Subthalamic stimulation impairs stopping of ongoing movements
Subthalamic stimulation impairs stopping of ongoing movements
复制标题
DOI：
10.1093/brain/awaa341
复制
发表时间：
2021-01-01
期刊：
影响因子：
14.5
通讯作者：
Kuehn, Andrea A.
中科院分区：
文献类型：
--
作者：
Lofredi, Roxanne;Auernig, Georg Cem;Kuehn, Andrea A.
丘脑底核是全球停止网络的一部分，该网络还包括右半球的前辅助运动区和额下回。在帕金森氏病中，丘脑底脑深部电刺激可改善运动起始和速度，但其对停止正在进行的运动的影响尚不清楚。在这里，我们研究运动停止和刺激体积的停止网络的连接之间的关系。在视觉提示开始和终止连续旋转运动期间，收集了17例帕金森病患者在丘脑底核刺激和非丘脑底核刺激下的停和走时间。脑深部电刺激接触被定位;刺激体积计算和连接概况估计使用公开可用的，规范的结构连接体。丘脑底核刺激显著增加停止时间，这与刺激体积的连接，以presupplementary运动区和额下回的右半球。使用三个独立的分析流验证了这一发现的鲁棒性：体素全脑连接，感兴趣区域连接和以束为中心的方法。我们的研究揭示了额底丘脑抑制三角在停止正在进行的运动中的作用，并可能激发基于电路的自适应刺激策略来控制停止损伤，可能反映在刺激诱导的运动障碍。
The subthalamic nucleus is part of a global stopping network that also includes the presupplementary motor area and inferior frontal gyrus of the right hemisphere. In Parkinson's disease, subthalamic deep brain stimulation improves movement initiation and velocity, but its effect on stopping of ongoing movement is unknown. Here, we examine the relation between movement stopping and connectivity of stimulation volumes to the stopping network. Stop and go times were collected in 17 patients with Parkinson's disease on and off subthalamic stimulation during visually cued initiation and termination of continuous, rotational movements. Deep brain stimulation contacts were localized; the stimulation volume computed and connectivity profiles estimated using an openly available, normative structural connectome. Subthalamic stimulation significantly increased stop times, which correlated with the connectivity of the stimulation volume to presupplementary motor area and inferior frontal gyrus of the right hemisphere. The robustness of this finding was validated using three separate analysis streams: voxel-wise whole-brain connectivity, region of interest connectivity and a tract-centred method. Our study sheds light on the role of the fronto-subthalamic inhibitory triangle in stopping of ongoing movements and may inspire circuit based adaptive stimulation strategies for control of stopping impairment, possibly reflected in stimulation-induced dyskinesia.