Common and unique responses to dopamine agonist therapy and deep brain stimulation in Parkinson's disease: An H215O PET study

Trent J. Bradberry, Leonard Verhagen Metman, José L. Contreras-Vidal, Pepijn Van Den Munckhof, Lara A. Hosey, Jennifer L W Thompson, Geralyn M. Schulz, Frederick Lenz, Rajesh Pahwa, Kelly E. Lyons, Allen R. Braun

Research output: Contribution to journalArticle

Abstract

Background: Dopamine agonist therapy and deep brain stimulation (DBS) of the subthalamic nucleus (STN) are antiparkinsonian treatments that act on a different part of the basal ganglia-thalamocortical motor circuitry, yet produce similar symptomatic improvements. Objective/Hypothesis: The purpose of this study was to identify common and unique brain network features of these standard treatments. Methods: We analyzed images produced by H215O positron emission tomography (PET) of patients with Parkinson's disease (PD) at rest. Nine patients were scanned before and after injection of apomorphine, and 11 patients were scanned while bilateral stimulators were off and while they were on. Results: Both treatments produced common deactivations of the neocortical sensorimotor areas, including the supplementary motor area, precentral gyrus, and postcentral gyrus, and in subcortical structures, including the putamen and cerebellum. We observed concomitant activations of the superior parietal lobule and the midbrain in the region of the substantia nigra/STN. We also detected unique, treatment-specific changes with possible motor-related consequences in the basal ganglia, thalamus, neocortical sensorimotor cortex, and posterolateral cerebellum. Unique changes in nonmotor regions may reflect treatment-specific effects on verbal fluency and limbic functions. Conclusions: Many of the common effects of these treatments are consistent with the standard pathophysiologic model of PD. However, the common effects in the cerebellum are not readily explained by the model. Consistent deactivation of the cerebellum is interesting in light of recent reports of synaptic pathways directly connecting the cerebellum and basal ganglia, and may warrant further consideration for incorporation into the model.

Original languageEnglish (US)
Pages (from-to)605-615
Number of pages11
JournalBrain Stimulation
Volume5
Issue number4
DOIs
StatePublished - Oct 2012

Fingerprint

Deep Brain Stimulation
Dopamine Agonists
Positron-Emission Tomography
Parkinson Disease
Cerebellum
Basal Ganglia
Subthalamic Nucleus
Therapeutics
Antiparkinson Agents
Parietal Lobe
Somatosensory Cortex
Apomorphine
Putamen
Motor Cortex
Frontal Lobe
Substantia Nigra
Mesencephalon
Thalamus
Injections
Brain

Keywords

  • apomorphine
  • deep brain stimulation
  • Parkinson's disease
  • positron emission tomography

ASJC Scopus subject areas

  • Clinical Neurology
  • Neuroscience(all)
  • Biophysics

Cite this

Bradberry, T. J., Metman, L. V., Contreras-Vidal, J. L., Van Den Munckhof, P., Hosey, L. A., Thompson, J. L. W., ... Braun, A. R. (2012). Common and unique responses to dopamine agonist therapy and deep brain stimulation in Parkinson's disease: An H215O PET study. Brain Stimulation, 5(4), 605-615. https://doi.org/10.1016/j.brs.2011.09.002

Common and unique responses to dopamine agonist therapy and deep brain stimulation in Parkinson's disease : An H215O PET study. / Bradberry, Trent J.; Metman, Leonard Verhagen; Contreras-Vidal, José L.; Van Den Munckhof, Pepijn; Hosey, Lara A.; Thompson, Jennifer L W; Schulz, Geralyn M.; Lenz, Frederick; Pahwa, Rajesh; Lyons, Kelly E.; Braun, Allen R.

In: Brain Stimulation, Vol. 5, No. 4, 10.2012, p. 605-615.

Research output: Contribution to journalArticle

Bradberry, TJ, Metman, LV, Contreras-Vidal, JL, Van Den Munckhof, P, Hosey, LA, Thompson, JLW, Schulz, GM, Lenz, F, Pahwa, R, Lyons, KE & Braun, AR 2012, 'Common and unique responses to dopamine agonist therapy and deep brain stimulation in Parkinson's disease: An H215O PET study', Brain Stimulation, vol. 5, no. 4, pp. 605-615. https://doi.org/10.1016/j.brs.2011.09.002
Bradberry TJ, Metman LV, Contreras-Vidal JL, Van Den Munckhof P, Hosey LA, Thompson JLW et al. Common and unique responses to dopamine agonist therapy and deep brain stimulation in Parkinson's disease: An H215O PET study. Brain Stimulation. 2012 Oct;5(4):605-615. https://doi.org/10.1016/j.brs.2011.09.002
Bradberry, Trent J. ; Metman, Leonard Verhagen ; Contreras-Vidal, José L. ; Van Den Munckhof, Pepijn ; Hosey, Lara A. ; Thompson, Jennifer L W ; Schulz, Geralyn M. ; Lenz, Frederick ; Pahwa, Rajesh ; Lyons, Kelly E. ; Braun, Allen R. / Common and unique responses to dopamine agonist therapy and deep brain stimulation in Parkinson's disease : An H215O PET study. In: Brain Stimulation. 2012 ; Vol. 5, No. 4. pp. 605-615.
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AU - Van Den Munckhof, Pepijn

AU - Hosey, Lara A.

AU - Thompson, Jennifer L W

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AU - Pahwa, Rajesh

AU - Lyons, Kelly E.

AU - Braun, Allen R.

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