Title:
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Neural plasticity in human brain connectivity: the effects of long term deep brain stimulation of the subthalamic nucleus in Parkinson's disease
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Author:
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Van Hartevelt, Tim J.; Cabral, Joana R. B.; Møller, Arne; Green, Alex L.; Aziz, Tipu Z.; Kringelbach, Morten L.; Deco, Gustavo
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Abstract:
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Background: Positive clinical outcomes are now well established for deep brain stimulation, but little is known about the effects of long-term deep brain stimulation on brain structural and functional connectivity. Here, we used the rare opportunity to acquire pre- and postoperative diffusion tensor imaging in a patient undergoing deep brain stimulation in bilateral subthalamic nuclei for Parkinson’s Disease. This allowed us to analyse the differences in structural connectivity before and after deep brain stimulation. Further, a computational model of spontaneous brain activity was used to estimate the changes in functional connectivity arising from the specific changes in structural connectivity./nResults: We found significant localised structural changes as a result of long-term deep brain stimulation. These changes were found in sensory-motor, prefrontal/limbic, and olfactory brain regions which are known to be affected in Parkinson’s Disease. The nature of these changes was an increase of nodal efficiency in most areas and a decrease of nodal efficiency in the precentral sensory-motor area. Importantly, the computational model clearly shows the impact of deep brain stimulation-induced structural alterations on functional brain changes, which is to shift the neural dynamics back towards a healthy regime. The results demonstrate that deep brain stimulation in Parkinson’s Disease leads to a topological reorganisation towards healthy bifurcation of the functional networks measured in controls, which suggests a potential neural mechanism for the alleviation of symptoms./nConclusions: The findings suggest that long-term deep brain stimulation has not only restorative effects on the structural connectivity, but also affects the functional connectivity at a global level. Overall, our results support causal changes in human neural plasticity after long-term deep brain stimulation and may help to identify the underlying mechanisms of deep brain stimulation. |
Abstract:
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MLK and TJVH are funded by the TrygFonden Charitable Foundation. TZA is funded by the Medical Research Council, the Norman Collisson Foundation/nand the Charles Wolfson Charitable Trust. ALG is supported by the NIHR Biomedical Research Centre, Oxford. GD and JC were supported by the ERC Advanced/nGrant: DYSTRUCTURE (n. 295129), by the Spanish Research Project SAF2010-16085 and by the CONSOLIDER-INGENIO 2010 Programme CSD2007-00012, the FP7-/nICT BrainScales and by the Brain Network Recovery Group through the James S. McDonnell Foundation. |
Rights:
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© 2014 van Hartevelt et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.(http://creativecommons.org/licenses/by/4.0/)
http://creativecommons.org/licenses/by/4.0/ |
Document type:
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Article Article - Published version |
Published by:
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Public Library of Science (PLoS)
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