Single-pulse subthalamic deep brain stimulation reduces premotor-motor facilitation in Parkinson's disease

Anne Weissbach; Kaviraja Udupa; Zhen Ni; Carolyn Gunraj; Cricia Rinchon; Julianne Baarbe; Alfonso Fasano; Renato P Munhoz; Anthony Lang; Vera Tadic; Norbert Brüggemann; Alexander Münchau; Tobias Bäumer; Robert Chen

doi:10.1016/j.parkreldis.2019.08.003

Single-pulse subthalamic deep brain stimulation reduces premotor-motor facilitation in Parkinson's disease

Parkinsonism Relat Disord. 2019 Sep:66:224-227. doi: 10.1016/j.parkreldis.2019.08.003. Epub 2019 Aug 7.

Authors

Affiliations

¹ Institute of Neurogenetics, University of Lübeck, Germany; Department of Neurology, University of Lübeck, Germany.
² Edmond J. Safra Program in Parkinson's Disease, Morton and Gloria Shulman Movement Disorder Clinic, Toronto Western Hospital, University Health Network, University of Toronto, Toronto, Ontario, Canada.
³ Edmond J. Safra Program in Parkinson's Disease, Morton and Gloria Shulman Movement Disorder Clinic, Toronto Western Hospital, University Health Network, University of Toronto, Toronto, Ontario, Canada; Krembil Research Institute, Toronto, Ontario, Canada.
⁴ Institute of Neurogenetics, University of Lübeck, Germany.
⁵ Edmond J. Safra Program in Parkinson's Disease, Morton and Gloria Shulman Movement Disorder Clinic, Toronto Western Hospital, University Health Network, University of Toronto, Toronto, Ontario, Canada; Krembil Research Institute, Toronto, Ontario, Canada. Electronic address: [email protected].

PMID: 31427071
DOI: 10.1016/j.parkreldis.2019.08.003

Abstract

Introduction: Deep brain stimulation improves motor symptoms in Parkinson's disease and changes primary motor cortex excitability, but how subthalamic nucleus stimulation affects premotor-motor cortical connectivity remains unclear.

Methods: We investigated 10 Parkinson patients in whom single subthalamic nucleus stimulation was time-locked to transcranial magnetic dual-coil, paired-pulse stimulation of the dorsal premotor and primary motor cortex. Premotor-motor interaction with deep brain stimulation switched off was compared to 10 controls.

Results: Parkinson patients showed abnormally facilitated premotor-motor interaction with deep brain stimulation switched off compared to controls. This abnormal premotor-motor facilitation was abolished during subthalamic nucleus stimulation at 3 Hz.

Conclusions: In Parkinson's disease, aberrant signals from the basal ganglia leading to a loss of physiological premotor-motor inhibition can be normalized by subthalamic deep brain stimulation. This effect is likely mediated by activation of subthalamic-pallidal-thalamic projection to the premotor cortex.

Keywords: Deep brain stimulation; Motor cortex; Parkinson's disease; Premotor cortex; TMS.

Publication types

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

MeSH terms

Aged
Deep Brain Stimulation*
Female
Humans
Male
Middle Aged
Motor Cortex / physiopathology*
Parkinson Disease / physiopathology*
Parkinson Disease / therapy*
Subthalamic Nucleus*
Transcranial Magnetic Stimulation*

Abstract

Publication types

MeSH terms

Grants and funding