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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  • Tim J. Van Hartevelt, Center for Functionally Integrative Neuroscience, Aarhus University, University of Oxford, Oxford
  • ,
  • Joana Cabral
  • Gustavo Deco, Universitat Pompeu Fabra, Barcelona
  • ,
  • Arne Møller
  • Alexander L. Green, John Radcliffe Hospital
  • ,
  • Tipu Z. Aziz, John Radcliffe Hospital
  • ,
  • Morten L. Kringelbach

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. Results: 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. Conclusions: 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.

Original languageEnglish
Article numbere86496
JournalP L o S One
Publication statusPublished - 22 Jan 2014

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