Pallidal deep brain stimulation and l-dopa effect on pet motor activation in advanced parkinson's disease

István Valálik, M. Emri, Z. Lengyel, Pál Mikecz, L. Trón, András Csókay, T. Márián

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

BACKGROUND AND PURPOSE The antiakinetic effect of internal Globus pallidus deep brain stimulation (Gpi-DBS) in Parkinson's disease is not clear and not either how this effect is modulated by L-dopa. METHODS Left Gpi-DBS and/or L-dopa effect was studied with auditory paced right-handed sequential movements on 15O-butanol positron emission tomography (PET) in five patients. Rest and for conditions during movements (DBS off/L-dopa off; DBS on/L-dopa off; DBS off/L-dopa on; DBS on/L-dopa on) were compared with statistical parametric mapping. RESULTS Gpi-DBS activated the right supplementary motor area/premotor (SMA/PMC), and right insular cortex (IC), and as L-dopa decreased the left sensorimotor cortex (M1/S1) activity. L-dopa increased the left ventrolateral thalamus (VLTH), and decreased the left superior parietal cortex (PC) activity. Gpi-DBS and L-dopa interaction showed right SMA/PMC, IC, and left PC activation, decrease of left VLTH, PMC, and dorsolateral prefrontal cortex (PFC) activity. CONCLUSIONS The improvement of bradykinesia with Gpi-DBS is secondary and contributed to the regress of M1/S1-related rigidity and compensatory SMA/PMC, and IC activation. L-dopa and Gpi-DBS alone each reduces M1/S1 overactivity. Interaction ignores this effect, moreover has akinetic effect in the left VLTH, PMC, and PFC. Motor improvement possibly related to left PC and compensatory right SMA/PMC, and IC activation. J Neuroimaging 2009;19:253-258.

Original languageEnglish
Pages (from-to)253-256
Number of pages4
JournalJournal of Neuroimaging
Volume19
Issue number3
DOIs
Publication statusPublished - Jul 2009

Fingerprint

Dihydroxyphenylalanine
Deep Brain Stimulation
Pets
Levodopa
Parkinson Disease
Globus Pallidus
Ventral Thalamic Nuclei
Cerebral Cortex
Parietal Lobe
Prefrontal Cortex
Hypokinesia
Butanols
Motor Cortex
Neuroimaging
Positron-Emission Tomography

Keywords

  • Deep brain stimulation
  • Globus pallidus
  • L-dopa
  • Parkinson's disease
  • PET
  • Sequential movements

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Clinical Neurology

Cite this

Pallidal deep brain stimulation and l-dopa effect on pet motor activation in advanced parkinson's disease. / Valálik, István; Emri, M.; Lengyel, Z.; Mikecz, Pál; Trón, L.; Csókay, András; Márián, T.

In: Journal of Neuroimaging, Vol. 19, No. 3, 07.2009, p. 253-256.

Research output: Contribution to journalArticle

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AU - Trón, L.

AU - Csókay, András

AU - Márián, T.

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