Functional Neural Changes after Low-Frequency Bilateral Globus Pallidus Internus Deep Brain Stimulation for Post-Hypoxic Cortical Myoclonus: Voxel-Based Subtraction Analysis of Serial Positron Emission
Post-hypoxic myoclonus (PHM) and Lance–Adams syndrome (LAS) are rare conditions following cardiopulmonary resuscitation. The aim of this study was to identify functional activity in the cerebral cortex after a hypoxic event and to investigate alterations that could be modulated by deep brain stimula...
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MDPI AG
2020-10-01
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| Online Access: | https://www.mdpi.com/2076-3425/10/10/730 |
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| author | Myung Ji Kim So Hee Park Kyoung Heo Jin Woo Chang Joong Il Kim Won Seok Chang |
| author_facet | Myung Ji Kim So Hee Park Kyoung Heo Jin Woo Chang Joong Il Kim Won Seok Chang |
| author_sort | Myung Ji Kim |
| collection | DOAJ |
| description | Post-hypoxic myoclonus (PHM) and Lance–Adams syndrome (LAS) are rare conditions following cardiopulmonary resuscitation. The aim of this study was to identify functional activity in the cerebral cortex after a hypoxic event and to investigate alterations that could be modulated by deep brain stimulation (DBS). A voxel-based subtraction analysis of serial positron emission tomography (PET) scans was performed in a 34-year-old woman with chronic medically refractory PHM that improved with bilateral globus pallidus internus (Gpi) DBS implanted three years after the hypoxic event. The patient required low-frequency stimulation to show myoclonus improvement. Using voxel-based statistical parametric mapping, we identified a decrease in glucose metabolism in the prefrontal lobe including the dorsolateral, orbito-, and inferior prefrontal cortex, which was suspected to be the origin of the myoclonus from postoperative PET/magnetic resonance imaging (MRI) after DBS. Based on the present study results, voxel-based subtraction of PET appears to be a useful approach for monitoring patients with PHM treated with DBS. Further investigation and continuous follow-up on the use of PET analysis and DBS treatment for patients with PHM are necessary to help understanding the pathophysiology of PHM, or LAS. |
| first_indexed | 2024-03-10T15:40:57Z |
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| id | doaj.art-ee0c77ba51014beca02564e72aae782c |
| institution | Directory Open Access Journal |
| issn | 2076-3425 |
| language | English |
| last_indexed | 2024-03-10T15:40:57Z |
| publishDate | 2020-10-01 |
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| spelling | doaj.art-ee0c77ba51014beca02564e72aae782c2023-11-20T16:53:32ZengMDPI AGBrain Sciences2076-34252020-10-01101073010.3390/brainsci10100730Functional Neural Changes after Low-Frequency Bilateral Globus Pallidus Internus Deep Brain Stimulation for Post-Hypoxic Cortical Myoclonus: Voxel-Based Subtraction Analysis of Serial Positron EmissionMyung Ji Kim0So Hee Park1Kyoung Heo2Jin Woo Chang3Joong Il Kim4Won Seok Chang5Department of Neurosurgery, Brain Research Institute, College of Medicine, Yonsei University, Seoul 03722, KoreaDepartment of Neurosurgery, Brain Research Institute, College of Medicine, Yonsei University, Seoul 03722, KoreaDepartment of Neurology, College of Medicine, Yonsei University, Seoul 03722, KoreaDepartment of Neurosurgery, Brain Research Institute, College of Medicine, Yonsei University, Seoul 03722, KoreaFuture Medicine Division, Korea Institute of Oriental Medicine, Daejeon 34054, KoreaDepartment of Neurosurgery, Brain Research Institute, College of Medicine, Yonsei University, Seoul 03722, KoreaPost-hypoxic myoclonus (PHM) and Lance–Adams syndrome (LAS) are rare conditions following cardiopulmonary resuscitation. The aim of this study was to identify functional activity in the cerebral cortex after a hypoxic event and to investigate alterations that could be modulated by deep brain stimulation (DBS). A voxel-based subtraction analysis of serial positron emission tomography (PET) scans was performed in a 34-year-old woman with chronic medically refractory PHM that improved with bilateral globus pallidus internus (Gpi) DBS implanted three years after the hypoxic event. The patient required low-frequency stimulation to show myoclonus improvement. Using voxel-based statistical parametric mapping, we identified a decrease in glucose metabolism in the prefrontal lobe including the dorsolateral, orbito-, and inferior prefrontal cortex, which was suspected to be the origin of the myoclonus from postoperative PET/magnetic resonance imaging (MRI) after DBS. Based on the present study results, voxel-based subtraction of PET appears to be a useful approach for monitoring patients with PHM treated with DBS. Further investigation and continuous follow-up on the use of PET analysis and DBS treatment for patients with PHM are necessary to help understanding the pathophysiology of PHM, or LAS.https://www.mdpi.com/2076-3425/10/10/730deep brain stimulation (DBS)globus pallidum internus (Gpi)Lance–Adams syndrome (LAS)PET/MRI co-registrationpost hypoxic myoclonus (PHM)voxel-based subtraction analysis |
| spellingShingle | Myung Ji Kim So Hee Park Kyoung Heo Jin Woo Chang Joong Il Kim Won Seok Chang Functional Neural Changes after Low-Frequency Bilateral Globus Pallidus Internus Deep Brain Stimulation for Post-Hypoxic Cortical Myoclonus: Voxel-Based Subtraction Analysis of Serial Positron Emission Brain Sciences deep brain stimulation (DBS) globus pallidum internus (Gpi) Lance–Adams syndrome (LAS) PET/MRI co-registration post hypoxic myoclonus (PHM) voxel-based subtraction analysis |
| title | Functional Neural Changes after Low-Frequency Bilateral Globus Pallidus Internus Deep Brain Stimulation for Post-Hypoxic Cortical Myoclonus: Voxel-Based Subtraction Analysis of Serial Positron Emission |
| title_full | Functional Neural Changes after Low-Frequency Bilateral Globus Pallidus Internus Deep Brain Stimulation for Post-Hypoxic Cortical Myoclonus: Voxel-Based Subtraction Analysis of Serial Positron Emission |
| title_fullStr | Functional Neural Changes after Low-Frequency Bilateral Globus Pallidus Internus Deep Brain Stimulation for Post-Hypoxic Cortical Myoclonus: Voxel-Based Subtraction Analysis of Serial Positron Emission |
| title_full_unstemmed | Functional Neural Changes after Low-Frequency Bilateral Globus Pallidus Internus Deep Brain Stimulation for Post-Hypoxic Cortical Myoclonus: Voxel-Based Subtraction Analysis of Serial Positron Emission |
| title_short | Functional Neural Changes after Low-Frequency Bilateral Globus Pallidus Internus Deep Brain Stimulation for Post-Hypoxic Cortical Myoclonus: Voxel-Based Subtraction Analysis of Serial Positron Emission |
| title_sort | functional neural changes after low frequency bilateral globus pallidus internus deep brain stimulation for post hypoxic cortical myoclonus voxel based subtraction analysis of serial positron emission |
| topic | deep brain stimulation (DBS) globus pallidum internus (Gpi) Lance–Adams syndrome (LAS) PET/MRI co-registration post hypoxic myoclonus (PHM) voxel-based subtraction analysis |
| url | https://www.mdpi.com/2076-3425/10/10/730 |
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