Effects of subthalamic nucleus stimulation on motor cortex plasticity in Parkinson disease.

Abstract

OBJECTIVE:

We hypothesized that subthalamic nucleus (STN) deep brain stimulation (DBS) will improve long-term potentiation (LTP)-like plasticity in motor cortex in Parkinson disease (PD).

METHODS:

We studied 8 patients with PD treated with STN-DBS and 9 age-matched healthy controls. Patients with PD were studied in 4 sessions in medication (Med) OFF/stimulator (Stim) OFF, Med-OFF/Stim-ON, Med-ON/Stim-OFF, and Med-ON/Stim-ON states in random order. Motor evoked potential amplitude and cortical silent period duration were measured at baseline before paired associated stimulation (PAS) and at 3 different time intervals (T0, T30, T60) up to 60 minutes after PAS in the abductor pollicis brevis and abductor digiti minimi muscles.

RESULTS:

Motor evoked potential size significantly increased after PAS in controls (+67.7% of baseline at T30) and in patients in the Med-ON/Stim-ON condition (+55.8% of baseline at T30), but not in patients in the Med-OFF/Stim-OFF (-0.4% of baseline at T30), Med-OFF/Stim-ON (+10.3% of baseline at T30), and Med-ON/Stim-OFF conditions (+17.3% of baseline at T30). Cortical silent period duration increased after PAS in controls but not in patients in all test conditions.

CONCLUSIONS:

Our findings suggest that STN-DBS together with dopaminergic medications restore LTP-like plasticity in motor cortex in PD. Restoration of cortical plasticity may be one of the mechanisms of how STN-DBS produces clinical benefit.

• Authors: Sang Jin Kim, Kaviraja Udupa, Zhen Ni, Elena Moro, Carolyn Gunraj, Filomena Mazzella, Andres M Lozano, Mojgan Hodaie, Anthony E Lang, Robert Chen
• Journal: Neurology (Neurology) Vol. 85 Issue 5 Pg. 425-32 (Aug 04 2015) ISSN: 1526-632X [Electronic] United States
• PMID: 26156511 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: © 2015 American Academy of Neurology.

Topics

• Aged
• Deep Brain Stimulation (trends)
• Evoked Potentials, Motor (physiology)
• Female
• Humans
• Long-Term Potentiation (physiology)
• Male
• Middle Aged
• Motor Cortex (physiology)
• Neuronal Plasticity (physiology)
• Parkinson Disease (physiopathology, therapy)
• Subthalamic Nucleus (physiology)
• Treatment Outcome