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Does subthalamic nucleus stimulation affect the frontal limbic areas? A single-photon emission computed tomography study using a manual anatomical segmentation method

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Abstract

Among the basal ganglia nuclei, the subthalamic nucleus (STN) is considered to play a major role in output modulation. The STN represents a relay of the motor cortico-basal ganglia-thalamo-cortical circuit and has become the standard surgical target for treating Parkinson’s patients with long-term motor fluctuations and dyskinesia. But chronic bilateral stimulation of the STN produces cognitive effects. According to animal and clinical studies, the STN also appears to have direct or indirect connections with the frontal associative and limbic areas. This prospective study was conducted to analyse regional cerebral blood flow changes in single-photon emission computed tomography imaging of six Parkinson’s patients before and after STN stimulation. We particularly focused on the dorsolateral prefrontal cortex and the frontal limbic areas using a manual anatomical MRI segmentation method. We defined nine regions of interest, segmenting each MR slice to quantify the regional cerebral blood flow on pre- and postoperative SPECT images. We normalised the region-of-interest-based measurements to the entire brain volume. The patients showed increased activation during STN stimulation in the dorsolateral prefrontal cortex bilaterally and no change in the anterior cingulate and orbito-frontal cortices. In our study, STN stimulation induced activation of premotor and associative frontal areas. Further studies are needed to underline involvement of the STN with the so-called limbic system.

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Authors and Affiliations

  1. Service de Neurochirurgie, Hôpital Pontchaillou, rue Henri Le Guilloux, 35033, Rennes cedex, France

    C. Haegelen & X. Morandi

  2. Faculté de Médecine de Rennes, Avenue du Professeur Léon Bernard, Laboratoire IDM-UPRES-EA3192, 35043, Rennes cedex, France

    C. Haegelen, B. Aubert Broche, P. Jannin, B. Gibaud & X. Morandi

  3. Service de Neurologie, Hôpital Pontchaillou, rue Henri Le Guilloux, 35033, Rennes cedex, France

    M. Verin

  4. Département de Médecine Nucléaire, Centre Eugène Marquis, Avenue Bataille Flandres-Dunkerque, 35042, Rennes cedex, France

    F. Prigent

  5. Faculté de Médecine de Rennes, Avenue du Professeur Léon Bernard, Laboratoire d’Anatomie et d’Organogenèse, 35043, Rennes cedex, France,  

    X. Morandi & X. Morandi

Authors
  1. C. Haegelen
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  2. M. Verin
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  3. B. Aubert Broche
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Correspondence to X. Morandi.

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Haegelen, C., Verin, M., Broche, B.A. et al. Does subthalamic nucleus stimulation affect the frontal limbic areas? A single-photon emission computed tomography study using a manual anatomical segmentation method. Surg Radiol Anat 27, 389–394 (2005). https://doi.org/10.1007/s00276-005-0021-8

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  • DOI: https://doi.org/10.1007/s00276-005-0021-8

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