Skip to main content

Advertisement

SpringerLink
Log in

The reorganization of motor network in hemidystonia from the perspective of deep brain stimulation

  • Original Research
  • Published:
Brain Imaging and Behavior Aims and scope Submit manuscript

Abstract

Hemidystonia is usually ‘secondary’ to structural lesions within the cortico-striato-pallido-thalamic or the cerebello-thalamo-cortical loops. Globus pallidus internus Deep Brain Stimulation (GPi DBS) is a validated technique in the treatment of primary dystonia and still under assessment for secondary dystonia. Results of DBS in hemidystonia are limited and heterogeneous. Further knowledge concerning motor network organization after focal brain lesions might contribute to the understanding of this mitigated response to DBS and to the refinement of DBS indications and techniques in secondary dystonia. This study aimed to identify movement-related functional magnetic resonance imaging (fMRI) activation patterns in a group of hemidystonic patients in comparison to healthy controls (HC). Further analysis assessed recruitment pattern in different patient subgroups defined according to clinical and radiological criteria relevant to GPi DBS eligibility (hyperkinetic/hypokinetic and prepallidal/postpallidal). Eleven patients and nine HC underwent fMRI with a block-design alternating active and rest conditions. The motor paradigm consisted of self-paced elbow flexion-extension movements. The main results were as follows: single-subject studies revealed several activation patterns involving motor-related network regions; both ipsilesional and contralesional hemispheres showed abnormal patterns of activity; compared with HC, hemidystonic patients showed decreased brain activity in ipsilesional thalamus, pallidal and temporal areas during affected arm task execution; ‘hypokinetic’ subgroup was commonly related to widespread bilateral overactivity. This study provides additional arguments for case-by-case assessment of DBS surgery indication and target selection in hemidystonia. Single-lead approach might be unable to modulate a highly disorganized network activity in certain patients with this clinical syndrome.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  • Albanese, A., Bhatia, K., Bressman, S. B., Delong, M. R., Fahn, S., Fung, V. S., et al. (2013). Phenomenology and classification of dystonia: a consensus update. Movement Disorders, 28(7), 863–873. doi:10.1002/mds.25475.

    Article  PubMed Central  PubMed  Google Scholar 

  • Avanzino, L., Martino, D., Martino, I., Pelosin, E., Vicario, C. M., Bove, M., et al. (2013). Temporal expectation in focal hand dystonia. Brain, 136(Pt 2), 444–454. doi:10.1093/brain/aws328.

    Article  PubMed  Google Scholar 

  • Beck, S., Houdayer, E., Richardson, S. P., & Hallett, M. (2009). The role of inhibition from the left dorsal premotor cortex in right-sided focal hand dystonia. Brain Stimulation, 2(4), 208–214. doi:10.1016/j.brs.2009.03.004.

    Article  PubMed Central  PubMed  Google Scholar 

  • Bostan, A. C., Dum, R. P., & Strick, P. L. (2010). The basal ganglia communicate with the cerebellum. Proceedings of the National Academy of Sciences of the United States of America, 107(18), 8452–8456. doi:10.1073/pnas.1000496107.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  • Ceballos-Baumann, A. O., Passingham, R. E., Marsden, C. D., & Brooks, D. J. (1995). Motor reorganization in acquired hemidystonia. Annals of Neurology, 37(6), 746–757. doi:10.1002/ana.410370608.

    Article  CAS  PubMed  Google Scholar 

  • Chuang, C., Fahn, S., & Frucht, S. J. (2002). The natural history and treatment of acquired hemidystonia: report of 33 cases and review of the literature. Journal of Neurology, Neurosurgery & Psychiatry, 72(1), 59–67.

    Article  CAS  Google Scholar 

  • Coubes, P., Roubertie, A., Vayssiere, N., Hemm, S., & Echenne, B. (2000). Treatment of DYT1-generalised dystonia by stimulation of the internal globus pallidus. Lancet, 355(9222), 2220–2221. doi:10.1016/S0140-6736(00)02410-7.

    Article  CAS  PubMed  Google Scholar 

  • Cramer, S. C. (1999). Stroke recovery. Lessons from functional MR imaging and other methods of human brain mapping. Physical Medicine and Rehabilitation Clinics of North America, 10(4), 875–886. ix.

    CAS  PubMed  Google Scholar 

  • Detante, O., Vercueil, L., Thobois, S., Broussolle, E., Costes, N., Lavenne, F., et al. (2004). Globus pallidus internus stimulation in primary generalized dystonia: a H215O PET study. Brain, 127(Pt 8), 1899–1908. doi:10.1093/brain/awh213.

    Article  PubMed  Google Scholar 

  • Didelot, A., Mauguière, F., Redouté, J., Bouvard, S., Lothe, A., Reilhac, A., et al. (2010). Voxel-based analysis of asymmetry index maps increases the specificity of 18F-MPPF PET abnormalities for localizing the epileptogenic zone in temporal lobe epilepsies. Journal of Nuclear Medicine, 51(11), 1732–1739. doi:10.2967/jnumed.109.070938.

    Article  PubMed  Google Scholar 

  • Eickhoff, S. B., Stephan, K. E., Mohlberg, H., Grefkes, C., Fink, G. R., Amunts, K., et al. (2005). A new SPM toolbox for combining probabilistic cytoarchitectonic maps and functional imaging data. NeuroImage, 25(4), 1325–1335. doi:10.1016/j.neuroimage.2004.12.034.

    Article  PubMed  Google Scholar 

  • Eltahawy, H. A., Saint-Cyr, J., Giladi, N., Lang, A. E., & Lozano, A. M. (2004). Primary dystonia is more responsive than secondary dystonia to pallidal interventions: outcome after pallidotomy or pallidal deep brain stimulation. Neurosurgery, 54(3), 613–619. discussion 619–621.

    Article  PubMed  Google Scholar 

  • Fahn, S. (1988). Concept and classification of dystonia. Advances in Neurology, 50, 1–8.

    Article  CAS  PubMed  Google Scholar 

  • Fuller, J., Prescott, I. A., Moro, E., Toda, H., Lozano, A., & Hutchison, W. D. (2013). Pallidal deep brain stimulation for a case of hemidystonia secondary to a striatal stroke. Stereotactic and Functional Neurosurgery, 91(3), 190–197. doi:10.1159/000345113.

    Article  PubMed  Google Scholar 

  • Gimeno, H., Tustin, K., Selway, R., & Lin, J. P. (2012). Beyond the Burke-Fahn-Marsden Dystonia Rating Scale: deep brain stimulation in childhood secondary dystonia. European Journal of Paediatric Neurology, 16(5), 501–508. doi:10.1016/j.ejpn.2011.12.014.

    Article  PubMed  Google Scholar 

  • Hamasaki, T., Yamada, K., & Kuratsu, J. (2008). Hemidystonia secondary to thalamic hemorrhage treated with GPi stimulation. Movement Disorders, 23(12), 1762–1766. doi:10.1002/mds.22183.

    Article  PubMed  Google Scholar 

  • Hanakawa, T., Dimyan, M. A., & Hallett, M. (2008). Motor planning, imagery, and execution in the distributed motor network: a time-course study with functional MRI. Cerebral Cortex, 18(12), 2775–2788. doi:10.1093/cercor/bhn036.

    Article  PubMed Central  PubMed  Google Scholar 

  • Hasegawa, H., Mundil, N., Samuel, M., Jarosz, J., & Ashkan, K. (2009). The treatment of persistent vascular hemidystonia-hemiballismus with unilateral GPi deep brain stimulation. Movement Disorders, 24(11), 1697–1698. doi:10.1002/mds.22598.

    Article  PubMed  Google Scholar 

  • Hoshi, E., Tremblay, L., Féger, J., Carras, P. L., & Strick, P. L. (2005). The cerebellum communicates with the basal ganglia. Nature Neuroscience, 8(11), 1491–1493. doi:10.1038/nn1544.

    Article  CAS  PubMed  Google Scholar 

  • Huang, Y. Z., Rothwell, J. C., Lu, C. S., Wang, J., & Chen, R. S. (2010). Restoration of motor inhibition through an abnormal premotor-motor connection in dystonia. Movement Disorders, 25(6), 696–703. doi:10.1002/mds.22814.

    Article  PubMed Central  PubMed  Google Scholar 

  • Isaias, I. U., Alterman, R. L., & Tagliati, M. (2009). Deep brain stimulation for primary generalized dystonia: long-term outcomes. Archives of Neurology, 66(4), 465–470. doi:10.1001/archneurol.2009.20.

    Article  PubMed  Google Scholar 

  • Islam, T., Kupsch, A., Bruhn, H., Scheurig, C., Schmidt, S., & Hoffmann, K. T. (2009). Decreased bilateral cortical representation patterns in writer’s cramp: a functional magnetic resonance imaging study at 3.0 T. Neurological Sciences, 30(3), 219–226. doi:10.1007/s10072-009-0045-7.

    Article  PubMed  Google Scholar 

  • Johansen-Berg, H., Rushworth, M. F., Bogdanovic, M. D., Kischka, U., Wimalaratna, S., & Matthews, P. M. (2002). The role of ipsilateral premotor cortex in hand movement after stroke. Proceedings of the National Academy of Sciences of the United States of America, 99(22), 14518–14523. doi:10.1073/pnas.222536799.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  • Kahan, J., Mancini, L., Urner, M., Friston, K., Hariz, M., Holl, E., et al. (2012). Therapeutic subthalamic nucleus deep brain stimulation reverses cortico-thalamic coupling during voluntary movements in Parkinson’s disease. PLoS One, 7(12), e50270. doi:10.1371/journal.pone.0050270.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  • Kang, D. W., Kang, J. H., Lee, M. S., & Chang, J. W. (2010). Posttraumatic hemidystonia treated with unilateral globus pallidus interna stimulation: long-term follow-up and radiologic features. Neuromodulation, 13(4), 261–264. doi:10.1111/j.1525-1403.2010.00306.x.

    Article  PubMed  Google Scholar 

  • Karbe, H., Holthoff, V. A., Rudolf, J., Herholz, K., & Heiss, W. D. (1992). Positron emission tomography demonstrates frontal cortex and basal ganglia hypometabolism in dystonia. Neurology, 42(8), 1540–1544.

    Article  CAS  PubMed  Google Scholar 

  • Katsakiori, P. F., Kefalopoulou, Z., Markaki, E., Paschali, A., Ellul, J., Kagadis, G. C., et al. (2009). Deep brain stimulation for secondary dystonia: results in 8 patients. Acta Neurochirurgica (Wien), 151(5), 473–478. doi:10.1007/s00701-009-0281-x. discussion 478.

    Article  CAS  Google Scholar 

  • Kim, J. P., Chang, W. S., & Chang, J. W. (2012). The long-term surgical outcomes of secondary hemidystonia associated with post-traumatic brain injury. Acta Neurochirurgica (Wien), 154(5), 823–830. doi:10.1007/s00701-012-1306-4.

    Article  Google Scholar 

  • Koch, G., Schneider, S., Bäumer, T., Franca, M., Münchau, A., Cheeran, B., et al. (2008). Altered dorsal premotor-motor interhemispheric pathway activity in focal arm dystonia. Movement Disorders, 23(5), 660–668. doi:10.1002/mds.21881.

    Article  PubMed  Google Scholar 

  • Kojovic, M., Pareés, I., Kassavetis, P., Palomar, F. J., Mir, P., Teo, J. T., et al. (2013). Secondary and primary dystonia: pathophysiological differences. Brain, 136(Pt 7), 2038–2049. doi:10.1093/brain/awt150.

    Article  PubMed  Google Scholar 

  • Koy, A., Hellmich, M., Pauls, K. A., Marks, W., Lin, J. P., Fricke, O., et al. (2013). Effects of deep brain stimulation in dyskinetic cerebral palsy: a meta-analysis. Movement Disorders, 28(5), 647–654. doi:10.1002/mds.25339.

    Article  PubMed  Google Scholar 

  • Krauss, J. K., Pohle, T., Weber, S., Ozdoba, C., & Burgunder, J. M. (1999). Bilateral stimulation of globus pallidus internus for treatment of cervical dystonia. Lancet, 354(9181), 837–838. doi:10.1016/S0140-6736(99)80022-1.

    Article  CAS  PubMed  Google Scholar 

  • Krystkowiak, P., Martinat, P., Defebvre, L., Pruvo, J. P., Leys, D., & Destée, A. (1998). Dystonia after striatopallidal and thalamic stroke: clinicoradiological correlations and pathophysiological mechanisms. Journal of Neurology, Neurosurgery & Psychiatry, 65(5), 703–708.

    Article  CAS  Google Scholar 

  • Kumar, R., Dagher, A., Hutchison, W. D., Lang, A. E., & Lozano, A. M. (1999). Globus pallidus deep brain stimulation for generalized dystonia: clinical and PET investigation. Neurology, 53(4), 871–874.

    Article  CAS  PubMed  Google Scholar 

  • Lehéricy, S., Vidailhet, M., Dormont, D., Piérot, L., Chiras, J., Mazetti, P., et al. (1996). Striatopallidal and thalamic dystonia. A magnetic resonance imaging anatomoclinical study. Archives of Neurology, 53(3), 241–250.

    Article  PubMed  Google Scholar 

  • Lehéricy, S., Gerardin, E., Poline, J. B., Meunier, S., Van de Moortele, P. F., Le Bihan, D., et al. (2004). Motor execution and imagination networks in post-stroke dystonia. Neuroreport, 15(12), 1887–1890.

    Article  PubMed  Google Scholar 

  • Lehéricy, S., Tijssen, M. A., Vidailhet, M., Kaji, R., & Meunier, S. (2013). The anatomical basis of dystonia: current view using neuroimaging. Movement Disorders, 28(7), 944–957. doi:10.1002/mds.25527.

    Article  PubMed  Google Scholar 

  • Loher, T. J., Hasdemir, M. G., Burgunder, J. M., & Krauss, J. K. (2000). Long-term follow-up study of chronic globus pallidus internus stimulation for posttraumatic hemidystonia. Journal of Neurosurgery, 92(3), 457–460. doi:10.3171/jns.2000.92.3.0457.

    Article  CAS  PubMed  Google Scholar 

  • Loher, T. J., Capelle, H. H., Kaelin-Lang, A., Weber, S., Weigel, R., Burgunder, J. M., et al. (2008). Deep brain stimulation for dystonia: outcome at long-term follow-up. Journal of Neurology, 255(6), 881–884. doi:10.1007/s00415-008-0798-6.

    Article  CAS  PubMed  Google Scholar 

  • Luft, A. R., Waller, S., Forrester, L., Smith, G. V., Whitall, J., Macko, R. F., et al. (2004). Lesion location alters brain activation in chronically impaired stroke survivors. NeuroImage, 21(3), 924–935. doi:10.1016/j.neuroimage.2003.10.026.

    Article  PubMed  Google Scholar 

  • Manto, M., Bower, J. M., Conforto, A. B., Delgado-García, J. M., da Guarda, S. N., Gerwig, M., et al. (2012). Consensus paper: roles of the cerebellum in motor control–the diversity of ideas on cerebellar involvement in movement. Cerebellum, 11(2), 457–487. doi:10.1007/s12311-011-0331-9.

    Article  PubMed Central  PubMed  Google Scholar 

  • Marsden, C. D., Obeso, J. A., Zarranz, J. J., & Lang, A. E. (1985). The anatomical basis of symptomatic hemidystonia. Brain, 108(Pt 2), 463–483.

    Article  PubMed  Google Scholar 

  • McClelland, V., Mills, K., Siddiqui, A., Selway, R., & Lin, J. P. (2011). Central motor conduction studies and diagnostic magnetic resonance imaging in children with severe primary and secondary dystonia. Developmental Medicine and Child Neurology, 53(8), 757–763. doi:10.1111/j.1469-8749.2011.03981.x.

    Article  PubMed  Google Scholar 

  • Neychev, V. K., Gross, R. E., Lehéricy, S., Hess, E. J., & Jinnah, H. A. (2011). The functional neuroanatomy of dystonia. Neurobiology of Disease, 42(2), 185–201. doi:10.1016/j.nbd.2011.01.026.

    Article  PubMed Central  PubMed  Google Scholar 

  • Obeso, J. A., & Giménez-Roldán, S. (1988). Clinicopathological correlation in symptomatic dystonia. Advances in Neurology, 50, 113–122.

    CAS  PubMed  Google Scholar 

  • Perlmutter, J. S., & Raichle, M. E. (1984). Pure hemidystonia with basal ganglion abnormalities on positron emission tomography. Annals of Neurology, 15(3), 228–233. doi:10.1002/ana.410150303.

    Article  CAS  PubMed  Google Scholar 

  • Pettigrew, L. C., & Jankovic, J. (1985). Hemidystonia: a report of 22 patients and a review of the literature. Journal of Neurology, Neurosurgery & Psychiatry, 48(7), 650–657.

    Article  CAS  Google Scholar 

  • Sadnicka, A., Hoffland, B. S., Bhatia, K. P., van de Warrenburg, B. P., & Edwards, M. J. (2012). The cerebellum in dystonia - help or hindrance? Clinical Neurophysiology, 123(1), 65–70. doi:10.1016/j.clinph.2011.04.027.

    Article  CAS  PubMed  Google Scholar 

  • Thobois, S., Ballanger, B., Xie-Brustolin, J., Damier, P., Durif, F., Azulay, J. P., et al. (2008). Globus pallidus stimulation reduces frontal hyperactivity in tardive dystonia. Journal of Cerebral Blood Flow and Metabolism, 28(6), 1127–1138. doi:10.1038/sj.jcbfm.9600610.

    Article  PubMed  Google Scholar 

  • Tsang, E. W., Hamani, C., Moro, E., Mazzella, F., Lozano, A. M., Yeh, I. J., et al. (2012). Prominent 5–18 Hz oscillations in the pallidal-thalamic circuit in secondary dystonia. Neurology, 78(5), 361–363. doi:10.1212/WNL.0b013e318245293f.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  • Vidailhet, M., Vercueil, L., Houeto, J. L., Krystkowiak, P., Benabid, A. L., Cornu, P., et al. (2005). Bilateral deep-brain stimulation of the globus pallidus in primary generalized dystonia. New England Journal of Medicine, 352(5), 459–467. doi:10.1056/NEJMoa042187.

    Article  CAS  PubMed  Google Scholar 

  • Vidailhet, M., Yelnik, J., Lagrange, C., Fraix, V., Grabli, D., Thobois, S., et al. (2009). Bilateral pallidal deep brain stimulation for the treatment of patients with dystonia-choreoathetosis cerebral palsy: a prospective pilot study. Lancet Neurology, 8(8), 709–717. doi:10.1016/S1474-4422(09)70151-6.

    Article  Google Scholar 

  • Vidailhet, M., Jutras, M. F., Grabli, D., & Roze, E. (2013). Deep brain stimulation for dystonia. Journal of Neurology, Neurosurgery & Psychiatry, 84(9), 1029–1042. doi:10.1136/jnnp-2011-301714.

    Article  Google Scholar 

  • Ward, N. S. (2006). The neural substrates of motor recovery after focal damage to the central nervous system. Archives of Physical Medicine and Rehabilitation, 87(12 Suppl 2), S30–S35. doi:10.1016/j.apmr.2006.08.334.

    PubMed  Google Scholar 

  • Ward, N. S., Brown, M. M., Thompson, A. J., & Frackowiak, R. S. (2003a). Neural correlates of motor recovery after stroke: a longitudinal fMRI study. Brain, 126(Pt 11), 2476–2496. doi:10.1093/brain/awg245.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  • Ward, N. S., Brown, M. M., Thompson, A. J., & Frackowiak, R. S. (2003b). Neural correlates of outcome after stroke: a cross-sectional fMRI study. Brain, 126(Pt 6), 1430–1448.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  • Witt, J., Starr, P. A., & Ostrem, J. L. (2013). Use of pallidal deep brain stimulation in postinfarct hemidystonia. Stereotactic and Functional Neurosurgery, 91(4), 243–247. doi:10.1159/000345262.

    Article  PubMed  Google Scholar 

  • Wu, C. C., Fairhall, S. L., McNair, N. A., Hamm, J. P., Kirk, I. J., Cunnington, R., et al. (2010). Impaired sensorimotor integration in focal hand dystonia patients in the absence of symptoms. Journal of Neurology, Neurosurgery & Psychiatry, 81(6), 659–665. doi:10.1136/jnnp.2009.185637.

    Article  Google Scholar 

  • Zhang, J. G., Zhang, K., Wang, Z. C., Ge, M., & Ma, Y. (2006). Deep brain stimulation in the treatment of secondary dystonia. Chinese Medical Journal, 119(24), 2069–2074.

    PubMed  Google Scholar 

Download references

Acknowledgments

The authors thank also the patients and the families who participated in the study.

Conflict of interest

Financial disclosure related to research covered in this article: No conflict of interest related to this work is reported by the authors.

Full financial disclosure: V. Gonzalez, L. Cif and P. Coubes received lecture fees from Medtronic Company. E. Le Bars, L. EH van Dokkum, I. Laffont, N. Menjot de Champfleur, A. Bonafé and M. Zanca: report no disclosures.

Ethical standards

This research has been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki. Informed written consent was provided by all subjects participating in the study.

Author information

Authors and Affiliations

  1. Functional Neurosurgery Unit, Department of Neurosurgery, Hôpital Gui de Chauliac, University Hospital of Montpellier, 80 Avenue Augustin Fliche, 34295, Montpellier Cedex 5, France

    Victoria Gonzalez, Laura Cif & Philippe Coubes

  2. Institut de Génomique Fonctionnelle, INSERM, UMR_S 661, CNRS UMR 5203, Montpellier, France

    Victoria Gonzalez, Laura Cif & Philippe Coubes

  3. University of Montpellier 1, Montpellier, France

    Victoria Gonzalez, Emmanuelle Le Bars, Laura Cif, Liesjet E. H. van Dokkum, Isabelle Laffont, Alain Bonafé, Nicolas Menjot de Champfleur, Michel Zanca & Philippe Coubes

  4. Neuroradiology Department, University Hospital of Montpellier, Montpellier, France

    Emmanuelle Le Bars, Alain Bonafé & Nicolas Menjot de Champfleur

  5. Movement to Health, Euromov, Montpellier, France

    Liesjet E. H. van Dokkum

  6. Physical Medicine and Rehabilitation Department, University Hospital of Montpellier, Montpellier, France

    Isabelle Laffont

  7. Nuclear Medicine Department, University Hospital of Montpellier, Montpellier, France

    Michel Zanca

Authors
  1. Victoria Gonzalez
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Emmanuelle Le Bars
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Laura Cif
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Liesjet E. H. van Dokkum
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Isabelle Laffont
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Alain Bonafé
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Nicolas Menjot de Champfleur
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Michel Zanca
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Philippe Coubes
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Victoria Gonzalez.

Additional information

Emmanuelle Le Bars and Laura Cif equally contributed to this study

Electronic supplementary material

Below is the link to the electronic supplementary material.

ESM_1

Table 4 and 5 Within-subject studies: anatomic MNI coordinates of significant clusters with dystonic and non-dystonic movements (DOCX 43.3 kb)

ESM_2

Table 6 One-sample t tests Group analysis within healthy control and hemidystonic groups: anatomic MNI coordinates of significant clusters with dystonic and non-dystonic movements (DOCX 32.4 kb)

ESM_3

Fig. 3 Task-related activity patterns in single-subject studies (P FWE-corr<0.05) with dystonic (right) arm movements: a) healthy control (contralateral SMC activity); b) hyperkinetic subgroup patient (contralateral lobule VII cerebellar activity); c) hyperkinetic subgroup (contralateral SMC, SMA, lobule VII cerebellar activity); d, e, f) Hypokinetic subgroup patients (bilateral activity observed in three patients) (JPEG 19 kb)

High Resolution Image (TIFF 1030 kb)

Rights and permissions

Reprints and permissions

About this article

Cite this article

Gonzalez, V., Le Bars, E., Cif, L. et al. The reorganization of motor network in hemidystonia from the perspective of deep brain stimulation. Brain Imaging and Behavior 9, 223–235 (2015). https://doi.org/10.1007/s11682-014-9300-5

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11682-014-9300-5

Keywords

Search

Navigation