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

doi:10.1016/j.parkreldis.2019.08.003

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^*

^*Corresponding author for this work

4 Citations (Scopus)

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.

Original language	English
Journal	Parkinsonism and Related Disorders
Volume	66
Pages (from-to)	224-227
Number of pages	4
ISSN	1353-8020
DOIs	https://doi.org/10.1016/j.parkreldis.2019.08.003
Publication status	Published - 07.08.2019

Funding

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.

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This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 3 Good Health and Well-being
SDG 10 Reduced Inequalities

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Weissbach, A., Udupa, K., Ni, Z., Gunraj, C., Rinchon, C., Baarbe, J., Fasano, A., Munhoz, R. P., Lang, A., Tadic, V., Brüggemann, N., Münchau, A., Bäumer, T., & Chen, R. (2019). Single-pulse subthalamic deep brain stimulation reduces premotor-motor facilitation in Parkinson's disease. Parkinsonism and Related Disorders, 66, 224-227. https://doi.org/10.1016/j.parkreldis.2019.08.003

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

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.",

author = "Anne Weissbach and Kaviraja Udupa and Zhen Ni and Carolyn Gunraj and Cricia Rinchon and Julianne Baarbe and Alfonso Fasano and Munhoz, \{Renato P.\} and Anthony Lang and Vera Tadic and Norbert Br{\"u}ggemann and Alexander M{\"u}nchau and Tobias B{\"a}umer and Robert Chen",

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doi = "10.1016/j.parkreldis.2019.08.003",

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Weissbach, A, Udupa, K, Ni, Z, Gunraj, C, Rinchon, C, Baarbe, J, Fasano, A, Munhoz, RP, Lang, A, Tadic, V , Brüggemann, N , Münchau, A , Bäumer, T & Chen, R 2019, 'Single-pulse subthalamic deep brain stimulation reduces premotor-motor facilitation in Parkinson's disease', Parkinsonism and Related Disorders, vol. 66, pp. 224-227. https://doi.org/10.1016/j.parkreldis.2019.08.003

TY - JOUR

T1 - Single-pulse subthalamic deep brain stimulation reduces premotor-motor facilitation in Parkinson's disease

AU - Weissbach, Anne

AU - Udupa, Kaviraja

AU - Ni, Zhen

AU - Gunraj, Carolyn

AU - Rinchon, Cricia

AU - Baarbe, Julianne

AU - Fasano, Alfonso

AU - Munhoz, Renato P.

AU - Lang, Anthony

AU - Tadic, Vera

AU - Brüggemann, Norbert

AU - Münchau, Alexander

AU - Bäumer, Tobias

AU - Chen, Robert

PY - 2019/8/7

Y1 - 2019/8/7

N2 - 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.

AB - 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.

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DO - 10.1016/j.parkreldis.2019.08.003

M3 - Journal articles

AN - SCOPUS:85070689484

SN - 1353-8020

VL - 66

SP - 224

EP - 227

JO - Parkinsonism and Related Disorders

JF - Parkinsonism and Related Disorders

ER -

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

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