丘脑下部脑电切除术不能恢复帕金森病患者运动准备过程中的皮质脊髓抑制缺陷

IF 3.7 3区 医学 Q1 CLINICAL NEUROLOGY
Emmanuelle Wilhelm , Gerard Derosiere , Caroline Quoilin , Inci Cakiroglu , Susana Paço , Christian Raftopoulos , Bart Nuttin , Julie Duque
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引用次数: 0

摘要

目的帕金森病(PD)患者的运动准备机制发生了变化,尤其是皮质脊髓兴奋性的抑制(称为 "准备性抑制"),这被认为有助于健康人的运动执行。眼下核(STN)的深部脑刺激(DBS)是治疗晚期帕金森病的一种有吸引力的方法,因此我们旨在研究该核对与帕金森病相关的皮质脊髓动态变化的潜在贡献。运动诱发电位(MEPs)是在静息状态下或在运动准备过程中通过指令延迟选择反应时间任务(包括左手或右手反应)激发的。结果无论 STN-DBS 的状态如何,当探测反应手侧时,PD 患者都表现出准备性抑制缺陷,尤其是当反应手侧对应于他们受影响最严重的手时。然而,这种缺陷对 STN-DBS 无反应这一事实要求我们今后对运动准备期间这种调节机制的神经来源进行研究。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Subthalamic DBS does not restore deficits in corticospinal suppression during movement preparation in Parkinson’s disease

Objective

Parkinson’s disease (PD) patients exhibit changes in mechanisms underlying movement preparation, particularly the suppression of corticospinal excitability – termed “preparatory suppression” – which is thought to facilitate movement execution in healthy individuals. Deep brain stimulation (DBS) of the subthalamic nucleus (STN) being an attractive treatment for advanced PD, we aimed to study the potential contribution of this nucleus to PD-related changes in such corticospinal dynamics.

Methods

On two consecutive days, we applied single-pulse transcranial magnetic stimulation to the primary motor cortex of 20 advanced PD patients treated with bilateral STN-DBS (ON vs. OFF), as well as 20 healthy control subjects. Motor-evoked potentials (MEPs) were elicited at rest or during movement preparation in an instructed-delay choice reaction time task including left- or right-hand responses. Preparatory suppression was assessed by expressing MEPs during movement preparation relative to rest.

Results

PD patients exhibited a deficit in preparatory suppression when it was probed on the responding hand side, particularly when this corresponded to their most-affected hand, regardless of their STN-DBS status.

Conclusions

Advanced PD patients displayed a reduction in preparatory suppression which was not restored by STN-DBS.

Significance

The current findings confirm that PD patients lack preparatory suppression, as previously reported. Yet, the fact that this deficit was not responsive to STN-DBS calls for future studies on the neural source of this regulatory mechanism during movement preparation.

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来源期刊
Clinical Neurophysiology
Clinical Neurophysiology 医学-临床神经学
CiteScore
8.70
自引率
6.40%
发文量
932
审稿时长
59 days
期刊介绍: As of January 1999, The journal Electroencephalography and Clinical Neurophysiology, and its two sections Electromyography and Motor Control and Evoked Potentials have amalgamated to become this journal - Clinical Neurophysiology. Clinical Neurophysiology is the official journal of the International Federation of Clinical Neurophysiology, the Brazilian Society of Clinical Neurophysiology, the Czech Society of Clinical Neurophysiology, the Italian Clinical Neurophysiology Society and the International Society of Intraoperative Neurophysiology.The journal is dedicated to fostering research and disseminating information on all aspects of both normal and abnormal functioning of the nervous system. The key aim of the publication is to disseminate scholarly reports on the pathophysiology underlying diseases of the central and peripheral nervous system of human patients. Clinical trials that use neurophysiological measures to document change are encouraged, as are manuscripts reporting data on integrated neuroimaging of central nervous function including, but not limited to, functional MRI, MEG, EEG, PET and other neuroimaging modalities.
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