Altered Functional Connectivity of the Subthalamic Nucleus in Parkinson's Disease: Focus on Candidates for Deep Brain Stimulation.


Journal

Journal of Parkinson's disease
ISSN: 1877-718X
Titre abrégé: J Parkinsons Dis
Pays: Netherlands
ID NLM: 101567362

Informations de publication

Date de publication:
2023
Historique:
medline: 4 9 2023
pubmed: 4 6 2023
entrez: 4 6 2023
Statut: ppublish

Résumé

The hypothesis that the effectiveness of deep brain stimulation (DBS) in Parkinson's disease (PD) would be related to connectivity dysfunctions between the site of stimulation and other brain regions is growing. To investigate how the subthalamic nucleus (STN), the most frequently used DBS target for PD, is functionally linked to other brain regions in PD patients according to DBS eligibility. Clinical data and resting-state functional MRI were acquired from 60 PD patients and 60 age- and sex-matched healthy subjects within an ongoing longitudinal project. PD patients were divided into 19 patients eligible for DBS and 41 non-candidates. Bilateral STN were selected as regions of interest and a seed-based functional MRI connectivity analysis was performed. A decreased functional connectivity between STN and sensorimotor cortex in both PD patient groups compared to controls was found. Whereas an increased functional connectivity between STN and thalamus was found in PD patient groups relative to controls. Candidates for DBS showed a decreased functional connectivity between bilateral STN and bilateral sensorimotor areas relative to non-candidates. In patients eligible for DBS, a weaker STN functional connectivity with left supramarginal and angular gyri was related with a more severe rigidity and bradykinesia whereas a higher connectivity between STN and cerebellum/pons was related to poorer tremor score. Our results suggest that functional connectivity of STN varies among PD patients eligible or not for DBS. Future studies would confirm whether DBS modulates and restores functional connectivity between STN and sensorimotor areas in treated patients.

Sections du résumé

BACKGROUND
The hypothesis that the effectiveness of deep brain stimulation (DBS) in Parkinson's disease (PD) would be related to connectivity dysfunctions between the site of stimulation and other brain regions is growing.
OBJECTIVE
To investigate how the subthalamic nucleus (STN), the most frequently used DBS target for PD, is functionally linked to other brain regions in PD patients according to DBS eligibility.
METHODS
Clinical data and resting-state functional MRI were acquired from 60 PD patients and 60 age- and sex-matched healthy subjects within an ongoing longitudinal project. PD patients were divided into 19 patients eligible for DBS and 41 non-candidates. Bilateral STN were selected as regions of interest and a seed-based functional MRI connectivity analysis was performed.
RESULTS
A decreased functional connectivity between STN and sensorimotor cortex in both PD patient groups compared to controls was found. Whereas an increased functional connectivity between STN and thalamus was found in PD patient groups relative to controls. Candidates for DBS showed a decreased functional connectivity between bilateral STN and bilateral sensorimotor areas relative to non-candidates. In patients eligible for DBS, a weaker STN functional connectivity with left supramarginal and angular gyri was related with a more severe rigidity and bradykinesia whereas a higher connectivity between STN and cerebellum/pons was related to poorer tremor score.
CONCLUSION
Our results suggest that functional connectivity of STN varies among PD patients eligible or not for DBS. Future studies would confirm whether DBS modulates and restores functional connectivity between STN and sensorimotor areas in treated patients.

Identifiants

pubmed: 37270810
pii: JPD230005
doi: 10.3233/JPD-230005
pmc: PMC10473091
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

797-809

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Auteurs

Luigi Albano (L)

Neuroimaging Research Unit, Division of Neuroscience, IRCCS Ospedale San Raffaele, Milan, Italy.
Neurosurgery and Gamma Knife Radiosurgery Unit, IRCCS Ospedale San Raffaele, Milan, Italy.
Vita-Salute San Raffaele University, Milan, Italy.

Federica Agosta (F)

Neuroimaging Research Unit, Division of Neuroscience, IRCCS Ospedale San Raffaele, Milan, Italy.
Vita-Salute San Raffaele University, Milan, Italy.
Neurology Unit, IRCCS Ospedale San Raffaele, Milan, Italy.

Silvia Basaia (S)

Neuroimaging Research Unit, Division of Neuroscience, IRCCS Ospedale San Raffaele, Milan, Italy.

Camilla Cividini (C)

Neuroimaging Research Unit, Division of Neuroscience, IRCCS Ospedale San Raffaele, Milan, Italy.
Vita-Salute San Raffaele University, Milan, Italy.

Tanja Stojkovic (T)

Clinic of Neurology, Faculty of Medicine, University of Belgrade, Belgrade, Serbia.

Elisabetta Sarasso (E)

Neuroimaging Research Unit, Division of Neuroscience, IRCCS Ospedale San Raffaele, Milan, Italy.

Iva Stankovic (I)

Clinic of Neurology, Faculty of Medicine, University of Belgrade, Belgrade, Serbia.

Aleksandra Tomic (A)

Clinic of Neurology, Faculty of Medicine, University of Belgrade, Belgrade, Serbia.

Vladana Markovic (V)

Clinic of Neurology, Faculty of Medicine, University of Belgrade, Belgrade, Serbia.

Elisa Canu (E)

Neuroimaging Research Unit, Division of Neuroscience, IRCCS Ospedale San Raffaele, Milan, Italy.

Elka Stefanova (E)

Clinic of Neurology, Faculty of Medicine, University of Belgrade, Belgrade, Serbia.

Pietro Mortini (P)

Neurosurgery and Gamma Knife Radiosurgery Unit, IRCCS Ospedale San Raffaele, Milan, Italy.
Vita-Salute San Raffaele University, Milan, Italy.

Vladimir S Kostic (VS)

Clinic of Neurology, Faculty of Medicine, University of Belgrade, Belgrade, Serbia.

Massimo Filippi (M)

Neuroimaging Research Unit, Division of Neuroscience, IRCCS Ospedale San Raffaele, Milan, Italy.
Vita-Salute San Raffaele University, Milan, Italy.
Neurology Unit, IRCCS Ospedale San Raffaele, Milan, Italy.
Neurorehabilitation Unit, IRCCS Ospedale San Raffaele, Milan, Italy.
Neurophysiology Service, IRCCS Ospedale San Raffaele, Milan, Italy.

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