Patient-specific analysis of the relationship between the volume of tissue activated during DBS and verbal fluency.
Patient-specific analysis of the relationship between the volume of tissue activated during DBS and verbal fluency.
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DOI：
10.1016/j.neuroimage.2010.03.068
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发表时间：
2011-01
期刊：
影响因子：
5.7
通讯作者：
Okun, M S
中科院分区：
文献类型：
--
作者：
Mikos, A;Bowers, D;Noecker, A M;McIntyre, C C;Won, M;Chaturvedi, A;Foote, K D;Okun, M S
用于治疗晚期帕金森氏病的脑深部电刺激（DBS）涉及通常在丘脑底核（ESTA）或苍白球（GPi）内植入具有四个小触点的电极导线。虽然从认知的角度来看通常是安全的，但BRDBS通常与单词的快速产生（一种称为语言流畅性的技能）的减少有关。几乎所有比较术前和术后语言流畅性表现的研究都发现DBS会降低语言流畅性。这种下降可能部分归因于外科手术，但刺激效应的相对贡献尚不清楚。在本研究中，我们使用患者特定的DBS计算机模型来研究刺激对语言流畅性表现的影响。具体来说，我们调查的关系，激活的神经组织的体积和位置，以口头流畅性的结果。刺激不同的电极接触的大脑皮层内并没有影响总的语言流畅性分数。然而，激活模型揭示了激活组织的位置和体积与语言流畅性表现之间的微妙关系。在腹侧接触，更多的组织激活内的腹侧与降低字母流畅性的表现。在最佳接触，更多的组织内的激活与改善字母流畅性的表现。这些发现表明刺激对言语流畅性表现的微妙影响，与STN的功能性非运动亚区/躯体特征一致。
Deep brain stimulation (DBS) for the treatment of advanced Parkinson’s disease involves implantation of a lead with four small contacts usually within the subthalamic nucleus (STN) or globus pallidus internus (GPi). While generally safe from a cognitive standpoint, STN DBS has been commonly associated with a decrease in the speeded production of words, a skill referred to as verbal fluency. Virtually all studies comparing pre-surgical to post-surgical verbal fluency performance have detected a decrease with DBS. The decline may be attributable in part to the surgical procedures, yet the relative contributions of stimulation effects are not known. In the present study, we used patient-specific DBS computer models to investigate the effects of stimulation on verbal fluency performance. Specifically, we investigated relationships of the volume and locus of activated STN tissue to verbal fluency outcome. Stimulation of different electrode contacts within the STN did not affect total verbal fluency scores. However, models of activation revealed subtle relationships between the locus and volume of activated tissue and verbal fluency performance. At ventral contacts, more tissue activation inside the STN was associated with decreased letter fluency performance. At optimal contacts, more tissue activation within the STN was associated with improved letter fluency performance. These findings suggest subtle effects of stimulation on verbal fluency performance, consistent with the functional non-motor subregions/somatopy of the STN.