Sweet spot for resting-state functional MRI effect of deep brain stimulation in dystonia lies in the lower pallidal area
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 indic...
Saved in:
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2025-01-01
|
| Series: | NeuroImage: Clinical |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2213158225000208 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850035283763920896 |
|---|---|
| author | Pavel Filip Andrej Lasica Dimitra Kiakou Karsten Mueller Jiří Keller Dušan Urgošík Daniel Novák Robert Jech |
| author_facet | Pavel Filip Andrej Lasica Dimitra Kiakou Karsten Mueller Jiří Keller Dušan Urgošík Daniel Novák Robert Jech |
| author_sort | Pavel Filip |
| collection | DOAJ |
| description | 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. |
| format | Article |
| id | doaj-art-0dfb86673b9f4b09bc90fa76a0b7cc58 |
| institution | DOAJ |
| issn | 2213-1582 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | NeuroImage: Clinical |
| spelling | doaj-art-0dfb86673b9f4b09bc90fa76a0b7cc582025-08-20T02:57:32ZengElsevierNeuroImage: Clinical2213-15822025-01-014510375010.1016/j.nicl.2025.103750Sweet spot for resting-state functional MRI effect of deep brain stimulation in dystonia lies in the lower pallidal areaPavel Filip0Andrej Lasica1Dimitra Kiakou2Karsten Mueller3Jiří Keller4Dušan Urgošík5Daniel Novák6Robert Jech7Department of Neurology, First Faculty of Medicine, Charles University and General University Hospital in Prague, Kateřinská 30, 120 00 Prague, Czech Republic; Center for Magnetic Resonance Research (CMRR), University of Minnesota, Minneapolis, MN, USA; Department of Cybernetics, Czech Technical University in Prague, Prague, Czech RepublicDepartment of Neurology, First Faculty of Medicine, Charles University and General University Hospital in Prague, Kateřinská 30, 120 00 Prague, Czech RepublicDepartment of Neurology, First Faculty of Medicine, Charles University and General University Hospital in Prague, Kateřinská 30, 120 00 Prague, Czech Republic; Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, GermanyDepartment of Neurology, First Faculty of Medicine, Charles University and General University Hospital in Prague, Kateřinská 30, 120 00 Prague, Czech Republic; Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, GermanyDepartment of Radiology, Na Homolce Hospital, Prague, Czech Republic; Third Faculty of Medicine, Charles University in Prague, Prague, Czech RepublicDepartment of stereotactic and radiation neurosurgery, Nemocnice Na Homolce, Prague, Czech RepublicDepartment of Cybernetics, Czech Technical University in Prague, Prague, Czech RepublicDepartment of Neurology, First Faculty of Medicine, Charles University and General University Hospital in Prague, Kateřinská 30, 120 00 Prague, Czech Republic; Corresponding author.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.http://www.sciencedirect.com/science/article/pii/S2213158225000208Deep brain stimulationDystoniaInternal globus pallidusResting-state functional magnetic resonance imaging |
| spellingShingle | Pavel Filip Andrej Lasica Dimitra Kiakou Karsten Mueller Jiří Keller Dušan Urgošík Daniel Novák Robert Jech Sweet spot for resting-state functional MRI effect of deep brain stimulation in dystonia lies in the lower pallidal area NeuroImage: Clinical Deep brain stimulation Dystonia Internal globus pallidus Resting-state functional magnetic resonance imaging |
| title | Sweet spot for resting-state functional MRI effect of deep brain stimulation in dystonia lies in the lower pallidal area |
| title_full | Sweet spot for resting-state functional MRI effect of deep brain stimulation in dystonia lies in the lower pallidal area |
| title_fullStr | Sweet spot for resting-state functional MRI effect of deep brain stimulation in dystonia lies in the lower pallidal area |
| title_full_unstemmed | Sweet spot for resting-state functional MRI effect of deep brain stimulation in dystonia lies in the lower pallidal area |
| title_short | Sweet spot for resting-state functional MRI effect of deep brain stimulation in dystonia lies in the lower pallidal area |
| title_sort | sweet spot for resting state functional mri effect of deep brain stimulation in dystonia lies in the lower pallidal area |
| topic | Deep brain stimulation Dystonia Internal globus pallidus Resting-state functional magnetic resonance imaging |
| url | http://www.sciencedirect.com/science/article/pii/S2213158225000208 |
| work_keys_str_mv | AT pavelfilip sweetspotforrestingstatefunctionalmrieffectofdeepbrainstimulationindystonialiesinthelowerpallidalarea AT andrejlasica sweetspotforrestingstatefunctionalmrieffectofdeepbrainstimulationindystonialiesinthelowerpallidalarea AT dimitrakiakou sweetspotforrestingstatefunctionalmrieffectofdeepbrainstimulationindystonialiesinthelowerpallidalarea AT karstenmueller sweetspotforrestingstatefunctionalmrieffectofdeepbrainstimulationindystonialiesinthelowerpallidalarea AT jirikeller sweetspotforrestingstatefunctionalmrieffectofdeepbrainstimulationindystonialiesinthelowerpallidalarea AT dusanurgosik sweetspotforrestingstatefunctionalmrieffectofdeepbrainstimulationindystonialiesinthelowerpallidalarea AT danielnovak sweetspotforrestingstatefunctionalmrieffectofdeepbrainstimulationindystonialiesinthelowerpallidalarea AT robertjech sweetspotforrestingstatefunctionalmrieffectofdeepbrainstimulationindystonialiesinthelowerpallidalarea |