Global and multi-focal changes in cerebral blood flow during subthalamic nucleus stimulation in Parkinson's disease. Issue 4 (April 2018)

• Record Type: Journal Article
• Authors: Mubeen, Asim M; Ardekani, Babak; Tagliati, Michele; Alterman, Ron; Dhawan, Vijay; Eidelberg, David; Sidtis, John J
• Is Part Of: Journal of cerebral blood flow & metabolism. Volume 38:Issue 4(2018)
• Page Start: 697
• Page End: 705
• Publication Date: 2018-04
• Subjects: Deep brain stimulation -- cerebral blood flow -- subthalamic nucleus -- Parkinson's disease -- positron emission tomography; Cerebral circulation -- Periodicals; Brain -- Metabolism -- Periodicals; Brain -- Blood-vessels -- Periodicals; Cerebrovascular disease -- Periodicals; 612.824
• DOI: 10.1177/0271678X17705042
• Languages: English
• ISSNs: 0271-678X

Abstract

Electrical stimulation of subthalamic nuclei (STN) is a widely used therapy in Parkinson's disease (PD). While deep brain stimulation (DBS) of the STN alters the neurophysiological activity in basal ganglia, the therapeutic mechanism has not been established. A positron emission tomography (PET) study of cerebral blood flow (CBF) during speech production in PD subjects treated with STN-DBS found significant increases in global (whole-brain) CBF. 1 That study utilized a series of whole-slice regions of interest to obtain global CBF values. The present study examined this effect using a voxel-based principal component analysis (PCA) combined with Fisher's linear discriminant analysis (FLDA) to classify STN-DBS on versus STN-DBS off whole-brain images. The approach yielded wide-spread CBF changes that classified STN-DBS status with accuracy, sensitivity, and specificity approaching 90%. The PCA component of the analysis supported the observation of a global CBF change during STN-DBS. The FLDA component demonstrated wide-spread multi-focal CBF changes. Further, CBF measurements related to a number of subject characteristics when STN-DBS was off, but not when it was on, suggesting that the normal relationship between CBF and behavior may be disrupted by this form of neuromodulation.