umu.sePublikasjoner
Endre søk
RefereraExporteraLink to record
Permanent link

Direct link
Referera
Referensformat
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Annet format
Fler format
Språk
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Annet språk
Fler språk
Utmatningsformat
  • html
  • text
  • asciidoc
  • rtf
Deep brain stimulation in the caudal zona incerta modulates the sensorimotor cerebello-cerebral circuit in essential tremor
Umeå universitet, Medicinska fakulteten, Umeå centrum för funktionell hjärnavbildning (UFBI). Umeå universitet, Medicinska fakulteten, Institutionen för integrativ medicinsk biologi (IMB).ORCID-id: 0000-0002-3068-0065
Umeå universitet, Medicinska fakulteten, Institutionen för farmakologi och klinisk neurovetenskap.
Umeå universitet, Medicinska fakulteten, Institutionen för integrativ medicinsk biologi (IMB).
Umeå universitet, Medicinska fakulteten, Umeå centrum för funktionell hjärnavbildning (UFBI). Umeå universitet, Medicinska fakulteten, Institutionen för integrativ medicinsk biologi (IMB).
2020 (engelsk)Inngår i: NeuroImage, ISSN 1053-8119, E-ISSN 1095-9572, Vol. 209, artikkel-id 116511Artikkel i tidsskrift (Fagfellevurdert) Published
Abstract [en]

Essential tremor is effectively treated with deep brain stimulation (DBS), but the neural mechanisms underlying the treatment effect are poorly understood. Essential tremor is driven by a dysfunctional cerebello-thalamo-cerebral circuit resulting in pathological tremor oscillations. DBS is hypothesised to interfere with these oscillations at the stimulated target level, but it is unknown whether the stimulation modulates the activity of the cerebello-thalamo-cerebral circuit during different task states (with and without tremor) in awake essential tremor patients. To address this issue, we used functional MRI in 16 essential tremor patients chronically implanted with DBS in the caudal zona incerta. During scanning, the patients performed unilateral tremor-inducing postural holding and pointing tasks as well as rest, with contralateral stimulation turned On and Off.

We show that DBS exerts both task-dependent as well as task-independent modulation of the sensorimotor cerebello-cerebral regions (p ​≤ ​0.05, FWE cluster-corrected for multiple comparisons). Task-dependent modulation (DBS ​× ​task interaction) resulted in two patterns of stimulation effects. Firstly, activity decreases (blood oxygen level-dependent signal) during tremor-inducing postural holding in the primary sensorimotor cortex and cerebellar lobule VIII, and activity increases in the supplementary motor area and cerebellar lobule V during rest (p ​≤ ​0.05, post hoc two-tailed t-test). These effects represent differences at the effector level and may reflect DBS-induced tremor reduction since the primary sensorimotor cortex, cerebellum and supplementary motor area exhibit less motor task-activity as compared to the resting condition during On stimulation. Secondly, task-independent modulation (main effect of DBS) was observed as activity increase in the lateral premotor cortex during all motor tasks, and also during rest (p ​≤ ​0.05, post hoc two-tailed t-test). This task-independent effect may mediate the therapeutic effects of DBS through the facilitation of the premotor control over the sensorimotor circuit, making it less susceptible to tremor entrainment.

Our findings support the notion that DBS in essential tremor is modulating the sensorimotor cerebello-cerebral circuit, distant to the stimulated target, and illustrate the complexity of stimulation mechanisms by demonstrating task-dependent as well as task-independent actions in cerebello-cerebral regions.

sted, utgiver, år, opplag, sider
Elsevier, 2020. Vol. 209, artikkel-id 116511
Emneord [en]
Essential tremor, Deep brain stimulation, Caudal zona incerta, Functional MRI, Cerebello-cerebral circuit
HSV kategori
Forskningsprogram
neurokirurgi; neurologi; fysiologi
Identifikatorer
URN: urn:nbn:se:umu:diva-167200DOI: 10.1016/j.neuroimage.2019.116511OAI: oai:DiVA.org:umu-167200DiVA, id: diva2:1384862
Forskningsfinansiär
Västerbotten County CouncilTilgjengelig fra: 2020-01-11 Laget: 2020-01-11 Sist oppdatert: 2020-01-13bibliografisk kontrollert

Open Access i DiVA

fulltext(2597 kB)15 nedlastinger
Filinformasjon
Fil FULLTEXT01.pdfFilstørrelse 2597 kBChecksum SHA-512
f5bc30515615745f321a64e05555baccb3a5399372dafbd199491c3457eaeafbcfb7b1df008ac31897ba0b39095f2d814017f8f7cb6c4b6f38265db5aee17053
Type fulltextMimetype application/pdf

Andre lenker

Forlagets fulltekst

Personposter BETA

Awad, AmarBlomstedt, PatricWestling, GöranEriksson, Johan

Søk i DiVA

Av forfatter/redaktør
Awad, AmarBlomstedt, PatricWestling, GöranEriksson, Johan
Av organisasjonen
I samme tidsskrift
NeuroImage

Søk utenfor DiVA

GoogleGoogle Scholar
Totalt: 15 nedlastinger
Antall nedlastinger er summen av alle nedlastinger av alle fulltekster. Det kan for eksempel være tidligere versjoner som er ikke lenger tilgjengelige

doi
urn-nbn

Altmetric

doi
urn-nbn
Totalt: 75 treff
RefereraExporteraLink to record
Permanent link

Direct link
Referera
Referensformat
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Annet format
Fler format
Språk
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Annet språk
Fler språk
Utmatningsformat
  • html
  • text
  • asciidoc
  • rtf