Cerebello-striatal interaction mediates effects of subthalamic nucleus deep brain stimulation in Parkinson’s disease.

Cerebello-striatal interaction mediates effects of subthalamic nucleus deep brain stimulation in Parkinson’s disease.

Publication date: Sep 03, 2019

In Parkinson’s disease (PD), dopamine replacement therapy (DRT) enhances the effective connectivity of the prefrontal cortex (PFC) and supplementary motor area (SMA). The clinical effects of deep brain stimulation (DBS) of the subthalamic nucleus (STN) go beyond DRT effects including highly beneficial tremor suppression.

Here, we aimed to determine DBS-related changes of a motor network using resting state fMRI in PD patients with chronic STN DBS.

In a repeated-measurement design, 26 medicated PD patients (60.9 years (SD 8.9)) were investigated using resting state fMRI while bipolar STN stimulation was (i) active or (ii) switched off, and dynamic causal modelling was subsequently performed.

DBS improved the MDS-UPDRS-III score by 26.4% (DBS ON/Med ON vs. DBS OFF/Med ON). Active stimulation resulted in an increased effective connectivity from cerebellum to putamen (p = 0.00118). In addition, there was a stronger coupling from PFC to cerebellum (p = 0.021), as well as from cerebellum to SMA (p = 0.043) on an uncorrected level. Coupling strength from PFC to cerebellum correlated with the DBS-related change of the resting tremor subscore (r = 0.54, p = 0.031). Self-connections increased as a function of DBS in the right PFC, PMC, SMA, M1, thalamus and left cerebellum.

DBS-related improvement of Parkinsonian signs appears to be driven by an interaction between the cerebellum and the putamen. Resting tremor suppression may be related to an enhanced prefronto-cerebellar network. Activation of the mesial premotor loop (PFC-SMA) as seen in DRT may thus be secondary due to the primary modulation of cerebellar networks.

Hanssen, H., Steinhardt, J., M”unchau, A., Al-Zubaidi, A., Tzvi, E., Heldmann, M., Schramm, P., Neumann, A., Rasche, D., Saryyeva, A., Voges, J., , Galazky, B”untjen, L., Heinze, H.J., Krauss, J.K., , Tronnier, M”unte, T.F., and Br”uggemann, N. Cerebello-striatal interaction mediates effects of subthalamic nucleus deep brain stimulation in Parkinson’s disease. 22227. 2019 Parkinsonism Relat Disord.

Concepts Keywords
Bipolar Cerebellum
Cerebellar Putamen
Cerebellum Subthalamic nucleus
Coupling Supplementary motor area
DBS Deep brain stimulation
Deep Brain Stimulation Neurotechnology
Dopamine Motor system
FMRI Neurosurgical procedures
Mesial Electrotherapy
Modulation Basal ganglia
Parkinson Nervous system
Parkinsonian Medicine
Parkinsonism Related motor network
Prefrontal Cortex Deep brain stimulation
Putamen
SD 8
Striatal
Subthalamic Nucleus
Supplementary Motor Area
Thalamus
Tremor

Semantics

Type Source Name
gene UNIPROT PAFAH1B1
gene UNIPROT SCN8A
disease DOID MDS
disease MESH tremor
gene UNIPROT EEF1A2
gene UNIPROT CFP
gene UNIPROT EPHB2
drug DRUGBANK Dopamine

Similar

Original Article

Leave a Comment

Your email address will not be published. Required fields are marked *