Subthalamic nucleus stimulation at high and low frequencies engages different brain networks to enhance gait performance in Parkinson's disease

IF 4.5 2区医学 Q1 NEUROIMAGING

NeuroImage Pub Date : 2025-09-14 DOI:10.1016/j.neuroimage.2025.121455

Yin Jiang , Hutao Xie , Yutong Bai , Quan Zhang , Yu Diao , Houyou Fan , Xin Zhang , Hua Zhang , Jian Li , Anchao Yang , Fangang Meng , Jianguo Zhang

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引用次数: 0

Abstract

Background

Subthalamic nucleus (STN) deep brain stimulation (DBS) is used to treat Parkinson’s disease (PD), yet neither high-frequency stimulation (HFS) nor low frequency stimulation (LFS) fully resolves gait issues. Previous studies indicate that STN-DBS modulates motor-related brain networks. Given that PD patients with gait disturbances exhibit cognitive deficits—and considering the extensive projections between the STN and cerebral cortex—we hypothesized that varying STN stimulation frequencies may improve gait by modulating distinct brain networks.

Methods

We collected gait data, cortical electrophysiological signals, and resting-state fMRI from 44 PD patients and 32 healthy controls. Multi-network cortical activity and functional connectivity were c ompared under three conditions: DBS OFF, HFS, and LFS. Additionally, the connectivity values were correlated to the gait behaviors and clinical assessment scores.

Results

We found that: (1) HFS improved both motor and gait performance, while LFS enhanced gait but may not be optimal for long-term use; (2) STN-DBS induced widespread modulation across sensorimotor, frontoparietal, salience, dorsal attention, and default mode networks. HFS improved motor and gait functions via network modulation related to motor control, whereas LFS may enhance gait by boosting executive-related cortical activities and connections; (3) Relative to healthy controls, PD exhibited widespread reductions in functional connectivity, with DBS modulation trending toward normalization.

Conclusions

These results reveal distinct brain network responses to different STN-DBS frequencies in PD, offering a theoretical basis for optimizing DBS treatment for gait impairments. These findings provide critical insights for tailoring DBS parameters to maximize both motor and cognitive benefits in PD patients.

查看原文本刊更多论文

在高和低频率丘脑下核刺激参与不同的大脑网络，以提高帕金森病的步态表现。

背景：丘脑底核（STN）深部脑刺激（DBS）被用于治疗帕金森病（PD），但无论是高频刺激（HFS）还是低频刺激（LFS）都不能完全解决步态问题。先前的研究表明，STN-DBS调节运动相关的大脑网络。考虑到伴有步态障碍的PD患者表现出认知缺陷，并考虑到STN和大脑皮层之间的广泛投射，我们假设不同的STN刺激频率可能通过调节不同的大脑网络来改善步态。方法：收集44例PD患者和32例健康对照者的步态数据、皮质电生理信号和静息状态fMRI。在DBS OFF、HFS和LFS三种情况下比较多网络皮层活动和功能连通性。此外，连通性值与步态行为和临床评估得分相关。结果：我们发现：(1)HFS改善了运动和步态性能，而LFS增强了步态，但可能不是长期使用的最佳选择；(2) STN-DBS诱导了感觉运动、额顶叶、显著性、背侧注意和默认模式网络的广泛调制。高强度刺激通过运动控制相关的网络调节改善运动和步态功能，而低强度刺激可能通过促进执行相关的皮层活动和连接来改善步态；(3)与健康对照相比，PD表现出广泛的功能连接减少，DBS调节趋于正常化。结论：这些结果揭示了PD患者脑网络对不同STN-DBS频率的不同反应，为优化DBS治疗步态障碍提供了理论依据。这些发现为定制DBS参数以最大化PD患者的运动和认知益处提供了重要见解。

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

NeuroImage 医学-核医学

CiteScore

11.30

自引率

10.50%

发文量

809

审稿时长

63 days

期刊介绍： NeuroImage, a Journal of Brain Function provides a vehicle for communicating important advances in acquiring, analyzing, and modelling neuroimaging data and in applying these techniques to the study of structure-function and brain-behavior relationships. Though the emphasis is on the macroscopic level of human brain organization, meso-and microscopic neuroimaging across all species will be considered if informative for understanding the aforementioned relationships.