Modified Fluorodeoxyglucose Metabolism in Motor Circuitry by Subthalamic Deep Brain Stimulation

Background: Adjustment of the motor circuitry has been described in the treatment of Parkinson disease (PD). Objectives: To evaluate the modulation of the motor circuitry of PD patients by subthalamic deep brain stimulation (STN DBS) using ¹⁸F-fluorodeoxyglucose (FDG) and positron emission tomography (PET). Methods: Resting-state brain ¹⁸F-FDG PET imaging was performed for 8 PD patients before surgery and also 1 year after STN DBS treatment; changes in regional glucose metabolism were identified. The PD-related pattern (PDRP) of metabolic covariation was also evaluated. In addition, the correlations between glucose metabolism and clinical alleviation were determined. Results: Pronounced elevations in parietal and occipital glucose metabolism due to STN DBS modification were found; an obvious reduction in caudate, putamen, cerebellum, and frontal cortex glucose metabolism was detected after STN DBS interventions. The alleviation of rigidity correlated with an increment in glucose metabolism in the parietal lobe. STN DBS inhibited the PDRP; the decrease in the PDRP correlated with the inhibition of the glucose metabolism of the caudate and the augmented glucose metabolism of the occipital lobe. Conclusion: STN DBS modulates cortical function through the cortical-striatothalamocortial motor circuitry and cerebellothalamocortical motor circuitry.
Stereotact Funct Neurosurg 2017;95:93-101

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