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A Network Analysis of 15O-H2O PET Reveals Deep Brain Stimulation Effects on Brain Network of Parkinson’s Disease

박범희|이종두|장진우|김해유|김중일|윤미선|박해정|오맹근
연세대학교의과대학 (Yonsei University College of Medicine)|2015.05|Yonsei Medical Journal|제56권 제3호|pp. 726-736|DOI 10.3349/ymj.2015.56.3.726

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키워드

Parkinson’s diseaseDeep brain stimulationindependent component analysisbrain networksH2O PET
주제분류의학일반

초록

Purpose: As Parkinson’s disease (PD) can be considered a network abnormality, the effects of deep brain stimulation (DBS) need to be investigated in the aspect of networks. This study aimed to examine how DBS of the bilateral subthalamic nucleus(STN) affects the motor networks of patients with idiopathic PD during motorperformance and to show the feasibility of the network analysis using cross-sectional positron emission tomography (PET) images in DBS studies. Materials and Methods: We obtained [15O]H2O PET images from ten patients with PD duringa sequential finger-to-thumb opposition task and during the resting state, with DBS-On and DBS-Off at STN. To identify the alteration of motor networks in PD and their changes due to STN-DBS, we applied independent component analysis (ICA) to all the cross-sectional PET images. We analysed the strength of each component according to DBS effects, task effects and interaction effects. Results: ICA blindly decomposed components of functionally associated distributed clusters,which were comparable to the results of univariate statistical parametric mapping. ICA further revealed that STN-DBS modifies usage-strengths of components corresponding to the basal ganglia-thalamo-cortical circuits in PD patients by increasingthe hypoactive basal ganglia and by suppressing the hyperactive cortical motor areas, ventrolateral thalamus and cerebellum. Conclusion: Our results suggestthat STN-DBS may affect not only the abnormal local activity, but also alter brain networks in patients with PD. This study also demonstrated the usefulness of ICA for cross-sectional PET data to reveal network modifications due to DBS, which was not observable using the subtraction method.

Abstract

Purpose: As Parkinson’s disease (PD) can be considered a network abnormality, the effects of deep brain stimulation (DBS) need to be investigated in the aspect of networks. This study aimed to examine how DBS of the bilateral subthalamic nucleus(STN) affects the motor networks of patients with idiopathic PD during motorperformance and to show the feasibility of the network analysis using cross-sectional positron emission tomography (PET) images in DBS studies. Materials and Methods: We obtained [15O]H2O PET images from ten patients with PD duringa sequential finger-to-thumb opposition task and during the resting state, with DBS-On and DBS-Off at STN. To identify the alteration of motor networks in PD and their changes due to STN-DBS, we applied independent component analysis (ICA) to all the cross-sectional PET images. We analysed the strength of each component according to DBS effects, task effects and interaction effects. Results: ICA blindly decomposed components of functionally associated distributed clusters,which were comparable to the results of univariate statistical parametric mapping. ICA further revealed that STN-DBS modifies usage-strengths of components corresponding to the basal ganglia-thalamo-cortical circuits in PD patients by increasingthe hypoactive basal ganglia and by suppressing the hyperactive cortical motor areas, ventrolateral thalamus and cerebellum. Conclusion: Our results suggestthat STN-DBS may affect not only the abnormal local activity, but also alter brain networks in patients with PD. This study also demonstrated the usefulness of ICA for cross-sectional PET data to reveal network modifications due to DBS, which was not observable using the subtraction method.

참고문헌 (45)

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