Sweet spot for resting-state functional MRI effect of deep brain stimulation in dystonia lies in the lower pallidal area

IF 3.4 2区医学 Q2 NEUROIMAGING

Neuroimage-Clinical Pub Date : 2025-01-01 DOI:10.1016/j.nicl.2025.103750

Pavel Filip , Andrej Lasica , Dimitra Kiakou , Karsten Mueller , Jiří Keller , Dušan Urgošík , Daniel Novák , Robert Jech

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引用次数: 0

Abstract

Introduction

Deep brain stimulation (DBS) of the internal globus pallidus (GPi) is a well-established, effective treatment for dystonia. Substantial variability of therapeutic success has been the one of the drivers of an ongoing debate about proper stimulation site and settings, with several indications of the notional sweet spot pointing to the lower GPi or even subpallidal area.

Methods

The presented patient-blinded, random-order study with cross-sectional verification against healthy controls enrolled 17 GPi DBS idiopathic, cervical or generalised dystonia patients to compare the effect of the stimulation in the upper and lower GPi area, with the focus on sensorimotor network connectivity and local activity measured using functional magnetic resonance.

Results

Stimulation brought both these parameters to levels closer to the state detected in healthy controls. This effect was much more pronounced during the stimulation in the lower GPi area or beneath it than in slightly higher positions, with stimulation-related changes detected by both metrics of interest in the sensorimotor cortex, striatum, thalamus and cerebellum.

Conclusions

All in all, this study not only replicated the results of previous studies on GPi DBS as a modality restoring sensorimotor network connectivity and local activity in dystonia towards the levels in healthy population, but also showed that lower GPi area or even subpallidal structures, be it white matter or even small, but essential nodes in the zona incerta as nucleus basalis of Meynert, are important regions to consider when programming DBS in dystonia patients.

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脑深部刺激对肌张力障碍静息状态功能MRI效果的“甜点”位于下苍白区

脑深部刺激（DBS）内苍白球（GPi）是一种行之有效的治疗肌张力障碍的方法。治疗成功的巨大差异一直是关于适当刺激地点和环境的持续争论的驱动因素之一，有几个迹象表明，概念上的最佳点指向GPi较低甚至是pallial下区域。方法采用患者盲法、随机顺序研究，对17例GPi DBS特发性、颈部或全身性肌张力障碍患者进行横断面验证，比较刺激GPi上、下区域的效果，重点关注感觉运动网络连通性和局部活动，使用功能磁共振测量。结果刺激使这两个参数的水平更接近健康对照组的水平。与稍高的位置相比，在GPi较低或更低的位置受到刺激时，这种效果更为明显，感觉运动皮层、纹状体、丘脑和小脑的两种感兴趣指标都检测到了与刺激相关的变化。综上所述，本研究不仅重复了以往关于GPi DBS作为一种将肌张力障碍患者的感觉运动网络连连性和局部活动恢复到健康人群水平的研究结果，而且还表明GPi下区域甚至是苍白质下结构，无论是白质，还是像Meynert基底核一样细小但必不可少的神经带节点，都是肌张力障碍患者DBS编程时需要考虑的重要区域。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Neuroimage-Clinical NEUROIMAGING-

CiteScore

7.50

自引率

4.80%

发文量

368

审稿时长

52 days

期刊介绍： NeuroImage: Clinical, a journal of diseases, disorders and syndromes involving the Nervous System, provides a vehicle for communicating important advances in the study of abnormal structure-function relationships of the human nervous system based on imaging. The focus of NeuroImage: Clinical is on defining changes to the brain associated with primary neurologic and psychiatric diseases and disorders of the nervous system as well as behavioral syndromes and developmental conditions. The main criterion for judging papers is the extent of scientific advancement in the understanding of the pathophysiologic mechanisms of diseases and disorders, in identification of functional models that link clinical signs and symptoms with brain function and in the creation of image based tools applicable to a broad range of clinical needs including diagnosis, monitoring and tracking of illness, predicting therapeutic response and development of new treatments. Papers dealing with structure and function in animal models will also be considered if they reveal mechanisms that can be readily translated to human conditions.