TY  - JOUR
AU  - Accolla, Ettore A
AU  - Herrojo Ruiz, Maria
AU  - Horn, Andreas
AU  - Schneider, Gerd-Helge
AU  - Schmitz-Hübsch, Tanja
AU  - Draganski, Bogdan
AU  - Kühn, Andrea A
TI  - Brain networks modulated by subthalamic nucleus deep brain stimulation.
JO  - Brain
VL  - 139
IS  - 9
SN  - 0006-8950
CY  - Oxford
PB  - Oxford Univ. Press
M1  - DZNE-2020-05103
SP  - 2503-2515
PY  - 2016
AB  - 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.
KW  - Aged
KW  - Amygdala: diagnostic imaging
KW  - Amygdala: physiopathology
KW  - Beta Rhythm: physiology
KW  - Cerebral Cortex: diagnostic imaging
KW  - Cerebral Cortex: physiopathology
KW  - Deep Brain Stimulation
KW  - Diffusion Tensor Imaging: methods
KW  - Electroencephalography: methods
KW  - Female
KW  - Humans
KW  - Male
KW  - Middle Aged
KW  - Nerve Net: diagnostic imaging
KW  - Nerve Net: physiopathology
KW  - Parkinson Disease: diagnostic imaging
KW  - Parkinson Disease: physiopathology
KW  - Parkinson Disease: therapy
KW  - Subthalamic Nucleus: diagnostic imaging
KW  - Subthalamic Nucleus: physiopathology
LB  - PUB:(DE-HGF)16
C6  - pmid:27412387
DO  - DOI:10.1093/brain/aww182
UR  - https://pub.dzne.de/record/138781
ER  -