Motor Cortical Network Excitability in Parkinson's Disease
Motor Cortical Network Excitability in Parkinson's Disease
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DOI：
10.1002/mds.28914
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发表时间：
2022-01-09
影响因子：
8.6
通讯作者：
Berardelli, Alfredo
中科院分区：
文献类型：
--
作者：
Leodori, Giorgio;De Bartolo, Maria Ilenia;Berardelli, Alfredo
背景帕金森病（PD）的运动障碍反映了基底节-丘脑皮层回路集中在初级运动皮层（M1）和辅助运动区（SMA）的变化。先前的研究使用经颅磁刺激（TMS）诱发的肌电图活动评估了PD的M1兴奋性。TMS诱发的脑电图活动可能揭示PD中更广泛的运动皮层网络变化。目的探讨帕金森病（PD）患者运动皮层网络兴奋性的变化。方法比较20例PD患者和19例健康对照者（HC）的经颅磁刺激诱发皮层电位（TEPs），并分析其与运动迟缓的相关性。结果与HC相比，非PD患者从M1对侧（M1+）和同侧（M1-）到运动迟缓最严重侧的P30反应较小，SMA前N40增加。多巴胺能治疗使M1+和M1- P30以及SMA前N40的振幅正常化。我们发现在PD患者中，M1+ P30振幅与运动迟缓呈正相关。结论PD患者M1 P30和pre-SMA N40的变化提示PD患者双侧M1兴奋性降低，pre-SMA兴奋性升高。多巴胺能治疗的效果和临床相关性表明，这些皮质变化可能反映了异常的基底节-丘脑皮质活动。经颅磁刺激脑电图提供了新的见解运动皮层网络的变化与PD的病理生理学。(c)2022国际帕金森和运动障碍协会
Background Motor impairment in Parkinson's disease (PD) reflects changes in the basal ganglia-thalamocortical circuit converging on the primary motor cortex (M1) and supplementary motor area (SMA). Previous studies assessed M1 excitability in PD using transcranial magnetic stimulation (TMS)-evoked electromyographic activity. TMS-evoked electroencephalographic activity may unveil broader motor cortical network changes in PD. Objective The aim was to assess motor cortical network excitability in PD. Methods We compared TMS-evoked cortical potentials (TEPs) from M1 and the pre-SMA between 20 PD patients tested off and on medication and 19 healthy controls (HCs) and investigated possible correlations with bradykinesia. Results Off PD patients compared to HCs had smaller P30 responses from the M1s contralateral (M1+) and ipsilateral (M1-) to the most bradykinetic side and increased pre-SMA N40. Dopaminergic therapy normalized the amplitude of M1+ and M1- P30 as well as pre-SMA N40. We found a positive correlation between M1+ P30 amplitude and bradykinesia in off PD patients. Conclusions Changes in M1 P30 and pre-SMA N40 in PD suggest that M1 excitability is reduced on both sides, whereas pre-SMA excitability is increased. The effect of dopaminergic therapy and the clinical correlation suggest that these cortical changes may reflect abnormal basal ganglia-thalamocortical activity. TMS electroencephalography provides novel insight into motor cortical network changes related to the pathophysiology of PD. (c) 2022 International Parkinson and Movement Disorder Society