title: Brain energization in response to deep brain stimulation of subthalamic nuclei in Parkinson's disease.
abstract: Deep brain stimulation (DBS) of the subthalamic nucleus (STN) is an effective treatment in a subgroup of medically refractory patients with Parkinson's disease (PD). Here, we compared resting-state (18)F-fluorodeoxyglucose (FDG) positron emission tomography images in the stimulator off (DBS_OFF) and on (DBS_ON) conditions in eight PD patients in an unmedicated state, on average 2 years after bilateral electrode implantation. Global standardized uptake value (SUV) significantly increased by ∼11% in response to STN-DBS. To avoid any bias in the voxel-based analysis comparing DBS_ON and DBS_OFF conditions, individual scan intensity was scaled to a region where FDG-SUV did not differ significantly between conditions. The resulting FDG-SUV ratio (FDG-SUVR) was found to increase in many regions in response to STN-DBS including the target area of surgery, caudate nuclei, primary sensorimotor, and associative cortices. Contrary to previous studies, we could not find any regional decrease in FDG-SUVR. These findings were indirectly supported by comparing the extent of areas with depressed FDG-SUVR in DBS_OFF and DBS_ON relatively to 10 normal controls. Altogether, these novel results support the prediction that the effect of STN-DBS on brain activity in PD is unidirectional and consists in an increase in many subcortical and cortical regions.
authors.affiliation: Cyclotron Research Center, University of Liege, Liège, Belgium. ggarraux@ulg.ac.be
authors.forename: Gaëtan
authors.initials: G
authors.lastname: Garraux
authors.forename: Mohamed A
authors.initials: MA
authors.lastname: Bahri
authors.forename: Christian
authors.initials: C
authors.lastname: Lemaire
authors.forename: Christian
authors.initials: C
authors.lastname: Degueldre
authors.forename: Eric
authors.initials: E
authors.lastname: Salmon
authors.forename: Bruno
authors.initials: B
authors.lastname: Kaschten
mesh_terms: D000328:Adult; D046690:Deep Brain Stimulation; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000000981:diagnostic imaging* / Q000601:surgery / Q000628:therapy*; D049268:Positron-Emission Tomography; D019275:Radiopharmaceuticals; D020531:Subthalamic Nucleus / Q000000981:diagnostic imaging* / Q000601:surgery*
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18