title: Effects of subthalamic nucleus stimulation on motor cortex plasticity in Parkinson disease.
abstract: OBJECTIVE
  We hypothesized that subthalamic nucleus (STN) deep brain stimulation (DBS) will improve long-term potentiation (LTP)-like plasticity in motor cortex in Parkinson disease (PD).
  
  
  METHODS
  We studied 8 patients with PD treated with STN-DBS and 9 age-matched healthy controls. Patients with PD were studied in 4 sessions in medication (Med) OFF/stimulator (Stim) OFF, Med-OFF/Stim-ON, Med-ON/Stim-OFF, and Med-ON/Stim-ON states in random order. Motor evoked potential amplitude and cortical silent period duration were measured at baseline before paired associated stimulation (PAS) and at 3 different time intervals (T0, T30, T60) up to 60 minutes after PAS in the abductor pollicis brevis and abductor digiti minimi muscles.
  
  
  RESULTS
  Motor evoked potential size significantly increased after PAS in controls (+67.7% of baseline at T30) and in patients in the Med-ON/Stim-ON condition (+55.8% of baseline at T30), but not in patients in the Med-OFF/Stim-OFF (-0.4% of baseline at T30), Med-OFF/Stim-ON (+10.3% of baseline at T30), and Med-ON/Stim-OFF conditions (+17.3% of baseline at T30). Cortical silent period duration increased after PAS in controls but not in patients in all test conditions.
  
  
  CONCLUSIONS
  Our findings suggest that STN-DBS together with dopaminergic medications restore LTP-like plasticity in motor cortex in PD. Restoration of cortical plasticity may be one of the mechanisms of how STN-DBS produces clinical benefit.
authors.affiliation: From the Division of Neurology (S.J.K., K.U., Z.N., E.M., C.G., F.M., A.E.L., R.C.), University of Toronto, Toronto Western Research Institute, University Health Network and the Edmond J. Safra Program in Parkinson's Disease, Toronto; Division of Neurosurgery and Toronto Western Research Institute (A.M.L., M.H.), University Health Network, University of Toronto; Brain & Spinal Cord Rehab Program (F.M.), Toronto Rehab, University Health Network, Canada; Service de Neurologie (E.M.), CHU Grenoble, Joseph Fourier University, Grenoble, France; and Department of Neurology (S.J.K.), Inje University College of Medicine, Busan, South Korea.
authors.forename: Sang Jin
authors.initials: SJ
authors.lastname: Kim
authors.affiliation: From the Division of Neurology (S.J.K., K.U., Z.N., E.M., C.G., F.M., A.E.L., R.C.), University of Toronto, Toronto Western Research Institute, University Health Network and the Edmond J. Safra Program in Parkinson's Disease, Toronto; Division of Neurosurgery and Toronto Western Research Institute (A.M.L., M.H.), University Health Network, University of Toronto; Brain & Spinal Cord Rehab Program (F.M.), Toronto Rehab, University Health Network, Canada; Service de Neurologie (E.M.), CHU Grenoble, Joseph Fourier University, Grenoble, France; and Department of Neurology (S.J.K.), Inje University College of Medicine, Busan, South Korea.
authors.forename: Kaviraja
authors.initials: K
authors.lastname: Udupa
authors.affiliation: From the Division of Neurology (S.J.K., K.U., Z.N., E.M., C.G., F.M., A.E.L., R.C.), University of Toronto, Toronto Western Research Institute, University Health Network and the Edmond J. Safra Program in Parkinson's Disease, Toronto; Division of Neurosurgery and Toronto Western Research Institute (A.M.L., M.H.), University Health Network, University of Toronto; Brain & Spinal Cord Rehab Program (F.M.), Toronto Rehab, University Health Network, Canada; Service de Neurologie (E.M.), CHU Grenoble, Joseph Fourier University, Grenoble, France; and Department of Neurology (S.J.K.), Inje University College of Medicine, Busan, South Korea.
authors.forename: Zhen
authors.initials: Z
authors.lastname: Ni
authors.affiliation: From the Division of Neurology (S.J.K., K.U., Z.N., E.M., C.G., F.M., A.E.L., R.C.), University of Toronto, Toronto Western Research Institute, University Health Network and the Edmond J. Safra Program in Parkinson's Disease, Toronto; Division of Neurosurgery and Toronto Western Research Institute (A.M.L., M.H.), University Health Network, University of Toronto; Brain & Spinal Cord Rehab Program (F.M.), Toronto Rehab, University Health Network, Canada; Service de Neurologie (E.M.), CHU Grenoble, Joseph Fourier University, Grenoble, France; and Department of Neurology (S.J.K.), Inje University College of Medicine, Busan, South Korea.
authors.forename: Elena
authors.initials: E
authors.lastname: Moro
authors.affiliation: From the Division of Neurology (S.J.K., K.U., Z.N., E.M., C.G., F.M., A.E.L., R.C.), University of Toronto, Toronto Western Research Institute, University Health Network and the Edmond J. Safra Program in Parkinson's Disease, Toronto; Division of Neurosurgery and Toronto Western Research Institute (A.M.L., M.H.), University Health Network, University of Toronto; Brain & Spinal Cord Rehab Program (F.M.), Toronto Rehab, University Health Network, Canada; Service de Neurologie (E.M.), CHU Grenoble, Joseph Fourier University, Grenoble, France; and Department of Neurology (S.J.K.), Inje University College of Medicine, Busan, South Korea.
authors.forename: Carolyn
authors.initials: C
authors.lastname: Gunraj
authors.affiliation: From the Division of Neurology (S.J.K., K.U., Z.N., E.M., C.G., F.M., A.E.L., R.C.), University of Toronto, Toronto Western Research Institute, University Health Network and the Edmond J. Safra Program in Parkinson's Disease, Toronto; Division of Neurosurgery and Toronto Western Research Institute (A.M.L., M.H.), University Health Network, University of Toronto; Brain & Spinal Cord Rehab Program (F.M.), Toronto Rehab, University Health Network, Canada; Service de Neurologie (E.M.), CHU Grenoble, Joseph Fourier University, Grenoble, France; and Department of Neurology (S.J.K.), Inje University College of Medicine, Busan, South Korea.
authors.forename: Filomena
authors.initials: F
authors.lastname: Mazzella
authors.affiliation: From the Division of Neurology (S.J.K., K.U., Z.N., E.M., C.G., F.M., A.E.L., R.C.), University of Toronto, Toronto Western Research Institute, University Health Network and the Edmond J. Safra Program in Parkinson's Disease, Toronto; Division of Neurosurgery and Toronto Western Research Institute (A.M.L., M.H.), University Health Network, University of Toronto; Brain & Spinal Cord Rehab Program (F.M.), Toronto Rehab, University Health Network, Canada; Service de Neurologie (E.M.), CHU Grenoble, Joseph Fourier University, Grenoble, France; and Department of Neurology (S.J.K.), Inje University College of Medicine, Busan, South Korea.
authors.forename: Andres M
authors.initials: AM
authors.lastname: Lozano
authors.affiliation: From the Division of Neurology (S.J.K., K.U., Z.N., E.M., C.G., F.M., A.E.L., R.C.), University of Toronto, Toronto Western Research Institute, University Health Network and the Edmond J. Safra Program in Parkinson's Disease, Toronto; Division of Neurosurgery and Toronto Western Research Institute (A.M.L., M.H.), University Health Network, University of Toronto; Brain & Spinal Cord Rehab Program (F.M.), Toronto Rehab, University Health Network, Canada; Service de Neurologie (E.M.), CHU Grenoble, Joseph Fourier University, Grenoble, France; and Department of Neurology (S.J.K.), Inje University College of Medicine, Busan, South Korea.
authors.forename: Mojgan
authors.initials: M
authors.lastname: Hodaie
authors.affiliation: From the Division of Neurology (S.J.K., K.U., Z.N., E.M., C.G., F.M., A.E.L., R.C.), University of Toronto, Toronto Western Research Institute, University Health Network and the Edmond J. Safra Program in Parkinson's Disease, Toronto; Division of Neurosurgery and Toronto Western Research Institute (A.M.L., M.H.), University Health Network, University of Toronto; Brain & Spinal Cord Rehab Program (F.M.), Toronto Rehab, University Health Network, Canada; Service de Neurologie (E.M.), CHU Grenoble, Joseph Fourier University, Grenoble, France; and Department of Neurology (S.J.K.), Inje University College of Medicine, Busan, South Korea.
authors.forename: Anthony E
authors.initials: AE
authors.lastname: Lang
authors.affiliation: From the Division of Neurology (S.J.K., K.U., Z.N., E.M., C.G., F.M., A.E.L., R.C.), University of Toronto, Toronto Western Research Institute, University Health Network and the Edmond J. Safra Program in Parkinson's Disease, Toronto; Division of Neurosurgery and Toronto Western Research Institute (A.M.L., M.H.), University Health Network, University of Toronto; Brain & Spinal Cord Rehab Program (F.M.), Toronto Rehab, University Health Network, Canada; Service de Neurologie (E.M.), CHU Grenoble, Joseph Fourier University, Grenoble, France; and Department of Neurology (S.J.K.), Inje University College of Medicine, Busan, South Korea. robert.chen@uhn.ca.
authors.forename: Robert
authors.initials: R
authors.lastname: Chen
mesh_terms: D000368:Aged; D046690:Deep Brain Stimulation / Q000639:trends*; D019054:Evoked Potentials, Motor / Q000502:physiology*; D005260:Female; D006801:Humans; D017774:Long-Term Potentiation / Q000502:physiology; D008297:Male; D008875:Middle Aged; D009044:Motor Cortex / Q000502:physiology*; D009473:Neuronal Plasticity / Q000502:physiology*; D010300:Parkinson Disease / Q000503:physiopathology / Q000628:therapy*; D020531:Subthalamic Nucleus / Q000502:physiology*; D016896:Treatment Outcome