Effects of unilateral pedunculopontine stimulation on electromyographic activation patterns during gait in individual patients with Parkinson's disease
Effects of unilateral pedunculopontine stimulation on electromyographic activation patterns during gait in individual patients with Parkinson's disease
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DOI：
10.1007/s00702-011-0705-7
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发表时间：
2011-10-01
影响因子：
3.3
通讯作者：
Mazzone, P.
中科院分区：
文献类型：
--
作者：
Caliandro, Pietro;Insola, A.;Mazzone, P.
在帕金森病（PD）中，脚桥核脑深部刺激（PPTg-DBS）对步态的影响一直是国际争论的对象。有证据表明，在步态周期的摆动晚期-站立早期，胫骨前肌（TA）的表面肌电激活（sEMG）降低与PD患者纹状体多巴胺缺乏有关。在本研究中，我们报告了PPTg-DBS对个体PD患者步态期间肌电模式影响的初步结果。为了评估TA的sEMG幅度，将晚摆动-早站立相（RMS-A）中的TA爆发的均方根（RMS）归一化为晚站立-早摆动（RMS-B）中的TA爆发的RMS的百分比。我们研究了三名男性患者在以下条件：对PPTg-DBS/左旋多巴，对PPTg-DBS/关闭左旋多巴，关闭PPTg-DBS/左旋多巴，关闭PPTg-DBS/关闭左旋多巴。每次评估都填写了《评估报告准则III》。我们没有观察到PPTg-DBS/关闭左旋多巴和关闭PPTg-DBS/关闭左旋多巴之间的APPLICATRS III评分存在差异。在关闭PPTg-DBS/关闭左旋多巴时，患者A（右侧植入物）分别在80%和83%的步态周期中显示右侧和左侧RMSA缺失。患者B（右侧植入物）在86%的周期中显示右侧RMS-A缺失。患者C（左侧植入物）的RMS-A双侧正常。在接受PPTg-DBS/停用左旋多巴时，没有患者显示RMS-A降低。虽然我们评估的受试者数量非常少，但我们的观察结果表明，PPTg在步态稳态期间调节TA激活模式中起作用。
In Parkinson's disease (PD), the effects of deep brain stimulation of the pedunculopontine nucleus (PPTg-DBS) on gait has been object of international debate. Some evidence demonstrated that, in the late swing-early stance phase of gait cycle, a reduced surface electromyographic activation (sEMG) of tibialis anterior (TA) is linked to the striatal dopamine deficiency in PD patients. In the present study we report preliminary results on the effect of PPTg-DBS on electromyographic patterns during gait in individual PD patients. To evaluate the sEMG amplitude of TA, the root mean square (RMS) of the TA burst in late swing-early stance phase (RMS-A) was normalized as a percent of the RMS of the TA burst in late stance-early swing (RMS-B). We studied three male patients in the following conditions: on PPTg-DBS/on l-dopa, on PPTg-DBS/off l-dopa, off PPTg-DBS/on l-dopa, off PPTg-DBS/off l-dopa. For each assessment the UPDRS III was filled in. We observed no difference between on PPTg-DBS/off l-dopa and off PPTg-DBS/off l-dopa in UPDRS III scores. In off PPTg-DBS/off l-dopa, patient A (right implant) showed absence of the right and left RMSA, respectively, in 80% and 83% of gait cycles. Patient B (right implant) showed absence of the right RMS-A in 86% of cycles. RMS-A of the patient C (left implant) was bilaterally normal. In on PPTg- DBS/off l-dopa, no patient showed reduced RMS-A. Although the very low number of subjects we evaluated, our observations suggest that PPTg plays a role in modulating TA activation pattern during the steady state of gait.