Abstract
Background Patients with Parkinson's disease (PD) undergoing deep brain electrode implantation experience a temporary improvement in motor symptoms before the electrical stimulation begins. We usually call this the microlesion effect (MLE), but the mechanism behind it is not clear. Purpose This study aimed to assess the alterations in brain functions at the regional and whole-brain levels, using regional homogeneity (ReHo) and functional connectivity (FC), during the postoperative microlesion period after deep brain stimulation (DBS) in PD patients. Method Resting-state functional MRI data were collected from 27 PD patients before and after the first day of DBS and 12 healthy controls (HCs) in this study. The ReHo in combination with FC analysis was used to investigate the alterations of regional brain activity in all the subjects. Results There were increased ReHo in the basal ganglia-thalamocortical circuit (left supplementary motor area and bilateral paracentral lobule), whereas decreased ReHo in the default mode network (DMN) (left angular gyrus, bilateral precuneus), prefrontal cortex (bilateral middle frontal gyrus), and the cerebello-thalamocortical (CTC) circuit (Cerebellum_crus2/1_L) after DBS. In addition, we also found abnormal FC in the lingual gyrus, cerebellum, and DMN. Conclusion Microlesion of the thalamus caused by electrode implantation can alter the activity of the basal ganglia-thalamocortical circuit, prefrontal cortex, DMN, and CTC circuit and induce abnormal FC in the lingual gyrus, cerebellum, prefrontal cortex, and DMN among PD patients. The findings of this study contribute to the understanding of the mechanism of MLE.
Highlights
Deep brain stimulation (DBS) is a widely accepted surgical method used for the treatment of mid-to-late-stage Parkinson’s disease (PD), which can significantly improve motor symptoms of PD and reduce drug-induced complications [1,2,3]
Previous studies have suggested that postoperative verbal fluency [3, 10] and cognitive decline [3, 10] may be related to microlesion effect (MLE)
The postPD group exhibited decreased regional homogeneity (ReHo) in the left posterior cerebellar lobe (Cerebellum_crus2/1_L), left middle temporal gyrus (MTG), left angular gyrus, bilateral precuneus, and bilateral middle frontal gyrus (MFG) compared to the pre-PD group
Summary
Deep brain stimulation (DBS) is a widely accepted surgical method used for the treatment of mid-to-late-stage Parkinson’s disease (PD), which can significantly improve motor symptoms of PD and reduce drug-induced complications [1,2,3]. After DBS electrodes are implanted, a temporary improvement in the motor symptoms of PD patients, including tremor, rigidity, and bradykinesia, can be observed immediately over several days to weeks. We usually call this the microlesion effect (MLE). Patients with Parkinson’s disease (PD) undergoing deep brain electrode implantation experience a temporary improvement in motor symptoms before the electrical stimulation begins. We usually call this the microlesion effect (MLE), but the mechanism behind it is not clear. Microlesion of the thalamus caused by electrode implantation can alter the activity of the basal ganglia-thalamocortical circuit, prefrontal cortex, DMN, and CTC circuit and induce abnormal FC in the lingual gyrus, cerebellum, prefrontal cortex, and DMN among PD patients. e findings of this study contribute to the understanding of the mechanism of MLE
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