, Emission-Computed, Single-Photon |
| title | Changes in Regional Cerebral Blood Flow Caused by Deep-Brain Stimulation of the Subthalamic Nucleus in Parkinson's Disease |
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