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Wang F, Xin M, Li X, Li L, Wang C, Dai L, Zheng C, Cao K, Yang X, Ge Q, Li B, Wang T, Zhan S, Li D, Zhang X, Paerhati H, Zhou Y, Liu J, Sun B. Effects of deep brain stimulation on dopamine D2 receptor binding in patients with treatment-refractory depression. J Affect Disord 2024; 356:672-680. [PMID: 38657771 DOI: 10.1016/j.jad.2024.04.082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 03/26/2024] [Accepted: 04/21/2024] [Indexed: 04/26/2024]
Abstract
BACKGROUND Depression is a chronic psychiatric disorder related to diminished dopaminergic neurotransmission. Deep brain stimulation (DBS) has shown effectiveness in treating patients with treatment-refractory depression (TRD). This study aimed to evaluate the effect of DBS on dopamine D2 receptor binding in patients with TRD. METHODS Six patients with TRD were treated with bed nucleus of the stria terminalis (BNST)-nucleus accumbens (NAc) DBS were recruited. Ultra-high sensitivity [11C]raclopride dynamic total-body positron emission tomography (PET) imaging was used to assess the brain D2 receptor binding. Each patient underwent a [11C]raclopride PET scan for 60-min under DBS OFF and DBS ON, respectively. A simplified reference tissue model was used to generate parametric images of binding potential (BPND) with the cerebellum as reference tissue. RESULTS Depression and anxiety symptoms improved after 3-6 months of DBS treatment. Compared with two-day-nonstimulated conditions, one-day BNST-NAc DBS decreased [11C]raclopride BPND in the amygdala (15.9 %, p < 0.01), caudate nucleus (15.4 %, p < 0.0001) and substantia nigra (10.8 %, p < 0.01). LIMITATIONS This study was limited to the small sample size and lack of a healthy control group. CONCLUSIONS Chronic BNST-NAc DBS improved depression and anxiety symptoms, and short-term stimulation decreased D2 receptor binding in the amygdala, caudate nucleus, and substantia nigra. The findings suggest that DBS relieves depression and anxiety symptoms possibly by regulating the dopaminergic system.
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Affiliation(s)
- Fang Wang
- Department of Neurosurgery, Center for Functional Neurosurgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China; Clinical Research Center for Mental Disorders, Shanghai Pudong New Area Mental Health Center, School of Medicine, Tongji University, Shanghai 200124, China
| | - Mei Xin
- Department of Nuclear Medicine, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200127, China
| | - Xuefei Li
- Central Research Institute, United Imaging Healthcare Group Co., Ltd, Shanghai 201815, China
| | - Lianghua Li
- Department of Nuclear Medicine, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200127, China
| | - Cheng Wang
- Department of Nuclear Medicine, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200127, China
| | - Lulin Dai
- Department of Neurosurgery, Center for Functional Neurosurgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - Chaojie Zheng
- Central Research Institute, United Imaging Healthcare Group Co., Ltd, Shanghai 201815, China
| | - Kaiyi Cao
- Central Research Institute, United Imaging Healthcare Group Co., Ltd, Shanghai 201815, China
| | - Xuefei Yang
- Central Research Institute, United Imaging Healthcare Group Co., Ltd, Shanghai 201815, China
| | - Qi Ge
- Central Research Institute, United Imaging Healthcare Group Co., Ltd, Shanghai 201815, China
| | - Bolun Li
- Central Research Institute, United Imaging Healthcare Group Co., Ltd, Shanghai 201815, China
| | - Tao Wang
- Department of Neurosurgery, Center for Functional Neurosurgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - Shikun Zhan
- Department of Neurosurgery, Center for Functional Neurosurgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - Dianyou Li
- Department of Neurosurgery, Center for Functional Neurosurgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - Xiaoxiao Zhang
- Department of Neurosurgery, Center for Functional Neurosurgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - Halimureti Paerhati
- Department of Neurosurgery, Center for Functional Neurosurgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - Yun Zhou
- Central Research Institute, United Imaging Healthcare Group Co., Ltd, Shanghai 201815, China.
| | - Jianjun Liu
- Department of Nuclear Medicine, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200127, China.
| | - Bomin Sun
- Department of Neurosurgery, Center for Functional Neurosurgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China.
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Xing Y, Tench C, Wongwandee M, Schwarz ST, Bajaj N, Auer DP. Coordinate based meta-analysis of motor functional imaging in Parkinson's: disease-specific patterns and modulation by dopamine replacement and deep brain stimulation. Brain Imaging Behav 2020; 14:1263-1280. [PMID: 30809759 PMCID: PMC7381438 DOI: 10.1007/s11682-019-00061-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECTIVE To investigate factors affecting the pattern of motor brain activation reported in people with Parkinson's (PwP), aiming to differentiate disease-specific features from treatment effects. METHODS A co-ordinate-based-meta-analysis (CBMA) of functional motor neuroimaging studies involving patients with Parkinson's (PwP), and healthy controls (HC) identified 126 suitable articles. The experiments were grouped based on subject feature, medication status (onMed/offMed), deep brain stimulation (DBS) status (DBSon/DBSoff) and type of motor initiation. RESULTS HC and PwP shared similar neural networks during upper extremity motor tasks but with differences of reported frequency in mainly bilateral putamen, insula and ipsilateral inferior parietal and precentral gyri. The activation height was significantly reduced in the bilateral putamen, left SMA, left subthalamus nucleus, right thalamus and right midial global pallidum in PwPoffMed (vs. HC), and pre-SMA hypoactivation correlated with disease severity. These changes were not found in patients on dopamine replacement therapy (PwPonMed vs. HC) in line with a restorative function. By contrast, left SMA and primary motor cortex showed hyperactivation in the medicated state (vs. HC) suggesting dopaminergic overcompensation. Deep-brain stimulation (PwP during the high frequency subthalamus nucleus (STN) DBS vs. no stimulation) induced a decrease in left SMA activity and the expected increase in the left subthalamic/thalamic region regardless of hand movement. We further demonstrated a disease related effect of motor intention with only PwPoffMed showing increased activation in the medial frontal lobe in self-initiated studies. CONCLUSION We describe a consistent disease-specific pattern of putaminal hypoactivation during motor tasks that appears reversed by dopamine replacement. Inconsistent reports of altered SMA/pre-SMA activation can be explained by task- and medication-specific variation in intention. Moreover, SMA activity was reduced during STN-DBS, while dopamine-induced hyperactivation of SMA which might underpin hyperdynamic L-dopa related overcompensation.
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Affiliation(s)
- Yue Xing
- Radiological Sciences, Division of Clinical Neuroscience, University of Nottingham, Nottingham, NG7 2UH, UK.
- Sir Peter Mansfield Imaging Centre, University of Nottingham, Nottingham, NG7 2UH, UK.
- NIHR Nottingham Biomedical Research Centre, University of Nottingham, Nottingham, NG7 2UH, UK.
- Radiological Sciences, Sir Peter Mansfield Imaging Centre, NIHR Nottingham BRC, University of Nottingham, Nottingham, NG7 2UH, UK.
| | - Christopher Tench
- Division of Clinical Neurology, Queen's Medical Centre, University of Nottingham, Nottingham, UK
| | - Monton Wongwandee
- Department of Medicine, Srinakharinwirot University, Nakhon Nayok, Thailand
| | - Stefan T Schwarz
- Radiological Sciences, Division of Clinical Neuroscience, University of Nottingham, Nottingham, NG7 2UH, UK
- Department of Radiology, Cardiff and Vale University Health Board, Cardiff, Wales
| | - Nin Bajaj
- Department of Neurology, Nottingham University Hospitals, Nottingham, NG7 2UH, UK
| | - Dorothee P Auer
- Radiological Sciences, Division of Clinical Neuroscience, University of Nottingham, Nottingham, NG7 2UH, UK.
- Sir Peter Mansfield Imaging Centre, University of Nottingham, Nottingham, NG7 2UH, UK.
- NIHR Nottingham Biomedical Research Centre, University of Nottingham, Nottingham, NG7 2UH, UK.
- Radiological Sciences, Sir Peter Mansfield Imaging Centre, NIHR Nottingham BRC, University of Nottingham, Nottingham, NG7 2UH, UK.
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Stefani A, Trendafilov V, Liguori C, Fedele E, Galati S. Subthalamic nucleus deep brain stimulation on motor-symptoms of Parkinson's disease: Focus on neurochemistry. Prog Neurobiol 2017; 151:157-174. [PMID: 28159574 DOI: 10.1016/j.pneurobio.2017.01.003] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2016] [Revised: 01/20/2017] [Accepted: 01/22/2017] [Indexed: 12/19/2022]
Abstract
Deep brain stimulation (DBS) has become a standard therapy for Parkinson's disease (PD) and it is also currently under investigation for other neurological and psychiatric disorders. Although many scientific, clinical and ethical issues are still unresolved, DBS delivered into the subthalamic nucleus (STN) has improved the quality of life of several thousands of patients. The mechanisms underlying STN-DBS have been debated extensively in several reviews; less investigated are the biochemical consequences, which are still under scrutiny. Crucial and only partially understood, for instance, are the complex interplays occurring between STN-DBS and levodopa (LD)-centred therapy in the post-surgery follow-up. The main goal of this review is to address the question of whether an improved motor control, based on STN-DBS therapy, is also achieved through the additional modulation of other neurotransmitters, such as noradrenaline (NA) and serotonin (5-HT). A critical issue is to understand not only acute DBS-mediated effects, but also chronic changes, such as those involving cyclic nucleotides, capable of modulating circuit plasticity. The present article will discuss the neurochemical changes promoted by STN-DBS and will document the main results obtained in microdialysis studies. Furthermore, we will also examine the preliminary achievements of voltammetry applied to humans, and discuss new hypothetical investigational routes, taking into account novel players such as glia, or subcortical regions such as the pedunculopontine (PPN) area. Our further understanding of specific changes in brain chemistry promoted by STN-DBS would further disseminate its utilisation, at any stage of disease, avoiding an irreversible lesioning approach.
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Affiliation(s)
- A Stefani
- Department of System Medicine, University of Rome "Tor Vergata", Via Montpellier 1, 00133 Rome, Italy
| | - V Trendafilov
- Laboratory for Biomedical Neurosciences (LBN), Neurocenter of Southern Switzerland (NSI), Lugano, Switzerland
| | - C Liguori
- Department of System Medicine, University of Rome "Tor Vergata", Via Montpellier 1, 00133 Rome, Italy
| | - E Fedele
- Department of Pharmacy, Pharmacology and Toxicology Unit and Center of Excellence for Biomedical Research, University of Genoa, 16148 Genoa, Italy
| | - S Galati
- Laboratory for Biomedical Neurosciences (LBN), Neurocenter of Southern Switzerland (NSI), Lugano, Switzerland.
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Subthalamotomy-induced changes in dopamine receptors in parkinsonian monkeys. Exp Neurol 2014; 261:816-25. [DOI: 10.1016/j.expneurol.2014.08.018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2014] [Revised: 08/11/2014] [Accepted: 08/16/2014] [Indexed: 11/17/2022]
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Abstract
The use of functional brain imaging techniques, including positron emission tomography (PET), single-photon emission computed tomography (SPECT), and functional magnetic resonance imaging (fMRI), has allowed for monitoring neuronal and neurochemical activities in the living human brain and identifying abnormal changes in various neurological and psychiatric diseases. Combining these methods with techniques such as deep brain stimulation (DBS) and transcranial magnetic stimulation (TMS) has greatly advanced our understanding of the effects of such treatment on brain activity at targeted regions as well as specific disease-related networks. Indeed, recent network-level analysis focusing on inter-regional covarying activities in data interpretation has unveiled several key mechanisms underlying the therapeutic effects of brain stimulation. However, non-negligible discrepancies have been reported in the literature, attributable in part to the heterogeneity of both imaging and brain stimulation techniques. This chapter summarizes recent studies that combine brain imaging and brain stimulation, and includes discussion of future direction in these lines of research.
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Deep brain stimulation induces striatal dopamine release in obsessive-compulsive disorder. Biol Psychiatry 2014; 75:647-52. [PMID: 23938318 DOI: 10.1016/j.biopsych.2013.06.021] [Citation(s) in RCA: 76] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2013] [Revised: 05/22/2013] [Accepted: 06/14/2013] [Indexed: 11/20/2022]
Abstract
BACKGROUND Obsessive-compulsive disorder is a chronic psychiatric disorder related to dysfunctional dopaminergic neurotransmission. Deep brain stimulation (DBS) targeted at the nucleus accumbens (NAc) has recently become an effective treatment for therapy-refractory obsessive-compulsive disorder, but its effect on dopaminergic transmission is unknown. METHODS We measured the effects of NAc DBS in 15 patients on the dopamine D2/3 receptor availability in the striatum with [(123)I]iodobenzamide ([(123)I]IBZM) single photon emission computed tomography. We correlated changes in [(123)I]IBZM binding potential (BP) with plasma levels of homovanillic acid (HVA) and clinical symptoms. RESULTS Acute (1-hour) and chronic (1-year) DBS decreased striatal [(123)I]IBZM BP compared with the nonstimulated condition in the putamen. BP decreases were observed after 1 hour of stimulation, and chronic stimulation was related to concurrent HVA plasma elevations, implying DBS-induced dopamine release. BP decreases in the area directly surrounding the electrodes were significantly correlated with changes in clinical symptoms (45% symptom decrease). CONCLUSIONS NAc DBS induced striatal dopamine release, which was associated with increased HVA plasma levels and improved clinical symptoms, suggesting that DBS may compensate for a defective dopaminergic system.
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Lin CH, Chen CM, Lu MK, Tsai CH, Chiou JC, Liao JR, Duann JR. VBM Reveals Brain Volume Differences between Parkinson's Disease and Essential Tremor Patients. Front Hum Neurosci 2013; 7:247. [PMID: 23785322 PMCID: PMC3682128 DOI: 10.3389/fnhum.2013.00247] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2013] [Accepted: 05/19/2013] [Indexed: 01/18/2023] Open
Abstract
Symptoms of essential tremor (ET) are similar to those of Parkinson’s disease (PD) during their initial stages. Presently, there are few stable biomarkers available on a neuroanatomical level for distinguishing between these two diseases. However, few investigations have directly compared the changes in brain volume and assessed the compensatory effects of a change in the parts of the brain associated with PD and with ET. To determine the compensatory and/or degenerative anatomical changes in the brains of PD and ET patients, the present study tested, via two voxel-based morphometry (VBM) approaches (Basic vs. DARTEL VBM processing), the anatomical brain images of 10 PD and 10 ET patients, as well as of 13 age-matched normal controls, obtained through a 3T magnetic resonance scanner. These findings indicate that PD and ET caused specific patterns of brain volume alterations in the brains examined. In addition, our observations also revealed compensatory effects, or self-reorganization, occurring in the thalamus and the middle temporal gyrus in the PD and ET patients, due perhaps in part to the enhanced thalamocortical sensorimotor interaction and the head-eye position readjustment, respectively, in these PD and ET patients. Such a distinction may lend itself to use as a biomarker for differentiating between these two diseases.
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Affiliation(s)
- Ching-Hung Lin
- Biomedical Engineering R&D Center, China Medical University , Taichung , Taiwan ; Biomedical Electronics Translational Research Center, National Chiao Tung University , Hsinchu , Taiwan ; Department of Psychology, Soochow University , Taipei , Taiwan
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8
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Watabe-Uchida M, Zhu L, Ogawa SK, Vamanrao A, Uchida N. Whole-brain mapping of direct inputs to midbrain dopamine neurons. Neuron 2012; 74:858-73. [PMID: 22681690 DOI: 10.1016/j.neuron.2012.03.017] [Citation(s) in RCA: 862] [Impact Index Per Article: 71.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/10/2012] [Indexed: 12/27/2022]
Abstract
Recent studies indicate that dopamine neurons in the ventral tegmental area (VTA) and substantia nigra pars compacta (SNc) convey distinct signals. To explore this difference, we comprehensively identified each area's monosynaptic inputs using the rabies virus. We show that dopamine neurons in both areas integrate inputs from a more diverse collection of areas than previously thought, including autonomic, motor, and somatosensory areas. SNc and VTA dopamine neurons receive contrasting excitatory inputs: the former from the somatosensory/motor cortex and subthalamic nucleus, which may explain their short-latency responses to salient events; and the latter from the lateral hypothalamus, which may explain their involvement in value coding. We demonstrate that neurons in the striatum that project directly to dopamine neurons form patches in both the dorsal and ventral striatum, whereas those projecting to GABAergic neurons are distributed in the matrix compartment. Neuron-type-specific connectivity lays a foundation for studying how dopamine neurons compute outputs.
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Affiliation(s)
- Mitsuko Watabe-Uchida
- Department of Molecular and Cellular Biology, Harvard University, Cambridge, MA 02138, USA.
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9
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Beukers RJ, Contarino MF, Speelman JD, Schuurman PR, Booij J, Tijssen MAJ. Deep Brain Stimulation of the Pallidum is Effective and Might Stabilize Striatal D(2) Receptor Binding in Myoclonus-Dystonia. Front Neurol 2012; 3:22. [PMID: 22363319 PMCID: PMC3282300 DOI: 10.3389/fneur.2012.00022] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2011] [Accepted: 02/03/2012] [Indexed: 11/25/2022] Open
Abstract
Purpose: To assess clinical efficacy of deep brain stimulation (DBS) of the pallidum in Myoclonus–Dystonia (M–D) patients, and to compare pre- and post-operative striatal dopamine D2 receptor availability. Methods: Clinical parameters were scored using validated rating scales for myoclonus and dystonia. Dopamine D2 receptor binding of three patients was studied before surgery and approximately 2 years post-operatively using 123-I-iodobenzamide Single Photon Emission Computed Tomography. Two patients who did not undergo surgery served as controls. Results: Clinically, the three M–D patients improved 83, 17, and 100%, respectively on the myoclonus rating scale and 78, 23, and 65% on the dystonia rating scale after DBS. Dopamine D2 receptor binding did not change after surgery. In the two control subjects, binding has lowered further. Conclusion: These findings confirm that DBS of the pallidum has beneficial effects on motor symptoms in M–D and suggest this procedure might stabilize dopamine D2 receptor binding.
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Affiliation(s)
- R J Beukers
- Department of Neurology, Academic Medical Centre, University of Amsterdam Amsterdam, Netherlands
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Blum K, Chen ALC, Oscar-Berman M, Chen TJH, Lubar J, White N, Lubar J, Bowirrat A, Braverman E, Schoolfield J, Waite RL, Downs BW, Madigan M, Comings DE, Davis C, Kerner MM, Knopf J, Palomo T, Giordano JJ, Morse SA, Fornari F, Barh D, Femino J, Bailey JA. Generational association studies of dopaminergic genes in reward deficiency syndrome (RDS) subjects: selecting appropriate phenotypes for reward dependence behaviors. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2011; 8:4425-59. [PMID: 22408582 PMCID: PMC3290972 DOI: 10.3390/ijerph8124425] [Citation(s) in RCA: 92] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/26/2011] [Revised: 11/23/2011] [Accepted: 11/23/2011] [Indexed: 11/26/2022]
Abstract
UNLABELLED Abnormal behaviors involving dopaminergic gene polymorphisms often reflect an insufficiency of usual feelings of satisfaction, or Reward Deficiency Syndrome (RDS). RDS results from a dysfunction in the "brain reward cascade," a complex interaction among neurotransmitters (primarily dopaminergic and opioidergic). Individuals with a family history of alcoholism or other addictions may be born with a deficiency in the ability to produce or use these neurotransmitters. Exposure to prolonged periods of stress and alcohol or other substances also can lead to a corruption of the brain reward cascade function. We evaluated the potential association of four variants of dopaminergic candidate genes in RDS (dopamine D1 receptor gene [DRD1]; dopamine D2 receptor gene [DRD2]; dopamine transporter gene [DAT1]; dopamine beta-hydroxylase gene [DBH]). METHODOLOGY We genotyped an experimental group of 55 subjects derived from up to five generations of two independent multiple-affected families compared to rigorously screened control subjects (e.g., N = 30 super controls for DRD2 gene polymorphisms). Data related to RDS behaviors were collected on these subjects plus 13 deceased family members. RESULTS Among the genotyped family members, the DRD2 Taq1 and the DAT1 10/10 alleles were significantly (at least p < 0.015) more often found in the RDS families vs. controls. The TaqA1 allele occurred in 100% of Family A individuals (N = 32) and 47.8% of Family B subjects (11 of 23). No significant differences were found between the experimental and control positive rates for the other variants. CONCLUSIONS Although our sample size was limited, and linkage analysis is necessary, the results support the putative role of dopaminergic polymorphisms in RDS behaviors. This study shows the importance of a nonspecific RDS phenotype and informs an understanding of how evaluating single subset behaviors of RDS may lead to spurious results. Utilization of a nonspecific "reward" phenotype may be a paradigm shift in future association and linkage studies involving dopaminergic polymorphisms and other neurotransmitter gene candidates.
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Affiliation(s)
- Kenneth Blum
- Department of Psychiatry, School of Medicine and McKnight Brain Institute, University of Florida, W University Ave., Gainesville, FL 32601, USA;
- Department of Nutrigenomics, LifeGen, Inc., P.O. Box 366, 570 Lederach Stattion Way, Lederach, PA 19450, USA; (R.L.W.); (B.W.D.); (M.M.)
- Department of Integrative Medicine, PATH Medical Research Foundation, 304 Park Ave. South, New York, NY 10010, USA; (M.M.K.); (J.K.)
- Department of Holistic Medicine, G&G Holistic Addiction Treatment, Inc., 1590 Northeast 162nd Street, North Miami Beach, FL 33162, USA;
- Department of Research, National Institute for Holistic Addiction Studies, 1590 Northeast 162nd Street, North Miami Beach, FL 33162, USA;
- Dominion Diagnostics, Inc., 211 Circuit Road, North Kingstown, RI 02852, USA;
- Center for Genomics and Applied Gene Technology, Institute of Integrative Omics and Applied Biotechnology, Nonakuri, Purba Medinipur, West Bengal, India;
| | - Amanda L. C. Chen
- Department of Engineering Management Advanced Technology, Chang Jung Christian University, No. 396, Sec. 1, Changrong Road, Tainan 71101, Taiwan
| | - Marlene Oscar-Berman
- Department of Anatomy & Neurobiology, Boston University School of Medicine, 72 East Concord Street, Boston, MA 02118, USA;
| | - Thomas J. H. Chen
- Department of Occupational Safety and Health, Chang Jung Christian University, No. 396, Sec. 1, Changrong Road, Tainan 71101, Taiwan;
| | - Joel Lubar
- Emeritus, Department of Physiology, University of Tennessee, 719 Andy Holt Tower, Knoxville, TN 37996, USA;
| | - Nancy White
- Unique Mindcare, Inc., 1900 Saint James Place, Houston, TX 77056, USA;
| | - Judith Lubar
- Department of Neurofeedback, Southeastern Biofeedback and Neurobehavioral Clinic, 101 Westwood Road, Knoxville, TN 37919, USA;
| | - Abdalla Bowirrat
- Department of Neuroscience & Population Genetics, EMMS Nazareth Hospital, Nazareth, Israel;
| | - Eric Braverman
- Department of Neurosurgery, Weill Cornell College of Medicine, 1300 York Ave., New York, NY 10065, USA;
- Department of Integrative Medicine, PATH Medical Research Foundation, 304 Park Ave. South, New York, NY 10010, USA; (M.M.K.); (J.K.)
| | - John Schoolfield
- Department of Academic Informatics Services, University of Texas Health Science Center, 7703 Floyd Curl Drive, San Antonio, TX 78229, USA;
| | - Roger L. Waite
- Department of Nutrigenomics, LifeGen, Inc., P.O. Box 366, 570 Lederach Stattion Way, Lederach, PA 19450, USA; (R.L.W.); (B.W.D.); (M.M.)
| | - Bernard W. Downs
- Department of Nutrigenomics, LifeGen, Inc., P.O. Box 366, 570 Lederach Stattion Way, Lederach, PA 19450, USA; (R.L.W.); (B.W.D.); (M.M.)
| | - Margaret Madigan
- Department of Nutrigenomics, LifeGen, Inc., P.O. Box 366, 570 Lederach Stattion Way, Lederach, PA 19450, USA; (R.L.W.); (B.W.D.); (M.M.)
| | - David E. Comings
- Department of Genomic Research, Carlsbad Science Foundation, Department of Medical Genetics, City of Hope National Medical Center, 1500 Duarte Road, Duarte, CA 91010, USA;
| | - Caroline Davis
- Department of Kinesiology and Health Sciences, York University, 4700 Keele Street, Toronto, ON M3J 1P3, Canada;
| | - Mallory M. Kerner
- Department of Integrative Medicine, PATH Medical Research Foundation, 304 Park Ave. South, New York, NY 10010, USA; (M.M.K.); (J.K.)
| | - Jennifer Knopf
- Department of Integrative Medicine, PATH Medical Research Foundation, 304 Park Ave. South, New York, NY 10010, USA; (M.M.K.); (J.K.)
| | - Tomas Palomo
- Hospital Universitario 12 de Octubre, Servicio de Psiquiatria, Av. Cordoba SN, Madrid 28041, Spain;
| | - John J. Giordano
- Department of Holistic Medicine, G&G Holistic Addiction Treatment, Inc., 1590 Northeast 162nd Street, North Miami Beach, FL 33162, USA;
- Department of Research, National Institute for Holistic Addiction Studies, 1590 Northeast 162nd Street, North Miami Beach, FL 33162, USA;
| | - Siobhan A. Morse
- Department of Holistic Medicine, G&G Holistic Addiction Treatment, Inc., 1590 Northeast 162nd Street, North Miami Beach, FL 33162, USA;
- Department of Research, National Institute for Holistic Addiction Studies, 1590 Northeast 162nd Street, North Miami Beach, FL 33162, USA;
| | - Frank Fornari
- Dominion Diagnostics, Inc., 211 Circuit Road, North Kingstown, RI 02852, USA;
| | - Debmalya Barh
- Center for Genomics and Applied Gene Technology, Institute of Integrative Omics and Applied Biotechnology, Nonakuri, Purba Medinipur, West Bengal, India;
| | - John Femino
- Meadows Edge Recovery Center, 580 10 Rod Road, North Kingstown, RI 02852, USA;
| | - John A. Bailey
- Department of Psychiatry, School of Medicine and McKnight Brain Institute, University of Florida, W University Ave., Gainesville, FL 32601, USA;
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Tormenti MJ, Tomycz ND, Coffman KA, Kondziolka D, Crammond DJ, Tyler-Kabara EC. Bilateral subthalamic nucleus deep brain stimulation for dopa-responsive dystonia in a 6-year-old child. J Neurosurg Pediatr 2011; 7:650-3. [PMID: 21631204 DOI: 10.3171/2011.3.peds10402] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Tyrosine hydroxylase (TH) deficiency is a rare autosomal recessive metabolic disease that results in the decreased production of catecholamines. Standard treatment relies on combinations of levodopa and carbidopa, anticholinergic agents, serotonergic agonists, and monamine oxidase B inhibitors. Unfortunately, severely affected children often require escalating doses of medication and suffer from dyskinesias as well as significant on/off symptomatology. The authors present a case of medically intractable dopa-responsive dystonia in a 6-year-old boy whose condition significantly improved with bilateral subthalamic nucleus deep brain stimulation. This case is unique in its novel approach to tyrosine hydroxylase deficiency and the young age of the patient.
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Affiliation(s)
- Matthew J Tormenti
- UPMC Center for Brain Function and Behavior, Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
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12
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Ko JH, Strafella AP. Dopaminergic neurotransmission in the human brain: new lessons from perturbation and imaging. Neuroscientist 2011; 18:149-68. [PMID: 21536838 DOI: 10.1177/1073858411401413] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Dopamine plays an important role in several brain functions and is involved in the pathogenesis of several psychiatric and neurological disorders. Neuroimaging techniques such as positron emission tomography allow us to quantify dopaminergic activity in the living human brain. Combining these with brain stimulation techniques offers us the unique opportunity to tackle questions regarding region-specific neurochemical activity. Such studies may aid clinicians and scientists to disentangle neural circuitries within the human brain and thereby help them to understand the underlying mechanisms of a given function in relation to brain diseases. Furthermore, it may also aid the development of alternative treatment approaches for various neurological and psychiatric conditions.
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Affiliation(s)
- Ji Hyun Ko
- PET Imaging Centre, Centre for Addiction and Mental Health, University of Toronto, Ontario, Canada
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Naskar S, Sood SK, Goyal V, Dhara M. RETRACTED: Mechanism(s) of deep brain stimulation and insights into cognitive outcomes in Parkinson's disease. ACTA ACUST UNITED AC 2010; 65:1-13. [DOI: 10.1016/j.brainresrev.2010.04.010] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2010] [Revised: 04/12/2010] [Accepted: 04/27/2010] [Indexed: 11/30/2022]
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Kovacs N, Auer T, Balas I, Karadi K, Zambo K, Schwarcz A, Klivenyi P, Jokeit H, Horvath K, Nagy F, Janszky J. Neuroimaging and cognitive changes during déjà vu. Epilepsy Behav 2009; 14:190-6. [PMID: 18804184 DOI: 10.1016/j.yebeh.2008.08.017] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2008] [Revised: 08/28/2008] [Accepted: 08/29/2008] [Indexed: 10/21/2022]
Abstract
OBJECTIVE The cause or the physiological role of déjà vu (DV) in healthy people is unknown. The pathophysiology of DV-type epileptic aura is also unresolved. Here we describe a 22-year-old woman treated with deep brain stimulation (DBS) of the left internal globus pallidus for hemidystonia. At certain stimulation settings, DBS elicited reproducible episodes of DV. METHODS Neuropsychological tests and single-photon-emission computed tomography (SPECT) were performed during DBS-evoked DV and during normal DBS stimulation without DV. RESULTS SPECT during DBS-evoked DV revealed hyperperfusion of the right (contralateral to the electrode) hippocampus and other limbic structures. Neuropsychological examinations performed during several evoked DV episodes revealed disturbances in nonverbal memory. CONCLUSION Our results confirm the role of mesiotemporal structures in the pathogenesis of DV. We hypothesize that individual neuroanatomy and disturbances in gamma oscillations or in the dopaminergic system played a role in DBS-elicited DV in our patient.
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Affiliation(s)
- Norbert Kovacs
- Department of Neurology, University of Pecs, Pecs, Hungary.
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Lacombe E, Carcenac C, Boulet S, Feuerstein C, Bertrand A, Poupard A, Savasta M. High-frequency stimulation of the subthalamic nucleus prolongs the increase in striatal dopamine induced by acute l-3,4-dihydroxyphenylalanine in dopaminergic denervated rats. Eur J Neurosci 2007; 26:1670-80. [PMID: 17822436 PMCID: PMC2798123 DOI: 10.1111/j.1460-9568.2007.05747.x] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
High-frequency stimulation of the subthalamic nucleus (STN-HFS) is a powerful approach for treating the motor symptoms of Parkinson's disease (PD). It results in clinical improvement in patients with PD, further reducing the l-3,4-dihydroxyphenylalanine (L-DOPA) requirement and thus L-DOPA-induced dyskinesia. However, it remains unclear how STN-HFS modifies the response to L-DOPA. We investigated the effect of STN-HFS on striatal extracellular concentrations of dopamine and its metabolites following acute L-DOPA administration in intact or partially dopaminergic denervated (DA-PL) rats. L-DOPA treatment significantly increased striatal dopamine levels in intact and DA-PL animals, with the maximal effect observed 1 h after L-DOPA injection. This increase was more pronounced in DA-PL rats (ipsilateral to the lesion) than in intact animals. It remained fairly stable 1 h after the maximal effect of L-DOPA and then decreased towards basal values. STN-HFS in intact rats had no effect on the maximal L-DOPA-induced increase in striatal extracellular dopamine concentration or the return to basal values, the profiles observed being similar to those for non-stimulated intact animals. Conversely, STN-HFS amplified the L-DOPA-induced increase in striatal dopamine levels during the stimulation period (1 h) in DA-PL rats and this increase was sustained throughout the post-stimulation period (2.5 h), without the return to basal levels observed in stimulated intact and non-stimulated rats. These new neurochemical data suggest that STN-HFS interferes with L-DOPA effects, probably synergically, by stabilizing dopamine levels in the striatum and shed light on the mechanisms of STN-HFS in PD.
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Affiliation(s)
- Emilie Lacombe
- GIN, Grenoble Institut des Neurosciences
INSERM : U836CEAUniversité Joseph Fourier - Grenoble ICHU GrenobleUJF - Site Santé La Tronche BP 170 38042 Grenoble Cedex 9,FR
| | - Carole Carcenac
- GIN, Grenoble Institut des Neurosciences
INSERM : U836CEAUniversité Joseph Fourier - Grenoble ICHU GrenobleUJF - Site Santé La Tronche BP 170 38042 Grenoble Cedex 9,FR
| | - Sabrina Boulet
- GIN, Grenoble Institut des Neurosciences
INSERM : U836CEAUniversité Joseph Fourier - Grenoble ICHU GrenobleUJF - Site Santé La Tronche BP 170 38042 Grenoble Cedex 9,FR
| | - Claude Feuerstein
- GIN, Grenoble Institut des Neurosciences
INSERM : U836CEAUniversité Joseph Fourier - Grenoble ICHU GrenobleUJF - Site Santé La Tronche BP 170 38042 Grenoble Cedex 9,FR
- CHU Grenoble
CHU GrenobleUniversité Joseph Fourier - Grenoble IFR
| | - Anne Bertrand
- GIN, Grenoble Institut des Neurosciences
INSERM : U836CEAUniversité Joseph Fourier - Grenoble ICHU GrenobleUJF - Site Santé La Tronche BP 170 38042 Grenoble Cedex 9,FR
| | - Annie Poupard
- GIN, Grenoble Institut des Neurosciences
INSERM : U836CEAUniversité Joseph Fourier - Grenoble ICHU GrenobleUJF - Site Santé La Tronche BP 170 38042 Grenoble Cedex 9,FR
| | - Marc Savasta
- GIN, Grenoble Institut des Neurosciences
INSERM : U836CEAUniversité Joseph Fourier - Grenoble ICHU GrenobleUJF - Site Santé La Tronche BP 170 38042 Grenoble Cedex 9,FR
- CHU Grenoble
CHU GrenobleUniversité Joseph Fourier - Grenoble IFR
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Hebb MO, Garcia R, Gaudet P, Mendez IM. Bilateral Stimulation of the Globus Pallidus Internus to Treat Choreathetosis in Huntingtonʼs Disease: Technical Case Report. Neurosurgery 2006; 58:E383; discussion E383. [PMID: 16462466 DOI: 10.1227/01.neu.0000195068.19801.18] [Citation(s) in RCA: 68] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE AND IMPORTANCE Huntington's disease (HD) produces debilitating motor abnormalities that are poorly responsive to medical therapy. Deep brain stimulation (DBS) may offer a treatment option for afflicted patients, but its role in the management of HD remains unclear. In the present case, DBS leads were implanted bilaterally into the posteroventral globus pallidus internus (GPi) to control disabling and medically intractable choreathetosis in a severely affected HD patient. The surgical procedure, intraoperative electrophysiological findings, and 12-month postoperative course, with patient video, are presented. CLINICAL PRESENTATION This 41-year-old man with genetically confirmed HD developed motor symptoms at age 28. He had completed multiple medical trials without alleviation of his progressive and debilitating choreathetosis. Extensive clinical assessment, including neuropsychological testing, was performed to determine surgical candidacy. INTERVENTION DBS leads were bilaterally implanted, under stereotactic guidance, into the posteroventral GPi. Disease progression and symptom control were assessed at regular postoperative intervals. Bilateral pallidal stimulation produced a dramatic reduction in choreathetoid movements and improvement in overall motor functioning. The patient also exhibited normalization of body weight, mood, and energy level, as well as improved performance of activities of daily living. These effects were sustained at 1 year after surgery. CONCLUSION The clinical benefits of DBS observed in this HD patient were comparable to those reported in other hyperkinetic disorders and demonstrate that pallidal stimulation can provide long-term alleviation of HD-associated choreathetosis.
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Affiliation(s)
- Matthew O Hebb
- Division of Neurosurgery, Department of Surgery, Dalhousie University, Halifax, Nova Scotia, Canada
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Nimura T, Yamaguchi K, Ando T, Shibuya S, Oikawa T, Nakagawa A, Shirane R, Itoh M, Tominaga T. Attenuation of fluctuating striatal synaptic dopamine levels in patients with Parkinson disease in response to subthalamic nucleus stimulation: a positron emission tomography study. J Neurosurg 2005; 103:968-73. [PMID: 16381182 DOI: 10.3171/jns.2005.103.6.0968] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Object. The “wearing-off” phenomenon often hampers the treatment of Parkinson disease (PD). Although deep brain stimulation (DBS) of the subthalamic nucleus (STN) is known to ameliorate the wearing-off phenomenon, the mechanism by which it does this remains unclear. As part of an inquiry into the mechanism of STN DBS, the authors measured synaptic dopamine levels in the striatum by performing positron emission tomography (PET) with [11C]raclopride.
Methods. Three patients with PD who were experiencing the wearing-off phenomenon underwent PET scanning before and after DBS of the STN. The clinical features in these patients were evaluated by applying the Hoehn and Yahr, United Parkinson's Disease Rating, and Schwab and England Activities of Daily Living Scales. Before and after surgery, PET scans were obtained using [11C]raclopride prior to and 1 hour following an oral administration of levodopa. Regions of interest for the [11C]raclopride binding potential (RacloBP) were set in the bilateral putamen and the caudate nucleus.
All clinical scores were dramatically improved postoperatively. Deep brain stimulation of the STN reduced the baseline RacloBP in both the putamen and caudate nucleus, but the differences between the pre- and postoperative levels were insignificant. Before DBS of the STN, the levodopa administration significantly reduced RacloBP in the putamen (p < 0.0001). Postoperatively the drug-induced reduction in RacloBP became statistically insignificant. The drug-induced increase in synaptic dopamine concentrations in the putamen preoperatively was estimated to be approximately four times higher than that after surgery (p < 0.01). The drug-induced RacloBP change in the caudate nucleus was similar to that in the putamen, although the magnitude of the change was lower (p < 0.005). The drug-induced increase in the caudate nucleus was also reduced postoperatively (p < 0.05).
Conclusions. Deep brain stimulation of the STN induces the stabilization of synaptic dopamine concentrations in the striatum and may attribute to the alleviation of levodopa-related motor fluctuations.
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Affiliation(s)
- Taro Nimura
- Department of Neurosurgery, Miyagi National Hospital, Japan.
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Abstract
Deep brain stimulation at high frequency was first used in 1997 to replace thalamotomy in treating the characteristic tremor of Parkinson's disease, and has subsequently been applied to the pallidum and the subthalamic nucleus. The subthalamic nucleus is a key node in the functional control of motor activity in the basal ganglia. Its inhibition suppresses symptoms in animal models of Parkinson's disease, and high frequency chronic stimulation does the same in human patients. Acute and long-term results after deep brain stimulation show a dramatic and stable improvement of a patient's clinical condition, which mimics the effects of levodopa treatment. The mechanism of action may involve a functional disruption of the abnormal neural messages associated with the disease. Long-term changes, neural plasticity and neural protection might be induced in the network. Similar effects of stimulation and lesioning have led to the extension of this technique for other targets and diseases.
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Affiliation(s)
- Alim Louis Benabid
- INSERM U318 Preclinical Neurosciences, Joseph Fourier University, Pavillon B, University Hospital, 38043, Grenoble, France.
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