Deep brain stimulation of the subthalamic nucleus versus levodopa challenge in Parkinson's disease: measuring the on- and off-conditions with FDG-PET.
In order to compare the effects of high-frequency stimulation of the subthalamic nucleus (STN-DBS) and a levodopa-challenge on cerebral metabolic activity, we conducted PET scans with [(18)F]2-fluoro-2-deoxyglucose (FDG) in the drug- and stimulation- on- and off-condition in a single patient suffering from advanced PD. Our data revealed evidence for improved thalamocortical processing released from inhibition by overactive basal ganglia output nuclei in both on-conditions. While levodopa also led to a reduction of lentiform hyperactivity, effective STN stimulation seemed to interfere with distinct cerebellar and limbic circuits.
Hilker
R
R
Department of Neurology, Medical University of Cologne, Federal Republic of Germany.
Voges
J
J
Thiel
A
A
Ghaemi
M
M
Herholz
K
K
Sturm
V
V
Heiss
W-D
WD
D000368:Aged; D000978:Antiparkinson Agents / Q000627:therapeutic use*; D001923:Brain Chemistry / Q000502:physiology / Q000528:radiation effects; D004599:Electric Stimulation Therapy; D019788:Fluorodeoxyglucose F18; D007839:Functional Laterality / Q000502:physiology; D005684:Gait / Q000502:physiology; D005947:Glucose / Q000378:metabolism; D006801:Humans; D007980:Levodopa / Q000627:therapeutic use*; D008297:Male; D010300:Parkinson Disease / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000628:therapy*; D019275:Radiopharmaceuticals; D020531:Subthalamic Nucleus / Q000000981:diagnostic imaging / Q000378:metabolism / Q000502:physiology*; D014055:Tomography, Emission-Computed
D000978:Antiparkinson Agents; D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18; D007980:Levodopa; D005947:Glucose