精细调节γ跟踪帕金森病的药物周期：一项动态脑感觉研究

IF 7.4 1区医学 Q1 CLINICAL NEUROLOGY

Movement Disorders Pub Date : 2025-03-13 DOI:10.1002/mds.30160

Aaron Colombo MSc, Elena Bernasconi MSc, Laura Alva MD, Mario Sousa MD, Ines Debove MD, Andreas Nowacki MD, Camille Serquet MSc, Katrin Petermann MSc, T.A. Khoa Nguyen PhD, Andreia D. Magalhães MD, PhD, Lenard Lachenmayer MD, Julia Waskönig MD, Tobias Nef PhD, Michael Schuepbach MD, Claudio Pollo MD, Paul Krack MD, PhD, Alberto Averna PhD, Gerd Tinkhauser MD, PhD

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引用次数: 0

摘要

新型商用脑感觉神经刺激器使我们能够在现实生活中的帕金森病（PD）门诊环境中将大脑活动与症状和药物状态联系起来。尽管各种候选生物标志物已被提出用于适应性深部脑刺激（DBS），但缺乏对其动态特征的全面比较。目的系统比较三种候选生物标志物-低频、β (β)和微调γ (FTG)活性的动态神经生理动力学和临床特性。方法：我们调查了14例植入美敦力感知PC的PD患者，他们在常规药物和刺激下进行了长达2个4周的动态多模式记录。记录下丘脑核低频、β和FTG活动的局部场电位（LFPs）。此外，使用可穿戴设备记录客观运动症状状态、身体活动和心率，以及使用日记记录药物摄入时间、睡眠唤醒时间和主观症状状态。还将LFP动态与关闭/打开多巴胺能药物和刺激条件下的高分辨率医院记录进行了比较。结果ftg在群体和个体水平上可靠地索引了门诊环境下的药物状态，这些光谱动态可以通过高分辨率的医院记录来预测。FTG和低频均与基于可穿戴设备的运动障碍评分相关，而基于日记的运动障碍事件仅与FTG相关。重要的是，FTG显示了药物状态，无论是否存在运动障碍，也不管潜在的运动和心率伪影。24小时的数据显示了巨大的昼夜节律能量变化，这可能会过度驱动药物摄入动态。尽管低时间分辨率记录存在局限性，但这项工作为了解生物标志物的真实动态提供了有价值的见解。具体来说，它强调了FTG作为适应性DBS药物状态的主要和可靠指标的效用。©2025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》。

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Finely Tuned γ Tracks Medication Cycles in Parkinson's Disease: An Ambulatory Brain-Sense Study

Background

Novel commercial brain-sense neurostimulators enable us to contextualize brain activity with symptom and medication states in real-life ambulatory settings in Parkinson's disease (PD). Although various candidate biomarkers have been proposed for adaptive deep brain stimulation (DBS), a comprehensive comparison of their ambulatory profiles is lacking.

Objectives

To systematically compare the ambulatory neurophysiological dynamics and clinical properties of three candidate biomarkers—low-frequency, beta (β), and finely tuned γ (FTG) activity.

Methods

We investigated 14 PD patients implanted with the Medtronic Percept PC, who underwent up to two 4-week ambulatory multimodal recording periods on their regular medication and stimulation. Subthalamic nucleus local field potentials (LFPs) of low-frequency, β, and FTG activity were recorded. Additionally, objective motor symptom states, physical activity and heart rate using wearables, as well as medication-intake times, sleep-awake times, and subjective symptom states using diaries were co-registered. LFP dynamics were also compared to high-resolution in-hospital recordings under off/on dopaminergic medication and stimulation conditions.

Results

FTG reliably indexed off to on medication states in the ambulatory setting at the group and individual levels, and these spectral dynamics could be anticipated by high-resolution in-hospital recordings. Both FTG and low-frequency correlated with wearable-based dyskinesia scores, whereas diary-based dyskinesia events were only linked to FTG. Importantly, FTG indicated on-medication states regardless of the presence of dyskinesia and despite potential motion and heart rate artifacts. The 24-hour profile revealed large circadian power shifts that may overdrive medication-intake dynamics.

Conclusion

Despite the limitations of low-temporal resolution recordings, this work provides valuable insights into the real-life dynamics of biomarkers. Specifically, it highlights the utility of FTG as a primary and reliable indicator of medication states for adaptive DBS. © 2025 The Author(s). Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.

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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.