Tremor Reduction by Deep Brain Stimulation Is Associated With Gamma Power Suppression in Parkinson's Disease.
Tremor Reduction by Deep Brain Stimulation Is Associated With Gamma Power Suppression in Parkinson's Disease.
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DOI：
10.1111/ner.12297
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发表时间：
2015-07
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影响因子：
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通讯作者：
Brown P
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作者：
Beudel M;Little S;Pogosyan A;Ashkan K;Foltynie T;Limousin P;Zrinzo L;Hariz M;Bogdanovic M;Cheeran B;Green AL;Aziz T;Thevathasan W;Brown P
静止性震颤是帕金森病(PD)的主要症状，通过丘脑底核(STN)的脑深部刺激(DBS)很容易被抑制。后者对运动迟缓和强直的治疗作用与抑制刺激电极附近夸大的β波(13-30 Hz)同步有关，而β波抑制与震颤幅度无关。在目前的研究中，我们调查震颤抑制是否与抑制其他频率的活动有关。我们记录了11例帕金森病患者15个半球在刺激STN时DBS电极的手震和对侧局部场电位(LFP)活动。施加DBS的电压从0.5V开始增加，直到达到震颤抑制或达到4.5V。当刺激强度达到2.5~3 V时，震颤减少到无DBS时的48.9%±10.9%(T14=−4.667，p<；0.001)。低伽马(31-45 Hz)功率同时抑制至92.5%±3%(T14=−2.348，p=0.034)。这在包含震颤频率及其谐波(4-12 赫兹)的频段上看不到，或者在β频段上看不到。此外，低伽马功率与受试者内震颤的严重程度相关(平均r=0.43±0.14，p=0.008)。对于其他两个频段的LFP功率，情况并非如此。我们的发现支持低伽马振荡和PD震颤之间的关系，并强化了丘脑下部LFP是一个丰富的信号的原理，该信号可能包含关于多种不同帕金森氏症特征的严重程度的信息。
Rest tremor is a cardinal symptom of Parkinson's disease (PD), and is readily suppressed by deep brain stimulation (DBS) of the subthalamic nucleus (STN). The therapeutic effect of the latter on bradykinesia and rigidity has been associated with the suppression of exaggerated beta (13–30 Hz) band synchronization in the vicinity of the stimulating electrode, but there is no correlation between beta suppression and tremor amplitude. In the present study, we investigate whether tremor suppression is related to suppression of activities at other frequencies. We recorded hand tremor and contralateral local field potential (LFP) activity from DBS electrodes during stimulation of the STN in 15 hemispheres in 11 patients with PD. DBS was applied with increasing voltages starting at 0.5 V until tremor suppression was achieved or until 4.5 V was reached. Tremor was reduced to 48.9% ± 10.9% of that without DBS once stimulation reached 2.5–3 V (t14 = −4.667, p < 0.001). There was a parallel suppression of low gamma (31–45 Hz) power to 92.5% ± 3% (t14 = −2.348, p = 0.034). This was not seen over a band containing tremor frequencies and their harmonic (4–12 Hz), or over the beta band. Moreover, low gamma power correlated with tremor severity (mean r = 0.43 ± 0.14, p = 0.008) within subjects. This was not the case for LFP power in the other two bands. Our findings support a relationship between low gamma oscillations and PD tremor, and reinforce the principle that the subthalamic LFP is a rich signal that may contain information about the severity of multiple different Parkinsonian features.