Motor and Nonmotor Circuitry Activation Induced by Subthalamic Nucleus Deep Brain Stimulation in Patients With Parkinson Disease: Intraoperative Functional Magnetic Resonance Imaging for Deep Brain Stimulation.
Motor and Nonmotor Circuitry Activation Induced by Subthalamic Nucleus Deep Brain Stimulation in Patients With Parkinson Disease: Intraoperative Functional Magnetic Resonance Imaging for Deep Brain Stimulation.
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DOI：
10.1016/j.mayocp.2015.03.022
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发表时间：
2015-06
影响因子：
8.9
通讯作者：
Lee KH
中科院分区：
文献类型：
--
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
为了验证先前研究提出的假设，即PD患者的丘脑底核（DBS）脑深部电刺激（DBS）会影响运动和非运动网络的活动，我们对接受DBS的患者进行了术中fMRI检查。10例接受DBS治疗PD的患者在通过外部脉冲发生器提供高频刺激期间接受术中1.5T fMRI。本研究在2013年1月1日至2014年9月30日期间进行。我们观察到运动回路中的血氧水平依赖性（BOLD）信号变化（FDR<.001），包括初级运动、运动前和辅助运动皮质、丘脑、脚桥核（PPN）和小脑，以及边缘系统回路，包括扣带和岛叶皮质。在对我们的数据集应用Bonferroni校正（p<.001）后，也观察到运动网络的激活，这表明在受试者中，运动回路中的BOLD变化与非运动网络中发生的变化相比更加一致。这些研究结果支持的运动和非运动网络的活动，并提出了复杂的机制，在这种治疗方式的疗效的基础上，DBS的调制作用。此外，这些结果表明，在所有受试者中，与非运动网络中发生的变化相比，运动回路中的BOLD变化更加一致。随着进一步的研究结合使用真实的时间术中功能磁共振成像与DBS治疗患者的临床结局，功能成像技术不仅有可能阐明DBS功能的机制，而且还可以指导和协助受运动和神经精神疾病影响的患者的手术治疗。
To test the hypothesis suggested by previous studies that subthalamic nucleus (STN) deep brain stimulation (DBS) in patients with PD would affect the activity of both motor and non-motor networks, we applied intraoperative fMRI to patients receiving DBS. Ten patients receiving STN DBS for PD underwent intraoperative 1.5T fMRI during high frequency stimulation delivered via an external pulse generator. The study was conducted between the dates of January 1, 2013 and September 30, 2014. We observed blood oxygen level dependent (BOLD) signal changes (FDR<.001) in the motor circuitry, including primary motor, premotor, and supplementary motor cortices, thalamus, pedunculopontine nucleus (PPN), and cerebellum, as well as in the limbic circuitry, including cingulate and insular cortices. Activation of the motor network was observed also after applying a Bonferroni correction (p<.001) to our dataset, suggesting that, across subjects, BOLD changes in the motor circuitry are more consistent compared to those occurring in the non-motor network. These findings support the modulatory role of STN DBS on the activity of motor and non-motor networks, and suggest complex mechanisms at the basis of the efficacy of this treatment modality. Furthermore, these results suggest that, across subjects, BOLD changes in the motor circuitry are more consistent compared to those occurring in the non-motor network. With further studies combining the use of real time intraoperative fMRI with clinical outcomes in patients treated with DBS, functional imaging techniques have the potential not only to elucidate the mechanisms of DBS functioning, but also to guide and assist in the surgical treatment of patients affected by movement and neuropsychiatric disorders.
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影响因子：
9.9
作者：
Grafton, ST;Turner, RS;Crutcher, M
通讯作者：
Crutcher, M
影响因子：
2.6
作者：
Campbell MC;Karimi M;Weaver PM;Wu J;Perantie DC;Golchin NA;Tabbal SD;Perlmutter JS;Hershey T
通讯作者：
Hershey T
影响因子：
5.9
作者：
Hesselmann, V;Sorger, B;Sturm, V
通讯作者：
Sturm, V
影响因子：
8.6
作者：
Funkiewiez, A;Ardouin, C;Pollak, P
通讯作者：
Pollak, P
影响因子：
14.5
作者：
Asanuma, Kotaro;Tang, Chengke;Eidelberg, David
通讯作者：
Eidelberg, David