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Brain networks modulated by subthalamic nucleus deep brain stimulation.

Accolla, Ettore A; Herrojo Ruiz, Maria; Horn, Andreas; Schneider, Gerd-Helge; Schmitz-Hübsch, Tanja; Draganski, Bogdan and Kühn, Andrea A. 2016. Brain networks modulated by subthalamic nucleus deep brain stimulation. Brain: A Journal of Neurology, 139(9), pp. 2503-2515. ISSN 0006-8950 [Article]

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Abstract or Description

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.

Item Type:

Article

Identification Number (DOI):

https://doi.org/10.1093/brain/aww182

Keywords:

deep brain stimulation, Parkinson’s disease, Parkinson’s disease: imaging, subthalamic nucleus, beta oscillations

Departments, Centres and Research Units:

Psychology

Dates:

DateEvent
15 June 2016Accepted
13 July 2016Published Online
September 2016Published

Item ID:

18784

Date Deposited:

01 Aug 2016 09:57

Last Modified:

08 Jan 2020 14:19

Peer Reviewed:

Yes, this version has been peer-reviewed.

URI:

http://research.gold.ac.uk/id/eprint/18784

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