Subdural motor cortex stimulation in Parkinson's disease does not modify movement-related rCBF pattern

Area of Science:

• Neuroscience
• Neurosurgery
• Neurology

Background:

• Parkinson's disease (PD) significantly impacts motor function.
• Electrical stimulation of the primary motor cortex (MCS) is being explored as a potential treatment for PD.
• MCS is considered an alternative for patients unsuitable for deep brain stimulation (DBS) of the subthalamic nucleus (STN).

Purpose of the Study:

• To investigate the effects of unilateral MCS on motor performance and regional cerebral blood flow (rCBF) in PD patients.
• To assess the efficacy of different MCS stimulation frequencies (50 Hz and 130 Hz) compared to an OFF-stimulation condition.

Main Methods:

• Four patients with advanced PD underwent unilateral MCS.
• Positron emission tomography (PET) with [(15)O] H2O was used to measure rCBF during a joystick motor task.
• Motor performance and UPDRS motor scores were evaluated during OFF and ON stimulation conditions, while patients were medication-off.

Main Results:

• No significant improvement in joystick task performance was observed with different MCS stimulation frequencies.
• MCS did not alter the pattern of movement-related rCBF.
• No changes in UPDRS motor scores were detected between OFF and ON stimulation states.

Conclusions:

• Unilateral MCS did not demonstrate a clear effect on motor performance or movement-related brain activation in advanced PD patients.
• While potentially simpler and safer than STN DBS, MCS showed limited efficacy in this study.
• Further research is needed to determine the therapeutic potential of MCS for Parkinson's disease.