Universität zu Köln

Greuel, Andrea, Pauls, K. Amande M., Koy, Anne, Suedmeyer, Martin, Schnitzler, Alfons ORCID: 0000-0002-6414-7939, Timmermann, Lars, Fink, Gereon R. ORCID: 0000-0002-8230-1856 and Eggers, Carsten (2020). Pallidal Deep Brain Stimulation Reduces Sensorimotor Cortex Activation in Focal/Segmental Dystonia. Mov. Disord., 35 (4). S. 629 - 640. HOBOKEN: WILEY. ISSN 1531-8257

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Abstract

Background Although deep brain stimulation of the globus pallidus internus (GPi-DBS) is an established treatment for many forms of dystonia, including generalized as well as focal forms, its effects on brain (dys-)function remain to be elucidated, particularly for focal and segmental dystonia. Clinical response to GPi-DBS typically comes with some delay and lasts up to several days, sometimes even weeks, once stimulation is discontinued. Objective This study investigated how neural activity during rest and motor activation is affected by GPi-DBS while excluding the potential confound of altered feedback as a result of therapy-induced differences in dystonic muscle contractions. Methods Two groups of patients with focal or segmental dystonia were included in the study: 6 patients with GPi-DBS and 8 without DBS (control group). All 14 patients had cervical dystonia. Using (H2O)-O-15 PET, regional cerebral blood flow was measured at rest and during a motor task performed with a nondystonic hand. Results In patients with GPi-DBS (stimulation ON and OFF), activity at rest was reduced in a prefrontal network, and during the motor task, sensorimotor cortex activity was lower than in patients without DBS. Within-group contrasts (tapping > rest) showed less extensive task-induced motor network activation in GPi-DBS patients than in non-DBS controls. Reduced sensorimotor activation amounted to a significant group-by-task interaction only in the stimulation ON state. Conclusions These findings support previous observations in generalized dystonia that suggested that GPi-DBS normalizes dystonia-associated sensorimotor and prefrontal hyperactivity, indicating similar mechanisms in generalized and focal or segmental dystonia. Evidence is provided that these effects extend into the OFF state, which was not previously demonstrated by neuroimaging. (c) 2020 The Authors. Movement Disorders published by Wiley Periodicals, Inc. on behalf of International Parkinson and Movement Disorder Society.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Greuel, Andrea UNSPECIFIED UNSPECIFIED UNSPECIFIED Pauls, K. Amande M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Koy, Anne UNSPECIFIED UNSPECIFIED UNSPECIFIED Suedmeyer, Martin UNSPECIFIED UNSPECIFIED UNSPECIFIED Schnitzler, Alfons UNSPECIFIED orcid.org/0000-0002-6414-7939 UNSPECIFIED Timmermann, Lars UNSPECIFIED UNSPECIFIED UNSPECIFIED Fink, Gereon R. UNSPECIFIED orcid.org/0000-0002-8230-1856 UNSPECIFIED Eggers, Carsten UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-338969
DOI:	10.1002/mds.27970
Journal or Publication Title:	Mov. Disord.
Volume:	35
Number:	4
Page Range:	S. 629 - 640
Date:	2020
Publisher:	WILEY
Place of Publication:	HOBOKEN
ISSN:	1531-8257
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language BLOOD-FLOW CHANGES; GLOBUS-PALLIDUS; GENERALIZED DYSTONIA; CERVICAL DYSTONIA; SUSTAINED RELIEF; BOTULINUM TOXIN; FOCAL DYSTONIA; DYT1 DYSTONIA; WRITERS CRAMP; FOLLOW-UP Multiple languages Clinical Neurology Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/33896