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Supplementary and Primary Sensory Motor Area Activity in Parkinson's Disease: Regional Cerebral Blood Flow Changes During Finger Movements and Effects of Apomorphine

Supplementary and Primary Sensory Motor Area Activity in Parkinson's Disease: Regional Cerebral... Abstract • We have measured with single-photon emission tomography the regional cerebral blood flow changes that occurred in the supplementary motor areas and in the primary sensory motor areas during sequential finger-to-thumb opposition movements of the right hand in seven akinetic patients with Parkinson's disease and in nine normal volunteers. Parkinsonian patients were studied before ("off" condition) and after a subcutaneous injection of apomorphine hydrochloride which was able to switch them "on" (on condition). In normal volunteers and parkinsonian patients in the on condition, regional cerebral blood flow significantly increased in the supplementary motor areas and in the contralateral primary sensory motor cortex but not in the ipsilateral primary sensory motor cortex. On the contrary, no significant regional cerebral blood flow change was observed in these areas in parkinsonian patients in the off condition. These results support the hypothesis that a functional cortical motor area deafferentation is involved in the pathophysiological makeup of akinesia and that this abnormality is reversed by dopaminergic drugs. References 1. Marsden CD. Slowness of movements in Parkinson's disease . Mov Disord . 1989;4:S26-S37.Crossref 2. Marsden CD. The mysterious motor function of the basal ganglia: the Robert Wartenberg lecture . Neurology . 1982;514:514-539.Crossref 3. Benecke R, Rothwell JC, Dick JP, Day BR, Marsden CD. Performance of simultaneous movements in patients with Parkinson's disease . Brain . 1986;109:739-757.Crossref 4. Benecke R, Rothwell JC, Dick JP, Day BR, Marsden CD. Disturbance of sequential movements in patients with Parkinson's disease . Brain . 1987;110:361-379.Crossref 5. Jurgens U. The efferent and afferent connections of the supplementary motor area . Brain Res . 1984;300:63-87.Crossref 6. Schell GR, Strick PL. The origin of thalamic inputs to the accurate premotor and supplementary motor areas . J Neurosci . 1984;4:539-560. 7. Kornhuber HH, Deecke L. An electrical sign of participation of the mesial supplementary motor cortex in human voluntary finger movement . Brain Res . 1978;159:473-476.Crossref 8. Deecke L, Englitz HG, Kornhuber HH, Schmidt G. Cerebral potentials preceding voluntary movements in patients with bilateral or unilateral parkinsonian akinesia . In: De Smedt JE, ed. Progress in Clinical Neurophysiology . Basel, Switzerland: Kaiger; 1987;1:151-163. 9. Simpson JA, Khuraibet AJ. Readiness potential of cortical area 6 preceding self paced movement in Parkinson's disease . J Neurol Neurosurg Psychiatry . 1987;50:1184-1191.Crossref 10. Barrett G, Shibasaki H, Neshige R. Cortical potential shifts preceding voluntary movement are normal in parkinsonism . Electroencephalogr Clin Neurophysiol . 1986;63:340-348.Crossref 11. Dick JP, Benecke R, Rothwell JC, Day BR, Marsden CD. Simple and complex movement in a patient with infarction of the right supplementary motor area . Mov Disord . 1986;1:255-266.Crossref 12. Olesen J. Contralateral focal increase of cerebral blood flow in man during arm work . Brain . 1971;94:635-646.Crossref 13. Roland PE, Larsen B. Focal increase of cerebral blood flow during stereognostic testing in man . Arch Neurol . 1976;33:551-558.Crossref 14. Ingvar DH, Philipson L. Distribution of cerebral blood flow in dominant hemisphere during motor ideation and motor performance . Ann Neurol . 1977;2:230-237.Crossref 15. Roland PE, Skinhøj E, Larsen B, Lassen N. The role of different cortical areas in the organization of voluntary movements in man: a regional cerebral blood flow study . Acta Neurol Scand . 1977;56:S542-S543. 16. Roland PE, Larsen B, Lassen NA, Skinhøj E. Supplementary motor area and other cortical areas in organization of voluntary movements in man . J Neurophysiol . 1980;43:118-136. 17. Roland PE, Skinhøj E, Lassen NA, Larsen B. Different cortical areas in man in organization of voluntary movements in extrapersonal space . J Neurophysiol . 1980;43:137-150. 18. Orgogozo JM, Larsen B, Roland PE, Lassen NA. Activation de l'aire motrice supplémentaire au cours des mouvements volontaires chez l'homme . Rev Neurol . 1979;135:705-717. 19. Orgogozo JM, Larsen B. Activation of the supplementary motor area during voluntary movements in man suggests it works as a supramotor area . Science . 1979;206:847-850.Crossref 20. Halsey JH, Blauenstein UW, Wilson EM, Wills EH. Regional cerebral blood flow comparison of right and left hand movement . Neurology . 1979;29:21-28.Crossref 21. Lauritzen M, Henricksen L, Lassen NA. Regional cerebral blood flow during rest and skilled hand movements by xenon-133 inhalation and emission computerized tomography . J Cereb Blood Flow Metab . 1981;1:385-389.Crossref 22. Roland PE, Meyer E, Shibasaki T, Yamamoto YL, Thomsen CJ. Regional cerebral blood flow changes in cortex and basal ganglia during voluntary movements in normal human volunteers . J Neurophysiol . 1982;48:467-480. 23. Fox PT, Raichle ME, Thach WT. Functional mapping of the human cerebellum with positron emission tomography . Proc Natl Acad Sci U S A . 1985;82:7462-7466.Crossref 24. Colebatch JG, Cunningham VJ, Dieber MP, et al. Regional cerebral blood flow during unilateral arm and hand movements in human volunteers . J Physiol . 1990;423:9P. 25. Colebatch JG, Findley LJ, Frackowiak RS, Marsden CD, Brooks DJ. Preliminary report: activation of the cerebellum in essential tremor . Lancet . 1990;2:1028-1030.Crossref 26. Chollet F, Di Piero V, Wise RJ, Brooks DJ, Dolan RJ, Frackowiak RS. The functional anatomy of motor recovery after stroke in humans: a study with positron emission tomography . Ann Neurol . 1991;291:63-71.Crossref 27. Gibb W, Lees A. The relevance of Lewy body to the pathogenesis of idiopathic Parkinson's disease . J Neurol Neurosurg Psychiatry . 1988;51:745-752.Crossref 28. Hoehn MH, Yahr MH. Parkinsonism: onset, progression and mortality . Neurology . 1967;17:427-442.Crossref 29. Fahn S, Elton R, Unified Parkinson's Disease Rating Scale Development Committee. Unified Parkinson's disease rating scale . In: Fahn S, Marsden CD, Calne D, eds. Recent Developments in Parkinson's Disease . New York, NY: Macmillan Publishing Co Inc; 1987;2:153-163. 30. Hughes A, Lees A, Stern G. Apomorphine test to predict dopaminergic responsiveness in parkinsonian syndromes . Lancet . 1990;2:32-34.Crossref 31. Celsis P, Goldman T, Henriksen L, Larsen N. A method for calculating regional cerebral blood flow from emission computed tomography of inert gas concentrations . J Comput Assist Tomogr . 1981;5:641-645.Crossref 32. Montastruc JL, Celsis P, Agniel A, et al. Levodopa-induced regional cerebral blood flow changes in normal volunteers and patients with Parkinson's disease: lack of correlation with clinical or neuropsychological improvements . Mov Disord . 1987;2:279-289.Crossref 33. Talairach J, Tournoux P. Co-planar Stereotaxic Atlas of the Human Brain . Stuttgart, Federal Republic of Germany: Georg Thieme Verlag; 1988. 34. Fox PT, Mintum MA, Rieman EM, Raichle ME. Enhanced detection of focal brain responses using intersubject averaging and change distribution analysis of substracted PET images . J Cereb Blood Flow Metab . 1988;8:642-653.Crossref 35. Lassen NA, Ingvar DH. Brain regions involved in voluntary movements as revealed by radioisotopic mapping of CBF or CMR-glucose changes . Rev Neurol . 1990;146:620-625. 36. Dick JP, Cowan JM, Day BL, et al. The corticomotoneurone connection is normal in Parkinson's disease . Nature . 1984;312:407-409.Crossref 37. Wise R, Chollet F, Hadar U, Friston K, Hoffner E, Frackowiak R. Distribution of cortical neural networks involved in word comprehension and word retrieval . Brain . 1991;114:1803-1817.Crossref 38. Delong MR. Primate models of movement disorders of basal ganglia origin . Trends Neurosci . 1990;13:381-385. 39. Sabatini U, Rascol O, Celsis P, et al. Subcutaneous apomorphine increases regional central blood flow in parkinsonian patients via peripheral mechanisms . Br J Clin Pharmacol . 1991;32:229-234.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Neurology American Medical Association

Supplementary and Primary Sensory Motor Area Activity in Parkinson's Disease: Regional Cerebral Blood Flow Changes During Finger Movements and Effects of Apomorphine

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American Medical Association
Copyright
Copyright © 1992 American Medical Association. All Rights Reserved.
ISSN
0003-9942
eISSN
1538-3687
DOI
10.1001/archneur.1992.00530260044017
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Abstract

Abstract • We have measured with single-photon emission tomography the regional cerebral blood flow changes that occurred in the supplementary motor areas and in the primary sensory motor areas during sequential finger-to-thumb opposition movements of the right hand in seven akinetic patients with Parkinson's disease and in nine normal volunteers. Parkinsonian patients were studied before ("off" condition) and after a subcutaneous injection of apomorphine hydrochloride which was able to switch them "on" (on condition). In normal volunteers and parkinsonian patients in the on condition, regional cerebral blood flow significantly increased in the supplementary motor areas and in the contralateral primary sensory motor cortex but not in the ipsilateral primary sensory motor cortex. On the contrary, no significant regional cerebral blood flow change was observed in these areas in parkinsonian patients in the off condition. These results support the hypothesis that a functional cortical motor area deafferentation is involved in the pathophysiological makeup of akinesia and that this abnormality is reversed by dopaminergic drugs. References 1. Marsden CD. Slowness of movements in Parkinson's disease . Mov Disord . 1989;4:S26-S37.Crossref 2. Marsden CD. The mysterious motor function of the basal ganglia: the Robert Wartenberg lecture . Neurology . 1982;514:514-539.Crossref 3. Benecke R, Rothwell JC, Dick JP, Day BR, Marsden CD. Performance of simultaneous movements in patients with Parkinson's disease . Brain . 1986;109:739-757.Crossref 4. Benecke R, Rothwell JC, Dick JP, Day BR, Marsden CD. Disturbance of sequential movements in patients with Parkinson's disease . Brain . 1987;110:361-379.Crossref 5. Jurgens U. The efferent and afferent connections of the supplementary motor area . Brain Res . 1984;300:63-87.Crossref 6. Schell GR, Strick PL. The origin of thalamic inputs to the accurate premotor and supplementary motor areas . J Neurosci . 1984;4:539-560. 7. Kornhuber HH, Deecke L. An electrical sign of participation of the mesial supplementary motor cortex in human voluntary finger movement . Brain Res . 1978;159:473-476.Crossref 8. Deecke L, Englitz HG, Kornhuber HH, Schmidt G. Cerebral potentials preceding voluntary movements in patients with bilateral or unilateral parkinsonian akinesia . In: De Smedt JE, ed. Progress in Clinical Neurophysiology . Basel, Switzerland: Kaiger; 1987;1:151-163. 9. Simpson JA, Khuraibet AJ. Readiness potential of cortical area 6 preceding self paced movement in Parkinson's disease . J Neurol Neurosurg Psychiatry . 1987;50:1184-1191.Crossref 10. Barrett G, Shibasaki H, Neshige R. Cortical potential shifts preceding voluntary movement are normal in parkinsonism . Electroencephalogr Clin Neurophysiol . 1986;63:340-348.Crossref 11. Dick JP, Benecke R, Rothwell JC, Day BR, Marsden CD. Simple and complex movement in a patient with infarction of the right supplementary motor area . Mov Disord . 1986;1:255-266.Crossref 12. Olesen J. Contralateral focal increase of cerebral blood flow in man during arm work . Brain . 1971;94:635-646.Crossref 13. Roland PE, Larsen B. Focal increase of cerebral blood flow during stereognostic testing in man . Arch Neurol . 1976;33:551-558.Crossref 14. Ingvar DH, Philipson L. Distribution of cerebral blood flow in dominant hemisphere during motor ideation and motor performance . Ann Neurol . 1977;2:230-237.Crossref 15. Roland PE, Skinhøj E, Larsen B, Lassen N. The role of different cortical areas in the organization of voluntary movements in man: a regional cerebral blood flow study . Acta Neurol Scand . 1977;56:S542-S543. 16. Roland PE, Larsen B, Lassen NA, Skinhøj E. Supplementary motor area and other cortical areas in organization of voluntary movements in man . J Neurophysiol . 1980;43:118-136. 17. Roland PE, Skinhøj E, Lassen NA, Larsen B. Different cortical areas in man in organization of voluntary movements in extrapersonal space . J Neurophysiol . 1980;43:137-150. 18. Orgogozo JM, Larsen B, Roland PE, Lassen NA. Activation de l'aire motrice supplémentaire au cours des mouvements volontaires chez l'homme . Rev Neurol . 1979;135:705-717. 19. Orgogozo JM, Larsen B. Activation of the supplementary motor area during voluntary movements in man suggests it works as a supramotor area . Science . 1979;206:847-850.Crossref 20. Halsey JH, Blauenstein UW, Wilson EM, Wills EH. Regional cerebral blood flow comparison of right and left hand movement . Neurology . 1979;29:21-28.Crossref 21. Lauritzen M, Henricksen L, Lassen NA. Regional cerebral blood flow during rest and skilled hand movements by xenon-133 inhalation and emission computerized tomography . J Cereb Blood Flow Metab . 1981;1:385-389.Crossref 22. Roland PE, Meyer E, Shibasaki T, Yamamoto YL, Thomsen CJ. Regional cerebral blood flow changes in cortex and basal ganglia during voluntary movements in normal human volunteers . J Neurophysiol . 1982;48:467-480. 23. Fox PT, Raichle ME, Thach WT. Functional mapping of the human cerebellum with positron emission tomography . Proc Natl Acad Sci U S A . 1985;82:7462-7466.Crossref 24. Colebatch JG, Cunningham VJ, Dieber MP, et al. Regional cerebral blood flow during unilateral arm and hand movements in human volunteers . J Physiol . 1990;423:9P. 25. Colebatch JG, Findley LJ, Frackowiak RS, Marsden CD, Brooks DJ. Preliminary report: activation of the cerebellum in essential tremor . Lancet . 1990;2:1028-1030.Crossref 26. Chollet F, Di Piero V, Wise RJ, Brooks DJ, Dolan RJ, Frackowiak RS. The functional anatomy of motor recovery after stroke in humans: a study with positron emission tomography . Ann Neurol . 1991;291:63-71.Crossref 27. Gibb W, Lees A. The relevance of Lewy body to the pathogenesis of idiopathic Parkinson's disease . J Neurol Neurosurg Psychiatry . 1988;51:745-752.Crossref 28. Hoehn MH, Yahr MH. Parkinsonism: onset, progression and mortality . Neurology . 1967;17:427-442.Crossref 29. Fahn S, Elton R, Unified Parkinson's Disease Rating Scale Development Committee. Unified Parkinson's disease rating scale . In: Fahn S, Marsden CD, Calne D, eds. Recent Developments in Parkinson's Disease . New York, NY: Macmillan Publishing Co Inc; 1987;2:153-163. 30. Hughes A, Lees A, Stern G. Apomorphine test to predict dopaminergic responsiveness in parkinsonian syndromes . Lancet . 1990;2:32-34.Crossref 31. Celsis P, Goldman T, Henriksen L, Larsen N. A method for calculating regional cerebral blood flow from emission computed tomography of inert gas concentrations . J Comput Assist Tomogr . 1981;5:641-645.Crossref 32. Montastruc JL, Celsis P, Agniel A, et al. Levodopa-induced regional cerebral blood flow changes in normal volunteers and patients with Parkinson's disease: lack of correlation with clinical or neuropsychological improvements . Mov Disord . 1987;2:279-289.Crossref 33. Talairach J, Tournoux P. Co-planar Stereotaxic Atlas of the Human Brain . Stuttgart, Federal Republic of Germany: Georg Thieme Verlag; 1988. 34. Fox PT, Mintum MA, Rieman EM, Raichle ME. Enhanced detection of focal brain responses using intersubject averaging and change distribution analysis of substracted PET images . J Cereb Blood Flow Metab . 1988;8:642-653.Crossref 35. Lassen NA, Ingvar DH. Brain regions involved in voluntary movements as revealed by radioisotopic mapping of CBF or CMR-glucose changes . Rev Neurol . 1990;146:620-625. 36. Dick JP, Cowan JM, Day BL, et al. The corticomotoneurone connection is normal in Parkinson's disease . Nature . 1984;312:407-409.Crossref 37. Wise R, Chollet F, Hadar U, Friston K, Hoffner E, Frackowiak R. Distribution of cortical neural networks involved in word comprehension and word retrieval . Brain . 1991;114:1803-1817.Crossref 38. Delong MR. Primate models of movement disorders of basal ganglia origin . Trends Neurosci . 1990;13:381-385. 39. Sabatini U, Rascol O, Celsis P, et al. Subcutaneous apomorphine increases regional central blood flow in parkinsonian patients via peripheral mechanisms . Br J Clin Pharmacol . 1991;32:229-234.Crossref

Journal

Archives of NeurologyAmerican Medical Association

Published: Feb 1, 1992

References