title: Levodopa affects functional brain networks in Parkinsonian resting tremor.
abstract: Resting tremor in idiopathic Parkinson's disease (PD) is associated with an oscillatory network comprising cortical as well as subcortical brain areas. To shed light on the effect of levodopa on these network interactions, we investigated 10 patients with tremor-dominant PD and reanalyzed data in 11 healthy volunteers mimicking PD resting tremor. To this end, we recorded surface electromyograms of forearm muscles and neuromagnetic activity using a 122-channel whole-head magnetometer (MEG). Measurements were performed after overnight withdrawal of levodopa (OFF) and 30 min after oral application of fast-acting levodopa (ON). During OFF, patients showed the typical antagonistic resting tremor. Using the analysis tool Dynamic Imaging of Coherent Sources, we identified the oscillatory network associated with tremor comprising contralateral primary sensorimotor cortex (S1/M1), supplementary motor area (SMA), contralateral premotor cortex (PMC), thalamus, secondary somatosensory cortex (S2), posterior parietal cortex (PPC), and ipsilateral cerebellum oscillating at 8 to 10 Hz. After intake of levodopa, we found a significant decrease of cerebro-cerebral coupling between thalamus and motor cortical areas. Similarly, in healthy controls mimicking resting tremor, we found a significant decrease of functional interaction within a thalamus-premotor-motor network during rest. However, in patients with PD, decrease of functional interaction between thalamus and PMC was significantly stronger when compared with healthy controls. These data support the hypothesis that (1) in patients with PD the basal ganglia and motor cortical structures become more closely entrained and (2) levodopa is associated with normalization of the functional interaction between thalamus and motor cortical areas.
authors.affiliation: Department of Neurology, Heinrich-Heine University, Düsseldorf, Germany. bettina.pollok@uni-duesseldorf.de
authors.forename: Bettina
authors.initials: B
authors.lastname: Pollok
authors.forename: Houssain
authors.initials: H
authors.lastname: Makhloufi
authors.forename: Markus
authors.initials: M
authors.lastname: Butz
authors.forename: Joachim
authors.initials: J
authors.lastname: Gross
authors.forename: Lars
authors.initials: L
authors.lastname: Timmermann
authors.forename: Lars
authors.initials: L
authors.lastname: Wojtecki
authors.forename: Alfons
authors.initials: A
authors.lastname: Schnitzler
mesh_terms: D000978:Antiparkinson Agents / Q000494:pharmacology* / Q000627:therapeutic use; D001921:Brain / Q000187:drug effects* / Q000503:physiopathology; D001931:Brain Mapping; D002531:Cerebellum / Q000187:drug effects / Q000503:physiopathology; D004576:Electromyography; D005260:Female; D006801:Humans; D007980:Levodopa / Q000494:pharmacology* / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D009044:Motor Cortex / Q000187:drug effects / Q000503:physiopathology; D009415:Nerve Net / Q000187:drug effects*; D010296:Parietal Lobe / Q000187:drug effects / Q000503:physiopathology; D020734:Parkinsonian Disorders / Q000150:complications / Q000188:drug therapy / Q000503:physiopathology*; D013003:Somatosensory Cortex / Q000187:drug effects / Q000503:physiopathology; D013788:Thalamus / Q000187:drug effects / Q000503:physiopathology; D014202:Tremor / Q000209:etiology / Q000503:physiopathology*
chemical_list: D000978:Antiparkinson Agents; D007980:Levodopa