Effect of Subthalamic Nucleus Stimulation during Exercise on the Mesolimbocortical Dopaminergic Region in Parkinson'S Disease: A Positron Emission Tomography Study

• Published in: Journal of cerebral blood flow and metabolism Vol. 33; no. 3; pp. 415 - 421
• Main Authors: Nozaki, Takao, Sugiyama, Kenji, Yagi, Shunsuke, Yoshikawa, Etsuji, Kanno, Toshihiko, Asakawa, Tetsuya, Ito, Tae, Terada, Tatsuhiro, Namba, Hiroki, Ouchi, Yasuomi
• Format: Journal Article
• Language: English
• Published: London, England SAGE Publications 01.03.2013; Sage Publications Ltd; Nature Publishing Group
• Subjects: Aged; Caudate Nucleus - diagnostic imaging; Caudate Nucleus - metabolism; Caudate Nucleus - physiopathology; Dopamine - metabolism; Dopamine Antagonists - administration & dosage; Dopamine Antagonists - pharmacokinetics; Dopaminergic Neurons - diagnostic imaging; Dopaminergic Neurons - metabolism; Exercise; Female; Humans; Male; Middle Aged; Motor Activity; Nucleus Accumbens - diagnostic imaging; Nucleus Accumbens - metabolism; Nucleus Accumbens - physiopathology; Original; Parkinson Disease - diagnostic imaging; Parkinson Disease - drug therapy; Parkinson Disease - metabolism; Parkinson Disease - physiopathology; Positron-Emission Tomography; Raclopride - administration & dosage; Raclopride - pharmacokinetics; Radiography; Subthalamic Nucleus - diagnostic imaging; Subthalamic Nucleus - metabolism; Subthalamic Nucleus - physiopathology; Parkinson's disease; caudate; nucleus accumbens; positron emission tomography; subthalamic nucleus stimulation; dopamine release
• ISSN: 0271-678X; 1559-7016
• DOI: 10.1038/jcbfm.2012.183

To elucidate the dynamic effects of deep brain stimulation (DBS) in the subthalamic nucleus (STN) during activity on the dopaminergic system, 12 PD patients who had STN-DBS operations at least 1 month prior, underwent two positron emission tomography scans during right-foot movement in DBS-off and DBS-on conditions. To quantify motor performance changes, the motion speed and mobility angle of the foot at the ankle were measured twice. Estimations of the binding potential of [11C]raclopride (BPND) were based on the Logan plot method. Significant motor recovery was found in the DBS-on condition. The STN-DBS during exercise significantly reduced the [11C]raclopride BPND in the caudate and the nucleus accumbens (NA), but not in the dorsal or ventral putamen. The magnitude of dopamine release in the NA correlated negatively with the magnitude of motor load, indicating that STN-DBS facilitated motor behavior more smoothly and at less expense to dopamine neurons in the region. The lack of dopamine release in the putamen and the significant dopamine release in the ventromedial striatum by STN-DBS during exercise indicated dopaminergic activation occurring in the motivational circuit during action, suggesting a compensatory functional activation of the motor loop from the nonmotor to the motor loop system.