OPTIMIZING STN-DBS TOWARDS THE ALLEVIATION OF STIMULATION-INDUCED COGNITIVE SIDE EFFECTS
Relevant for Research Area
Deep brain stimulation (DBS) of the subthalamic nucleus (STN) is a common therapy to alleviate motor symptoms in Parkinson’s disease (PD) but may have detrimental effects on the prefrontal cortex (PFC) and related cognitive functions. Extant models of PFC functioning propose a rostro-caudal gradient of organization with rostral PFC modulating activity of caudal PFC. Capitalizing on the high temporal and adequate spatial resolution of multi- channel near-infrared spectroscopy (NIRS), the aim of the ODASIC project was to assess DBS-induced alterations on prefrontal functioning using cross-spectral inference of directed interactions within the PFC. Results of the ODASIC yielded first evidence for the assumption of rostro-caudally directed interactions in the human PFC, with rostral areas controlling information processing in caudal areas. While prior evidence supporting this position did not demonstrate that rostral-to-caudal influences are actually causal, the project’s novel methodological approach with multi- channel NIRS revealed that directed interactions within PFC are indeed asymmetrically distributed along a rostro-caudal axis but also separable along a ventro-dorsal axis. Comprehensive analyses in PD patients further demonstrated that this functional network architecture of the human PFC is reliably affected by STN-DBS. Switching STN-DBS ON and OFF changed the strength of rostro-caudally directed interactions within the PFC in a highly reproducible manner. Further analyses confirmed a specific link between directed interactions in PFC activity and inter-individual differences in cognitive functioning.
These findings of the ODASIC project not only add new fundamental evidence to models of prefrontal functional organization and theories of cortico-basal ganglia circuitry but also provide a new perspective on the ramifications of DBS for remote functional networks.
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Köstering L, Leonhart R, Stahl C, Weiller C, Kaller CP (2013). Age-related changes in complex cognition: Assessment of planning ability and underlying cognitive processes. Talk presented at the 2013 Annual Meeting of the German Society of Neurology (DGN), 09/2013, Dresden.
Köstering L, Leonhart R, Stahl C, Weiller C, Kaller CP (2013). Delineating the cognitive foundations of planning performance in healthy ageing: Mediation effects of fluid abilities and working memory capacity. Poster presented at the 2013 Psychologie und Gehirn Meeting, 05/2013, Wuerzburg.
Köstering L, Schmidt CSM, Egger K, Amtage F, Peter J, Klöppel S, Beume L-A, Hoeren M, Weiller C, Kaller CP (2015). Assessment of planning performance in clinical samples: Reliability and validity of the Tower of London Task (TOL-F). Talk presented at the 30th Annual Meeting of the German Society for Neuropsychology (GNP), 09/2015, Luebeck.
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Nitschke K, Finkel L, Köstering L, Weiller C, Kaller CP (2013). A quantitative meta- analysis on the neural basis of planning: Activation Likelihood Estimation (ALE) of functional imaging results in the Tower of London task. Poster presented at the 2013 Psychologie und Gehirn Meeting, 05/2013, Wuerzburg.
Nitschke K, Finkel L, Köstering L, Weiller C, Kaller CP (2013). The neural basis of planning: A meta-analysis with Activation Likelihood Estimation (ALE) of functional imaging results. Poster presented at the 2013 Meeting of the Deutsche Gesellschaft für Psychiatrie und Psychotherapie, Psychosomatik und Nervenheilkunde (DGPPN), 11/2013, Berlin.
Nitschke K, Finkel L, Köstering L, Weiller C, Kaller CP (2014). A quantitative meta- analysis on functional imaging results in the Tower of London task. Poster presented at the 20th Annual Meeting of the Organization for Human Brain Mapping (OHBM), 06/2014, Hamburg.
Schumacher FK (2014). The hierarchical organization of the prefrontal cortex and its alteration by deep brain stimulation in Parkinson’s disease. Talk presented at the 2014 Challenge Workshop on Formal Models of (Dis)Ordered Cognition (FOMOCOG), 03/2014, Heidelberg.
Schumacher FK, Amtage F, Köstering L, Weiller C, Schelter BO, Kaller CP (2014). The hierarchical organization of the prefrontal cortex and its alteration by deep brain stimulation in Parkinson’s disease. Poster presented at the 2014 Psychologie und Gehirn Meeting, 05/2014, Luebeck.
Schumacher FK, Amtage F, Köstering L, Weiller C, Schelter BO, Kaller CP (2014). The impact of deep brain stimulation on the hierarchical organization of the prefrontal cortex in Parkinson's disease. Poster presented at the Annual Meeting of the German Society of Neurology (DGN), 09/2014, Munich. Poster prize.
Schumacher FK, Amtage F, Köstering LV, Horn A, Piroth T, Weiller C, Schelter BO, Coenen VA, Kaller CP (2016). Deep brain stimulation of the subthalamic nucleus alters the hierarchical organization of the prefrontal cortex in Parkinson’s disease: Moderating effects of disease duration at surgery. Poster presented at the 2016 Conference of the Society for functional Near-Infrared Spectroscopy, 10/2016, Paris.
Schumacher FK, Amtage F, Middell E, Schmitz CH, Schumacher LV, Horn A, Piroth T, Weiller C, Schelter BO, Coenen VA, Kaller CP (2017). Network effects of subthalamic nucleus deep brain stimulation on the prefrontal cortex. Poster and talk presented at the 23rd Annual Meeting of the Organization for Human Brain Mapping (OHBM), 06/2017, Vancouver.
Schumacher FK, Schelter BO, Rahm B, Köstering L, Nitschke K, Unterrainer JM, Weiller C, Kaller CP (2014). Separating ventral and dorsal axes of the rostro-caudal hierarchy in the lateral prefrontal cortex. Poster presented at the 20th Annual Meeting of the Organization for Human Brain Mapping (OHBM), 06/2014, Hamburg.
Schumacher FK, Schelter BO, Rahm B, Loosli SV, Ruh N, Heinze K, Unterrainer JM, Weiller C, Kaller CP (2013). Rostro-kaudale Gradienten der hierarchischen Organisation im dorsalen und ventralen präfrontalen Kortex. Poster presented at the 2013 Psychologie und Gehirn Meeting, 05/2013, Wuerzburg.
Schumacher FK, Schelter BO, Rahm B, Loosli SV, Ruh N, Heinze K, Unterrainer JM, Weiller C, Kaller CP (2013). Ventrale und dorsale Komponenten der rostro-kaudalen hierarchischen Organisation des präfrontalen Kortex. Poster presented at the 2013 Annual Meeting of the German Society of Neurology (DGN), 09/2013, Dresden.