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DOI: 10.1148/radiol.2391041990
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Parkinson Disease: Pattern of Functional MR Imaging Activation during Deep Brain Stimulation of Subthalamic Nucleus—Initial Experience1

Micheal D. Phillips, MD, Kenneth B. Baker, PhD, Mark J. Lowe, PhD, Jean A. Tkach, PhD, Scott E. Cooper, MD, PhD, Brian H. Kopell, MD and Ali R. Rezai, MD

1 From the Departments of Radiology (M.D.P., M.J.L., J.A.T.), Neurology (S.E.C.), and Neurosurgery (K.B.B., A.R.R.), Cleveland Clinic Foundation, Mellen Center/U-15, 9500 Euclid Ave, Cleveland, OH 44195; and Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, Wis (B.H.K.). Received November 23, 2004; revision requested January 27, 2005; revision received April 26; final version accepted June 3. Supported in part by State of Ohio Biomedical Research and Technology Transfer Grant. Address correspondence to M.D.P. (e-mail: phillim{at}ccf.org).


Figure 1
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  		Figure 1: Subject 1. Colorized functional MR imaging activation data displayed in yellow, orange, and red on anatomic magnetization-prepared rapid acquisition gradient-echo images displayed in transverse, coronal, and transverse planes from left to right. Only left-sided DBS was performed. Arrows point to bilateral DBS electrodes. Areas of activation were identified within left posterior globus pallidus externa (left and middle images), posterior putamen (left and middle images), left thalamus (middle image), and right cerebellum (right image).

 

Figure 2
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  		Figure 2a: Subject 3. Colorized functional MR imaging activation data displayed in yellow, orange, and red on anatomic magnetization-prepared rapid acquisition gradient-echo images in transverse plane. Foci of activation within (a) right thalamus and (b) right globus pallidus externa during right-sided DBS. (c) Foci of activation within left globus pallidus externa and left thalamus during left-sided DBS.

 

Figure 2
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  		Figure 2b: Subject 3. Colorized functional MR imaging activation data displayed in yellow, orange, and red on anatomic magnetization-prepared rapid acquisition gradient-echo images in transverse plane. Foci of activation within (a) right thalamus and (b) right globus pallidus externa during right-sided DBS. (c) Foci of activation within left globus pallidus externa and left thalamus during left-sided DBS.

 

Figure 2
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  		Figure 2c: Subject 3. Colorized functional MR imaging activation data displayed in yellow, orange, and red on anatomic magnetization-prepared rapid acquisition gradient-echo images in transverse plane. Foci of activation within (a) right thalamus and (b) right globus pallidus externa during right-sided DBS. (c) Foci of activation within left globus pallidus externa and left thalamus during left-sided DBS.

 

Figure 3
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  		Figure 3a: Subject 5. Colorized functional MR imaging activation data displayed in yellow, orange, and red on anatomic magnetization-prepared rapid acquisition gradient-echo images in (a, d, e) transverse and (b, c) coronal planes. (a–c) Pattern of activation during right-sided DBS. Foci of activation were identified within the (a, b) ipsilateral posterior globus pallidus externa and posterior putamen with a smaller focus of activation identified in the contralateral globus pallidus externa and putamen and in the (c) contralateral cerebellum with a smaller focus of activation in the ipsilateral cerebellum. (d, e) Pattern of activation during left-sided DBS. Foci of activation were identified within (d) ipsilateral globus pallidus externa and (e) thalamus.

 

Figure 3
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  		Figure 3b: Subject 5. Colorized functional MR imaging activation data displayed in yellow, orange, and red on anatomic magnetization-prepared rapid acquisition gradient-echo images in (a, d, e) transverse and (b, c) coronal planes. (a–c) Pattern of activation during right-sided DBS. Foci of activation were identified within the (a, b) ipsilateral posterior globus pallidus externa and posterior putamen with a smaller focus of activation identified in the contralateral globus pallidus externa and putamen and in the (c) contralateral cerebellum with a smaller focus of activation in the ipsilateral cerebellum. (d, e) Pattern of activation during left-sided DBS. Foci of activation were identified within (d) ipsilateral globus pallidus externa and (e) thalamus.

 

Figure 3
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  		Figure 3c: Subject 5. Colorized functional MR imaging activation data displayed in yellow, orange, and red on anatomic magnetization-prepared rapid acquisition gradient-echo images in (a, d, e) transverse and (b, c) coronal planes. (a–c) Pattern of activation during right-sided DBS. Foci of activation were identified within the (a, b) ipsilateral posterior globus pallidus externa and posterior putamen with a smaller focus of activation identified in the contralateral globus pallidus externa and putamen and in the (c) contralateral cerebellum with a smaller focus of activation in the ipsilateral cerebellum. (d, e) Pattern of activation during left-sided DBS. Foci of activation were identified within (d) ipsilateral globus pallidus externa and (e) thalamus.

 

Figure 3
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  		Figure 3d: Subject 5. Colorized functional MR imaging activation data displayed in yellow, orange, and red on anatomic magnetization-prepared rapid acquisition gradient-echo images in (a, d, e) transverse and (b, c) coronal planes. (a–c) Pattern of activation during right-sided DBS. Foci of activation were identified within the (a, b) ipsilateral posterior globus pallidus externa and posterior putamen with a smaller focus of activation identified in the contralateral globus pallidus externa and putamen and in the (c) contralateral cerebellum with a smaller focus of activation in the ipsilateral cerebellum. (d, e) Pattern of activation during left-sided DBS. Foci of activation were identified within (d) ipsilateral globus pallidus externa and (e) thalamus.

 

Figure 3
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  		Figure 3e: Subject 5. Colorized functional MR imaging activation data displayed in yellow, orange, and red on anatomic magnetization-prepared rapid acquisition gradient-echo images in (a, d, e) transverse and (b, c) coronal planes. (a–c) Pattern of activation during right-sided DBS. Foci of activation were identified within the (a, b) ipsilateral posterior globus pallidus externa and posterior putamen with a smaller focus of activation identified in the contralateral globus pallidus externa and putamen and in the (c) contralateral cerebellum with a smaller focus of activation in the ipsilateral cerebellum. (d, e) Pattern of activation during left-sided DBS. Foci of activation were identified within (d) ipsilateral globus pallidus externa and (e) thalamus.

 




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