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Evaluation of the effects of DBS in the caudal Zona incerta on brain activity during a working memory task in patients with essential tremor

Philipson, Johanna ; Awad, Amar ; Lindström, Lena LU ; Blomstedt, Patric ; Jahanshahi, Marjan and Eriksson, Johan (2023) In Neuroimage: Reports 3(4).
Abstract

Essential tremor (ET) is characterized by bilateral upper limb postural and/or kinetic tremor, but also cognitive deficits. Tremor in ET, as well as aspects of cognitive deficits associated with ET, have been suggested to be linked to dysfunction in the cerebello-thalamo-cerebral circuit. In ET patients with disabling and medically intractable motor symptoms, Deep Brain Stimulation (DBS) is effective in reducing tremor. DBS in the caudal Zona incerta (cZi) has been shown to modulate the activity of the sensorimotor cerebello-cerebral circuit during motor tasks. Whether the activity in the cerebello-cerebral circuit is modulated by DBS during tasks involving working memory is unknown. The present study therefore aimed to investigate the... (More)

Essential tremor (ET) is characterized by bilateral upper limb postural and/or kinetic tremor, but also cognitive deficits. Tremor in ET, as well as aspects of cognitive deficits associated with ET, have been suggested to be linked to dysfunction in the cerebello-thalamo-cerebral circuit. In ET patients with disabling and medically intractable motor symptoms, Deep Brain Stimulation (DBS) is effective in reducing tremor. DBS in the caudal Zona incerta (cZi) has been shown to modulate the activity of the sensorimotor cerebello-cerebral circuit during motor tasks. Whether the activity in the cerebello-cerebral circuit is modulated by DBS during tasks involving working memory is unknown. The present study therefore aimed to investigate the possible effects of cZi DBS on working-memory processing in ET patients by means of task-based blood oxygen level-dependent (BOLD) fMRI. Thirteen ET patients completed a working-memory task during DBS OFF and ON conditions. The task involved three conditions: maintenance, manipulation, and control. Behaviorally, there was no significant effect from DBS on accuracy, but a marginally significant Task x DBS interaction was detected for response times (RTs). However, post hoc comparisons for each condition failed to reach statistical significance. FMRI analyses revealed that DBS did not alter BOLD signal in regions of interest (lateral prefrontal cortex, parietal cortex, and the cerebellum), or in a complementary whole-brain analysis. The present study indicates that DBS in the cZi in patients with ET has at most marginal effects on working memory, which is consistent with the results of pre- and post-DBS neuropsychological assessment showing minimal cognitive effects of surgery.

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organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Deep brain stimulation, Essential tremor, fMRI, Working memory
in
Neuroimage: Reports
volume
3
issue
4
article number
100193
publisher
Elsevier
external identifiers
  • scopus:85175237822
DOI
10.1016/j.ynirp.2023.100193
language
English
LU publication?
yes
id
b7a3e9ee-e132-45a6-8a7c-b52722b00139
date added to LUP
2023-12-08 13:51:40
date last changed
2023-12-08 13:52:45
@article{b7a3e9ee-e132-45a6-8a7c-b52722b00139,
  abstract     = {{<p>Essential tremor (ET) is characterized by bilateral upper limb postural and/or kinetic tremor, but also cognitive deficits. Tremor in ET, as well as aspects of cognitive deficits associated with ET, have been suggested to be linked to dysfunction in the cerebello-thalamo-cerebral circuit. In ET patients with disabling and medically intractable motor symptoms, Deep Brain Stimulation (DBS) is effective in reducing tremor. DBS in the caudal Zona incerta (cZi) has been shown to modulate the activity of the sensorimotor cerebello-cerebral circuit during motor tasks. Whether the activity in the cerebello-cerebral circuit is modulated by DBS during tasks involving working memory is unknown. The present study therefore aimed to investigate the possible effects of cZi DBS on working-memory processing in ET patients by means of task-based blood oxygen level-dependent (BOLD) fMRI. Thirteen ET patients completed a working-memory task during DBS OFF and ON conditions. The task involved three conditions: maintenance, manipulation, and control. Behaviorally, there was no significant effect from DBS on accuracy, but a marginally significant Task x DBS interaction was detected for response times (RTs). However, post hoc comparisons for each condition failed to reach statistical significance. FMRI analyses revealed that DBS did not alter BOLD signal in regions of interest (lateral prefrontal cortex, parietal cortex, and the cerebellum), or in a complementary whole-brain analysis. The present study indicates that DBS in the cZi in patients with ET has at most marginal effects on working memory, which is consistent with the results of pre- and post-DBS neuropsychological assessment showing minimal cognitive effects of surgery.</p>}},
  author       = {{Philipson, Johanna and Awad, Amar and Lindström, Lena and Blomstedt, Patric and Jahanshahi, Marjan and Eriksson, Johan}},
  keywords     = {{Deep brain stimulation; Essential tremor; fMRI; Working memory}},
  language     = {{eng}},
  number       = {{4}},
  publisher    = {{Elsevier}},
  series       = {{Neuroimage: Reports}},
  title        = {{Evaluation of the effects of DBS in the caudal Zona incerta on brain activity during a working memory task in patients with essential tremor}},
  url          = {{http://dx.doi.org/10.1016/j.ynirp.2023.100193}},
  doi          = {{10.1016/j.ynirp.2023.100193}},
  volume       = {{3}},
  year         = {{2023}},
}