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Functional Imaging of Deep Brain Stimulation: fMRI, SPECT, and PET

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Deep Brain Stimulation in Neurological and Psychiatric Disorders

Part of the book series: Current Clinical Neurology ((CCNEU))

Abstract

This chapter gives an overview of the relevant literature concerning functional imaging and deep brain stimulation (DBS). Although there is no doubt about the clinical effects of DBS, knowledge concerning its mechanism of function is limited. Methods of functional imaging such as functional MRI (fMRI), single photon emission computed tomography (SPECT), and positron emission tomography (PET) to measure cerebral blood flow or fluorodeoxyclucose metabolism may help us understand the mechanisms of neurostimulation at the site of stimulation and also provide a global view of what is happening in the rest of the brain. Under review are typical patterns of activation/deactivation in the ipsiand contralateral hemispheres at subcortical and cortical levels while stimulating the subthalamic nucleus (STN), ventral intermediate nucleus of thalamus (VIM) and globus pallidus interna (GPi), while working on different types of tasks. The site of stimulation usually becomes overactivated, which indirectly supports a mechanism of locally increased neuronal activity which than spreads by orthodromic and/or antidromic fashion into areas not being directly stimulated by the DBS electrode. As follows from comparisons with neurostimulation in on and off modes, DBS usually leads to a normalization of pathological patterns of brain activations. Despite similar clinical effects, the mechanisms of DBS are different from those of stereotactic lesions. However, the majority of available studies have produced many contradictory results due to significant methodological differences between studies.

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Acknowledgments

Supported by grant from the Czech Ministry of Health (IGA MZ CR 1A/8629-5) and from the Czech Ministry of Education (research program MSM 0021620849)

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  1. First Faculty of Medicine, Movement Disorders Center, Department of Neurology, Charles University, Prague, Czech Republic

    Robert Jech

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  1. Robert Jech
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Editors and Affiliations

  1. Parkinson's Disease and Movement Disorders Center, Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA

    Daniel Tarsy MD  & Daniel Tarsy MD  & 

  2. Neuromodulation Research Center, Lerner Research Institute, The Cleveland Clinic Foundation, Cleveland, OH, USA

    Jerrold L. Vitek MD, PhD

  3. Department of Neurosurgery, University of California, San Francisco, CA, USA

    Philip A. Starr MD, PhD

  4. Departments of Neurology and Neurosurgery, McKnight Brain Institute, University of Florida, Gainesville, FL, USA

    Michael S. Okun MD

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© 2008 Humana Press, a part of Springer Science+Business Media, LLC

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Jech, R. (2008). Functional Imaging of Deep Brain Stimulation: fMRI, SPECT, and PET . In: Tarsy, D., Vitek, J.L., Starr, P.A., Okun, M.S. (eds) Deep Brain Stimulation in Neurological and Psychiatric Disorders. Current Clinical Neurology. Humana Press. https://doi.org/10.1007/978-1-59745-360-8_9

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  • DOI: https://doi.org/10.1007/978-1-59745-360-8_9

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