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Subthalamic Nucleus Deep Brain Stimulation Modulates 2 Distinct Neurocircuits.
Shen, Lunhao; Jiang, Changqing; Hubbard, Catherine S; Ren, Jianxun; He, Changgeng; Wang, Danhong; Dahmani, Louisa; Guo, Yi; Liu, Yiming; Xu, Shujun; Meng, Fangang; Zhang, Jianguo; Liu, Hesheng; Li, Luming.
Affiliation
  • Shen L; National Engineering Laboratory for Neuromodulation, School of Aerospace Engineering, Tsinghua University, Beijing, China.
  • Jiang C; Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA.
  • Hubbard CS; Department of Neuroscience, Medical University of South Carolina, Charleston, SC, USA.
  • Ren J; National Engineering Laboratory for Neuromodulation, School of Aerospace Engineering, Tsinghua University, Beijing, China.
  • He C; Department of Neuroscience, Medical University of South Carolina, Charleston, SC, USA.
  • Wang D; National Engineering Laboratory for Neuromodulation, School of Aerospace Engineering, Tsinghua University, Beijing, China.
  • Dahmani L; Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA.
  • Guo Y; National Engineering Laboratory for Neuromodulation, School of Aerospace Engineering, Tsinghua University, Beijing, China.
  • Liu Y; Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA.
  • Xu S; Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA.
  • Meng F; Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA.
  • Zhang J; Peking Union Medical College Hospital, Beijing, China.
  • Liu H; Qilu Hospital of Shandong University, Jinan, China.
  • Li L; Qilu Hospital of Shandong University, Jinan, China.
Ann Neurol ; 88(6): 1178-1193, 2020 12.
Article in En | MEDLINE | ID: mdl-32951262
ABSTRACT

OBJECTIVE:

Current understanding of the neuromodulatory effects of deep brain stimulation (DBS) on large-scale brain networks remains elusive, largely due to the lack of techniques that can reveal DBS-induced activity at the whole-brain level. Using a novel 3T magnetic resonance imaging (MRI)-compatible stimulator, we investigated whole-brain effects of subthalamic nucleus (STN) stimulation in patients with Parkinson disease.

METHODS:

Fourteen patients received STN-DBS treatment and participated in a block-design functional MRI (fMRI) experiment, wherein stimulations were delivered during "ON" blocks interleaved with "OFF" blocks. fMRI responses to low-frequency (60Hz) and high-frequency(130Hz) STN-DBS were measured 1, 3, 6, and 12 months postsurgery. To ensure reliability, multiple runs (48 minutes) of fMRI data were acquired at each postsurgical visit. Presurgical resting-state fMRI (30 minutes) data were also acquired.

RESULTS:

Two neurocircuits showed highly replicable, but distinct responses to STN-DBS. A circuit involving the globus pallidus internus (GPi), thalamus, and deep cerebellar nuclei was significantly activated, whereas another circuit involving the primary motor cortex (M1), putamen, and cerebellum showed DBS-induced deactivation. These 2 circuits were dissociable in terms of their DBS-induced responses and resting-state functional connectivity. The GPi circuit was frequency-dependent, selectively responding to high-frequency stimulation, whereas the M1 circuit was responsive in a time-dependent manner, showing enhanced deactivation over time. Finally, activation of the GPi circuit was associated with overall motor improvement, whereas M1 circuit deactivation was related to reduced bradykinesia.

INTERPRETATION:

Concurrent DBS-fMRI using 3T revealed 2 distinct circuits that responded differentially to STN-DBS and were related to divergent symptoms, a finding that may provide novel insights into the neural mechanisms underlying DBS. ANN NEUROL 2020;881178-1193.
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Full text: 1 Database: MEDLINE Main subject: Parkinson Disease / Putamen / Thalamus / Cerebellar Nuclei / Cerebellum / Globus Pallidus / Motor Cortex Language: En Journal: Ann Neurol Year: 2020 Type: Article Affiliation country: China
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Full text: 1 Database: MEDLINE Main subject: Parkinson Disease / Putamen / Thalamus / Cerebellar Nuclei / Cerebellum / Globus Pallidus / Motor Cortex Language: En Journal: Ann Neurol Year: 2020 Type: Article Affiliation country: China