Deep Brain Stimulation of Caudal Zona Incerta for Parkinson's Disease: One-Year Follow-Up and Electric Field Simulations

Persson, Rasmus Stenmark; Nordin, Teresa; Hariz, Gun‐Marie; Wårdell, Karin; Forsgren, Lars; Hariz, Marwan; Blomstedt, Patric

doi:10.1111/ner.13500

Cited by 12 publications

(12 citation statements)

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“…Motor functions were evaluated using the Movement Disorder Society Unified Parkinson’s Disease Rating Scale part III (MDS-UPDRS-III). MDS-UPDRS-III contained four domains ( Stenmark Persson et al, 2021 ), namely, tremor (items 15–18), rigidity (item 3), bradykinesia (items 2, 4–8, and 14), and axial (items 1 and 9–13). The Hamilton Depression Scale (HAM-D) and the Hamilton Anxiety Scale (HAM-A) were used to assess the severity of both preoperative and postoperative mood disorders.…”

Section: Methodsmentioning

confidence: 99%

Deep Brain Stimulation Modulates Multiple Abnormal Resting-State Network Connectivity in Patients With Parkinson’s Disease

Bai

Diao

Gan

et al. 2022

Front. Aging Neurosci.

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BackgroundDeep brain stimulation (DBS) improves motor and non-motor symptoms in patients with Parkinson’s disease (PD). Researchers mainly investigated the motor networks to reveal DBS mechanisms, with few studies extending to other networks. This study aimed to investigate multi-network modulation patterns using DBS in patients with PD.MethodsTwenty-four patients with PD underwent 1.5 T functional MRI (fMRI) scans in both DBS-on and DBS-off states, with twenty-seven age-matched healthy controls (HCs). Default mode, sensorimotor, salience, and left and right frontoparietal networks were identified by using the independent component analysis. Power spectra and functional connectivity of these networks were calculated. In addition, multiregional connectivity was established from 15 selected regions extracted from the abovementioned networks. Comparisons were made among groups. Finally, correlation analyses were performed between the connectivity changes and symptom improvements.ResultsCompared with HCs, PD-off showed abnormal power spectra and functional connectivity both within and among these networks. Some of the abovementioned abnormalities could be corrected by DBS, including increasing the power spectra in the sensorimotor network and modulating the parts of the ipsilateral functional connectivity in different regions centered in the frontoparietal network. Moreover, the DBS-induced functional connectivity changes were correlated with motor and depression improvements in patients with PD.ConclusionDBS modulated the abnormalities in multi-networks. The functional connectivity alterations were associated with motor and psychiatric improvements in PD. This study lays the foundation for large-scale brain network research on multi-network DBS modulation.

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Section: Methodsmentioning

confidence: 99%

Deep Brain Stimulation Modulates Multiple Abnormal Resting-State Network Connectivity in Patients With Parkinson’s Disease

Bai

Diao

Gan

et al. 2022

Front. Aging Neurosci.

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“…Quantitative measures of wrist movements with accelerometers ( Figure 5A ) were automatically linked to intraoperative test stimulations to find a threshold with the clinical effect ( Hemm et al, 2016 ). Patient-specific electric field studies have been applied for both movement disorders such as PD and ET ( Åström et al, 2010 ; Alonso et al, 2018 ; Göransson et al, 2021 ; Stenmark Persson et al, 2021 ) and in relation to psychiatric indication such as GTS ( Wårdell et al, 2015 ; Akbarian-Tefaghi et al, 2017 ) and OCD ( Naesstrom et al, 2021 ).…”

Section: Patient-specific Modeling Simulation and Visualization In De...mentioning

confidence: 99%

“…The present research in our consortium follows a similar approach to create group-specific anatomical references using multiple iterations of state-of-the-art non-linear image registration ( Figure 8 ). In our first study which included 15 patients with PD implanted in cZi ( Stenmark Persson et al, 2021 ), a group average brain template was built from pre-operative T1 MRI only, and non-linearly transformed with Advanced Normalization Tools (ANT) ( Figure 8C ). Further developments use an iterative mixed-modalities approach with finely tuned settings ( Vogel et al, 2021 ) to preserve details in the deep brain provided by both T1 and the WAIR images of 19 patients with PD and ET ( Vogel et al, 2020 , 2021 ) ( Figure 8A ).…”

Section: Deep Brain Anatomical Templates and Group Analysismentioning

confidence: 99%

“…Our approach to integrate additional anatomical information is based on manual delineation. This was either done by segmenting STN and red nucleus in the anatomical group template ( Stenmark Persson et al, 2021 ) ( Figure 8C ) or by using patient-specific manual delineation of 58 deep anatomical structures on T1/WAIR datasets from a single expert, a method developed by Lemaire et al (2010) and Lemaire (2021) . These structures were then projected into the template to build an anatomical atlas ( Vogel et al, 2020 ) ( Figure 8B ).…”

Section: Deep Brain Anatomical Templates and Group Analysismentioning

confidence: 99%

“…Implementation of this method can also be expanded to visualize induced improvements and adverse effects in patient-specific stimulation maps ( Shah et al, 2020 ). Stimulation maps from several patients can then be projected into the anatomical template space to set-up disease specific stimulation atlases as we have generated for patients with ET with implants in the VIM ( Vogel et al, 2021 ) and in the cZi ( Nordin et al, 2021b ; Stenmark Persson et al, 2021 ). Examples are shown in Figures 8C,D .…”

Section: Deep Brain Anatomical Templates and Group Analysismentioning

confidence: 99%

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Deep Brain Stimulation: Emerging Tools for Simulation, Data Analysis, and Visualization

et al. 2022

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Deep brain stimulation (DBS) is a well-established neurosurgical procedure for movement disorders that is also being explored for treatment-resistant psychiatric conditions. This review highlights important consideration for DBS simulation and data analysis. The literature on DBS has expanded considerably in recent years, and this article aims to identify important trends in the field. During DBS planning, surgery, and follow up sessions, several large data sets are created for each patient, and it becomes clear that any group analysis of such data is a big data analysis problem and has to be handled with care. The aim of this review is to provide an update and overview from a neuroengineering perspective of the current DBS techniques, technical aids, and emerging tools with the focus on patient-specific electric field (EF) simulations, group analysis, and visualization in the DBS domain. Examples are given from the state-of-the-art literature including our own research. This work reviews different analysis methods for EF simulations, tractography, deep brain anatomical templates, and group analysis. Our analysis highlights that group analysis in DBS is a complex multi-level problem and selected parameters will highly influence the result. DBS analysis can only provide clinically relevant information if the EF simulations, tractography results, and derived brain atlases are based on as much patient-specific data as possible. A trend in DBS research is creation of more advanced and intuitive visualization of the complex analysis results suitable for the clinical environment.

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Nucleus reticularis tegmenti pontis: a bridge between the basal ganglia and cerebellum for movement control

2023

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Neural processing in the basal ganglia is critical for normal movement. Diseases of the basal ganglia, such as Parkinson’s disease, produce a variety of movement disorders including akinesia and bradykinesia. Many believe that the basal ganglia influence movement via thalamic projections to motor areas of the cerebral cortex and through projections to the cerebellum, which also projects to the motor cortex via the thalamus. However, lesions that interrupt these thalamic pathways to the cortex have little effect on many movements, including limb movements. Yet, limb movements are severely impaired by basal ganglia disease or damage to the cerebellum. We can explain this impairment as well as the mild effects of thalamic lesions if basal ganglia and cerebellar output reach brainstem motor regions without passing through the thalamus. In this report, we describe several brainstem pathways that connect basal ganglia output to the cerebellum via nucleus reticularis tegmenti pontis (NRTP). Additionally, we propose that widespread afferent and efferent connections of NRTP with the cerebellum could integrate processing across cerebellar regions. The basal ganglia could then alter movements via descending projections of the cerebellum. Pathways through NRTP are important for the control of normal movement and may underlie deficits associated with basal ganglia disease.

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Deep Brain Stimulation of Caudal Zona Incerta for Parkinson's Disease: One-Year Follow-Up and Electric Field Simulations

Cited by 12 publications

References 44 publications

Deep Brain Stimulation Modulates Multiple Abnormal Resting-State Network Connectivity in Patients With Parkinson’s Disease

Deep Brain Stimulation Modulates Multiple Abnormal Resting-State Network Connectivity in Patients With Parkinson’s Disease

Deep Brain Stimulation: Emerging Tools for Simulation, Data Analysis, and Visualization

Nucleus reticularis tegmenti pontis: a bridge between the basal ganglia and cerebellum for movement control

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