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Effects of subthalamic nucleus stimulation on motor cortex excitability in Parkinson's disease.

Abstract : OBJECTIVE: To study the effects of subthalamic nucleus (STN) stimulation on motor cortex excitability in Parkinson's disease (PD). METHODS: Fifteen patients were evaluated under off-medication, OFF- and ON-STN conditions, using the UPDRS. We studied the effects of STN stimulation on motor cortex excitability under three conditions (OFF, ON with chronic therapeutic parameters, ON HighV with a voltage set 10% under permanent side effects threshold), using transcranial magnetic stimulation. We measured the central motor conduction time (CMCT), rest and active motor threshold (MT), F-wave persistence and amplitude, silent period (SP), intracortical inhibition and facilitation at 3, 5 and 15 ms interstimulus intervals (ISI). RESULTS: The UPDRS motor score decreased from 44.4+/-14.0 under OFF, to 15.2+/-8.0 under ON-STN condition. The CMCT and MT did not change across STN conditions. The F-wave parameters were within normal range under STN stimulation. STN stimulation lengthened the SP and induced facilitation at 15 ms ISI compared to the OFF-STN condition. CONCLUSION: Therapeutic STN stimulation modulates cortical excitability in PD. High voltage STN stimulation could also act on spinal excitability. SIGNIFICANCE: At the motor cortical level, STN stimulation may have a direct effect on intracortical interneurons, modifying the balance between excitation and inhibition.
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https://www.hal.inserm.fr/inserm-00378398
Contributor : Marc Savasta <>
Submitted on : Friday, April 24, 2009 - 11:04:45 AM
Last modification on : Thursday, November 21, 2019 - 2:18:24 AM

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Valérie Fraix, Pierre Pollak, Laurent Vercueil, Alim-Louis Benabid, François Mauguière. Effects of subthalamic nucleus stimulation on motor cortex excitability in Parkinson's disease.. Clinical Neurophysiology, Elsevier, 2008, 119 (11), pp.2513-8. ⟨10.1016/j.clinph.2008.07.217⟩. ⟨inserm-00378398⟩

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