Subthalamic nucleus stimulation improves Parkinsonian gait via brainstem locomotor centers

Background Subthalamic deep brain stimulation (STN‐DBS) can ameliorate gait disturbances in Parkinson's disease (PD). Using motor imagery and positron emission tomography (PET), we investigated how STN‐DBS interacts with supraspinal locomotor centers in PD. Methods Ten PD patients with bilatera...

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Published inMovement disorders Vol. 30; no. 8; pp. 1121 - 1125
Main Authors Weiss, Peter H., Herzog, Jan, Pötter-Nerger, Monika, Falk, Daniela, Herzog, Hans, Deuschl, Günther, Volkmann, Jens, Fink, Gereon R.
Format Journal Article
LanguageEnglish
Published United States Blackwell Publishing Ltd 01.07.2015
Wiley Subscription Services, Inc
Subjects
deep brain stimulation
Deep Brain Stimulation - methods
Gait Disorders, Neurologic - etiology
Gait Disorders, Neurologic - therapy
Humans
Imagination - physiology
locomotion
mesencephalic locomotor region
motor imagery
Movement disorders
Parkinson Disease - complications
Parkinson Disease - therapy
Parkinson's disease
pedunculopontine nucleus
Pedunculopontine Tegmental Nucleus - physiopathology
PET
Positron-Emission Tomography
Subthalamic Nucleus - surgery
Walking - physiology
mesencephalic locomotor region
Parkinson's disease
locomotion
motor imagery
pedunculopontine nucleus
PET
deep brain stimulation
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ISSN0885-3185
1531-8257
DOI10.1002/mds.26229

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Summary:Background Subthalamic deep brain stimulation (STN‐DBS) can ameliorate gait disturbances in Parkinson's disease (PD). Using motor imagery and positron emission tomography (PET), we investigated how STN‐DBS interacts with supraspinal locomotor centers in PD. Methods Ten PD patients with bilateral STN‐DBS actually walked or stood still under STN‐DBS ON or OFF conditions. Directly thereafter, subjects imagined walking or standing while changes in regional cerebral blood flow were measured by PET. Results Independent of STN‐DBS, imagined walking distance correlated with imagery duration. Compared with STN‐DBS OFF, STN‐DBS ON improved actual gait and increased imagined walking distance. Imagery of gait (vs. stance) induced activity in the supplementary motor area and the right superior parietal lobule for both STN‐DBS conditions. The improvement of imagined gait during STN‐DBS ON led to activity changes in the pedunculopontine nucleus/mesencephalic locomotor region (PPN/MLR). Conclusions Data suggest that STN‐DBS improves Parkinsonian gait by modulating PPN/MLR activity. © 2015 International Parkinson and Movement Disorder Society
Bibliography:ark:/67375/WNG-Q5WPRW54-9
ArticleID:MDS26229
Kompetenznetz Parkinson - No. BMBF FK01GI0201
istex:7F394F86EA13C2A25E5D24E6C5469DD91797CFE8
Full financial disclosures and author roles may be found in the online version of this article.
This study was supported by the Kompetenznetz Parkinson (BMBF FK01GI0201).
Drs. Weiss, Herzog, Pötter‐Nerger, Falk, Herzog, and Deuschl have nothing to report. Dr. Volkmann was supported by funding from the German Ministry of Research through the Network of European Funding for Neuroscience Research (ERA‐Net Neuron) scheme (grant #01eW0902). Dr. Fink was supported by the German Research Foundation (DFG KFO 219, Fi 773/8‐1 and Schu 1439/3‐1).
Shared first authorship.
Shared senior authorship.
Relevant conflicts of interest/financial disclosures
Funding agencies
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ISSN:0885-3185
1531-8257
DOI:10.1002/mds.26229