Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
European Journal of Nuclear Medicine and Molecular Imaging
Published in: European Journal of Nuclear Medicine and Molecular Imaging 1/2010

01-01-2010 | Original Article

Predictive potential of pre-operative functional neuroimaging in patients treated with subthalamic stimulation

Authors: Stelvio Sestini, Alberto Pupi, Franco Ammannati, Silvia Ramat, Sandro Sorbi, Roberto Sciagrà, Luigi Mansi, Antonio Castagnoli

Published in: European Journal of Nuclear Medicine and Molecular Imaging | Issue 1/2010

Login to get access

Abstract

Purpose

The aim of this study was to investigate the predictive potential of pre-operative regional cerebral blood flow (rCBF) in the pre-supplementary motor area (pre-SMA) and clinical factors in Parkinson’s disease (PD) patients treated with subthalamic nucleus (STN) stimulation.

Methods

Ten patients underwent rCBF SPECT and motor Unified Parkinson’s Disease Rating Scale (UPDRS) pre- and post-operatively during stimulation at 5 and 42 months. Statistical parametric mapping (SPM) was used to extract rCBF values in the pre-SMA because it is related with motor improvement. Post-operative outcomes included motor response to stimulation and percent improvement in UPDRS. Pre-operative predictors were explored by correlation test, linear regression and multivariate analyses.

Results

Higher pre-operative rCBF in the pre-SMA and younger age were associated with favourable outcomes at 5 and 42 months. Pre-operative rCBF results were significantly associated with baseline clinical factors.

Conclusion

This study shows that PD patients with younger age have higher rCBF values in the pre-SMA and better outcome, thus giving the rationale to the hypothesis that STN stimulation could be considered early in the course of disease.
Literature
1.
Benabid AL, Chabardes S, Mitrofanis J, Pollak P. Deep brain stimulation of the subthalamic nucleus for the treatment of Parkinson’s disease. Lancet Neurol 2009;8(1):67–81.CrossRefPubMed
2.
Tir M, Devos D, Blond S, Touzet G, Reyns N, Duhamel A, et al. Exhaustive, one-year follow-up of subthalamic nucleus deep brain stimulation in a large, single-center cohort of parkinsonian patients. Neurosurgery 2007;61(2):297–305.CrossRefPubMed
3.
Volkmann J. Deep brain stimulation for the treatment of Parkinson’s disease. J Clin Neurophysiol 2004;21:6–17.CrossRefPubMed
4.
Schüpbach WMM, Maltête D, Houeto JL, Tezenas du Montcel S, Mallet L, Welter ML, et al. Neurosurgery at an earlier stage of Parkinson disease: a randomized, controlled trial. Neurology 2007;68:267–71.CrossRefPubMed
5.
Mesnage V, Houeto J-L, Welter ML, Agid Y, Pidoux B, Dormont D, et al. Parkinson’s disease: neurosurgery at an earlier stage? J Neurol Neurosurg Psychiatry 2002;73:778–9.CrossRefPubMed
6.
Derost PP, Ouchchane L, Morand D, Ulla M, Llorca PM, Barget M, et al. Is DBS-STN appropriate to treat severe Parkinson disease in an elderly population? Neurology 2007;68:1345–55.CrossRefPubMed
7.
Charles PD, Van Blercom N, Krack P, Lee SL, Xie J, Besson G, et al. Predictors of effective bilateral subthalamic nucleus stimulation for PD. Neurology 2002;59(6):932–4.PubMed
8.
Welter ML, Houeto JL, Tezenas du Montcel S, Mesnage V, Bonnet AM, Pillon B, et al. Clinical predictive factors of subthalamic stimulation in Parkinson’s disease. Brain 2002;125:575–83.CrossRefPubMed
9.
Jaggi JL, Umemura A, Hurtig H, Siderowf AD, Colcher A, Stern MB, et al. Bilateral stimulation of the subthalamic nucleus in Parkinson’s disease: surgical efficacy and prediction of outcome. Stereotact Funct Neurosurg 2004;82:104–14.CrossRefPubMed
10.
Russmann H, Ghika J, Villemure JG, Robert B, Bogousslavsky J, Burkhard PR, et al. Subthalamic nucleus deep brain stimulation in Parkinson disease patients over age 70 years. Neurology 2004;63:1952–4.PubMed
11.
Pahwa P, Wilkinson SB, Overman J, Lyons KE. Preoperative clinical predictors of response to bilateral subthalamic stimulation in patients with Parkinson’s disease. Stereotact Funct Neurosurg 2005;83:80–3.CrossRefPubMed
12.
Kleiner-Fisman G, Herzog J, Fisman DN, Tamma F, Lyons KE, Pahwa R, et al. Subthalamic nucleus deep brain stimulation: summary and meta-analysis of outcomes. Mov Disord 2006;21(14):S290–304.CrossRefPubMed
13.
Kleiner-Fisman G, Fisman DN, Sime F, Saint-Cyr JA, Lozano AM, Lang AE. Long-term follow up of bilateral deep brain stimulation of the subthalamic nucleus in patients with advanced Parkinson disease. J Neurosurg 2003;99:489–95.CrossRefPubMed
14.
Vesper J, Haak S, Ostertag C, Nikkhah G. Subthalamic nucleus deep brain stimulation in elderly patients—analysis of outcome and complications. BMC Neurol 2007;7:7.CrossRefPubMed
15.
Lang AE, Houeto JL, Krack P, Kubu C, Lyons KE, Moro E, et al. Deep brain stimulation: preoperative issues. Mov Disord 2006;21(Suppl 14):S171–96.CrossRefPubMed
16.
Sestini S, Scotto di Luzio A, Ammannati F, De Cristofaro MTR, Cristofaro A, Martini S, et al. Changes in regional cerebral blood flow caused by deep-brain stimulation of the subthalamic nucleus in Parkinson’s disease. J Nucl Med 2002;43:725–32.PubMed
17.
Limousin P, Greene J, Pollak P, Rothwell J, Benabid AL, Frackowiak R. Changes in cerebral activity pattern due to subthalamic nucleus or internal pallidal stimulation in Parkinson’s disease. Ann Neurol 1997;42:283–91.CrossRefPubMed
18.
Ceballos-Baumann AO, Boecker H, Bartenstein P, von Falkenhayn I, Riescher H, Conrad B, et al. A positron emission tomographic study of subthalamic nucleus stimulation in Parkinson’s disease: enhanced movement-related activity of motor-association cortex and decreased motor cortex resting activity. Arch Neurol 1999;56:997–1003.CrossRefPubMed
19.
Sestini S, Ramat S, Formiconi AR, Ammannati F, Sorbi S, Pupi A. Brain networks underlying the clinical effects of long-term subthalamic stimulation for Parkinson’s disease: a 4-year follow-up study with rCBF SPECT. J Nucl Med 2005;46(9):1444–54.PubMed
20.
Sestini S, Pupi A, Ammannati F, Silvia R, Sorbi S, Castagnoli A. Are there adaptive changes in the human brain of patients with Parkinson’s disease treated with long-term deep brain stimulation of the subthalamic nucleus? A 4-year follow-up study with regional cerebral blood flow SPECT. Eur J Nucl Med Mol Imaging 2007;34(10):1646–57.CrossRefPubMed
21.
Hughes AJ, Daniel SE, Kilford L, Lees AJ. Accuracy of clinical diagnosis of idiopathic Parkinson’s disease: a clinico-pathological study of 100 cases. J Neurol Neurosurg Psychiatry 1992;55:181–4.CrossRefPubMed
22.
Ammannati F, Bordi L, Gronchi P. Alignment correction algorithm for transformation of stereotactic anterior commissure/posterior commissure-based coordinates for image-guided functional neurosurgery. Neurosurgery 1999;44:1366–8.CrossRefPubMed
23.
Taub E. Mathematical theory of stereotactic coordinate transformation: elimination of rotational targeting error by addition of a third reference point. J Neurosurg 2000;92:884–8.CrossRefPubMed
24.
Friston KJ, Frith CD, Liddle PF, Frackowiak RSJ. Comparing functional (PET) images: the assessment of significance change. J Cereb Blood Flow Metab 1991;11:690–9.PubMed
25.
Albin R, Young AB, Penny JB. The functional anatomy of basal ganglia disorders. Trends Neurosci 1989;12:366–75.CrossRefPubMed
26.
Alexander GE, Crutcher MD, DeLong MR. Basal ganglia-thalamocortical circuits: parallel substrates for motor, oculomotor, “prefrontal” and “limbic” functions. Prog Brain Res 1990;85:119–46.CrossRefPubMed
27.
DeLong MR. Primate models of movement disorders of basal ganglia origin. Trends Neurosci 1990;13:281–5.CrossRefPubMed
28.
Bergman H, Wichmann T, Karmon B, DeLong MR. The primate subthalamic nucleus. II. Neural activity in the MPTP model of parkinsonism. J Neurophysiol 1994;72:507–20.PubMed
29.
Miller WC, DeLong AR. Altered tonic activity of neurons in the globus pallidus and subthalamic nucleus in the primate MPTP model of parkinsonism. In: Carpenter MB, Jayaraman A, editors. The basal ganglia II. New York: Plenum; 1987;32: 415
30.
Bezard E, Gross CE, Brotchie JM. Presymptomatic compensation in Parkinson’s disease is not dopamine-mediated. Trends Neurosci 2003;26:215–21.CrossRefPubMed
31.
Benazzouz A, Gross C, Féger J, Boraud T, Bioulac B. Reversal of rigidity and improvement in motor performance by subthalamic high-frequency stimulation in MPTP-treated monkeys. Eur J Neurosci 1993;5:382–9.CrossRefPubMed
32.
Benazzouz A, Hallet M. Mechanism of action of deep brain stimulation. Neurology 2000;55(12 Suppl 6):S13–6.PubMed
33.
34.
35.
Schrag A, Ben-Shlomo Y, Brown R, Marsden CD, Quinn N. Young-onset Parkinson’s disease revisited—clinical features, natural history, and mortality. Mov Disord 1998;13:885–94.CrossRefPubMed
36.
Hallett M. Plasticity. In: Mazziotta JC, Toga AW, Frackowiak RSJ, editors. Brain mapping: the disorders. San Diego: Academic; 2000. p. 569–86.CrossRef
37.
Chollet F, Weiller C. Recovery of neurological function. In: Mazziotta JC, Toga AW, Frackowiak RSJ, editors. Brain mapping: the disorders. San Diego: Academic; 2000. p. 587–97.CrossRef
Metadata
Title
Predictive potential of pre-operative functional neuroimaging in patients treated with subthalamic stimulation
Authors
Stelvio Sestini
Alberto Pupi
Franco Ammannati
Silvia Ramat
Sandro Sorbi
Roberto Sciagrà
Luigi Mansi
Antonio Castagnoli
Publication date
01-01-2010
Publisher
Springer-Verlag
Published in
European Journal of Nuclear Medicine and Molecular Imaging / Issue 1/2010
Print ISSN: 1619-7070
Electronic ISSN: 1619-7089
DOI
https://doi.org/10.1007/s00259-009-1198-6

Other articles of this Issue 1/2010

European Journal of Nuclear Medicine and Molecular Imaging 1/2010 Go to the issue

Guidelines

FDG PET and PET/CT: EANM procedure guidelines for tumour PET imaging: version 1.0

Original Article

Detection of unknown primary neuroendocrine tumours (CUP-NET) using 68Ga-DOTA-NOC receptor PET/CT

Original Article

Sentinel lymph node biopsy in pregnant patients with breast cancer

Original Article

The impact of reconstruction method on the quantification of DaTSCAN images

Original Article

New starch-based radiotracer for lung perfusion scintigraphy

Original Article

Comparison of 68Ga-DOTATATE and 18F-fluorodeoxyglucose PET/CT in the detection of recurrent medullary thyroid carcinoma