Title
Focal changes of oxygen consumption in cerebral cortex of patients with Parkinson's disease during subthalamic stimulation.
Abstract
Motor symptoms of Parkinson's disease (PD) are substantially improved by bilateral high-frequency electrical stimulation of the subthalamic nucleus (STN). Altered cerebral blood flow (CBF) in a network of frontal cortical and subcortical structures has been reported in numerous studies of patients undergoing subthalamic stimulation. However, CBF is a controversial indicator of brain activation because measures of blood flow bear a variable relation to measures of brain work and energy metabolism. We hypothesized that STN stimulation would alter the rate of oxygen consumption (CMRO2) in cerebral cortical areas in proportion to previously reported changes in CBF in patients undergoing stimulation at rest. We used quantitative PET to map CMRO2 in brain of seven patients with Parkinson's disease, first in a baseline condition with pause of stimulation and medication for a period of 12 h, and again after 4 h of stimulation. Comparison of these two conditions revealed activation of CMRO2 in the cerebellum, and in specific posterior neocortical regions, most notably in the left lingual gyrus and in the right lateral occipitotemporal gyrus, both of which latter regions are linked to higher-order visual processing. CMRO2 was unaffected in the frontal cortex. Thus, the present findings do not support the original hypothesis, but suggest that STN stimulation increases energy metabolism in the posterior cerebral cortex, especially in regions involved in perception of movement and the direction of movement to visual cues.
Year
DOI
Venue
2004
10.1016/j.neuroimage.2004.02.019
NeuroImage
Keywords
DocType
Volume
Subthalamic stimulation,Parkinson's disease,Oxygen consumption
Journal
22
Issue
ISSN
Citations 
2
1053-8119
3
PageRank 
References 
Authors
1.51
1
6
Name
Order
Citations
PageRank
M S Vafaee131.51
K ØStergaard2152.71
N Sunde331.51
A GJEDDE4409.87
E Dupont531.51
Paul Cumming6154.58