Resting-state functional magnetic resonance imaging of the subthalamic microlesion and stimulation effects in Parkinson's disease: Indications of a principal role of the brainstem
| Autor: | Harald E. Möller, Robert Jech, Evžen Růžička, Stefan Holiga, Matthias L. Schroeter, Dušan Urgošík, Karsten Mueller |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2015 |
| Předmět: |
Male
GP globus pallidus Parkinson's disease Brain activity and meditation medicine.medical_treatment Deep Brain Stimulation Microlesion effect Brain mapping Subthalamic nucleus PD Parkinson's disease Severity of Illness Index lcsh:RC346-429 rm-ANOVA repeated measures analysis of variance 0302 clinical medicine BOLD blood-oxygenation-level dependent Image Processing Computer-Assisted 0303 health sciences Brain Mapping rs-fMRI resting-state fMRI medicine.diagnostic_test Echo-Planar Imaging Regular Article Parkinson Disease Middle Aged Magnetic Resonance Imaging ICA independent component analysis Neurology UPDRS-III motor part of the Unified Parkinson's Disease Rating Scale fMRI functional magnetic resonance imaging lcsh:R858-859.7 Female Brainstem Psychology Adult Deep brain stimulation FDR false discovery rate Cognitive Neuroscience MNI Montreal Neurological Institute Rest lcsh:Computer applications to medicine. Medical informatics 03 medical and health sciences MLE microlesion effect medicine PPN pedunculopontine nucleus Humans Radiology Nuclear Medicine and imaging Resting-state fMRI lcsh:Neurology. Diseases of the nervous system 030304 developmental biology DBS deep-brain stimulation Resting state fMRI Deep-brain stimulation medicine.disease Oxygen EC eigenvector centrality FWE family-wise error Neurology (clinical) Functional magnetic resonance imaging FDG-PET fluorodeoxyglucose positron emission tomography SD standard deviation Neuroscience 030217 neurology & neurosurgery STN subthalamic nucleus Brain Stem |
| Zdroj: | NeuroImage : Clinical NeuroImage: Clinical NeuroImage: Clinical, Vol 9, Iss C, Pp 264-274 (2015) |
| ISSN: | 2213-1582 |
| Popis: | During implantation of deep-brain stimulation (DBS) electrodes in the target structure, neurosurgeons and neurologists commonly observe a “microlesion effect” (MLE), which occurs well before initiating subthalamic DBS. This phenomenon typically leads to a transitory improvement of motor symptoms of patients suffering from Parkinson's disease (PD). Mechanisms behind MLE remain poorly understood. In this work, we exploited the notion of ranking to assess spontaneous brain activity in PD patients examined by resting-state functional magnetic resonance imaging in response to penetration of DBS electrodes in the subthalamic nucleus. In particular, we employed a hypothesis-free method, eigenvector centrality (EC), to reveal motor-communication-hubs of the highest rank and their reorganization following the surgery; providing a unique opportunity to evaluate the direct impact of disrupting the PD motor circuitry in vivo without prior assumptions. Penetration of electrodes was associated with increased EC of functional connectivity in the brainstem. Changes in connectivity were quantitatively related to motor improvement, which further emphasizes the clinical importance of the functional integrity of the brainstem. Surprisingly, MLE and DBS were associated with anatomically different EC maps despite their similar clinical benefit on motor functions. The DBS solely caused an increase in connectivity of the left premotor region suggesting separate pathophysiological mechanisms of both interventions. While the DBS acts at the cortical level suggesting compensatory activation of less affected motor regions, the MLE affects more fundamental circuitry as the dysfunctional brainstem predominates in the beginning of PD. These findings invigorate the overlooked brainstem perspective in the understanding of PD and support the current trend towards its early diagnosis. Highlights • DBS surgery in Parkinson's patients is often associated with a “microlesion effect” (MLE). • Mechanisms behind MLE remain poorly understood. • Using resting-state fMRI, we identified the brainstem as the principal hub responding to MLE. • This invigorates the overlooked brainstem perspective in the understanding of Parkinson's disease. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|