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000872731 1001_ $$0P:(DE-HGF)0$$aGreuel, Andrea$$b0
000872731 245__ $$aPallidal Deep Brain Stimulation Reduces Sensorimotor Cortex Activation in Focal/Segmental Dystonia
000872731 260__ $$aNew York, NY$$bWiley$$c2020
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000872731 520__ $$aBackgroundAlthough deep brain stimulation of the globus pallidus internus (GPi‐DBS) is an established treatment for many forms of dystonia, including generalized as well as focal forms, its effects on brain (dys‐)function remain to be elucidated, particularly for focal and segmental dystonia. Clinical response to GPi‐DBS typically comes with some delay and lasts up to several days, sometimes even weeks, once stimulation is discontinued.ObjectiveThis study investigated how neural activity during rest and motor activation is affected by GPi‐DBS while excluding the potential confound of altered feedback as a result of therapy‐induced differences in dystonic muscle contractions.MethodsTwo groups of patients with focal or segmental dystonia were included in the study: 6 patients with GPi‐DBS and 8 without DBS (control group). All 14 patients had cervical dystonia. Using H215O PET, regional cerebral blood flow was measured at rest and during a motor task performed with a nondystonic hand.ResultsIn patients with GPi‐DBS (stimulation ON and OFF), activity at rest was reduced in a prefrontal network, and during the motor task, sensorimotor cortex activity was lower than in patients without DBS. Within‐group contrasts (tapping > rest) showed less extensive task‐induced motor network activation in GPi‐DBS patients than in non‐DBS controls. Reduced sensorimotor activation amounted to a significant group‐by‐task interaction only in the stimulation ON state.ConclusionsThese findings support previous observations in generalized dystonia that suggested that GPi‐DBS normalizes dystonia‐associated sensorimotor and prefrontal hyperactivity, indicating similar mechanisms in generalized and focal or segmental dystonia. Evidence is provided that these effects extend into the OFF state, which was not previously demonstrated by neuroimaging. © 2020 The Authors. Movement Disorders published by Wiley Periodicals, Inc. on behalf of International Parkinson and Movement Disorder Society.
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000872731 7001_ $$0P:(DE-HGF)0$$aPauls, K. Amande M.$$b1
000872731 7001_ $$0P:(DE-HGF)0$$aKoy, Anne$$b2
000872731 7001_ $$0P:(DE-HGF)0$$aSüdmeyer, Martin$$b3
000872731 7001_ $$0P:(DE-HGF)0$$aSchnitzler, Alfons$$b4
000872731 7001_ $$0P:(DE-HGF)0$$aTimmermann, Lars$$b5
000872731 7001_ $$0P:(DE-Juel1)131720$$aFink, Gereon R.$$b6$$ufzj
000872731 7001_ $$0P:(DE-HGF)0$$aEggers, Carsten$$b7$$eCorresponding author
000872731 773__ $$0PERI:(DE-600)2041249-6$$a10.1002/mds.27970$$gp. mds.27970$$n4$$p629-639$$tMovement disorders$$v35$$x1531-8257$$y2020
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