Serial 1H-MRS of thalamus during deep brain stimulation of bilateral globus pallidus internus for primary generalized dystonia

Mikhail F. Chernov, Taku Ochiai, Takaomi Taira, Yuko Ono, Ryoichi Nakamura, Yoshihiro Muragaki, Hiroshi Iseki, Tomokatsu Hori, Kintomo Takakura

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    Abstract

    Introduction: The physiological mechanisms of deep brain stimulation (DBS) are not completely clear. Our understanding of them may be facilitated with the use of proton magnetic resonance spectroscopy (1H-MRS). Methods: Serial 1H-MRS of both thalami was performed during the course of DBS of bilateral globus pallidus internus in a patient with primary generalized dystonia. Results: Two days after microelectrode implantation, a pulse frequency of 185 Hz was applied for stimulation. It resulted in relief of symptoms and a decrease of Burke-Fahn-Marsden dystonia rating scale (BFMDRS) scores, and was accompanied by a prominent increase of N-acetylaspartate (NAA)/choline- containing compounds (Cho) ratio, a mild increase of NAA/creatine (Cr) ratio, and a moderate decrease of Cho/Cr ratio. Two weeks later, for a search of the optimal stimulation mode, the pulse frequency was switched to 60 Hz, which resulted in clinical deterioration and significant increase of BFMDRS scores. At that time, all investigated 1H-MRS-detected metabolic parameters had nearly returned to the pretreatment levels. Conclusion: Use of serial 1H-MRS investigations of various brain structures during DBS in cases of movement disorders permits detailed evaluation of the treatment response, has a potential for its possible prediction, and may facilitate understanding of the physiological mechanisms of stimulation.

    Original languageEnglish
    Pages (from-to)1055-1059
    Number of pages5
    JournalNeuroradiology
    Volume50
    Issue number12
    DOIs
    Publication statusPublished - 2008 Dec 1

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    Keywords

    • Choline-containing compounds
    • Deep brain stimulation
    • Generalized dystonia
    • N-Acetylaspartate
    • Proton magnetic resonance spectroscopy

    ASJC Scopus subject areas

    • Radiology Nuclear Medicine and imaging
    • Clinical Neurology
    • Cardiology and Cardiovascular Medicine

    Cite this

    Chernov, M. F., Ochiai, T., Taira, T., Ono, Y., Nakamura, R., Muragaki, Y., Iseki, H., Hori, T., & Takakura, K. (2008). Serial 1H-MRS of thalamus during deep brain stimulation of bilateral globus pallidus internus for primary generalized dystonia. Neuroradiology, 50(12), 1055-1059. https://doi.org/10.1007/s00234-008-0458-7