Deep brain stimulation effects in dystonia: time course of electrophysiological changes in early treatment.
Deep brain stimulation effects in dystonia: time course of electrophysiological changes in early treatment.
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肌张力障碍的深脑刺激作用：早期治疗中电生理变化的时间过程。
DOI：
10.1002/mds.23731
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发表时间：
2011-08-15
影响因子：
8.6
通讯作者：
Rothwell, John C.
中科院分区：
文献类型：
--
作者：
Ruge, Diane;Tisch, Stephen;Hariz, Marwan I.;Zrinzo, Ludvic;Bhatia, Kailash P.;Quinn, Niall P.;Jahanshahi, Marjan;Limousin, Patricia;Rothwell, John C.
Deep brain stimulation (DBS) to the internal globus pallidus is an effective treatment for primary dystonia. The optimal clinical effect often occurs only weeks to months after starting stimulation. To better understand the underlying electrophysiological changes in this period we assessed longitudinally two pathophysiological markers of dystonia in patients prior to and in the early treatment period (1,3,6 months) after DBS-surgery. Transcranial magnetic stimulation was used to track changes in short latency intracortical inhibition (SICI), a measure of excitability of GABAA-ergic corticocortical connections and long-term potentiation-like synaptic plasticity (as a response to paired associative stimulation, PAS). DBS remained ON for the duration of the study. Prior to surgery, inhibition was reduced and plasticity increased in patients compared to healthy controls. Following surgery and commencement of DBS, SICI increased towards normal levels over the following months with the same monotonic time course as the patients' clinical benefit. In contrast, synaptic plasticity changed rapidly following a non-monotonic time course: it was absent early (1 month) after surgery, and then over the following months increased towards levels observed in healthy individuals. We postulate that before surgery pre-existing high levels of plasticity form strong memories of dystonic movement patterns. When DBS is turned ON, it disrupts abnormal basal ganglia signals resulting in the absent response to PAS at one month. Clinical benefit is delayed because engrams of abnormal movement persist and take time to normalise. Our observations suggest that plasticity may be a driver of long term therapeutic effects of DBS in dystonia.
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影响因子：
8.6
作者：
Edwards, Mark J.;Huang, Ying-Zu;Bhatia, Kailash P.
通讯作者：
Bhatia, Kailash P.
影响因子：
9.9
作者：
Kühn, AA;Meyer, BU;Kupsch, A
通讯作者：
Kupsch, A
影响因子：
14.5
作者：
NAKASHIMA, K;ROTHWELL, JC;MARSDEN, CD
通讯作者：
MARSDEN, CD
影响因子：
5.3
作者：
Tisch, Stephen;Rothwell, John C.;Limousin, Patricia
通讯作者：
Limousin, Patricia
影响因子：
4.7
作者：
Schmidt, S.;Cichy, R. M.;Brandt, S. A.
通讯作者：
Brandt, S. A.