Bradykinesia and Its Progression Are Related to Interhemispheric Beta Coherence.
Bradykinesia and Its Progression Are Related to Interhemispheric Beta Coherence.
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运动迟缓及其进展与半球间 Beta 相干性有关。
DOI：
10.1002/ana.26605
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发表时间：
2023
影响因子：
11.2
通讯作者：
Bronte-Stewart,HelenM
中科院分区：
文献类型：
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作者：
Wilkins,KevinB;Kehnemouyi,YasmineM;Petrucci,MatthewN;Anderson,RossW;Parker,JordanE;Trager,MeganH;Neuville,RauminS;Koop,MandyM;Velisar,Anca;Blumenfeld,Zack;Quinn,EmmaJ;Bronte-Stewart,HelenM
目的运动迟缓是帕金森病（PD）的主要运动体征，但其神经基础尚不清楚。本研究的目的是检查长期丘脑下核（STN）深部脑刺激（DBS）后运动迟缓的变化是否与局部STN β (13-30 Hz)动力学或更广泛的双侧网络功能障碍有关。方法21例PD患者在STN植入感测神经刺激器（Activa®PC + S, Medtronic， PLC），每3至6个月进行一次纵向“洗脱”治疗研究，平均持续3年。在每次访问中，参与者停药（12/24/48小时）并关闭DBS （bbb60分钟），然后完成重复性手腕屈曲伸展任务，这是对运动迟缓的有效定量评估，同时记录局部场电位。通过β功率和爆发持续时间来研究局部STN β动力学，而半球间β同步则通过STN - STN β相干性来评估。结果脑内STN β相干性升高与运动迟缓加重有显著相关性，而对侧β功率或爆发持续时间不显著相关。运动迟缓随着时间的推移而恶化。大脑半球间的STN - STN相干性也随着时间的推移而增加，而β功率和爆发持续时间保持稳定。观察到的运动迟缓的变化与半球间β相干性的变化有关，同步性的增加与运动迟缓的进一步恶化有关。综上所述，这些发现提示脑半球间β同步是慢性STN型DBS后运动迟缓进展的神经相关因素。这可能意味着存在一个病理双侧网络，导致帕金森病运动迟缓。Ann neurol 2023；93:1029 - 1039
ObjectiveBradykinesia is the major cardinal motor sign of Parkinson disease (PD), but its neural underpinnings are unclear. The goal of this study was to examine whether changes in bradykinesia following long‐term subthalamic nucleus (STN) deep brain stimulation (DBS) are linked to local STN beta (13–30 Hz) dynamics or a wider bilateral network dysfunction.MethodsTwenty‐one individuals with PD implanted with sensing neurostimulators (Activa® PC + S, Medtronic, PLC) in the STN participated in a longitudinal ‘washout’ therapy study every three to 6 months for an average of 3 years. At each visit, participants were withdrawn from medication (12/24/48 hours) and had DBS turned off (>60 minutes) before completing a repetitive wrist‐flexion extension task, a validated quantitative assessment of bradykinesia, while local field potentials were recorded. Local STN beta dynamics were investigated via beta power and burst duration, while interhemispheric beta synchrony was assessed with STN‐STN beta coherence.ResultsHigher interhemispheric STN beta coherence, but not contralateral beta power or burst duration, was significantly associated with worse bradykinesia. Bradykinesia worsened off therapy over time. Interhemispheric STN‐STN beta coherence also increased over time, whereas beta power and burst duration remained stable. The observed change in bradykinesia was related to the change in interhemispheric beta coherence, with greater increases in synchrony associated with further worsening of bradykinesia.InterpretationTogether, these findings implicate interhemispheric beta synchrony as a neural correlate of the progression of bradykinesia following chronic STN DBS. This could imply the existence of a pathological bilateral network contributing to bradykinesia in PD. ANN NEUROL 2023;93:1029–1039