Globus Pallidus Stimulation Reduces Frontal Hyperactivity in Tardive Dystonia
Globus Pallidus Stimulation Reduces Frontal Hyperactivity in Tardive Dystonia
复制标题
苍白球刺激可减少迟发性肌张力障碍的额叶过度活跃
DOI：
10.1038/sj.jcbfm.9600610
复制
发表时间：
2008
影响因子：
6.3
通讯作者：
E. Broussolle
中科院分区：
文献类型：
--
作者：
S. Thobois;B. Ballanger;Jing Xie‐Brustolin;P. Damier;F. Durif;J. Azulay;P. Derost;T. Witjas;S. Raoul;D. Le Bars;E. Broussolle
迟发性肌张力障碍（TD）是一种由抗精神病药引起的致残性疾病。内部苍白球 (GPi) 刺激可以显着改善 TD。目前的正电子发射断层扫描和 H215O 研究旨在描述 5 名接受 GPi 刺激治疗的 TD 患者和 8 名对照组的 TD 脑激活异常以及 GPi 刺激对这些异常的影响。确定局部脑血流量（rCBF）的变化：（i）休息时； (ii) 在打开和关闭双侧 GPi 刺激时，在三个自由选择的方向上移动操纵杆时。与对照组相比，在非刺激条件下 TD 患者的 rCBF 显着增加：（1）在前额叶、运动前外侧和前扣带皮层的运动执行过程中； (2) 休息时，位于前额叶、前扣带皮层和小脑。内部苍白球刺激导致运动执行期间初级运动、前额皮质和小脑的 rCBF 减少 (1)； (2)休息时，在初级运动区和前扣带皮层以及辅助运动区。结果如下：（1）TD与大脑过度活动有关，尤其是前额叶和前运动区； (2) GPi 刺激会降低运动皮质、前运动皮质、前额皮质以及小脑的激活。
Tardive dystonia (TD) is a disabling disorder induced by neuroleptics. Internal globus pallidus (GPi) stimulation can dramatically improve TD. The present positron emission tomography and H215O study aimed to characterize the abnormalities of brain activation of TD and the impact of GPi stimulation on these abnormalities in five TD patients treated with GPi stimulation and eight controls. Changes of regional cerebral blood flow (rCBF) were determined: (i) at rest; (ii) when moving a joystick with the right hand in three freely chosen directions in on and off bilateral GPi stimulation. A significant increase of rCBF was found in TD patients in off-stimulation condition compared to controls: (1) during motor execution in the prefrontal, premotor lateral, and anterior cingulate cortex; (2) at rest, in the prefrontal and anterior cingulate cortex and the cerebellum. Internal globus pallidus stimulation led to a reduction of rCBF (1) during motor execution, in the primary motor and prefrontal cortex and the cerebellum; (2) at rest, in the primary motor and anterior cingulate cortex and supplementary motor area. The results are as follows: (1) TD is related to an excess of brain activity notably in the prefrontal and premotor areas; (2) GPi stimulation reduces the activation of motor, premotor, and prefrontal cortex as well as cerebellum.