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García-Gomar MG, Concha L, Soto-Abraham J, Tournier JD, Aguado-Carrillo G, Velasco-Campos F. Long-Term Improvement of Parkinson Disease Motor Symptoms Derived From Lesions of Prelemniscal Fiber Tract Components. Oper Neurosurg (Hagerstown) 2020; 19:539-550. [PMID: 32629480 DOI: 10.1093/ons/opaa186] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2019] [Accepted: 04/15/2020] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Prelemniscal radiations (Raprl) are composed of different fiber tracts, connecting the brain stem and cerebellum with basal ganglia and cerebral cortex. In Parkinson disease (PD), lesions in Raprl induce improvement of tremor, rigidity, and bradykinesia in some patients, while others show improvement of only 1 or 2 symptoms, suggesting different fiber tracts mediate different symptoms. OBJECTIVE To search for correlations between improvements of specific symptoms with surgical lesions of specific fiber tract components of Raprl in patients with PD. METHODS A total of 10 patients were treated with unilateral radiofrequency lesions directed to Raprl. The improvement for tremor, rigidity, bradykinesia, posture, and gait was evaluated at 24 to 33 mo after operation through the Unified Parkinson's Disease Rating Scale (UPDRS) score, and the precise location and extension of lesions through structural magnetic resonance imaging and probabilistic tractography at 6 to 8 mo postsurgery. Correlation between percentage of fiber tract involvement and percentage of UPDRS-III score improvement was evaluated through Spearman's correlation coefficient. RESULTS Group average improvement was 86% for tremor, 62% for rigidity, 56% for bradykinesia, and 45% for gait and posture. Improvement in global UPDRS score correlated with extent of lesions in fibers connecting with contralateral cerebellar cortex and improvement of posture and gait with fibers connecting with contralateral deep cerebellar nuclei. Lesion of fibers connecting the globus pallidum with pedunculopontine nucleus induced improvement of gait and posture over other symptoms. CONCLUSION Partial lesion of Raprl fibers resulted in symptom improvement at 2-yr follow-up. Lesions of selective fiber components may result in selective improvement of specific symptoms.
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Affiliation(s)
| | - Luis Concha
- Institute of Neurobiology, Universidad Nacional Autónoma de México, Campus Juriquilla, Juriquilla, Mexico
| | - Julian Soto-Abraham
- Unit for Stereotactic and Functional Neurosurgery, General Hospital of Mexico, Ciudad de México, Mexico
| | - Jacques D Tournier
- Department of Biomedical Engineering, School of Bioengineering and Imaging Sciences, King's College London, King's Health Partners, St. Thomas' Hospital, London, United Kingdom.,Centre for the Developing Brain, School of Bioengineering and Imaging Sciences, King's College London, King's Health Partners, St. Thomas' Hospital, London, United Kingdom
| | - Gustavo Aguado-Carrillo
- Unit for Stereotactic and Functional Neurosurgery, General Hospital of Mexico, Ciudad de México, Mexico
| | - Francisco Velasco-Campos
- Unit for Stereotactic and Functional Neurosurgery, General Hospital of Mexico, Ciudad de México, Mexico
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Velasco F, Esqueda-Liquidano M, Velasco A, García-Gomar M. Prelemniscal Lesion for Selective Improvement of Parkinson Disease Tremor. Stereotact Funct Neurosurg 2018; 96:54-59. [DOI: 10.1159/000486318] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2017] [Accepted: 12/05/2017] [Indexed: 12/19/2022]
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Velasco F, Carrillo-Ruiz JD, Salcido V, Castro G, Soto J, Velasco AL. Unilateral Stimulation of Prelemniscal Radiations for the Treatment of Acral Symptoms of Parkinson's Disease: Long-Term Results. Neuromodulation 2016; 19:357-64. [DOI: 10.1111/ner.12433] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2015] [Revised: 02/22/2016] [Accepted: 02/22/2016] [Indexed: 12/14/2022]
Affiliation(s)
- Francisco Velasco
- Unit for Stereotactic and Functional Neurosurgery and Radiosurgery; Mexico General Hospital; Mexico D.F. Mexico
| | - José D. Carrillo-Ruiz
- Unit for Stereotactic and Functional Neurosurgery and Radiosurgery; Mexico General Hospital; Mexico D.F. Mexico
| | - Víctor Salcido
- Unit for Stereotactic and Functional Neurosurgery and Radiosurgery; Mexico General Hospital; Mexico D.F. Mexico
| | - Guillermo Castro
- Unit for Stereotactic and Functional Neurosurgery and Radiosurgery; Mexico General Hospital; Mexico D.F. Mexico
| | - Julián Soto
- Unit for Stereotactic and Functional Neurosurgery and Radiosurgery; Mexico General Hospital; Mexico D.F. Mexico
| | - Ana Luisa Velasco
- Unit for Stereotactic and Functional Neurosurgery and Radiosurgery; Mexico General Hospital; Mexico D.F. Mexico
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García-Gomar MG, Soto-Abraham J, Velasco-Campos F, Concha L. Anatomic characterization of prelemniscal radiations by probabilistic tractography: implications in Parkinson's disease. Brain Struct Funct 2016; 222:71-81. [PMID: 26902343 DOI: 10.1007/s00429-016-1201-5] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2015] [Accepted: 02/09/2016] [Indexed: 12/19/2022]
Abstract
To characterize the anatomical connectivity of the prelemniscal radiations (Raprl), a white matter region within the posterior subthalamic area (PSA) that is an effective neurosurgical target for treating motor symptoms of Parkinson's disease (PD). Diffusion-weighted images were acquired from twelve healthy subjects using a 3T scanner. Constrained spherical deconvolution, a method that allows the distinction of crossing fibers within a voxel, was used to compute track-density images with sufficient resolution to accurately delineate distinct PSA regions and probabilistic tractography of Raprl in both hemispheres. Raprl connectivity was reproducible across all subjects and showed fibers traversing through this region towards primary and supplementary motor cortices, the orbitofrontal cortex, ventrolateral thalamus, and the globus pallidus, cerebellum and dorsal brainstem. All brain regions reached by Raprl fibers are part of motor circuits involved in the pathophysiology of PD; while these fiber systems converge at the level of the PSA, they can be spatially segregated. Fibers of distinct and specific motor control networks are identified within Raprl. The description of this anatomical crossroad suggests that, in the future, tractography could allow deep brain stimulation or lesional therapies in white matter targets according to individual patient's symptoms.
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Affiliation(s)
| | - Julian Soto-Abraham
- Unit for Stereotactic and Functional Neurosurgery and Radiosurgery, Mexico General Hospital, Mexico City, Mexico
| | - Francisco Velasco-Campos
- Unit for Stereotactic and Functional Neurosurgery and Radiosurgery, Mexico General Hospital, Mexico City, Mexico
| | - Luis Concha
- Instituto de Neurobiología, Universidad Nacional Autónoma de México, Querétaro, México.
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Sandström L, Hägglund P, Johansson L, Blomstedt P, Karlsson F. Speech intelligibility in Parkinson's disease patients with zona incerta deep brain stimulation. Brain Behav 2015; 5:e00394. [PMID: 26516614 PMCID: PMC4614054 DOI: 10.1002/brb3.394] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2015] [Revised: 07/06/2015] [Accepted: 08/16/2015] [Indexed: 11/08/2022] Open
Abstract
OBJECTIVES To investigate the effects of l-dopa (Levodopa) and cZi-DBS (deep brain stimulation in caudal zona incerta) on spontaneous speech intelligibility in patients with PD (Parkinson's disease). MATERIALS AND METHODS Spontaneous utterances were extracted from anechoic recordings from 11 patients with PD preoperatively (off and on l-dopa medication) and 6 and 12 months post bilateral cZi-DBS operation (off and on stimulation, with simultaneous l-dopa medication). Background noise with an amplitude corresponding to a clinical setting was added to the recordings. Intelligibility was assessed through a transcription task performed by 41 listeners in a randomized and blinded procedure. RESULTS A group-level worsening in spontaneous speech intelligibility was observed on cZi stimulation compared to off 6 months postoperatively (8 adverse, 1 positive, 2 no change). Twelve months postoperatively, adverse effects of cZi-DBS were not frequently observed (2 positive, 3 adverse, 6 no change). l-dopa administered preoperatively as part of the evaluation for DBS operation provided the overall best treatment outcome (1 adverse, 4 positive, 6 no change). CONCLUSIONS cZi-DBS was shown to have smaller negative effects when evaluated from spontaneous speech compared to speech effects reported previously. The previously reported reduction in word-level intelligibility 12 months postoperatively was not transferred to spontaneous speech for most patients. Reduced intelligibility due to cZi stimulation was much more prominent 6 months postoperatively than at 12 months.
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Affiliation(s)
- Linda Sandström
- Division of Speech and Language PathologyDepartment of Clinical SciencesUmeå UniversityUmeåSweden
| | - Patricia Hägglund
- Division of Speech and Language PathologyDepartment of Clinical SciencesUmeå UniversityUmeåSweden
| | - Louise Johansson
- Division of Speech and Language PathologyDepartment of Clinical SciencesUmeå UniversityUmeåSweden
| | - Patric Blomstedt
- Division of Clinical NeuroscienceDepartment of Pharmacology and Clinical NeuroscienceUmeå UniversityUmeåSweden
| | - Fredrik Karlsson
- Division of Speech and Language PathologyDepartment of Clinical SciencesUmeå UniversityUmeåSweden
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Castro G, Carrillo-Ruiz JD, Salcido V, Soto J, García-Gomar G, Velasco AL, Velasco F. Optimizing Prelemniscal Radiations as a Target for Motor Symptoms in Parkinson's Disease Treatment. Stereotact Funct Neurosurg 2015; 93:282-91. [DOI: 10.1159/000433446] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2015] [Accepted: 05/19/2015] [Indexed: 11/19/2022]
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Zhan L, Zhou J, Wang Y, Jin Y, Jahanshad N, Prasad G, Nir TM, Leonardo CD, Ye J, Thompson PM, for the Alzheimer’s Disease Neuroimaging Initiative. Comparison of nine tractography algorithms for detecting abnormal structural brain networks in Alzheimer's disease. Front Aging Neurosci 2015; 7:48. [PMID: 25926791 PMCID: PMC4396191 DOI: 10.3389/fnagi.2015.00048] [Citation(s) in RCA: 89] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2015] [Accepted: 03/25/2015] [Indexed: 11/13/2022] Open
Abstract
Alzheimer's disease (AD) involves a gradual breakdown of brain connectivity, and network analyses offer a promising new approach to track and understand disease progression. Even so, our ability to detect degenerative changes in brain networks depends on the methods used. Here we compared several tractography and feature extraction methods to see which ones gave best diagnostic classification for 202 people with AD, mild cognitive impairment or normal cognition, scanned with 41-gradient diffusion-weighted magnetic resonance imaging as part of the Alzheimer's Disease Neuroimaging Initiative (ADNI) project. We computed brain networks based on whole brain tractography with nine different methods - four of them tensor-based deterministic (FACT, RK2, SL, and TL), two orientation distribution function (ODF)-based deterministic (FACT, RK2), two ODF-based probabilistic approaches (Hough and PICo), and one "ball-and-stick" approach (Probtrackx). Brain networks derived from different tractography algorithms did not differ in terms of classification performance on ADNI, but performing principal components analysis on networks helped classification in some cases. Small differences may still be detectable in a truly vast cohort, but these experiments help assess the relative advantages of different tractography algorithms, and different post-processing choices, when used for classification.
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Affiliation(s)
- Liang Zhan
- Imaging Genetics Center, University of Southern California, Los AngelesCA, USA
- Department of Neurology, Psychiatry, Pediatrics, Engineering, Radiology, and Ophthalmology, Keck School of Medicine, University of Southern California, Los AngelesCA, USA
| | - Jiayu Zhou
- School of Computing, Informatics, and Decision Systems Engineering, Arizona State University, TempeAZ, USA
- Center for Evolutionary Medicine and Informatics, The Biodesign Institute, Arizona State University, TempeAZ, USA
| | - Yalin Wang
- School of Computing, Informatics, and Decision Systems Engineering, Arizona State University, TempeAZ, USA
| | - Yan Jin
- Imaging Genetics Center, University of Southern California, Los AngelesCA, USA
| | - Neda Jahanshad
- Imaging Genetics Center, University of Southern California, Los AngelesCA, USA
| | - Gautam Prasad
- Imaging Genetics Center, University of Southern California, Los AngelesCA, USA
| | - Talia M. Nir
- Imaging Genetics Center, University of Southern California, Los AngelesCA, USA
| | | | - Jieping Ye
- School of Computing, Informatics, and Decision Systems Engineering, Arizona State University, TempeAZ, USA
- Center for Evolutionary Medicine and Informatics, The Biodesign Institute, Arizona State University, TempeAZ, USA
| | - Paul M. Thompson
- Imaging Genetics Center, University of Southern California, Los AngelesCA, USA
- Department of Neurology, Psychiatry, Pediatrics, Engineering, Radiology, and Ophthalmology, Keck School of Medicine, University of Southern California, Los AngelesCA, USA
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