Antero-Lateral Subthalamic Nucleus Theta Stimulation Improves Verbal Fluency in Parkinson's Disease.

IF 7.4 1区医学 Q1 CLINICAL NEUROLOGY

Movement Disorders Pub Date : 2025-04-02 DOI:10.1002/mds.30185

Hannah Schoenwald, Bahne H Bahners, Silja Kannenberg, Till A Dembek, Michael T Barbe, Dafina Sylaj, Anja Spiewok, Saskia Elben, Tomke Muettel, Jan Vesper, Philipp Slotty, Alfons Schnitzler, Stefan J Groiss

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Abstract

Objective: Low-frequency deep brain stimulation (DBS) of the subthalamic nucleus (STN) has been associated with positive effects on verbal fluency (VF) in patients with Parkinson's disease. This prospective study investigates stimulation direction-dependent and site-specific effects of theta frequency DBS on VF.

Methods: In a double-blind, cross-over design (n = 20), we tested VF during left subthalamic theta stimulation (stimulation-off, omnidirectional, and threedirectional stimulation conditions). DBS electrode localization and electric field calculations were performed (n = 18). Probabilistic sweet spot mapping identified voxels with significant change in VF.

Results: Best directional stimulation improved VF performance significantly compared with the stimulation-off and omnidirectional stimulation condition. This effect followed a medial-to-anterolateral gradient with higher VF improvement observed on the border between the motor and associative subparts of the STN.

Conclusion: We provide first proof-of-principle evidence that directional theta frequency DBS improves VF, possibly related to stimulation of the anterolateral STN. © 2025 The Author(s). Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.

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目的：眼下核（STN）的低频深部脑刺激（DBS）对帕金森病患者的言语流畅性（VF）有积极影响。这项前瞻性研究调查了θ频率 DBS 对 VF 的刺激方向依赖性和特定部位效应：在双盲、交叉设计（n = 20）中，我们测试了左侧丘脑下θ刺激（刺激-关闭、全向和三向刺激条件）时的 VF。进行了 DBS 电极定位和电场计算（n = 18）。概率甜点图确定了VF发生显著变化的体素：结果：与停止刺激和全向刺激条件相比，最佳定向刺激可显著改善 VF 性能。这种效应呈从内侧到外侧的梯度，在 STN 运动亚区和联想亚区交界处观察到的 VF 改善程度更高：我们首次提供了原则性证据，证明定向θ频率 DBS 可改善 VF，这可能与刺激 STN 前外侧有关。© 2025 The Author(s).运动障碍》由 Wiley Periodicals LLC 代表国际帕金森和运动障碍协会出版。

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

Movement Disorders 医学-临床神经学

CiteScore

13.30

自引率

8.10%

发文量

371

审稿时长

12 months

期刊介绍： Movement Disorders publishes a variety of content types including Reviews, Viewpoints, Full Length Articles, Historical Reports, Brief Reports, and Letters. The journal considers original manuscripts on topics related to the diagnosis, therapeutics, pharmacology, biochemistry, physiology, etiology, genetics, and epidemiology of movement disorders. Appropriate topics include Parkinsonism, Chorea, Tremors, Dystonia, Myoclonus, Tics, Tardive Dyskinesia, Spasticity, and Ataxia.