1. Motor and Nonmotor Circuitry Activation Induced by Subthalamic Nucleus Deep Brain Stimulation in Patients With Parkinson Disease 
Emily J. Knight, PhD, Paola Testini, MD, Hoon-Ki Min, PhD, William S. Gibson, BS, Krzysztof R. Gorny, PhD, Christopher P. Favazza, PhD, Joel P. Felmlee, PhD, Inyong Kim, BS, Kirk M. Welker, MD, Daniel A. Clayton, MD, Bryan T. Klassen, MD, Su-youne Chang, PhD, Kendall H. Lee, MD, PhD 
Mayo Clinic Proceedings 
Volume 90, Issue 6, Pages (June 2015)
DOI: /j.mayocp
Copyright © 2015 Mayo Foundation for Medical Education and Research Terms and Conditions

2. Figure 1
A, Schematic drawing of the anthropomorphic phantom in the MRI bore illustrating placement extension wiring (blue), positioning of the deep brain stimulation (DBS) electrode, and placement of the temperature probes (red) on the proximal and distal DBS electrode contacts. B, Photograph of the intraoperative magnetic resonance imaging (MRI) suite. C, Plot of maximum change in temperature (ΔTmax) vs time during a series of pulse sequences: 3-dimensional magnetization-prepared rapid gradient-echo (3D MP-RAGE), stimulation on, wires along iso-line (specific absorption rate [SAR]=0.064 W/kg; mean ± SD ΔTmax=0.27°C±0.01°C) and gradient echo-echo planar imaging (GE-EPI), stimulation on, wires along iso-line (SAR=0.016 W/kg; mean ± SD ΔTmax=0.12°C±0.01°C). Temperature data shown were sampled at 1-second intervals and were smoothed using a 20-point running average.
Mayo Clinic Proceedings  , DOI: ( /j.mayocp )
Copyright © 2015 Mayo Foundation for Medical Education and Research Terms and Conditions

3. Figure 2
A, Areas of activation with unilateral subthalamic nucleus (STN) stimulation at 2-V amplitude, 90-microsecond pulse width, and 130- to 185-Hz frequency (n=10) for Parkinson disease. Slice locations are presented in Talairach coordinates. Significant activation (false discovery rate [FDR] <0.001) was observed in the bilateral premotor and primary motor cortices, precuneus, occipital lobes, cerebellum, and anterior and posterior cingulate cortices. Activation of the ipsilateral thalamus, pedunculopontine nucleus, parahippocampal gyrus, hippocampus, and contralateral insula were also observed. B, The mean ± SD time courses for regions of interest were plotted as average percentage change in blood oxygen level–dependent (BOLD) signal from baseline vs time (one scan is equal to repetition time of 3 seconds) using 10 frames (30 seconds) before stimulation (yellow box) as the baseline. CB = cerebellum; CC = cingulate cortex; HC = hippocampus; IC = insula; MC = motor cortex; OC = occipital cortex; PFC = prefrontal cortex; PPH = parahippocampal gyrus; PPN = pedunculopontine nucleus; PreCn = precuneus; SMA = supplementary motor area; SPL = supramarginal gyrus; SS = somatosensory cortex; TH = thalamus.
Mayo Clinic Proceedings  , DOI: ( /j.mayocp )
Copyright © 2015 Mayo Foundation for Medical Education and Research Terms and Conditions

4. Figure 3
Cortical areas of significant blood oxygen level–dependent activation resolved by cortex-based analysis projected on inflated representations of the dorsal (A) and medial (B) surfaces of the brain. Areas of activation included the bilateral supplementary motor area (SMA) and occipital lobes, ipsilateral primary motor and primary and secondary somatosensory cortices, thalamus, anterior cingulate gyrus, pedunculopontine nucleus (PPN), and contralateral precuneus (false discovery rate [FDR] <0.001). ACC = anterior cingulate cortex; PCC = posterior cingulate cortex.
Mayo Clinic Proceedings  , DOI: ( /j.mayocp )
Copyright © 2015 Mayo Foundation for Medical Education and Research Terms and Conditions

5. Figure 4
Comparison of blood oxygen level–dependent activation during deep brain stimulation conducted in the awake (n=5) (A) and anesthetized (n=5) (B) states . The signal strength was much stronger in the awake state, being significant at the false discovery rate (FDR) <0.01 level compared with the FDR<0.05 level in the anesthetized state. CB = cerebellum; CC = cingulate cortex; MC = motor cortex; PPH = parahippocampal gyrus; PPN = pedunculopontine nucleus; PreCn = precuneus; SMA = supplementary motor area; SPL = supramarginal gyrus; SS = somatosensory cortex.
Mayo Clinic Proceedings  , DOI: ( /j.mayocp )
Copyright © 2015 Mayo Foundation for Medical Education and Research Terms and Conditions