Journal Article

DZNE-2020-05103

http://join2-wiki.gsi.de/foswiki/pub/Main/Artwork/join2_logo100x88.png Brain networks modulated by subthalamic nucleus deep brain stimulation.

Accolla, E. A. (Corresponding author) ; Herrojo Ruiz, M. ; Horn, A. ; Schneider, G.-H. ; Schmitz-Hübsch, T. ; Draganski, B. ; Kühn, A. A. (Last author)DZNE*

2016
Oxford Univ. Press Oxford

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Please use a persistent id in citations: doi:10.1093/brain/aww182

Abstract: Deep brain stimulation of the subthalamic nucleus is an established treatment for the motor symptoms of Parkinson's disease. Given the frequent occurrence of stimulation-induced affective and cognitive adverse effects, a better understanding about the role of the subthalamic nucleus in non-motor functions is needed. The main goal of this study is to characterize anatomical circuits modulated by subthalamic deep brain stimulation, and infer about the inner organization of the nucleus in terms of motor and non-motor areas. Given its small size and anatomical intersubject variability, functional organization of the subthalamic nucleus is difficult to investigate in vivo with current methods. Here, we used local field potential recordings obtained from 10 patients with Parkinson's disease to identify a subthalamic area with an analogous electrophysiological signature, namely a predominant beta oscillatory activity. The spatial accuracy was improved by identifying a single contact per macroelectrode for its vicinity to the electrophysiological source of the beta oscillation. We then conducted whole brain probabilistic tractography seeding from the previously identified contacts, and further described connectivity modifications along the macroelectrode's main axis. The designated subthalamic 'beta' area projected predominantly to motor and premotor cortical regions additional to connections to limbic and associative areas. More ventral subthalamic areas showed predominant connectivity to medial temporal regions including amygdala and hippocampus. We interpret our findings as evidence for the convergence of different functional circuits within subthalamic nucleus' portions deemed to be appropriate as deep brain stimulation target to treat motor symptoms in Parkinson's disease. Potential clinical implications of our study are illustrated by an index case where deep brain stimulation of estimated predominant non-motor subthalamic nucleus induced hypomanic behaviour.

Keyword(s): Aged (MeSH) ; Amygdala: diagnostic imaging (MeSH) ; Amygdala: physiopathology (MeSH) ; Beta Rhythm: physiology (MeSH) ; Cerebral Cortex: diagnostic imaging (MeSH) ; Cerebral Cortex: physiopathology (MeSH) ; Deep Brain Stimulation (MeSH) ; Diffusion Tensor Imaging: methods (MeSH) ; Electroencephalography: methods (MeSH) ; Female (MeSH) ; Humans (MeSH) ; Male (MeSH) ; Middle Aged (MeSH) ; Nerve Net: diagnostic imaging (MeSH) ; Nerve Net: physiopathology (MeSH) ; Parkinson Disease: diagnostic imaging (MeSH) ; Parkinson Disease: physiopathology (MeSH) ; Parkinson Disease: therapy (MeSH) ; Subthalamic Nucleus: diagnostic imaging (MeSH) ; Subthalamic Nucleus: physiopathology (MeSH)

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Contributing Institute(s):

1. Clinical Study Team Berlin Kühn (Clinical Study Team Berlin 2)

Research Program(s):

1. 344 - Clinical and Health Care Research (POF3-344) (POF3-344)

Appears in the scientific report 2016

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Database coverage:
; BIOSIS Previews ; Clarivate Analytics Master Journal List ; Current Contents - Clinical Medicine ; Current Contents - Life Sciences ; Ebsco Academic Search ; IF >= 10 ; JCR ; NCBI Molecular Biology Database ; Nationallizenz ; PubMed Central ; SCOPUS ; Science Citation Index ; Science Citation Index Expanded ; Web of Science Core Collection

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