Effects of short-term deep brain stimulation in subthalamic nucleus on glucose metabolism in Parkinson′s disease

中华核医学与分子影像杂志 Pub Date : 2019-09-25 DOI:10.3760/CMA.J.ISSN.2095-2848.2019.09.001

J. Ge, P. Wu, Y. Guan, Huiwei Zhang, Ling Li, Jiaying Lu, Likun Yang, Wei Lin, C. Zuo

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Abstract

Objective To study the effect of short-term treatment of subthalamic nucleus (STN) deep brain stimulation (DBS) on cerebral glucose metabolism in patients with Parkinson′s disease (PD) and its relationship with the change of brain motor-related nerve pathways. Methods Five patients (2 males, 3 females; age: (63.6±11.8) years) with PD who underwent STN DBS between January 2014 and December 2018 were enrolled in this study. All patients underwent 18F-fluorodeoxyglucose (FDG) PET in " DBS-off" state before and 3 months after operation. Quantitative expression of PD-related metabolic pattern (PDRP) were calculated by scaled subprofile model/principal component analysis (SSM/PCA) on PET images. Brain regions with changes of glucose metabolism after DBS were located by statistical parametric mapping (SPM) paired t test. Results Compared with pre-operation, PDRP expression (5.1±1.3 vs 2.9±1.8) and unified Parkinson′s disease rating scale (UPDRS) motor score (50.2±8.2 vs 28.0±5.4) of PD patients were significantly decreased 3 months after STN DBS (t values: 6.17 and 3.88, both P<0.05). After DBS, the glucose metabolism of bilateral globus pallidus/putamen, caudate nucleus, thalamus, insula, pons and cerebellum decreased, while the glucose metabolism of bilateral prefrontal motor area and parietooccipital lobe increased (t=3.75, P<0.01). Conclusions Short-term STN DBS therapy can inhibit the cortico-striatum-pallidum-hypothalamus-cortex motor loop, which is abnormally excitable in the brain of PD. PDRP, as an imaging characterization of the regulation of this loop, is expected to become an imaging marker for monitoring the treatment of PD. Key words: Parkinson disease; Deep brain stimulation; Subthalamic nucleus; Positron-emission tomography; Deoxyglucose

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短期丘脑底核脑深部刺激对帕金森病患者糖代谢的影响

目的探讨丘脑底核（STN）脑深部刺激（DBS）短期治疗对帕金森病（PD）患者脑糖代谢的影响及其与脑运动相关神经通路变化的关系。方法5例PD患者（2男3女；年龄：（63.6±11.8）岁，于2014年1月至2018年12月接受STN DBS治疗。所有患者在术前和术后3个月均接受18F-氟脱氧葡萄糖（FDG）PET“DBS关闭”状态检查。通过缩放子文件模型/主成分分析（SSM/PCA）在PET图像上计算PD相关代谢模式（PDRP）的定量表达。采用统计参数映射（SPM）配对t检验定位DBS后糖代谢变化的脑区。结果与术前相比，STN DBS后3个月PD患者PDRP表达（5.1±1.3 vs 2.9±1.8）和帕金森病统一评定量表（UPDRS）运动评分（50.2±8.2 vs 28.0±5.4）显著降低（t值分别为6.17和3.88，均P<0.05），脑桥和小脑减少，而双侧前额叶运动区和顶枕叶的糖代谢增加（t=3.75，P<0.01），有望成为监测帕金森病治疗的影像学标志物。关键词：帕金森病；脑深部刺激；丘脑下核；正电子发射断层扫描；脱氧葡萄糖

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来源期刊

中华核医学与分子影像杂志核医学，分子影像

自引率

0.00%

发文量

5088

期刊介绍： Chinese Journal of Nuclear Medicine and Molecular Imaging (CJNMMI) was established in 1981, with the name of Chinese Journal of Nuclear Medicine, and renamed in 2012. As the specialized periodical in the domain of nuclear medicine in China, the aim of Chinese Journal of Nuclear Medicine and Molecular Imaging is to develop nuclear medicine sciences, push forward nuclear medicine education and basic construction, foster qualified personnel training and academic exchanges, and popularize related knowledge and raising public awareness. Topics of interest for Chinese Journal of Nuclear Medicine and Molecular Imaging include: -Research and commentary on nuclear medicine and molecular imaging with significant implications for disease diagnosis and treatment -Investigative studies of heart, brain imaging and tumor positioning -Perspectives and reviews on research topics that discuss the implications of findings from the basic science and clinical practice of nuclear medicine and molecular imaging - Nuclear medicine education and personnel training - Topics of interest for nuclear medicine and molecular imaging include subject coverage diseases such as cardiovascular diseases, cancer, Alzheimer’s disease, and Parkinson’s disease, and also radionuclide therapy, radiomics, molecular probes and related translational research.