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Differential effects of deep brain stimulation and levodopa treatment on brain activity change in Parkinson’s disease

MPS-Authors
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Mueller,  Karsten
Methods and Development Unit Nuclear Magnetic Resonance, MPI for Human Cognitive and Brain Sciences, Max Planck Society;

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Ballarini,  Tommaso
Department Neurology, MPI for Human Cognitive and Brain Sciences, Max Planck Society;

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Holiga,  Štefan
Methods and Development Unit Nuclear Magnetic Resonance, MPI for Human Cognitive and Brain Sciences, Max Planck Society;

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Möller,  Harald E.
Methods and Development Unit Nuclear Magnetic Resonance, MPI for Human Cognitive and Brain Sciences, Max Planck Society;

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Schroeter,  Matthias L.
Department Neurology, MPI for Human Cognitive and Brain Sciences, Max Planck Society;

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Mueller_Urgosik_2020.pdf
(Preprint), 3MB

Mueller_Urgosik_Ballarini_2020.pdf
(Publisher version), 2MB

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Citation

Mueller, K., Urgosik, D., Ballarini, T., Holiga, Š., Möller, H. E., Růžička, F., et al. (2020). Differential effects of deep brain stimulation and levodopa treatment on brain activity change in Parkinson’s disease. Brain Communications, 2(1): fcaa005. doi:10.1093/braincomms/fcaa005.


Cite as: http://hdl.handle.net/21.11116/0000-0004-CC9C-7
Abstract
Levodopa is the first-line treatment for Parkinson’s disease, although the precise mechanisms mediating its efficacy remain elusive. We aimed to elucidate treatment effects of levodopa on brain activity during execution of fine movements and to compare them with deep brain stimulation of the subthalamic nuclei. We studied 32 patients with Parkinson’s disease using functional magnetic resonance imaging during execution of finger-tapping task, alternating epochs of movement and rest. The task was performed after withdrawal and administration of a single levodopa dose. A subgroup of patients (n = 18) repeated the experiment after electrode implantation with stimulator on and off. Investigating levodopa treatment, we found a significant interaction between both factors of treatment state (off, on) and experimental task (finger tapping, rest) in bilateral putamen, but not in other motor regions. Specifically, during the off state of levodopa medication, activity in the putamen at rest was higher than during tapping. This represents an aberrant activity pattern probably indicating derangement of basal ganglia network activity due to lack of dopaminergic input. Levodopa medication reverted this pattern, so that putaminal activity during finger tapping was higher than during rest, as previously described in healthy controls. Within-group comparison with deep brain stimulation underlines the specificity of our findings with levodopa treatment. Indeed, a significant interaction was observed between treatment approach (levodopa, deep brain stimulation) and treatment state (off, on) in in bilateral putamen. Our functional MRI study compared for the first time the differential effects of levodopa treatment and deep brain stimulation on brain motor activity. We showed modulatory effects of levodopa on brain activity of the putamen during finger movement execution which were not observed with deep brain stimulation.