Strotzer, Quinn D. and Anthofer, Judith M. and Faltermeier, Rupert and Brawanski, Alexander T. and Torka, Elisabeth and Waldthaler, Josefine A. and Kohl, Zacharias and Fellner, Claudia and Beer, Anton L. and Schlaier, Juergen R. (2019) Deep brain stimulation: Connectivity profile for bradykinesia alleviation. ANNALS OF NEUROLOGY, 85 (6). pp. 852-864. ISSN 0364-5134, 1531-8249
Full text not available from this repository. (Request a copy)Abstract
Objective Subthalamic deep brain stimulation may alleviate bradykinesia in Parkinson patients. Research suggests that this stimulation effect may be mediated by brain networks like the corticocerebellar loop. This study investigated the connectivity between stimulation sites and cortical and subcortical structures to identify connections for effective stimulation. Methods We retrospectively investigated 21 patients with Parkinson disease with bilateral subthalamic deep brain stimulation. Stimulation effectiveness in reducing bradykinesia, tremor, and rigidity was evaluated for each electrode contact in brain hemispheres contralateral to the affected hemibody. Dysarthric side effects were also examined. Probabilistic tractography based on diffusion-weighted imaging was performed in individual patient-specific brains using electrode contacts as seeds. Connectivity profiles of contacts with effective and noneffective stimulation were compared. Results Connectivity profiles of effective and noneffective contacts differed. Moreover, the connectivity profile for bradykinesia differed from that for rigidity, tremor, or dysarthria. Regarding bradykinesia, effective contacts were significantly more often connected with the ipsilateral superior cerebellar peduncle and the ipsilateral dentate nucleus, which correspond to the ipsilateral portion of the cerebellothalamocortical pathway. Rigidity was mitigated by stimulation of ascending brainstem and intralaminar thalamic connections. Tremor alleviation was related to connections with the internal capsule (anterior limb) and the pallidum. Dysarthric side effects were associated with connections to the supplementary motor area and the decussating cerebellothalamocortical pathway. Interpretation Whereas bradykinesia seems to be mitigated by stimulation of the ascending, ipsilateral cerebellothalamocortical pathway, stimulation of the descending corticopontocerebellar pathway may be ineffective. Rigidity, tremor, and dysarthric side effects seem to be influenced by different neural networks. ANN NEUROL 2019;85:852-864.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | SUBTHALAMIC NUCLEUS; PARKINSONS-DISEASE; BASAL GANGLIA; TRACTOGRAPHY; MOVEMENTS; PATTERNS; PATHWAY; |
| Subjects: | 100 Philosophy & psychology > 150 Psychology 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Neurochirurgie Medicine > Lehrstuhl für Neurologie Medicine > Lehrstuhl für Röntgendiagnostik Human Sciences > Institut für Psychologie Human Sciences > Institut für Psychologie > Lehrstuhl für Psychologie I (Allgemeine Psychologie I und Methodenlehre) - Prof. Dr. Mark W. Greenlee |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 08 Apr 2020 08:13 |
| Last Modified: | 08 Apr 2020 08:13 |
| URI: | https://pred.uni-regensburg.de/id/eprint/26954 |
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