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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

Authors
 Myung Ji Kim  ;  So Hee Park  ;  Kyoung Heo  ;  Jin Woo Chang  ;  Joong Il Kim  ;  Won Seok Chang 
Citation
 BRAIN SCIENCES, Vol.10(10) : 730, 2020-10 
Journal Title
 BRAIN SCIENCES 
Issue Date
2020-10
Keywords
Lance–Adams syndrome (LAS) ; PET/MRI co-registration ; deep brain stimulation (DBS) ; globus pallidum internus (Gpi) ; post hypoxic myoclonus (PHM) ; voxel-based subtraction analysis
Abstract
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.
Files in This Item:
T202006069.pdf Download
DOI
10.3390/brainsci10100730
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Neurosurgery (신경외과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Neurology (신경과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Myung Ji(김명지)
Park, Se Ho(박세호) ORCID logo https://orcid.org/0000-0001-8089-2755
Chang, Won Seok(장원석) ORCID logo https://orcid.org/0000-0003-3145-4016
Chang, Jin Woo(장진우) ORCID logo https://orcid.org/0000-0002-2717-0101
Heo, Kyoung(허경)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/181568
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