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帕金森病患者高频深部脑刺激术后,底丘脑β频段或更高频率的振荡活动并无变化。

Subthalamic oscillatory activities at beta or higher frequency do not change after high-frequency DBS in Parkinson's disease.

作者信息

Foffani G, Ardolino G, Egidi M, Caputo E, Bossi B, Priori A

机构信息

Dipartimento di Scienze Neurologiche, Università di Milano, Fondazione IRCCS Ospedale Policlinico, Milan, Italy.

出版信息

Brain Res Bull. 2006 Mar 31;69(2):123-30. doi: 10.1016/j.brainresbull.2005.11.012. Epub 2005 Dec 13.

Abstract

This study aimed to assess whether changes in the patterns of local field potential (LFP) oscillations of the subthalamic nucleus (STN) underlie to the clinical improvement within 60 s after turning off subthalamic DBS. We studied by spectral analysis the STN LFPs recorded in 13 nuclei from 7 patients with Parkinson's disease before and immediately after unilateral high-frequency (130 Hz) stimulation of the same nucleus, when the clinical benefit of DBS was unchanged. The results were compared with LFP data previously reported [A. Priori, G. Foffani, A. Pesenti, F. Tamma, A.M. Bianchi, M. Pellegrini et al., Rhythm-specific pharmacological modulation of subthalamic activity in Parkinson's disease. Exp. Neurol. 189 (2004) 369-379]--namely 13 STN from 9 parkinsonian patients recorded before and after levodopa administration--which were used as a control. Before DBS, in the 'off' clinical state after overnight withdrawal of dopaminergic therapy, the STN spectrum did not significantly differ from the control nuclei, showing prominent activity at beta frequencies (13-20 and 20-35 Hz). After DBS (10-15 min) of the STN, the recorded nuclei significantly differed from the control, failing to show significant changes either in the beta bands or at higher frequencies (60-90 and 250-350 Hz). The patterns of subthalamic LFP oscillations after DBS therefore differ from those after dopaminergic medication. These results suggest (1) that subthalamic LFP modulations are not the epiphenomenon of peripheral motor improvement and (2) that the transitory clinical efficacy maintained after discontinuation of subthalamic DBS is not associated with local modulation of LFP activity at beta or higher frequencies within the STN.

摘要

本研究旨在评估丘脑底核(STN)局部场电位(LFP)振荡模式的变化是否是丘脑底核深部脑刺激(DBS)关闭后60秒内临床改善的基础。我们通过频谱分析研究了7例帕金森病患者13个核团在单侧高频(130Hz)刺激同一核团之前和之后立即记录的STN局部场电位,此时DBS的临床益处未变。将结果与先前报道的LFP数据进行比较 [A. Priori, G. Foffani, A. Pesenti, F. Tamma, A.M. Bianchi, M. Pellegrini等,帕金森病中丘脑底核活动的节律特异性药理调节。实验神经病学。189 (2004) 369 - 379]——即9例帕金森病患者在左旋多巴给药前后记录的13个STN——用作对照。在DBS之前,经过一夜的多巴胺能治疗撤药后处于“关”临床状态时,STN频谱与对照核团无显著差异,在β频率(13 - 20和20 - 35Hz)显示出突出的活动。在STN进行DBS(10 - 15分钟)后,记录的核团与对照有显著差异,在β频段或更高频率(60 - 90和250 - 350Hz)均未显示出显著变化。因此,DBS后丘脑底核LFP振荡模式与多巴胺能药物治疗后不同。这些结果表明:(1)丘脑底核LFP调制不是外周运动改善的附带现象;(2)丘脑底核DBS停止后维持的短暂临床疗效与STN内β或更高频率的LFP活动的局部调制无关。

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