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Brain networks modulated by subthalamic nucleus deep brain stimulation

Authors: Accolla, Ettore A.; Ruiz, Maria Herrojo; Horn, Andreas; Schneider, Gerd-Helge; Schmitz-Hübsch, Tanja; Draganski, Bogdan; Kühn, Andrea A.;

Brain networks modulated by subthalamic nucleus deep brain stimulation

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.

Keywords

Male, therapy [Parkinson Disease], Deep Brain Stimulation, physiopathology [Amygdala], methods [Electroencephalography], methods [Diffusion Tensor Imaging], physiopathology [Cerebral Cortex], diagnostic imaging [Subthalamic Nucleus], Subthalamic Nucleus, diagnostic imaging [Cerebral Cortex], physiopathology [Nerve Net], diagnostic imaging [Parkinson Disease], Humans, diagnostic imaging [Amygdala], Aged, Cerebral Cortex, diagnostic imaging [Nerve Net], physiopathology [Subthalamic Nucleus], Electroencephalography, Parkinson Disease, physiology [Beta Rhythm], Middle Aged, Amygdala, Diffusion Tensor Imaging, Female, physiopathology [Parkinson Disease], Nerve Net, Beta Rhythm, ddc: ddc:610

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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
125
Top 1%
Top 10%
Top 1%
Green
bronze