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    Cerebral blood flow responses to dorsal and ventral STN DBS correlate with gait and balance responses in Parkinson's disease

    Access Status
    Fulltext not available
    Authors
    Hill, Kylie
    Campbell, M.
    McNeely, M.
    Karimi, M.
    Ushe, M.
    Tabbal, S.
    Hershey, T.
    Flores, H.
    Hartlein, J.
    Lugar, H.
    Revilla, F.
    Videen, T.
    Earhart, G.
    Perlmutter, J.
    Date
    2013
    Type
    Journal Article
    
    Metadata
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    Citation
    Hill, K. and Campbell, M. and McNeely, M. and Karimi, M. and Ushe, M. and Tabbal, S. and Hershey, T. et al. 2013. Cerebral blood flow responses to dorsal and ventral STN DBS correlate with gait and balance responses in Parkinson's disease. Experimental Neurology. 241 (1): pp. 105-112.
    Source Title
    Experimental Neurology
    DOI
    10.1016/j.expneurol.2012.12.003
    ISSN
    0014-4886
    School
    School of Physiotherapy and Exercise Science
    URI
    http://hdl.handle.net/20.500.11937/44716
    Collection
    • Curtin Research Publications
    Abstract

    Objectives - The effects of subthalamic nucleus (STN) deep brain stimulation (DBS) on gait and balance vary and the underlying mechanisms remain unclear. DBS location may alter motor benefit due to anatomical heterogeneity in STN. The purposes of this study were to (1) compare the effects of DBS of dorsal (D-STN) versus ventral (V-STN) regions on gait, balance and regional cerebral blood flow (rCBF) and (2) examine the relationships between changes in rCBF and changes in gait and balance induced by D-STN or V-STN DBS. Methods - We used a validated atlas registration to locate and stimulate through electrode contacts in D-STN and V-STN regions of 37 people with Parkinson's disease. In a within-subjects, double-blind and counterbalanced design controlled for DBS settings, we measured PET rCBF responses in a priori regions of interest and quantified gait and balance during DBS Off, unilateral D-STN DBS and unilateral V-STN DBS. Results - DBS of either site increased stride length without producing significant group-level changes in gait velocity, cadence or balance. Both sites increased rCBF in subcortical regions and produced variable changes in cortical and cerebellar regions. DBS-induced changes in gait velocity are related to premotor cortex rCBF changes during V-STN DBS (r = − 0.40, p = 0.03) and to rCBF changes in the cerebellum anterior lobe during D-STN DBS (r = − 0.43, p = 0.02). Conclusions - DBS-induced changes in gait corresponded to rCBF responses in selected cortical and cerebellar regions. These relationships differed during D-STN versus V-STN DBS, suggesting DBS acts through distinct neuronal pathways dependent on DBS location.

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