Global and multi-focal changes in cerebral blood flow during subthalamic nucleus stimulation in Parkinson’s disease

• Published in: Journal of cerebral blood flow and metabolism Vol. 38; no. 4; pp. 697 - 705
• Main Authors: Mubeen, Asim M, Ardekani, Babak, Tagliati, Michele, Alterman, Ron, Dhawan, Vijay, Eidelberg, David, Sidtis, John J
• Format: Journal Article
• Language: English
• Published: London, England SAGE Publications 01.04.2018
• Subjects: Original; cerebral blood flow; positron emission tomography; Deep brain stimulation; subthalamic nucleus; Parkinson’s disease
• ISSN: 0271-678X; 1559-7016; 1559-7016
• DOI: 10.1177/0271678X17705042

Electrical stimulation of subthalamic nuclei (STN) is a widely used therapy in Parkinson’s disease (PD). While deep brain stimulation (DBS) of the STN alters the neurophysiological activity in basal ganglia, the therapeutic mechanism has not been established. A positron emission tomography (PET) study of cerebral blood flow (CBF) during speech production in PD subjects treated with STN-DBS found significant increases in global (whole-brain) CBF.1 That study utilized a series of whole-slice regions of interest to obtain global CBF values. The present study examined this effect using a voxel-based principal component analysis (PCA) combined with Fisher’s linear discriminant analysis (FLDA) to classify STN-DBS on versus STN-DBS off whole-brain images. The approach yielded wide-spread CBF changes that classified STN-DBS status with accuracy, sensitivity, and specificity approaching 90%. The PCA component of the analysis supported the observation of a global CBF change during STN-DBS. The FLDA component demonstrated wide-spread multi-focal CBF changes. Further, CBF measurements related to a number of subject characteristics when STN-DBS was off, but not when it was on, suggesting that the normal relationship between CBF and behavior may be disrupted by this form of neuromodulation.