Influence of cerebellar stereotactic stimulation on left–right electrodermal information transference in a patient with cerebral palsy
Petr Bob,1,2 Tomas Galanda,3 Peter Jombik,4 Jiri Raboch,1 Miroslav Galanda3
1Center for Neuropsychiatric Research of Traumatic Stress, Department of Psychiatry, 1st Faculty of Medicine, Charles University, Prague, Czech Republic; 2Central European Institute of Technology, Faculty of Medicine, Masaryk University, Brno, Czech Republic; 3Department of Neurosurgery, Slovak Medical University, Roosevelt Hospital, Banska Bystrica, Slovak Republic; 4Department of Neurology, Laboratory of Clinical Neurophysiology, Zvolen Hospital, Zvolen, Slovak Republic
Background and objectives: Recent evidence indicates that cerebral palsy is connected to specific autonomic dysregulation between sympathetic and parasympathetic efferent pathways, likely linked to hemispheric influences. These findings suggest a hypothesis that contralateral interhemispheric disinhibition, which may occur on various levels of brain processing including motor functions, could be linked to specific functional dysregulation and structural lesions, which may play a specific role in the modulation of autonomic functions and lead to autonomic dysregulation in cerebral palsy.
Method: With the aim of comparing autonomic functions as they relate to interhemispheric modulatory influences during therapeutically indicated stereotactic cerebellar stimulation, we have performed bilateral electrodermal activity measurement and calculations of pointwise transinformation (PTI) in a patient with cerebral palsy. Measurement was performed during therapeutic deep cerebellar stimulation in two cerebellar areas in anterior cerebellar lobe–culmen (left electrode) and central lobule–superior cerebellar peduncle (right electrode).
Results: The results indicate that information transference (PTI) is able to distinguish the states related to specific cerebellar stimulations and that lowest levels of the PTI have been found during stimulation of the central lobule–superior cerebellar peduncle (electrode deepest contact 1), indicating a significantly increased level of inhibition between the left and right sides.
Conclusion: The results may present potentially useful clinical findings indicating that increased PTI calculated from electrodermal activity could indirectly indicate disinhibitory activity as a possible indicator of a failure of interhemispheric communication that could explain some specific pathogenetic mechanisms in cerebral palsy. Nevertheless, these results need detailed confirmation in further research, as well as reliable clinical evaluation of their usefulness in the therapy of cerebral palsy.
Keywords: autonomic laterality, bilateral electrodermal activity, cerebral palsy, epileptiform activity, interhemispheric interaction, stereotactic cerebellar stimulation
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