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Functional Imaging Of Deep Brain Stimulation: FMRI, SPECT, And PET

R. Jech
Published 2008 · Medicine

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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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