title: Globus pallidus stimulation reduces frontal hyperactivity in tardive dystonia.
abstract: Tardive dystonia (TD) is a disabling disorder induced by neuroleptics. Internal globus pallidus (GPi) stimulation can dramatically improve TD. The present positron emission tomography and H(2)(15)O study aimed to characterize the abnormalities of brain activation of TD and the impact of GPi stimulation on these abnormalities in five TD patients treated with GPi stimulation and eight controls. Changes of regional cerebral blood flow (rCBF) were determined: (i) at rest; (ii) when moving a joystick with the right hand in three freely chosen directions in on and off bilateral GPi stimulation. A significant increase of rCBF was found in TD patients in off-stimulation condition compared to controls: (1) during motor execution in the prefrontal, premotor lateral, and anterior cingulate cortex; (2) at rest, in the prefrontal and anterior cingulate cortex and the cerebellum. Internal globus pallidus stimulation led to a reduction of rCBF (1) during motor execution, in the primary motor and prefrontal cortex and the cerebellum; (2) at rest, in the primary motor and anterior cingulate cortex and supplementary motor area. The results are as follows: (1) TD is related to an excess of brain activity notably in the prefrontal and premotor areas; (2) GPi stimulation reduces the activation of motor, premotor, and prefrontal cortex as well as cerebellum.
authors.affiliation: Université Lyon I, Hospices Civils de Lyon, Hôpital Neurologique et Neurochirurgical Pierre Wertheimer, Service de Neurologie C, Lyon, France. stephane.thobois@chu-lyon.fr
authors.forename: Stéphane
authors.initials: S
authors.lastname: Thobois
authors.forename: Bénédicte
authors.initials: B
authors.lastname: Ballanger
authors.forename: Jing
authors.initials: J
authors.lastname: Xie-Brustolin
authors.forename: Philippe
authors.initials: P
authors.lastname: Damier
authors.forename: Franck
authors.initials: F
authors.lastname: Durif
authors.forename: Jean-Philippe
authors.initials: JP
authors.lastname: Azulay
authors.forename: Philippe
authors.initials: P
authors.lastname: Derost
authors.forename: Tatiana
authors.initials: T
authors.lastname: Witjas
authors.forename: Sylvie
authors.initials: S
authors.lastname: Raoul
authors.forename: Didier
authors.initials: D
authors.lastname: Le Bars
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Broussolle
mesh_terms: D000328:Adult; D002560:Cerebrovascular Circulation; D004421:Dystonia / Q000503:physiopathology*; D005260:Female; D005917:Globus Pallidus / Q000502:physiology* / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D049268:Positron-Emission Tomography