title: Connectivity patterns of pallidal DBS electrodes in focal dystonia: a diffusion tensor tractography study.
abstract: Deep brain stimulation (DBS) of the internal pallidal segment (GPi: globus pallidus internus) is gold standard treatment for medically intractable dystonia, but detailed knowledge of mechanisms of action is still not available. There is evidence that stimulation of ventral and dorsal GPi produces opposite motor effects. The aim of this study was to analyse connectivity profiles of ventral and dorsal GPi. Probabilistic tractography was initiated from DBS electrode contacts in 8 patients with focal dystonia and connectivity patterns compared. We found a considerable difference in anterior-posterior distribution of fibres along the mesial cortical sensorimotor areas between the ventral and dorsal GPi connectivity. This finding of distinct GPi connectivity profiles further confirms the clinical evidence that the ventral and dorsal GPi belong to different functional and anatomic motor subsystems. Their involvement could play an important role in promoting clinical DBS effects in dystonia.
authors.affiliation: Department of Neurology, University of Munich at Marchioninistrasse 15, 81377 Munich, Germany. Electronic address: verena.rozanski@med.uni-muenchen.de.
authors.forename: Verena E
authors.initials: VE
authors.lastname: Rozanski
authors.forename: Christian
authors.initials: C
authors.lastname: Vollmar
authors.forename: João Paulo
authors.initials: JP
authors.lastname: Cunha
authors.forename: Sérgio Miguel Neves
authors.initials: SM
authors.lastname: Tafula
authors.forename: Seyed-Ahmad
authors.initials: SA
authors.lastname: Ahmadi
authors.forename: Maximilian
authors.initials: M
authors.lastname: Patzig
authors.forename: Jan-Hinnerk
authors.initials: JH
authors.lastname: Mehrkens
authors.forename: Kai
authors.initials: K
authors.lastname: Bötzel
mesh_terms: D000328:Adult; D000368:Aged; D063132:Connectome / Q000379:methods; D046690:Deep Brain Stimulation / Q000295:instrumentation / Q000379:methods*; D056324:Diffusion Tensor Imaging / Q000379:methods*; D020821:Dystonic Disorders / Q000473:pathology* / Q000628:therapy*; D004567:Electrodes, Implanted; D005260:Female; D005917:Globus Pallidus / Q000473:pathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009413:Nerve Fibers, Myelinated / Q000473:pathology*; D009415:Nerve Net / Q000473:pathology*; D009434:Neural Pathways / Q000473:pathology; D009473:Neuronal Plasticity; D016896:Treatment Outcome
keywords: Basal ganglia; Deep brain stimulation; Diffusion tensor imaging; Dystonia; Motor networks