Back to Search
Start Over
Cerebral blood flow responses to dorsal and ventral STN DBS correlate with gait and balance responses in Parkinson's disease.
- Source :
-
Experimental neurology [Exp Neurol] 2013 Mar; Vol. 241, pp. 105-12. Date of Electronic Publication: 2012 Dec 19. - Publication Year :
- 2013
-
Abstract
- Objectives: The effects of subthalamic nucleus (STN) deep brain stimulation (DBS) on gait and balance vary and the underlying mechanisms remain unclear. DBS location may alter motor benefit due to anatomical heterogeneity in STN. The purposes of this study were to (1) compare the effects of DBS of dorsal (D-STN) versus ventral (V-STN) regions on gait, balance and regional cerebral blood flow (rCBF) and (2) examine the relationships between changes in rCBF and changes in gait and balance induced by D-STN or V-STN DBS.<br />Methods: We used a validated atlas registration to locate and stimulate through electrode contacts in D-STN and V-STN regions of 37 people with Parkinson's disease. In a within-subjects, double-blind and counterbalanced design controlled for DBS settings, we measured PET rCBF responses in a priori regions of interest and quantified gait and balance during DBS Off, unilateral D-STN DBS and unilateral V-STN DBS.<br />Results: DBS of either site increased stride length without producing significant group-level changes in gait velocity, cadence or balance. Both sites increased rCBF in subcortical regions and produced variable changes in cortical and cerebellar regions. DBS-induced changes in gait velocity are related to premotor cortex rCBF changes during V-STN DBS (r=-0.40, p=0.03) and to rCBF changes in the cerebellum anterior lobe during D-STN DBS (r=-0.43, p=0.02).<br />Conclusions: DBS-induced changes in gait corresponded to rCBF responses in selected cortical and cerebellar regions. These relationships differed during D-STN versus V-STN DBS, suggesting DBS acts through distinct neuronal pathways dependent on DBS location.<br /> (Copyright © 2012 Elsevier Inc. All rights reserved.)
- Subjects :
- Aged
Cerebral Cortex diagnostic imaging
Female
Functional Laterality physiology
Gait Disorders, Neurologic etiology
Humans
Male
Middle Aged
Parkinson Disease complications
Parkinson Disease pathology
Parkinson Disease therapy
Positron-Emission Tomography
Sensation Disorders etiology
Severity of Illness Index
Statistics as Topic
Cerebral Cortex blood supply
Deep Brain Stimulation methods
Gait Disorders, Neurologic therapy
Postural Balance physiology
Regional Blood Flow physiology
Sensation Disorders therapy
Subthalamic Nucleus physiology
Subjects
Details
- Language :
- English
- ISSN :
- 1090-2430
- Volume :
- 241
- Database :
- MEDLINE
- Journal :
- Experimental neurology
- Publication Type :
- Academic Journal
- Accession number :
- 23262122
- Full Text :
- https://doi.org/10.1016/j.expneurol.2012.12.003