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01-02-2021 | Deep Brain Stimulation | Original Communication

Deep brain stimulation of the internal globus pallidus does not affect the limbic circuit in patients with Parkinson’s disease: a PET study

Authors: Xavier Palard-Novello, Sophie Drapier, Alexandre Bonnet, Antoine Girard, Gabriel Robert, Jean-François Houvenaghel, Paul Sauleau, Marc Vérin, Claire Haegelen, Florence Le Jeune

Published in: Journal of Neurology | Issue 2/2021

Abstract

Introduction

Internal globus pallidus (GPi) deep brain stimulation (DBS) is a safe and effective alternative treatment in Parkinson’s disease (PD) for patients with cognitive impairment. However, no study has yet investigated metabolic changes within a large series of patients undergoing GPi stimulation.

Objective

We assessed motor, cognitive and psychiatric changes, as well as modifications in brain glucose metabolism measured with FDG-PET, before and after bilateral GPi-DBS.

Methods

In the same week, 32 patients with PD underwent a motor, cognitive and psychiatric assessment and a resting-state FDG-PET scan, 4 months before and 4 months after GPi-DBS surgery. For the voxelwise metabolic change assessment, the p value was controlled for multiple comparisons using the family wise error rate.

Results

After GPi-DBS surgery, patients showed a significant overall improvement in motor status. No cognitive or psychiatric changes were observed after surgery. Nor were any clusters with significantly relative metabolic changes found in the limbic circuit after surgery. Clusters with significantly relative metabolic changes were observed in the left and right Brodmann area (BA) 6, the right BA 9, the right and left BA 39 and the left BA 17.

Conclusion

The present study confirmed that GPi-DBS is an effective treatment in patients with advanced PD, owing to metabolic changes in the areas involved in motor execution. The absence of relative metabolic decrease in the limbic circuit and the few changes affecting the associative circuit could explain why GPi-DBS is cognitively safe.

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Title: Deep brain stimulation of the internal globus pallidus does not affect the limbic circuit in patients with Parkinson’s disease: a PET study
Authors: Xavier Palard-Novello
Sophie Drapier
Alexandre Bonnet
Antoine Girard
Gabriel Robert
Jean-François Houvenaghel
Paul Sauleau
Marc Vérin
Claire Haegelen
Florence Le Jeune
Publication date: 01-02-2021
Publisher: Springer Berlin Heidelberg
Keywords: Deep Brain Stimulation
Parkinson's Disease
Published in: Journal of Neurology / Issue 2/2021
Print ISSN: 0340-5354
Electronic ISSN: 1432-1459
DOI: https://doi.org/10.1007/s00415-020-10212-y

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Deep brain stimulation of the internal globus pallidus does not affect the limbic circuit in patients with Parkinson’s disease: a PET study

Abstract

Introduction

Objective

Methods

Results

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Introduction

Objective

Methods

Results

Conclusion

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