Subthalamic nucleus stimulation restores corticospinal facilitation in Parkinson's disease
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Subthalamic nucleus stimulation restores corticospinal facilitation in Parkinson's disease. / Pötter-Nerger, Monika; Ilic, Tihomir V; Siebner, Hartwiq R; Deuschl, Günther; Volkmann, Jens.
in: MOVEMENT DISORD, Jahrgang 23, Nr. 15, 15.11.2008, S. 2210-5.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - Subthalamic nucleus stimulation restores corticospinal facilitation in Parkinson's disease
AU - Pötter-Nerger, Monika
AU - Ilic, Tihomir V
AU - Siebner, Hartwiq R
AU - Deuschl, Günther
AU - Volkmann, Jens
PY - 2008/11/15
Y1 - 2008/11/15
N2 - We have previously shown that in patients with Parkinson's disease (PD), high-frequency stimulation (HFS) of the subthalamic nucleus (STN) modifies spinal excitability via subcortical reticulospinal routes. To investigate whether STN-HFS also modifies spinal excitability via transcortical routes in PD, 10 patients with PD (9 men, 1 woman; 58.3 +/- 8.3 years) were investigated in the medical OFF-state with or without STN-HFS. The H-reflex of the right soleus muscle was recorded during slight plantar flexion at 20% of maximum force. A conditioning transcranial stimulus was applied at 95% of active motor threshold to the contralateral primary motor leg area (M1) 0-5 ms after eliciting the H-reflex. The same paradigm was applied to 8 healthy individuals (5 men, 3 women; 50.8 +/- 3.0 years). Transcranial magnetic stimulation (TMS) facilitated the H-reflex amplitude in healthy controls. A facilitatory effect of the corticospinal input on the H-reflex was also found in patients with PD, but only with STN-HFS switched on. When STN-HFS was discontinued, the H-reflex was no longer facilitated by the TMS pulse. Accordingly, analysis of variance showed a main effect of stimulation (F = 11.15; P = 0.005), ISI (F = 6.1; P = 0.003), and an interaction between stimulation and group (PD vs. control) (F = 8.9; P = 0.01). STN-HFS restores the normal facilitatory drive of a transcranially evoked motor cortical response to the spinal motoneuron pool. In addition to subcortical routes, STN-DBS also alters spinal excitability via transcortical pathways.
AB - We have previously shown that in patients with Parkinson's disease (PD), high-frequency stimulation (HFS) of the subthalamic nucleus (STN) modifies spinal excitability via subcortical reticulospinal routes. To investigate whether STN-HFS also modifies spinal excitability via transcortical routes in PD, 10 patients with PD (9 men, 1 woman; 58.3 +/- 8.3 years) were investigated in the medical OFF-state with or without STN-HFS. The H-reflex of the right soleus muscle was recorded during slight plantar flexion at 20% of maximum force. A conditioning transcranial stimulus was applied at 95% of active motor threshold to the contralateral primary motor leg area (M1) 0-5 ms after eliciting the H-reflex. The same paradigm was applied to 8 healthy individuals (5 men, 3 women; 50.8 +/- 3.0 years). Transcranial magnetic stimulation (TMS) facilitated the H-reflex amplitude in healthy controls. A facilitatory effect of the corticospinal input on the H-reflex was also found in patients with PD, but only with STN-HFS switched on. When STN-HFS was discontinued, the H-reflex was no longer facilitated by the TMS pulse. Accordingly, analysis of variance showed a main effect of stimulation (F = 11.15; P = 0.005), ISI (F = 6.1; P = 0.003), and an interaction between stimulation and group (PD vs. control) (F = 8.9; P = 0.01). STN-HFS restores the normal facilitatory drive of a transcranially evoked motor cortical response to the spinal motoneuron pool. In addition to subcortical routes, STN-DBS also alters spinal excitability via transcortical pathways.
KW - Analysis of Variance
KW - Deep Brain Stimulation
KW - Female
KW - H-Reflex
KW - Humans
KW - Male
KW - Middle Aged
KW - Muscle, Skeletal
KW - Parkinson Disease
KW - Pyramidal Tracts
KW - Statistics, Nonparametric
KW - Subthalamic Nucleus
KW - Time Factors
KW - Transcranial Magnetic Stimulation
KW - Controlled Clinical Trial
KW - Journal Article
KW - Research Support, Non-U.S. Gov't
U2 - 10.1002/mds.22284
DO - 10.1002/mds.22284
M3 - SCORING: Journal article
C2 - 18759343
VL - 23
SP - 2210
EP - 2215
JO - MOVEMENT DISORD
JF - MOVEMENT DISORD
SN - 0885-3185
IS - 15
ER -