Subthalamic γ Oscillation Underlying Rapid Eye Movement Sleep Abnormality in Parkinsonian Patients

IF 7.4 1区医学 Q1 CLINICAL NEUROLOGY

Movement Disorders Pub Date : 2024-12-20 DOI:10.1002/mds.30091

Lingxiao Guan ME, Huiling Yu MD, Yue Chen PhD, Chen Gong PhD, Hongwei Hao PhD, Yi Guo MD, PhD, Shujun Xu MD, PhD, Yuhuan Zhang BS, Xuemei Yuan BS, Guoping Yin MD, PhD, Jianguo Zhang MD, PhD, Huiling Tan PhD, Luming Li PhD

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Abstract

Background

Abnormal rapid eye movement (REM) sleep, including REM sleep behavior disorder (RBD) and reduced REM sleep, is common in Parkinson's disease (PD), highlighting the importance of further study on REM sleep. However, the biomarkers of REM disturbances remain unknown, leading to the lack of REM-specific neuromodulation interventions.

Objective

This study aims to investigate the neurophysiological biomarkers of REM disturbance in parkinsonian patients.

Methods

Ten PD patients implanted with bilateral subthalamic nucleus-deep brain stimulation (STN-DBS) were included in this study, of whom 4 were diagnosed with RBD. Sleep monitoring was conducted 1 month after surgery. Subthalamic local field potentials (LFP) were recorded through sensing-enabled DBS. The neurophysiological features of subthalamic LFP during phasic and tonic microstates of REM sleep and their correlation with REM sleep fragmentation and RBD were analyzed.

Results

Differences in subthalamic γ oscillation between phasic and tonic REM correlated positively with the severity of REM sleep fragmentation. Patients with RBD also exhibited stronger γ oscillations during REM sleep compared with non-RBD patients, and both increased β and γ were found before the onset of RBD episodes. Stimulation changes in simulated γ-triggered feedback modulation followed more closely with phasic REM density, whereas an opposite trend was found in simulated β-triggered feedback modulation.

Conclusion

Excess subthalamic γ oscillations may contribute to REM instability and RBD, suggesting that γ oscillation could serve as a feedback signal for adaptive DBS for REM sleep disorders. © 2024 The Author(s). Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.

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帕金森病患者快速眼动睡眠异常的丘脑下γ振荡

异常快速眼动（REM）睡眠包括REM睡眠行为障碍（RBD）和REM睡眠减少在帕金森病（PD）中很常见，因此进一步研究REM睡眠具有重要意义。然而，快速眼动障碍的生物标志物仍然未知，导致缺乏快速眼动特异性神经调节干预措施。目的探讨帕金森病患者快速眼动障碍的神经生理生物标志物。方法采用双侧丘脑底核-深部脑刺激（STN - DBS）治疗PD患者，其中4例诊断为RBD。术后1个月进行睡眠监测。通过感应激活DBS记录丘脑下局部场电位（LFP）。分析了快速眼动睡眠阶段和紧张性微状态下丘脑LFP的神经生理特征及其与快速眼动睡眠片段化和RBD的相关性。结果相性快速眼动与强直性快速眼动期间丘脑下γ振荡的差异与快速眼动睡眠破碎程度呈正相关。与非RBD患者相比，RBD患者在REM睡眠期间也表现出更强的γ振荡，并且在RBD发作前发现β和γ均增加。模拟γ‐触发的反馈调制的刺激变化与REM相相密度密切相关，而模拟β‐触发的反馈调制则相反。结论过量的丘脑下γ振荡可能与快速眼动睡眠不稳定和RBD有关，提示γ振荡可能是适应性DBS治疗快速眼动睡眠障碍的反馈信号。©2024作者。Wiley期刊有限责任公司代表国际帕金森和运动障碍学会出版的《运动障碍》。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Movement Disorders 医学-临床神经学

CiteScore

13.30

自引率

8.10%

发文量

371

审稿时长

12 months

期刊介绍： Movement Disorders publishes a variety of content types including Reviews, Viewpoints, Full Length Articles, Historical Reports, Brief Reports, and Letters. The journal considers original manuscripts on topics related to the diagnosis, therapeutics, pharmacology, biochemistry, physiology, etiology, genetics, and epidemiology of movement disorders. Appropriate topics include Parkinsonism, Chorea, Tremors, Dystonia, Myoclonus, Tics, Tardive Dyskinesia, Spasticity, and Ataxia.