Mapping Go-No-Go performance within the subthalamic nucleus region
Mapping Go-No-Go performance within the subthalamic nucleus region
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DOI：
10.1093/brain/awq256
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发表时间：
2010-12-01
期刊：
影响因子：
14.5
通讯作者：
Perlmutter, Joel S.
中科院分区：
文献类型：
--
作者：
Hershey, Tamara;Campbell, Meghan C.;Perlmutter, Joel S.
基底神经节被认为是重要的选择想要的和不想要的运动模式的抑制根据明确的规则（即反应抑制）。丘脑底核被假设在这一功能中起着特别关键的作用。帕金森氏病患者丘脑底核的脑深部刺激已被用于测试这一假设，但结果是可变的。根据目前对丘脑底核解剖组织的了解，我们提出，脑深部电刺激中使用的触点的位置可以解释丘脑底核脑深部电刺激对反应抑制任务的影响的变化。我们假设，刺激影响背侧丘脑底核（连接到运动皮层）将更有可能影响帕金森病的运动症状，刺激影响腹侧丘脑底核（连接到高阶皮层区域）将更有可能影响反应抑制任务的表现。我们招募了10名帕金森氏病患者，对丘脑底核进行双侧脑深部刺激，其中一个接触点位于大脑一侧的背侧丘脑底区，另一个接触点位于大脑一侧的腹侧丘脑底区。在三种条件下对患者进行Go-No-Go任务和运动评定量表测试：刺激关闭，单侧背侧刺激和单侧腹侧刺激。背侧和腹侧刺激都能改善运动症状，但只有腹侧丘脑底刺激会影响Go-No-Go的表现，减少命中率，增加误报率，但不会改变反应时间。这些结果表明，腹侧丘脑底核参与适当的选择和抑制的优势反应之间的平衡，在认知范式，但广泛的区域的丘脑底核区域参与帕金森氏病的运动症状。这一发现对解决先前研究中的不一致性具有影响，突出了丘脑底核腹侧区域在反应抑制中的作用，并提出了一种用于运动和认知功能的丘脑底核脑深部刺激的临床优化方法。
The basal ganglia are thought to be important in the selection of wanted and the suppression of unwanted motor patterns according to explicit rules (i.e. response inhibition). The subthalamic nucleus has been hypothesized to play a particularly critical role in this function. Deep brain stimulation of the subthalamic nucleus in individuals with Parkinson's disease has been used to test this hypothesis, but results have been variable. Based on current knowledge of the anatomical organization of the subthalamic nucleus, we propose that the location of the contacts used in deep brain stimulation could explain variability in the effects of deep brain stimulation of the subthalamic nucleus on response inhibition tasks. We hypothesized that stimulation affecting the dorsal subthalamic nucleus (connected to the motor cortex) would be more likely to affect motor symptoms of Parkinson's disease, and stimulation affecting the ventral subthalamic nucleus (connected to higher order cortical regions) would be more likely to affect performance on a response inhibition task. We recruited 10 individuals with Parkinson's disease and bilateral deep brain stimulation of the subthalamic nucleus with one contact in the dorsal and another in the ventral subthalamic region on one side of the brain. Patients were tested with a Go-No-Go task and a motor rating scale in three conditions: stimulation off, unilateral dorsal stimulation and unilateral ventral stimulation. Both dorsal and ventral stimulation improved motor symptoms, but only ventral subthalamic stimulation affected Go-No-Go performance, decreasing hits and increasing false alarms, but not altering reaction times. These results suggest that the ventral subthalamic nucleus is involved in the balance between appropriate selection and inhibition of prepotent responses in cognitive paradigms, but that a wide area of the subthalamic nucleus region is involved in the motor symptoms of Parkinson's disease. This finding has implications for resolving inconsistencies in previous research, highlights the role of the ventral subthalamic nucleus region in response inhibition and suggests an approach for the clinical optimization of deep brain stimulation of the subthalamic nucleus for both motor and cognitive functions.