Effects of subthalamic nucleus deep brain stimulation and l-dopa on blinking in Parkinson's disease
Effects of subthalamic nucleus deep brain stimulation and l-dopa on blinking in Parkinson's disease
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DOI：
10.1016/j.expneurol.2012.02.004
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发表时间：
2012-05-01
影响因子：
5.3
通讯作者：
Berardelli, Alfredo
中科院分区：
文献类型：
--
作者：
Bologna, Matteo;Fasano, Alfonso;Berardelli, Alfredo
在这项研究中，我们询问丘脑底核深部脑刺激 (STN-DBS) 单独使用或与左旋多巴联合使用是否可以改变帕金森病 (PD) 患者的自主性、自发性和反射性眨眼。在四种实验条件下对 16 名接受 STN-DBS 的 PD 患者进行了研究：无 STN-DBS 且无左旋多巴、仅 STN-DBS、仅左旋多巴和 STN-DBS 加左旋多巴。结果与 15 名健康对照者的结果进行了比较。通过要求参与者尽可能快地眨眼来评估自愿眨眼；在两次 60 秒的休息期间记录自发眨眼；反射性眨眼是通过电刺激眶上神经引起的。使用 SMART 运动系统记录和分析眨眼。 STN-DBS 增加了关闭和打开自愿眨眼阶段的峰值速度和幅度，但延长了阶段间暂停持续时间。左旋多巴对自愿眨眼没有影响，但逆转了 STN-DBS 期间观察到的增加的相间暂停持续时间。 STN-DBS 或左旋多巴后自发眨眼率增加。 STN-DBS 或左旋多巴不会改变反射性眨眼运动学。 STN-DBS 对随意眨眼运动学和自发眨眼率的影响可能是皮质基底神经节活动变化的结果。自愿眨眼的长时间暂停表明 STN-DBS 对颅骨区域有不利影响。这些结果还揭示了 STN-DBS 后眼睑张开失用症的病理生理学。 (C) 2012 Elsevier Inc. 保留所有权利。
In this study we asked whether subthalamic nucleus deep brain stimulation (STN-DBS) alone, or in combination with L-dopa, modifies voluntary, spontaneous and reflex blinking in patients with Parkinson's disease (PD). Sixteen PD patients who underwent STN-DBS were studied in four experimental conditions: without STN-DBS and without L-dopa, STN-DBS alone, L-dopa alone and STN-DBS plus L-dopa. The results were compared with those obtained in 15 healthy controls. Voluntary blinking was assessed by asking participants to blink as fast as possible; spontaneous blinking was recorded during two 60 s rest periods; reflex blinking was evoked by electrical stimulation of the supraorbital nerve. Blinking were recorded and analysed with the SMART motion system. STN-DBS increased the peak velocity and amplitude for both the closing and opening voluntary blink phases, but prolonged the inter-phase pause duration. L-dopa had no effects on voluntary blinking but reversed the increased inter-phase pause duration seen during STN-DBS. Spontaneous blink rate increased after either STN-DBS or L-dopa. Reflex blinking kinematics were not modified by STN-DBS or L-dopa. The STN-DBS effects on voluntary blinking kinematics and spontaneous blinking rate may occur as results of changes of cortico-basal ganglia activity. The prolonged pause duration of voluntary blinking indicates that STN-DBS has detrimental effects on the cranial region. These results also shed light on the pathophysiology of eyelids opening apraxia following STN-DBS. (C) 2012 Elsevier Inc. All rights reserved.