Differential modulation of subcortical target and cortex during deep brain stimulation

Neuroimage. 2003 Feb;18(2):517-24. doi: 10.1016/s1053-8119(02)00043-5.

Abstract

The combination of electrical deep brain stimulation (DBS) with functional imaging offers a unique model for tracing brain circuitry and for testing the modulatory potential of electrical stimulation on a neuronal network in vivo. We therefore applied parametric positron emission tomography (PET) analyses that allow characterization of rCBF responses as linear and nonlinear functions of the experimentally modulated stimulus (variable stimulator setting). In patients with electrodes in the thalamic ventrointermediate nucleus (VIM) for the treatment of essential tremor (ET) here we show that variations in voltage and frequency of thalamic stimulation have differential effects in a thalamo-cortical circuitry. Increasing stimulation amplitude was associated with a linear raise in rCBF at the thalamic stimulation site, but with a nonlinear rCBF response in the primary sensorimotor cortex (M1/S1). The reverse pattern in rCBF changes was observed with increasing stimulation frequency. These results indicate close connectivity between the stimulated nucleus (VIM) and primary sensorimotor cortex. Likewise, stimulation parameter-specific modulation occurs at this simple interface between an electrical and a cerebral system and suggests that the scope of DBS extends beyond an ablation-like on-off effect: DBS could rather allow a gradual tuning of activity within a neuronal circuit.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Brain Mapping
  • Cerebral Cortex / diagnostic imaging*
  • Cerebral Cortex / physiopathology
  • Electric Stimulation Therapy*
  • Essential Tremor / diagnostic imaging*
  • Essential Tremor / physiopathology
  • Essential Tremor / therapy
  • Female
  • Humans
  • Male
  • Middle Aged
  • Motor Cortex / diagnostic imaging
  • Motor Cortex / physiopathology
  • Nerve Net / diagnostic imaging
  • Nerve Net / physiopathology
  • Oxygen Consumption / physiology*
  • Prostheses and Implants*
  • Radionuclide Imaging
  • Regional Blood Flow / physiology
  • Somatosensory Cortex / diagnostic imaging
  • Somatosensory Cortex / physiopathology
  • Ventral Thalamic Nuclei / diagnostic imaging*
  • Ventral Thalamic Nuclei / physiopathology