Subthalamic stimulation and levodopa modulate cortical reactivity in Parkinson's patients
Subthalamic stimulation and levodopa modulate cortical reactivity in Parkinson's patients
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DOI：
10.1016/j.parkreldis.2016.10.009
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发表时间：
2017-01-01
影响因子：
4.1
通讯作者：
Koch, Giacomo
中科院分区：
文献类型：
--
作者：
Casula, Elias Paolo;Bassi, Mario Stampanoni;Koch, Giacomo
背景资料：丘脑底核深部脑刺激（DBS-DBS）和左旋多巴（LD）对帕金森病（PD）患者皮层活动的影响知之甚少。目的：通过结合经颅磁刺激（TMS）和脑电图（EEG），我们探讨了STN-DBS单独或与左旋多巴（LD）联合对植入PD患者样本中TMS诱发的皮层活动的影响。在三种临床条件下对PD患者进行了测试：i）STN-DBS开启的LD治疗（ON/ON条件）; ii）STN-DBS开启的无LD治疗（OFF/ON条件）; iii）STN-DBS关闭的无LD治疗（OFF/OFF条件）。在左侧M1上方输送TMS脉冲，同时采集EEG。结果：与OFF/OFF条件相比，STN-DBS增强了早期整体TMS诱发活动（~ 45 - 80 ms）和高α TMS诱发振荡（11-13 Hz），与LD治疗无关。LD摄入（开/开条件）产生了进一步增加的后期TMS诱发的活动（~ 80 - 130毫秒）和β TMS诱发的振荡（13-30赫兹），相比，关闭/关闭和关闭/开条件，正常化反应相比，HC范围的value.Conclusions：我们的数据显示，双边STN-DBS和LD治疗诱导调制特定的皮质成分和特定范围的频率。这些发现表明，STN-DBS和LD治疗可能对运动皮层活动具有协同作用。(C)2016爱思唯尔有限公司版权所有
Background: The effects of deep brain stimulation of the subthalamic nucleus (DBS-STN) and L-dopa (LD) on cortical activity in Parkinson's disease (PD) are poorly understood.Objectives: By combining transcranial magnetic stimulation (TMS) and electroencephalography (EEG) we explored the effects of STN-DBS, either alone or in combination with L-Dopa (LD), on TMS-evoked cortical activity in a sample of implanted PD patients.Methods: PD patients were tested in three clinical conditions: i) LD therapy with STN-DBS turned on (ON/ON condition); ii) without LD therapy with STN-DBS turned on (OFF/ON condition); iii) without LD therapy with STN-DBS turned off (OFF/OFF condition). TMS pulses were delivered over left M1 while simultaneously acquiring EEG. Eight age-matched healthy volunteers (HC) were tested as a control group.Results: STN-DBS enhanced early global TMS-evoked activity (-45-80ms) and high-alpha TMS-evoked oscillations (11-13 Hz) as compared to OFF/OFF condition, independently from concomitant LD therapy. LD intake (ON/ON condition) produced a further increase of late TMS-evoked activity (-80-130ms) and beta TMS-evoked oscillations (13-30 Hz), as compared to OFF/OFF and OFF/ON conditions, that normalized reactivity as compared to HC range of values.Conclusions: Our data reveal that bilateral STN-DBS and LD therapy induce a modulation of specific cortical components and specific ranges of frequency. These findings demonstrate that STN-DBS and LD therapy may have synergistic effects on motor cortical activity. (C) 2016 Elsevier Ltd. All rights reserved.