Functional anatomy of the subthalamic nucleus and the pathophysiology of cardinal features of Parkinson's disease unraveled by focused ultrasound ablation

The subthalamic nucleus (STN) modulates basal ganglia output and plays a fundamental role in the pathophysiology of Parkinson's disease (PD). Blockade/ablation of the STN improves motor signs in PD. We assessed the topography of focused ultrasound subthalamotomy (n = 39) by voxel-based lesion-s...

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Autores: Rodriguez-Rojas, Rafael, Máñez-Miró, Jorge U, Pineda-Pardo, José A, Del Álamo, Marta, Martínez-Fernández, Raúl, Obeso, José A
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2024
País:España
Institución:Consejo Superior de Investigaciones Científicas (CSIC)
Repositorio:DIGITAL.CSIC. Repositorio Institucional del CSIC
OAI Identifier:oai:digital.csic.es:10261/395821
Acceso en línea:http://hdl.handle.net/10261/395821
https://api.elsevier.com/content/abstract/scopus_id/85210281425
Access Level:acceso abierto
Palabra clave:http://metadata.un.org/sdg/3
Ensure healthy lives and promote well-being for all at all ages
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spelling Functional anatomy of the subthalamic nucleus and the pathophysiology of cardinal features of Parkinson's disease unraveled by focused ultrasound ablationRodriguez-Rojas, RafaelMáñez-Miró, Jorge UPineda-Pardo, José ADel Álamo, MartaMartínez-Fernández, RaúlObeso, José Ahttp://metadata.un.org/sdg/3Ensure healthy lives and promote well-being for all at all agesThe subthalamic nucleus (STN) modulates basal ganglia output and plays a fundamental role in the pathophysiology of Parkinson's disease (PD). Blockade/ablation of the STN improves motor signs in PD. We assessed the topography of focused ultrasound subthalamotomy (n = 39) by voxel-based lesion-symptom mapping to identify statistically validated brain voxels with the optimal effect against each cardinal feature and their respective cortical connectivity patterns by diffusion-weighted tractography. Bradykinesia and rigidity amelioration were associated with ablation of the rostral motor STN subregion connected to the supplementary motor and premotor cortices, whereas antitremor effect was explained by lesioning the posterolateral STN projection to the primary motor cortex. These findings were corroborated prospectively in another PD cohort (n = 12). This work concurs with recent deep brain stimulation findings that suggest different corticosubthalamic circuits underlying each PD cardinal feature. Our results provide sound evidence in humans of segregated anatomy of subthalamic-cortical connections and their distinct role in PD pathophysiology and normal motor control.The study was partially supported by the Fundación de investigación HM hospitales (Madrid). J.A.O. research in this area is supported by the Plan Nacional de investigación (Pid2019-111045RB- i00), Ministry of Science and education, Spain, Fundación MAPFRE, and the Focused Ultrasound Foundation (Virginia, United States). The supporting party had no role in data acquisition, analysis, orinterpretation. the corresponding author confirms that he had full access to all the data in the study and had final responsibility for the decision to submit for publication.Peer reviewedAmerican Association for the Advancement of ScienceFundación de Investigación HM HospitalesMinisterio de Ciencia e Innovación (España)Fundación MapfreFocused Ultrasound FoundationConsejo Superior de Investigaciones Científicas [https://ror.org/02gfc7t72]202520252024info:eu-repo/semantics/articlehttp://purl.org/coar/resource_type/c_6501Publisher's versioninfo:eu-repo/semantics/publishedVersionapplication/pdfhttp://hdl.handle.net/10261/395821https://api.elsevier.com/content/abstract/scopus_id/85210281425reponame:DIGITAL.CSIC. Repositorio Institucional del CSICinstname:Consejo Superior de Investigaciones Científicas (CSIC)Inglés#PLACEHOLDER_PARENT_METADATA_VALUE#info:eu-repo/grantAgreement/AEI/Plan Estatal de Investigación Científica y Técnica y de Innovación 2017-2020/PID2019-111045RB-I00https://doi.org/10.1126/sciadv.adr9891Síinfo:eu-repo/semantics/openAccessoai:digital.csic.es:10261/3958212026-05-22T06:33:51Z
dc.title.none.fl_str_mv Functional anatomy of the subthalamic nucleus and the pathophysiology of cardinal features of Parkinson's disease unraveled by focused ultrasound ablation
title Functional anatomy of the subthalamic nucleus and the pathophysiology of cardinal features of Parkinson's disease unraveled by focused ultrasound ablation
spellingShingle Functional anatomy of the subthalamic nucleus and the pathophysiology of cardinal features of Parkinson's disease unraveled by focused ultrasound ablation
Rodriguez-Rojas, Rafael
http://metadata.un.org/sdg/3
Ensure healthy lives and promote well-being for all at all ages
title_short Functional anatomy of the subthalamic nucleus and the pathophysiology of cardinal features of Parkinson's disease unraveled by focused ultrasound ablation
title_full Functional anatomy of the subthalamic nucleus and the pathophysiology of cardinal features of Parkinson's disease unraveled by focused ultrasound ablation
title_fullStr Functional anatomy of the subthalamic nucleus and the pathophysiology of cardinal features of Parkinson's disease unraveled by focused ultrasound ablation
title_full_unstemmed Functional anatomy of the subthalamic nucleus and the pathophysiology of cardinal features of Parkinson's disease unraveled by focused ultrasound ablation
title_sort Functional anatomy of the subthalamic nucleus and the pathophysiology of cardinal features of Parkinson's disease unraveled by focused ultrasound ablation
dc.creator.none.fl_str_mv Rodriguez-Rojas, Rafael
Máñez-Miró, Jorge U
Pineda-Pardo, José A
Del Álamo, Marta
Martínez-Fernández, Raúl
Obeso, José A
author Rodriguez-Rojas, Rafael
author_facet Rodriguez-Rojas, Rafael
Máñez-Miró, Jorge U
Pineda-Pardo, José A
Del Álamo, Marta
Martínez-Fernández, Raúl
Obeso, José A
author_role author
author2 Máñez-Miró, Jorge U
Pineda-Pardo, José A
Del Álamo, Marta
Martínez-Fernández, Raúl
Obeso, José A
author2_role author
author
author
author
author
dc.contributor.none.fl_str_mv Fundación de Investigación HM Hospitales
Ministerio de Ciencia e Innovación (España)
Fundación Mapfre
Focused Ultrasound Foundation
Consejo Superior de Investigaciones Científicas [https://ror.org/02gfc7t72]
dc.subject.none.fl_str_mv http://metadata.un.org/sdg/3
Ensure healthy lives and promote well-being for all at all ages
topic http://metadata.un.org/sdg/3
Ensure healthy lives and promote well-being for all at all ages
description The subthalamic nucleus (STN) modulates basal ganglia output and plays a fundamental role in the pathophysiology of Parkinson's disease (PD). Blockade/ablation of the STN improves motor signs in PD. We assessed the topography of focused ultrasound subthalamotomy (n = 39) by voxel-based lesion-symptom mapping to identify statistically validated brain voxels with the optimal effect against each cardinal feature and their respective cortical connectivity patterns by diffusion-weighted tractography. Bradykinesia and rigidity amelioration were associated with ablation of the rostral motor STN subregion connected to the supplementary motor and premotor cortices, whereas antitremor effect was explained by lesioning the posterolateral STN projection to the primary motor cortex. These findings were corroborated prospectively in another PD cohort (n = 12). This work concurs with recent deep brain stimulation findings that suggest different corticosubthalamic circuits underlying each PD cardinal feature. Our results provide sound evidence in humans of segregated anatomy of subthalamic-cortical connections and their distinct role in PD pathophysiology and normal motor control.
publishDate 2024
dc.date.none.fl_str_mv 2024
2025
2025
dc.type.none.fl_str_mv info:eu-repo/semantics/article
http://purl.org/coar/resource_type/c_6501
Publisher's version
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv http://hdl.handle.net/10261/395821
https://api.elsevier.com/content/abstract/scopus_id/85210281425
url http://hdl.handle.net/10261/395821
https://api.elsevier.com/content/abstract/scopus_id/85210281425
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv #PLACEHOLDER_PARENT_METADATA_VALUE#
info:eu-repo/grantAgreement/AEI/Plan Estatal de Investigación Científica y Técnica y de Innovación 2017-2020/PID2019-111045RB-I00
https://doi.org/10.1126/sciadv.adr9891
Sí
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv American Association for the Advancement of Science
publisher.none.fl_str_mv American Association for the Advancement of Science
dc.source.none.fl_str_mv reponame:DIGITAL.CSIC. Repositorio Institucional del CSIC
instname:Consejo Superior de Investigaciones Científicas (CSIC)
instname_str Consejo Superior de Investigaciones Científicas (CSIC)
reponame_str DIGITAL.CSIC. Repositorio Institucional del CSIC
collection DIGITAL.CSIC. Repositorio Institucional del CSIC
repository.name.fl_str_mv
repository.mail.fl_str_mv
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