病例报告：帕金森病患者通过自适应深部脑刺激改善步态

IF 4.3 3区工程技术 Q1 BIOTECHNOLOGY & APPLIED MICROBIOLOGY

Frontiers in Bioengineering and Biotechnology Pub Date : 2024-09-11 DOI:10.3389/fbioe.2024.1428189

Ioannis U. Isaias, Laura Caffi, Linda Borellini, Antonella M. Ampollini, Marco Locatelli, Gianni Pezzoli, Alberto Mazzoni, Chiara Palmisano

{"title":"病例报告：帕金森病患者通过自适应深部脑刺激改善步态","authors":"Ioannis U. Isaias, Laura Caffi, Linda Borellini, Antonella M. Ampollini, Marco Locatelli, Gianni Pezzoli, Alberto Mazzoni, Chiara Palmisano","doi":"10.3389/fbioe.2024.1428189","DOIUrl":null,"url":null,"abstract":"Gait disturbance is a common and severe symptom of Parkinson’s disease that severely impairs quality of life. Current treatments provide only partial benefits with wide variability in outcomes. Also, deep brain stimulation of the subthalamic nucleus (STN-DBS), a mainstay treatment for bradykinetic-rigid symptoms and parkinsonian tremor, is poorly effective on gait. We applied a novel DBS paradigm, adjusting the current amplitude linearly with respect to subthalamic beta power (adaptive DBS), in one parkinsonian patient with gait impairment and chronically stimulated with conventional DBS. We studied the kinematics of gait and gait initiation (anticipatory postural adjustments) as well as subthalamic beta oscillations with both conventional and adaptive DBS. With adaptive DBS, the patient showed a consistent and long-lasting improvement in walking while retaining benefits on other disease-related symptoms. We suggest that adaptive DBS can benefit gait in Parkinson’s disease possibly by avoiding overstimulation and dysfunctional entrainment of the supraspinal locomotor network.","PeriodicalId":12444,"journal":{"name":"Frontiers in Bioengineering and Biotechnology","volume":null,"pages":null},"PeriodicalIF":4.3000,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Case report: Improvement of gait with adaptive deep brain stimulation in a patient with Parkinson’s disease\",\"authors\":\"Ioannis U. Isaias, Laura Caffi, Linda Borellini, Antonella M. Ampollini, Marco Locatelli, Gianni Pezzoli, Alberto Mazzoni, Chiara Palmisano\",\"doi\":\"10.3389/fbioe.2024.1428189\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"Gait disturbance is a common and severe symptom of Parkinson’s disease that severely impairs quality of life. Current treatments provide only partial benefits with wide variability in outcomes. Also, deep brain stimulation of the subthalamic nucleus (STN-DBS), a mainstay treatment for bradykinetic-rigid symptoms and parkinsonian tremor, is poorly effective on gait. We applied a novel DBS paradigm, adjusting the current amplitude linearly with respect to subthalamic beta power (adaptive DBS), in one parkinsonian patient with gait impairment and chronically stimulated with conventional DBS. We studied the kinematics of gait and gait initiation (anticipatory postural adjustments) as well as subthalamic beta oscillations with both conventional and adaptive DBS. With adaptive DBS, the patient showed a consistent and long-lasting improvement in walking while retaining benefits on other disease-related symptoms. We suggest that adaptive DBS can benefit gait in Parkinson’s disease possibly by avoiding overstimulation and dysfunctional entrainment of the supraspinal locomotor network.\",\"PeriodicalId\":12444,\"journal\":{\"name\":\"Frontiers in Bioengineering and Biotechnology\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":4.3000,\"publicationDate\":\"2024-09-11\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Frontiers in Bioengineering and Biotechnology\",\"FirstCategoryId\":\"5\",\"ListUrlMain\":\"https://doi.org/10.3389/fbioe.2024.1428189\",\"RegionNum\":3,\"RegionCategory\":\"工程技术\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"BIOTECHNOLOGY & APPLIED MICROBIOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Frontiers in Bioengineering and Biotechnology","FirstCategoryId":"5","ListUrlMain":"https://doi.org/10.3389/fbioe.2024.1428189","RegionNum":3,"RegionCategory":"工程技术","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"BIOTECHNOLOGY & APPLIED MICROBIOLOGY","Score":null,"Total":0}

引用次数: 0

摘要

步态障碍是帕金森病常见的严重症状，严重影响患者的生活质量。目前的治疗方法只能提供部分疗效，且疗效差异很大。此外，眼下核深部脑刺激（STN-DBS）是治疗运动迟缓-僵直症状和帕金森震颤的主要方法，但对步态的疗效不佳。我们在一名患有步态障碍并长期接受传统 DBS 刺激的帕金森患者身上应用了一种新型 DBS 范式，即根据丘脑下β功率线性调整电流幅度（自适应 DBS）。我们研究了步态和步态启动（预期姿势调整）的运动学特性，以及传统和适应性 DBS 的丘脑下 beta 振荡。使用自适应 DBS 后，患者的行走能力得到了持续而持久的改善，同时其他疾病相关症状也得到了改善。我们认为，适应性 DBS 可避免对脊髓上运动网络的过度刺激和功能紊乱，从而改善帕金森病患者的步态。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

查看原文本刊更多论文

Case report: Improvement of gait with adaptive deep brain stimulation in a patient with Parkinson’s disease

Gait disturbance is a common and severe symptom of Parkinson’s disease that severely impairs quality of life. Current treatments provide only partial benefits with wide variability in outcomes. Also, deep brain stimulation of the subthalamic nucleus (STN-DBS), a mainstay treatment for bradykinetic-rigid symptoms and parkinsonian tremor, is poorly effective on gait. We applied a novel DBS paradigm, adjusting the current amplitude linearly with respect to subthalamic beta power (adaptive DBS), in one parkinsonian patient with gait impairment and chronically stimulated with conventional DBS. We studied the kinematics of gait and gait initiation (anticipatory postural adjustments) as well as subthalamic beta oscillations with both conventional and adaptive DBS. With adaptive DBS, the patient showed a consistent and long-lasting improvement in walking while retaining benefits on other disease-related symptoms. We suggest that adaptive DBS can benefit gait in Parkinson’s disease possibly by avoiding overstimulation and dysfunctional entrainment of the supraspinal locomotor network.

求助全文

通过发布文献求助，成功后即可免费获取论文全文。去求助

来源期刊

Frontiers in Bioengineering and Biotechnology Chemical Engineering-Bioengineering

CiteScore

8.30

自引率

5.30%

发文量

2270

审稿时长

12 weeks

期刊介绍： The translation of new discoveries in medicine to clinical routine has never been easy. During the second half of the last century, thanks to the progress in chemistry, biochemistry and pharmacology, we have seen the development and the application of a large number of drugs and devices aimed at the treatment of symptoms, blocking unwanted pathways and, in the case of infectious diseases, fighting the micro-organisms responsible. However, we are facing, today, a dramatic change in the therapeutic approach to pathologies and diseases. Indeed, the challenge of the present and the next decade is to fully restore the physiological status of the diseased organism and to completely regenerate tissue and organs when they are so seriously affected that treatments cannot be limited to the repression of symptoms or to the repair of damage. This is being made possible thanks to the major developments made in basic cell and molecular biology, including stem cell science, growth factor delivery, gene isolation and transfection, the advances in bioengineering and nanotechnology, including development of new biomaterials, biofabrication technologies and use of bioreactors, and the big improvements in diagnostic tools and imaging of cells, tissues and organs. In today`s world, an enhancement of communication between multidisciplinary experts, together with the promotion of joint projects and close collaborations among scientists, engineers, industry people, regulatory agencies and physicians are absolute requirements for the success of any attempt to develop and clinically apply a new biological therapy or an innovative device involving the collective use of biomaterials, cells and/or bioactive molecules. “Frontiers in Bioengineering and Biotechnology” aspires to be a forum for all people involved in the process by bridging the gap too often existing between a discovery in the basic sciences and its clinical application.