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Puelles L, Stühmer T, Rubenstein JLR, Diaz C. Critical test of the assumption that the hypothalamic entopeduncular nucleus of rodents is homologous with the primate internal pallidum. J Comp Neurol 2023; 531:1715-1750. [PMID: 37695031 DOI: 10.1002/cne.25536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Revised: 07/26/2023] [Accepted: 08/03/2023] [Indexed: 09/12/2023]
Abstract
The globus pallidus (GP) of primates is divided conventionally into distinct internal and external parts. The literature repeats since 1930 the opinion that the homolog of the primate internal pallidum in rodents is the hypothalamic entopeduncular nucleus (embedded within fiber tracts of the cerebral peduncle). To test this idea, we explored its historic fundaments, checked the development and genoarchitecture of mouse entopeduncular and pallidal neurons, and examined relevant comparative connectivity data. We found that the extratelencephalic mouse entopeduncular structure consists of four different components arrayed along a dorsoventral sequence in the alar hypothalamus. The ventral entopeduncular nucleus (EPV), with GABAergic neurons expressing Dlx5&6 and Nkx2-1, lies within the hypothalamic peduncular subparaventricular area. Three other formations-the dorsal entopeduncular nucleus (EPD), the prereticular entopeduncular nucleus (EPPRt ), and the preeminential entopeduncular nucleus (EPPEm )-lie within the overlying paraventricular area, under the subpallium. EPD contains glutamatergic neurons expressing Tbr1, Otp, and Pax6. The EPPRt has GABAergic cells expressing Isl1 and Meis2, whereas the EPPEm population expresses Foxg1 and may be glutamatergic. Genoarchitectonic observations on relevant areas of the mouse pallidal/diagonal subpallium suggest that the GP of rodents is constituted as in primates by two adjacent but molecularly and hodologically differentiable telencephalic portions (both expressing Foxg1). These and other reported data oppose the notion that the rodent extratelencephalic entopeduncular nucleus is homologous to the primate internal pallidum. We suggest instead that all mammals, including rodents, have dual subpallial GP components, whereas primates probably also have a comparable set of hypothalamic entopeduncular nuclei. Remarkably, there is close similarity in some gene expression properties of the telencephalic internal GP and the hypothalamic EPV. This apparently underlies their notable functional analogy, sharing GABAergic neurons and thalamopetal connectivity.
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Affiliation(s)
- Luis Puelles
- Department of Human Anatomy and Psychobiology and IMIB-Arrixaca Institute, University of Murcia, Murcia, Spain
| | - Thorsten Stühmer
- Nina Ireland Laboratory of Developmental Neurobiology, Department of Psychiatry, UCSF Medical School, San Francisco, California, USA
| | - John L R Rubenstein
- Nina Ireland Laboratory of Developmental Neurobiology, Department of Psychiatry, UCSF Medical School, San Francisco, California, USA
| | - Carmen Diaz
- School of Medicine and Institute for Research in Neurological Disabilities, University of Castilla-La Mancha, Albacete, Spain
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2
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Odorfer TM, Volkmann J. Deep Brain Stimulation for Focal or Segmental Craniocervical Dystonia in Patients Who Have Failed Botulinum Neurotoxin Therapy-A Narrative Review of the Literature. Toxins (Basel) 2023; 15:606. [PMID: 37888637 PMCID: PMC10611146 DOI: 10.3390/toxins15100606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 10/07/2023] [Accepted: 10/08/2023] [Indexed: 10/28/2023] Open
Abstract
(1) Background: The first-line treatment for patients with focal or segmental dystonia with a craniocervical distribution is still the intramuscular injection of botulinum neurotoxin (BoNT). However, some patients experience primary or secondary treatment failure from this potential immunogenic therapy. Deep brain stimulation (DBS) may then be used as a backup strategy in this situation. (2) Methods: Here, we reviewed the current study literature to answer a specific question regarding the efficacy and safety of the use of DBS, particularly for cervical dystonia (CD) and Meige syndrome (MS) in patients with documented treatment failure under BoNT. (3) Results: There are only two studies with the highest level of evidence in this area. Despite this clear limitation, in the context of the narrowly defined research question of this paper, it is possible to report 161 patients with CD or MS who were included in studies that were able to show a statistically significant reduction in dystonic symptoms using DBS. Safety and tolerability data appeared adequate. However, much of the information is based on retrospective observations. (4) Conclusions: The evidence base in this area is in need of further scientific investigation. Most importantly, more randomized, controlled and double-blind trials are needed, possibly including a head-to-head comparison of DBS and BoNT.
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Affiliation(s)
- Thorsten M. Odorfer
- Department of Neurology, University Hospital Würzburg, Josef-Schneider-Str. 11, 97080 Würzburg, Germany
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3
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Alonso-Martínez C, Rubio-Teves M, Porrero C, Clascá F. Cerebellar and basal ganglia inputs define three main nuclei in the mouse ventral motor thalamus. Front Neuroanat 2023; 17:1242839. [PMID: 37645018 PMCID: PMC10461449 DOI: 10.3389/fnana.2023.1242839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Accepted: 07/27/2023] [Indexed: 08/31/2023] Open
Abstract
The thalamus is a central link between cortical and subcortical brain motor systems. Axons from the deep nuclei of the cerebellum (DCN), or the output nuclei of the basal ganglia system (substantia nigra reticulata, SNr; and internal pallidum GPi/ENT) monosynaptically innervate the thalamus, prominently some nuclei of the ventral nuclear group. In turn, axons from these ventral nuclei innervate the motor and premotor areas of the cortex, where their input is critical for planning, execution and learning of rapid and precise movements. Mice have in recent years become a widely used model in motor system research. However, information on the distribution of cerebellar and basal ganglia inputs in the rodent thalamus remains poorly defined. Here, we mapped the distribution of inputs from DCN, SNr, and GPi/ENT to the ventral nuclei of the mouse thalamus. Immunolabeling for glutamatergic and GABAergic neurotransmission markers delineated two distinct main territories, characterized each by the presence of large vesicular glutamate transporter type 2 (vGLUT2) puncta or vesicular GABA transporter (vGAT) puncta. Anterograde labeling of axons from DCN revealed that they reach virtually all parts of the ventral nuclei, albeit its axonal varicosities (putative boutons) in the vGAT-rich sector are consistently smaller than those in the vGLUT2-rich sector. In contrast, the SNr axons innervate the whole vGAT-rich sector, but not the vGLUT2-rich sector. The GPi/ENT axons were found to innervate only a small zone of the vGAT-rich sector which is also targeted by the other two input systems. Because inputs fundamentally define thalamic cell functioning, we propose a new delineation of the mouse ventral motor nuclei that is consistent with the distribution of DCN, SNr and GPi/ENT inputs and resembles the general layout of the ventral motor nuclei in primates.
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Affiliation(s)
| | | | - César Porrero
- Department of Anatomy and Neuroscience, Universidad Autónoma de Madrid, Madrid, Spain
| | - Francisco Clascá
- Department of Anatomy and Neuroscience, Universidad Autónoma de Madrid, Madrid, Spain
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Liu A, Jiao Y, Zhang S, Kong H. Improved depressive symptoms in patients with refractory Gilles de la Tourette syndrome after deep brain stimulation of posteroventral globus pallidus interna. Brain Behav 2022; 12:e2635. [PMID: 35620847 PMCID: PMC9304849 DOI: 10.1002/brb3.2635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Revised: 01/29/2022] [Accepted: 02/12/2022] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE Deep brain stimulation (DBS) has been used on drug-resistant Gilles de la Tourette syndrome (GTS) for more than two decades until now, but the stimulating targets are still under exploration until now. In this study, the authors reported the efficacy of the bilateral posteroventral globus pallidus interna (GPi) DBS on tic severity and neuropsychiatry symptoms of seven individuals with GTS. METHOD Seven patients with drug-resistant GTS were enrolled in this study. The severity of these patients was evaluated with Yale Global Tics Severity Scale (YGTSS), Yale Brown Obsessive Compulsive Scale (YBOCS), Hamilton Depression Rating Scale (HAMD), Hamilton Anxiety Rating Scale (HAMA), and Global Assessment of Functioning Scale (GAF). Bilateral posteroventral GPi were selected as the permanent stimulating targets. Follow-up period was at least 5 years after surgery in the enrolled patients. RESULTS After surgery, one patient reported no improvement during the follow-up period, and a device removal surgery was performed. The other six patients reported minor to significant improvement. The overall YGTSS, YBOCS, HAMA HAMD, and GAF scores of these patients were changed positively after surgery, but only the improvement of the motor tic and HAMD scores had a statistical difference. No surgical complication was reported. CONCLUSIONS Bilateral posteroventral GPi DBS could relieve the motor tics and depressive symptoms of the enrolled patients significantly, but the vocal tics and other psychiatric symptoms presented a progression without statistical difference during the follow-up period. The results of this study suggested that bilateral posteroventral GPi are effective targets for the motor tics in GTS patients, especially with prominent depressive symptoms.
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Affiliation(s)
- Aijun Liu
- Department of Neurosurgery, the Chinese PLA General Hospital, Haidian, Beijing, China
| | - Yongcheng Jiao
- Department of Neurosurgery, the Chinese PLA General Hospital, Haidian, Beijing, China
| | - Shaohui Zhang
- Department of Neurosurgery, the Chinese PLA General Hospital, Haidian, Beijing, China
| | - Haibo Kong
- Department of Neurosurgery, the Chinese PLA General Hospital, Haidian, Beijing, China
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Navid MS, Kammermeier S, Niazi IK, Sharma VD, Vuong SM, Bötzel K, Greenlee JDW, Singh A. Cognitive task-related oscillations in human internal globus pallidus and subthalamic nucleus. Behav Brain Res 2022;:113787. [PMID: 35143905 DOI: 10.1016/j.bbr.2022.113787] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 02/01/2022] [Accepted: 02/03/2022] [Indexed: 11/21/2022]
Abstract
Recently it has been acknowledged that the basal ganglia nuclei play a major role in cognitive control; however, the contribution by their network remains unclear. Previous studies have demonstrated the role of the subthalamic nucleus (STN) in cognitive processing and suggested that its connections to cortical and other associated regions regulate response inhibition during conflict conditions. By contrast, the role of the internal globus pallidus (GPi) as the output nucleus before the thalamic relay has not yet been investigated during cognitive processing. We recorded local field potentials (LFPs) from externalized deep brain stimulation (DBS) electrodes implanted bilaterally in the GPi (n=9 participants with dystonia) and STN (n=8 participants with Parkinson's disease (PD)) during a primed flanker task. Both dystonia (GPi group) and PD participants (STN group) responded faster to the congruent trials than the incongruent trials. Overall, the dystonic GPi group was significantly faster than the PD STN group. LFPs showed elevated cue-triggered theta (3-7Hz) power in GPi and STN groups in a similar way. Response-triggered LFP beta power (13-25Hz) was significantly increased in the GPi group compared to the STN group. Results demonstrate that GPi activity appears to be critical in the cognitive processing of action selection and response during the presence of conflict tasks similar to the STN group.
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De Pretto M, Mouthon M, Debove I, Pollo C, Schüpbach M, Spierer L, Accolla EA. Proactive inhibition is not modified by deep brain stimulation for Parkinson's disease: An electrical neuroimaging study. Hum Brain Mapp 2021; 42:3934-3949. [PMID: 34110074 PMCID: PMC8288097 DOI: 10.1002/hbm.25530] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 04/23/2021] [Accepted: 05/03/2021] [Indexed: 11/06/2022] Open
Abstract
In predictable contexts, motor inhibitory control can be deployed before the actual need for response suppression. The brain functional underpinnings of proactive inhibition, and notably the role of basal ganglia, are not entirely identified. We investigated the effects of deep brain stimulation of the subthalamic nucleus or internal globus pallidus on proactive inhibition in patients with Parkinson's disease. They completed a cued go/no-go proactive inhibition task ON and (unilateral) OFF stimulation while EEG was recorded. We found no behavioural effect of either subthalamic nucleus or internal globus pallidus deep brain stimulation on proactive inhibition, despite a general improvement of motor performance with subthalamic nucleus stimulation. In the non-operated and subthalamic nucleus group, we identified periods of topographic EEG modulation by the level of proactive inhibition. In the subthalamic nucleus group, source estimation analysis suggested the initial involvement of bilateral frontal and occipital areas, followed by a right lateralized fronto-basal network, and finally of right premotor and left parietal regions. Our results confirm the overall preservation of proactive inhibition capacities in both subthalamic nucleus and internal globus pallidus deep brain stimulation, and suggest a partly segregated network for proactive inhibition, with a preferential recruitment of the indirect pathway.
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Affiliation(s)
- Michael De Pretto
- Neurology Unit, Medicine Section, Faculty of Sciences and Medicine, University of Fribourg, Fribourg, Switzerland
| | - Michael Mouthon
- Neurology Unit, Medicine Section, Faculty of Sciences and Medicine, University of Fribourg, Fribourg, Switzerland
| | - Ines Debove
- Movement Disorders Center, Department of Neurology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Claudio Pollo
- Department of Neurosurgery, Inselspital University Hospital Bern, Bern, Switzerland
| | - Michael Schüpbach
- Movement Disorders Center, Department of Neurology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Lucas Spierer
- Neurology Unit, Medicine Section, Faculty of Sciences and Medicine, University of Fribourg, Fribourg, Switzerland
| | - Ettore A Accolla
- Neurology Unit, Medicine Section, Faculty of Sciences and Medicine, University of Fribourg, Fribourg, Switzerland.,Neurology Unit, Department of Medicine, HFR - Cantonal Hospital Fribourg, Fribourg, Switzerland
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7
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Poulen G, Chan-Seng E, Sanrey E, Coubes P. Deep Brain Stimulation and Hypoxemic Perinatal Encephalopathy: State of Art and Perspectives. Life (Basel) 2021; 11:481. [PMID: 34070634 DOI: 10.3390/life11060481] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Revised: 05/20/2021] [Accepted: 05/24/2021] [Indexed: 12/12/2022] Open
Abstract
Cerebral palsy (CP) is a heterogeneous group of non-progressive syndromes with lots of clinical variations due to the extent of brain damages and etiologies. CP is majorly defined by dystonia and spasticity. The treatment of acquired dystonia in CP is very difficult. Many pharmacological treatments have been tried and surgical treatment consists of deep brain stimulation (continuous electrical neuromodulation) of internal globus pallidus (GPi). A peculiar cause of CP is neonatal encephalopathy due to an anoxic event in the perinatal period. Many studies showed an improvement of dystonia in CP patients with bilateral GPi DBS. However, it remains a variability in the range of 1% to 50%. Published case-series concerned mainly small population with a majority of adult patients. Selection of patients according to the clinical pattern, to the brain lesions observed on classical imaging and to DTI is the key of a high success rate of DBS in children with perinatal hypoxemic encephalopathy. Only a large retrospective study with a high number of patients in a homogeneous pediatric population with a long-term follow-up or a prospective multicenter trial investigation could answer with a high degree of certitude of the real interest of this therapeutic in children with hypoxemic perinatal encephalopathy.
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Johnson LA, Aman JE, Yu Y, Escobar Sanabria D, Wang J, Hill M, Dharnipragada R, Patriat R, Fiecas M, Li L, Schrock LE, Cooper SE, Johnson MD, Park MC, Harel N, Vitek JL. High-Frequency Oscillations in the Pallidum: A Pathophysiological Biomarker in Parkinson's Disease? Mov Disord 2021; 36:1332-1341. [PMID: 33847406 DOI: 10.1002/mds.28566] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2020] [Revised: 02/22/2021] [Accepted: 02/24/2021] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Abnormal oscillatory neural activity in the beta-frequency band (13-35 Hz) is thought to play a role in Parkinson's disease (PD); however, increasing evidence points to alterations in high-frequency ranges (>100 Hz) also having pathophysiological relevance. OBJECTIVES Studies have found that power in subthalamic nucleus (STN) high-frequency oscillations is increased with dopaminergic medication and during voluntary movements, implicating these brain rhythms in normal basal ganglia function. The objective of this study was to investigate whether similar signaling occurs in the internal globus pallidus (GPi), a nucleus increasingly used as a target for deep brain stimulation (DBS) for PD. METHODS Spontaneous and movement-related GPi field potentials were recorded from DBS leads in 5 externalized PD patients on and off dopaminergic medication, as well as from 3 rhesus monkeys before and after the induction of parkinsonism with the neurotoxin 1-methyl-4-phenyl-1,2,3,6 tetrahydropyridine. RESULTS In the parkinsonian condition, we identified a prominent oscillatory peak centered at 200-300 Hz that increased during movement. In patients the magnitude of high-frequency oscillation modulation was negatively correlated with bradykinesia. In monkeys, high-frequency oscillations were mostly absent in the naive condition but emerged after the neurotoxin 1-methyl-4-phenyl-1,2,3,6 tetrahydropyridine. In patients, spontaneous high-frequency oscillations were significantly attenuated on-medication. CONCLUSIONS Our findings provide evidence in support of the hypothesis that exaggerated, movement-modulated high-frequency oscillations in the GPi are pathophysiological features of PD. These findings suggest that the functional role(s) of high-frequency oscillations may differ between the STN and GPi and motivate additional investigations into their relationship to motor control in normal and diseased states.
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Affiliation(s)
- Luke A Johnson
- Department of Neurology, University of Minnesota, Minneapolis, Minnesota, USA
| | - Joshua E Aman
- Department of Neurology, University of Minnesota, Minneapolis, Minnesota, USA
| | - Ying Yu
- Department of Neurology, University of Minnesota, Minneapolis, Minnesota, USA
| | | | - Jing Wang
- Department of Neurology, University of Minnesota, Minneapolis, Minnesota, USA
| | - Meghan Hill
- Department of Neurology, University of Minnesota, Minneapolis, Minnesota, USA
| | - Rajiv Dharnipragada
- Department of Neurology, University of Minnesota, Minneapolis, Minnesota, USA
| | - Remi Patriat
- Department of Radiology, University of Minnesota, Minneapolis, Minnesota, USA
| | - Mark Fiecas
- School of Public Health Division of Biostatistics, University of Minnesota, Minneapolis, Minnesota, USA
| | - Laura Li
- Department of Neurology, University of Minnesota, Minneapolis, Minnesota, USA
| | - Lauren E Schrock
- Department of Neurology, University of Minnesota, Minneapolis, Minnesota, USA
| | - Scott E Cooper
- Department of Neurology, University of Minnesota, Minneapolis, Minnesota, USA
| | - Matthew D Johnson
- Department of Biomedical Engineering, University of Minnesota, Minneapolis, Minnesota, USA
| | - Michael C Park
- Department of Neurology, University of Minnesota, Minneapolis, Minnesota, USA.,Department of Neurosurgery, University of Minnesota, Minneapolis, Minnesota, USA
| | - Noam Harel
- Department of Radiology, University of Minnesota, Minneapolis, Minnesota, USA.,Department of Neurosurgery, University of Minnesota, Minneapolis, Minnesota, USA
| | - Jerrold L Vitek
- Department of Neurology, University of Minnesota, Minneapolis, Minnesota, USA
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Piña-Fuentes D, Beudel M, Little S, Brown P, Oterdoom DLM, van Dijk JMC. Adaptive deep brain stimulation as advanced Parkinson's disease treatment (ADAPT study): protocol for a pseudo-randomised clinical study. BMJ Open 2019; 9:e029652. [PMID: 31201193 PMCID: PMC6575861 DOI: 10.1136/bmjopen-2019-029652] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
INTRODUCTION Adaptive deep brain stimulation (aDBS), based on the detection of increased beta oscillations in the subthalamic nucleus (STN), has been assessed in patients with Parkinson's disease (PD) during the immediate postoperative setting. In these studies, aDBS was shown to be at least as effective as conventional DBS (cDBS), while stimulation time and side effects were reduced. However, the effect of aDBS on motor symptoms and stimulation-induced side effects during the chronically implanted phase (after the stun effect of DBS placement has disappeared) has not yet been determined. METHODS AND ANALYSIS This protocol describes a single-centre clinical study in which aDBS will be tested in 12 patients with PD undergoing battery replacement, with electrodes implanted in the STN, and as a proof of concept in the internal globus pallidus. Patients included will be allocated in a pseudo-randomised fashion to a three-condition (no stimulation/cDBS/ aDBS), cross-over design. A battery of tests will be conducted and recorded during each condition, which aim to measure the severity of motor symptoms and side effects. These tests include a tablet-based tapping test, a subscale of the Movement Disorder Society-unified Parkinson's disease rating scale (subMDS-UPDRS), the Speech Intelligibility Test (SIT) and a tablet-based version of the Stroop test. SubMDS-UPDRS and SIT recordings will be blindly assessed by independent raters. Data will be analysed using a linear mixed-effects model. ETHICS AND DISSEMINATION This protocol was approved by the Ethical Committee of the University Medical Centre Groningen, where the study will be carried out. Data management and compliance to research policies and standards of our centre, including data privacy, storage and veracity, will be controlled by an independent monitor. All the scientific findings derived from this protocol are aimed to be made public through publication of articles in international journals. TRIAL REGISTRATION NUMBER NTR 5456; Pre-results.
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Affiliation(s)
- Dan Piña-Fuentes
- Department of Neurosurgery, University Medical Centre Groningen, Groningen, The Netherlands
| | - Martijn Beudel
- Department of Neurology, University Medical Centre Groningen, Groningen, The Netherlands
- Department of Neurology, Amsterdam University Medical Centre, The Netherlands
| | - Simon Little
- Sobell Department of Motor Neuroscience and Movement Disorders, Institute of Neurology, Queen Square, London, UK
| | - Peter Brown
- Medical Research Council Brain Network Dynamics Unit, University of Oxford, Oxford, UK
- Nuffield Department of Clinical Neurosciences, University of Oxford, United Kingdom
| | - D L Marinus Oterdoom
- Department of Neurosurgery, University Medical Centre Groningen, Groningen, The Netherlands
| | - J Marc C van Dijk
- Department of Neurosurgery, University Medical Centre Groningen, Groningen, The Netherlands
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10
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Mao Z, Ling Z, Pan L, Xu X, Cui Z, Liang S, Yu X. Comparison of Efficacy of Deep Brain Stimulation of Different Targets in Parkinson's Disease: A Network Meta-Analysis. Front Aging Neurosci 2019; 11:23. [PMID: 30853908 PMCID: PMC6395396 DOI: 10.3389/fnagi.2019.00023] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Accepted: 01/28/2019] [Indexed: 11/13/2022] Open
Abstract
Background: Deep brain stimulation (DBS) is considered an effective treatment option for Parkinson's disease (PD). Several studies have demonstrated the efficacy of neurostimulation in patients with advanced PD. The subthalamic nucleus (STN), the internal globus pallidus (GPi), ventral intermediate nucleus (Vim), and pedunculopontine nucleus (PPN) are reportedly effective DBS targets for control of Parkinsonian tremors. However, there is no consensus on the ideal target for DBS in patients with Parkinson's disease. Only a few studies have directly compared the efficacy of DBS of the Vim, STN, and GPi. Therefore, we searched PubMed, Embase, Cochrane Library, and other databases for observational studies, extracted data on unified Parkinson's disease rating scale (UPDRS) scores and performed a comprehensive network meta-analysis of different strategies of DBS and compared the efficiency of DBS at different targets. Methods: Forest plot was used to examine the overall efficiency of DBS; cumulative probability value was used to rank the strategies under examination. A node-splitting model was employed to assess consistency of reported outcomes inconsistency. A total of 16 studies which focused on UPDRS improvement were included in the network meta-analysis. Results: By comparing the overall efficiency associated with each target, we confirmed the efficacy of DBS therapy in PD. Our findings revealed similar efficacy of DBS targeted at GPi and STN in the on-medication phase [GPi-3.9 (95% CI -7.0 to -0.96); STN-3.1 (-5.9 to -0.38)]; however, in the off-medication phase, Vim-targeted DBS was associated with better improvement in UPDRS scores and could be a choice as a DBS target for tremor-dominant Parkinsonism. Conclusions: Our findings will help improve clinical application of DBS.
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Affiliation(s)
- Zhiqi Mao
- Department of Neurosurgery, Chinese PLA General Hospital, Beijing, China
| | - Zhipei Ling
- Department of Neurosurgery, Chinese PLA General Hospital, Beijing, China
| | - Longsheng Pan
- Department of Neurosurgery, Chinese PLA General Hospital, Beijing, China
| | - Xin Xu
- Department of Neurosurgery, Chinese PLA General Hospital, Beijing, China
| | - Zhiqiang Cui
- Department of Neurosurgery, Chinese PLA General Hospital, Beijing, China
| | - Shuli Liang
- Department of Neurosurgery, Chinese PLA General Hospital, Beijing, China
| | - Xinguang Yu
- Department of Neurosurgery, Chinese PLA General Hospital, Beijing, China
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11
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Welter ML, Houeto JL, Worbe Y, Diallo MH, Hartmann A, Tezenas du Montcel S, Ansquer S, Thobois S, Fontaine D, Rouaud T, Cuny E, Karachi C, Mallet L. Long-term effects of anterior pallidal deep brain stimulation for tourette's syndrome. Mov Disord 2019; 34:586-588. [PMID: 30788865 DOI: 10.1002/mds.27645] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2018] [Revised: 01/11/2019] [Accepted: 01/28/2019] [Indexed: 11/10/2022] Open
Affiliation(s)
- Marie-Laure Welter
- Neurophysiology Department, CIC-CRB 1404, Rouen University Hospital, CHU Rouen, Rouen, France.,University of Rouen, Rouen, France.,Inserm 1127, Sorbonne Universités, UPMC Univ Paris 06, UMRS 1127, CNRS, UMR 7225, Institut du Cerveau et de la Moelle Epinière, Paris, France
| | - Jean-Luc Houeto
- INSERM-CIC 1402, University of Poitiers, CHU de Poitiers, Department of Neurology, Poitiers, France
| | - Yulia Worbe
- Inserm 1127, Sorbonne Universités, UPMC Univ Paris 06, UMRS 1127, CNRS, UMR 7225, Institut du Cerveau et de la Moelle Epinière, Paris, France.,AP-HP, Hôpitaux Universitaires Pitié Salpêtrière - Charles Foix, Neurology Department, Paris, France
| | - Mamadou Hassimiou Diallo
- AP-HP, Hôpitaux Universitaires Pitié Salpêtrière - Charles Foix, Biostatistics and Medical Informatics Unit and Clinical Research Unit, Paris, France
| | - Andreas Hartmann
- Inserm 1127, Sorbonne Universités, UPMC Univ Paris 06, UMRS 1127, CNRS, UMR 7225, Institut du Cerveau et de la Moelle Epinière, Paris, France.,AP-HP, Hôpitaux Universitaires Pitié Salpêtrière - Charles Foix, Neurology Department, Paris, France
| | - Sophie Tezenas du Montcel
- AP-HP, Hôpitaux Universitaires Pitié Salpêtrière - Charles Foix, Biostatistics and Medical Informatics Unit and Clinical Research Unit, Paris, France.,AP-HP, Hôpitaux Universitaires Pitié Salpêtrière - Charles Foix, Institut Pierre Louis d'Epidémiologie et de Santé Publique IPLESP, Paris, France
| | - Solène Ansquer
- INSERM-CIC 1402, University of Poitiers, CHU de Poitiers, Department of Neurology, Poitiers, France
| | - Stéphane Thobois
- University of Lyon, Institut des Sciences Cognitives Marc Jeannerod, CNRS, UMR 5229, Hospices Civils de Lyon, Hôpital Neurologique Pierre Wertheimer, Service de Neurologie C, Centre Expert Parkinson, Bron, France.,University of Lyon, Faculté de Médecine Lyon Sud Charles Mérieux, Oullins, France
| | - Denys Fontaine
- Nice University Hospital, Department of Neurosurgery, Université Côte d'Azur, Nice, France
| | - Tiphaine Rouaud
- Nantes University Hospital, Departments of Neurology, Nantes, France
| | - Emmanuel Cuny
- Charles Perrens Hospital, Departments of Neurosurgery, Bordeaux, France
| | - Carine Karachi
- Inserm 1127, Sorbonne Universités, UPMC Univ Paris 06, UMRS 1127, CNRS, UMR 7225, Institut du Cerveau et de la Moelle Epinière, Paris, France.,AP-HP, Hôpitaux Universitaires Pitié Salpêtrière - Charles Foix, Neurosurgery Department, Paris, France
| | - Luc Mallet
- Inserm 1127, Sorbonne Universités, UPMC Univ Paris 06, UMRS 1127, CNRS, UMR 7225, Institut du Cerveau et de la Moelle Epinière, Paris, France.,AP-HP, Personalised Neurology & Psychiatry University Department, Hôpitaux Universitaires Henri Mondor - Albert Chenevier, Université Paris Est Créteil, Créteil, France.,Department of Mental Health and Psychiatry, Geneva University Hospital, University of Geneva, Geneva, Switzerland
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- STIC: Traitement de la maladie de Gilles de la Tourette par stimulation bilatérale à haute fréquence de la partie antérieure du globus pallidus interne
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Pan Y, Wang L, Zhang Y, Zhang C, Qiu X, Tan Y, Zhou H, Sun B, Li D. Deep Brain Stimulation of the Internal Globus Pallidus Improves Response Initiation and Proactive Inhibition in Patients With Parkinson's Disease. Front Psychol 2018; 9:351. [PMID: 29681869 PMCID: PMC5897903 DOI: 10.3389/fpsyg.2018.00351] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2018] [Accepted: 03/02/2018] [Indexed: 01/10/2023] Open
Abstract
Background: Impulse control disorder is not uncommon in patients with Parkinson’s disease (PD) who are treated with dopamine replacement therapy and subthalamic deep brain stimulation (DBS). Internal globus pallidus (GPi)-DBS is increasingly used, but its role in inhibitory control has rarely been explored. In this study, we evaluated the effect of GPi-DBS on inhibitory control in PD patients. Methods: A stop-signal paradigm was used to test response initiation, proactive inhibition, and reactive inhibition. The subjects enrolled in the experiment were 27 patients with PD, of whom 13 had received only drug treatment and 14 had received bilateral GPi-DBS in addition to conventional medical treatment and 15 healthy individuals. Results: Our results revealed that with GPi-DBS on, patients with PD showed significantly faster responses than the other groups in trials where it was certain that no stop signal would be presented. Proactive inhibition was significantly different in the surgical patients with GPi-DBS on versus when GPi-DBS was off, in surgical patients with GPi-DBS on versus drug-treated patients, and in healthy controls versus drug-treated patients. Correlation analyses revealed that when GPi-DBS was on, there was a statistically significant moderate positive relationship between proactive inhibition and dopaminergic medication. Conclusion: GPi-DBS may lead to an increase in response initiation speed and improve the dysfunctional proactive inhibitory control observed in PD patients. Our results may help us to understand the role of the GPi in cortical-basal ganglia circuits.
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Affiliation(s)
- Yixin Pan
- Department of Functional Neurosurgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Linbin Wang
- Department of Functional Neurosurgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yingying Zhang
- Department of Functional Neurosurgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Chencheng Zhang
- Department of Functional Neurosurgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xian Qiu
- Department of Functional Neurosurgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yuyan Tan
- Department of Psychiatry, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Haiyan Zhou
- Department of Psychiatry, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Bomin Sun
- Department of Functional Neurosurgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Dianyou Li
- Department of Functional Neurosurgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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13
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Klingelhoefer L, Samuel M, Chaudhuri KR, Ashkan K. An update of the impact of deep brain stimulation on non motor symptoms in Parkinson's disease. J Parkinsons Dis 2014; 4:289-300. [PMID: 24613865 DOI: 10.3233/jpd-130273] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Deep brain stimulation (DBS) of the subthalamic nucleus (STN) is a well-established therapy for patients with Parkinson's disease (PD), especially those with advanced motor complications. The effect of STN DBS on non motor symptoms (NMS) of PD is less well studied. In this article, we review the pertinent literature on the impact of STN DBS on NMS when they co-exist with disabling motor symptoms in PD patients. We also present evidence that the number and the severity of most NMS decrease after STN DBS which can have a major impact on patients' quality of life.
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Affiliation(s)
- Lisa Klingelhoefer
- National Parkinson Foundation International Centre of Excellence, Department of Neurology, King's College Hospital and King's College, Denmark Hill, London, UK Department of Neurology, Technical University Dresden, Dresden, Germany
| | - Michael Samuel
- National Parkinson Foundation International Centre of Excellence, Department of Neurology, King's College Hospital, Denmark Hill, London, UK
| | - K Ray Chaudhuri
- National Parkinson Foundation International Centre of Excellence, Department of Neurology, King's College Hospital and King's College, Denmark Hill, London, UK
| | - Keyoumars Ashkan
- Department of Neurosurgery, King's College Hospital, Denmark Hill, London, UK
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14
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Morin N, Morissette M, Grégoire L, Gomez-Mancilla B, Gasparini F, Di Paolo T. Chronic treatment with MPEP, an mGlu5 receptor antagonist, normalizes basal ganglia glutamate neurotransmission in L-DOPA-treated parkinsonian monkeys. Neuropharmacology 2013; 73:216-31. [PMID: 23756168 DOI: 10.1016/j.neuropharm.2013.05.028] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2012] [Revised: 05/17/2013] [Accepted: 05/18/2013] [Indexed: 10/26/2022]
Abstract
Metabotropic glutamate 5 (mGlu5) receptor antagonists reduce L-3,4-dihydroxyphenylalanine (L-DOPA)-induced dyskinesias (LID) in Parkinson's disease (PD). The aim of this study was to investigate the long-term effect of the prototypal mGlu5 receptor antagonist 2-methyl-6-(phenylethynyl)pyridine (MPEP) on glutamate receptors known to be involved in the development of LID in the de novo chronic treatment of monkeys lesioned with 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP). MPTP monkeys were treated for one month with L-DOPA and developed dyskinesias while those treated with L-DOPA and MPEP (10 mg/kg) developed significantly less. Normal control and saline-treated MPTP monkeys were also included. All MPTP monkeys were extensively and similarly denervated. The basal ganglia [(3)H]ABP688 specific binding (mGlu5 receptors) was elevated in L-DOPA-treated MPTP monkeys compared to controls but not in those treated with L-DOPA and MPEP; dyskinesia scores of these monkeys correlated positively with their [(3)H]ABP688 specific binding. Striatal density (B(max)) of [(3)H]ABP688 specific binding increased in L-DOPA-treated MPTP monkeys compared to other groups and affinity (Kd) remained unchanged. Striatal mGlu5 receptor mRNA remained unchanged following treatments. Elevated basal ganglia specific binding of [(3)H]Ro 25-6981 (NMDA NR1/NR2B receptors), [(3)H]Ro 48-8587 (AMPA receptors) but not [(3)H]CGP-39653 (NMDA NR1/NR2A receptors) was observed only in L-DOPA-treated MPTP monkeys; dyskinesias scores correlated with binding. By contrast, basal ganglia [(3)H]LY341495 specific binding (mGlu2/3 receptors) decreased in L-DOPA-treated MPTP monkeys compared to controls, saline and L-DOPA + MPEP treated MPTP monkeys; dyskinesias scores correlated negatively with this binding. Hence, chronic MPEP treatment reduces the development of LID and is associated with a normalization of glutamate neurotransmission.
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Affiliation(s)
- Nicolas Morin
- Neuroscience Research Unit, Laval University Medical Center (CHUQ), Quebec, QC, Canada
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15
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Cho ZH, Min HK, Oh SH, Han JY, Park CW, Chi JG, Kim YB, Paek SH, Lozano AM, Lee KH. Direct visualization of deep brain stimulation targets in Parkinson disease with the use of 7-tesla magnetic resonance imaging. J Neurosurg 2010; 113:639-47. [PMID: 20380532 PMCID: PMC3160785 DOI: 10.3171/2010.3.jns091385] [Citation(s) in RCA: 137] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
OBJECT A challenge associated with deep brain stimulation (DBS) in treating advanced Parkinson disease (PD) is the direct visualization of brain nuclei, which often involves indirect approximations of stereotactic targets. In the present study, the authors compared T2*-weighted images obtained using 7-T MR imaging with those obtained using 1.5- and 3-T MR imaging to ascertain whether 7-T imaging enables better visualization of targets for DBS in PD. METHODS The authors compared 1.5-, 3-, and 7-T MR images obtained in 11 healthy volunteers and 1 patient with PD. RESULTS With 7-T imaging, distinct images of the brain were obtained, including the subthalamic nucleus (STN) and internal globus pallidus (GPi). Compared with the 1.5- and 3-T MR images of the STN and GPi, the 7-T MR images showed marked improvements in spatial resolution, tissue contrast, and signal-to-noise ratio. CONCLUSIONS Data in this study reveal the superiority of 7-T MR imaging for visualizing structures targeted for DBS in the management of PD. This finding suggests that by enabling the direct visualization of neural structures of interest, 7-T MR imaging could be a valuable aid in neurosurgical procedures.
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Affiliation(s)
- Zang-Hee Cho
- Neuroscience Research Institute, Gachon University of Medicine and Science, Incheon, Republic of Korea.
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