Subthalamic Nucleus Deep Brain Stimulation Modulates 2 Distinct Neurocircuits.
Subthalamic Nucleus Deep Brain Stimulation Modulates 2 Distinct Neurocircuits.
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DOI：
10.1002/ana.25906
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发表时间：
2020-12
影响因子：
11.2
通讯作者：
Li L
中科院分区：
文献类型：
--
作者：
Shen L;Jiang C;Hubbard CS;Ren J;He C;Wang D;Dahmani L;Guo Y;Liu Y;Xu S;Meng F;Zhang J;Liu H;Li L
目前对脑深部电刺激（DBS）对大规模脑网络的神经调节作用的理解仍然是难以捉摸的，这主要是由于缺乏可以在全脑水平上揭示DBS诱导的活动的技术。使用一种新型的3 T磁共振成像（MRI）兼容的刺激器，我们研究了帕金森病患者丘脑底核（STN）刺激的全脑效应。14名患者接受STN-DBS治疗，并参加了块设计功能性MRI（fMRI）实验，其中在“ON”块与“OFF”块交错期间提供刺激。术后1、3、6和12个月测量低频（60 Hz）和高频（130 Hz）STN-DBS的fMRI反应。为了确保可靠性，在每次术后访视时采集多次运行（48分钟）的fMRI数据。还采集了术前静息状态fMRI（30分钟）数据。两个神经回路表现出高度可复制性，但不同的反应STN-DBS。涉及苍白球内（GPi），丘脑和小脑深核的电路显着激活，而另一个电路涉及初级运动皮层（M1），壳核，小脑显示DBS诱导的失活。这两个回路在DBS诱导的反应和静息态功能连接方面是可分离的。GPi电路是频率依赖性的，选择性地响应高频刺激，而M1电路是响应时间依赖性的方式，随着时间的推移，表现出增强的失活。最后，GPi回路的激活与整体运动改善相关，而M1回路失活与运动迟缓减少相关。使用3 T的同步DBS-fMRI揭示了2个不同的电路，它们对STN-DBS有不同的反应，并与不同的症状有关，这一发现可能为DBS的神经机制提供新的见解。
Current understanding of the neuromodulatory effects of deep brain stimulation (DBS) on large-scale brain networks remains elusive, largely due to the lack of techniques that can reveal DBS-induced activity at the whole-brain level. Using a novel 3T magnetic resonance imaging (MRI)-compatible stimulator, we investigated whole-brain effects of subthalamic nucleus (STN) stimulation in patients with Parkinson disease. Fourteen patients received STN-DBS treatment and participated in a block-design functional MRI (fMRI) experiment, wherein stimulations were delivered during “ON” blocks interleaved with “OFF” blocks. fMRI responses to low-frequency (60Hz) and high-frequency(130Hz) STN-DBS were measured 1, 3, 6, and 12 months postsurgery. To ensure reliability, multiple runs (48 minutes) of fMRI data were acquired at each postsurgical visit. Presurgical resting-state fMRI (30 minutes) data were also acquired. Two neurocircuits showed highly replicable, but distinct responses to STN-DBS. A circuit involving the globus pallidus internus (GPi), thalamus, and deep cerebellar nuclei was significantly activated, whereas another circuit involving the primary motor cortex (M1), putamen, and cerebellum showed DBS-induced deactivation. These 2 circuits were dissociable in terms of their DBS-induced responses and resting-state functional connectivity. The GPi circuit was frequency-dependent, selectively responding to high-frequency stimulation, whereas the M1 circuit was responsive in a time-dependent manner, showing enhanced deactivation over time. Finally, activation of the GPi circuit was associated with overall motor improvement, whereas M1 circuit deactivation was related to reduced bradykinesia. Concurrent DBS-fMRI using 3T revealed 2 distinct circuits that responded differentially to STN-DBS and were related to divergent symptoms, a finding that may provide novel insights into the neural mechanisms underlying DBS.
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影响因子：
--
作者：
Bronstein JM;Tagliati M;Alterman RL;Lozano AM;Volkmann J;Stefani A;Horak FB;Okun MS;Foote KD;Krack P;Pahwa R;Henderson JM;Hariz MI;Bakay RA;Rezai A;Marks WJ Jr;Moro E;Vitek JL;Weaver FM;Gross RE;DeLong MR
通讯作者：
DeLong MR
影响因子：
7.6
作者：
Greenberg, Benjamin D.;Malone, Donald A.;Rasmussen, Steven A.
通讯作者：
Rasmussen, Steven A.
影响因子：
5.9
作者：
Hesselmann, V;Sorger, B;Sturm, V
通讯作者：
Sturm, V
影响因子：
5.3
作者：
Hill, K. K.;Campbell, M. C.;McNeely, M. E.;Karimi, M.;Ushe, M.;Tabbal, S. D.;Hershey, T.;Flores, H. P.;Hartlein, J. M.;Lugar, H. M.;Revilla, F. J.;Videen, T. O.;Earhart, G. M.;Perlmutter, J. S.
通讯作者：
Perlmutter, J. S.
影响因子：
8.9
作者：
Knight EJ;Testini P;Min HK;Gibson WS;Gorny KR;Favazza CP;Felmlee JP;Kim I;Welker KM;Clayton DA;Klassen BT;Chang SY;Lee KH
通讯作者：
Lee KH