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Single-pulse subthalamic deep brain stimulation reduces premotor-motor facilitation in Parkinson's disease

Anne Weissbach, Kaviraja Udupa, Zhen Ni, Carolyn Gunraj, Cricia Rinchon, Julianne Baarbe, Alfonso Fasano, Renato P. Munhoz, Anthony Lang, Vera Tadic, Norbert Brüggemann, Alexander Münchau, Tobias Bäumer, Robert Chen*

*Korrespondierende/r Autor/-in für diese Arbeit

Abstract

Introduction: Deep brain stimulation improves motor symptoms in Parkinson's disease and changes primary motor cortex excitability, but how subthalamic nucleus stimulation affects premotor-motor cortical connectivity remains unclear. Methods: We investigated 10 Parkinson patients in whom single subthalamic nucleus stimulation was time-locked to transcranial magnetic dual-coil, paired-pulse stimulation of the dorsal premotor and primary motor cortex. Premotor-motor interaction with deep brain stimulation switched off was compared to 10 controls. Results: Parkinson patients showed abnormally facilitated premotor-motor interaction with deep brain stimulation switched off compared to controls. This abnormal premotor-motor facilitation was abolished during subthalamic nucleus stimulation at 3 Hz. Conclusions: In Parkinson's disease, aberrant signals from the basal ganglia leading to a loss of physiological premotor-motor inhibition can be normalized by subthalamic deep brain stimulation. This effect is likely mediated by activation of subthalamic-pallidal-thalamic projection to the premotor cortex.

OriginalspracheEnglisch
ZeitschriftParkinsonism and Related Disorders
Jahrgang66
Seiten (von - bis)224-227
Seitenumfang4
ISSN1353-8020
DOIs
PublikationsstatusVeröffentlicht - 07.08.2019

Fördermittel

This work was supported by a Canadian Institutes of Health Research Foundation Grant to Robert Chen ( FDN 154292 ) and the German Research Foundation and the Else Kröner-Fresenius Foundation to Anne Weissbach ( DFG WE5919/1-1 and 2018_A55 ) and to Alexander Münchau ( SFB 936/project C5 and FOR 2698 ). Appendix A Anne Weissbach received a scholarship from the German Research Foundation ( DFG , WE5919/1-1 ) and received funding from the University of Lübeck ( Habilitationsstipendium , H03-2016 ). She receives funding from the Else Kröner-Fresenius Foundation ( 2018_A55 ) and an Edmond J. Safra fellowship in movement disorders from the Michael J Fox foundation. Kaviraya Udupa reports no disclosures. Zhen Ni reports no disclosures. Carolyn Gunraj reports no disclosures. Cricia Rinchon received a graduate student award through Parkinson Society Canada. Julianne Baarbe received a doctoral award through Canadian Institutes in Health Research (# 357215 ). Alfonso Fasano has received grant support from the University of Toronto , the McLaughlin Centre and the Michael J. Fox Foundation ; he received speaking honoraria from UCB pharma, Medtronic, Boston Scientific, Brain Lab, Abbvie, Novartis, Chiesi pharmaceutical, Ipsen and TEVA; he is in an advisory board for Abbvie and Ipsen and provided consultancies for UCB pharma, Medtronic, Boston Scientific, and Abbvie. Renato P Munhoz reports no disclosures. Antony Lang has served as an advisor for Abbvie, Acorda, Avanir Pharmaceuticals, Biogen, Bristol Myers Squibb, Cipla, Intekrin, and Merck; received honoraria from Sun Pharma, Medichem, Medtronic, Teva, UCB, AbbVie and Sunovion; received grants from Brain Canada , Canadian Institutes of Health Research , Edmond J Safra Philanthropic Foundation , Michael J. Fox Foundation , the Ontario Brain Institute , National Parkinson Foundation , Parkinson Society Canada , and W. Garfield Weston Foundation ; received publishing royalties from Saunders, Wiley-Blackwell, Johns Hopkins Press, and Cambridge University Press. Vera Tadic report no disclosures. Norbert Brüggemann received a honorarium from Grünenthal. He has been funded by the DFG and the Collaborative Center for X-linked Dystonia-Parkinsonism . Alexander Münchau receives funding from the German Research Foundation ( DFG , SFB 936 , project C5 , FOR 2698 ). He receives grants and Honoraria for lectures from Pharm Allergan, Ipsen, Merz Pharmaceuticals, Actelion, GlaxoSmithKline and Desitin. Tobias Bäumer receives funding from the German Research Foundation ( FOR 2698 ). He receives Honoraria from Merz Pharmaceuticals, Allergan and Ipsen Pharma. He is a medical advisor to Merz Pharmaceuticals. Robert Chen was supported by a Canadian Institutes of Health Research Foundation Grant ( FDN 154292 ), Catherine Manson Chair in Movement Disorders , Dystonia Medical Research Foundation and Weston Brain Institute . He received honoraria from GE Healthcare, Merz and Allergan. All authors do not have any conflict of interest.

UN SDGs

Dieser Output leistet einen Beitrag zu folgendem(n) Ziel(en) für nachhaltige Entwicklung

  1. SDG 3 – Gesundheit und Wohlergehen
    SDG 3 – Gesundheit und Wohlergehen
  2. SDG 10 – Weniger Ungleichheiten
    SDG 10 – Weniger Ungleichheiten

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