Altered plasticity of the human motor cortex in Parkinson's disease
Altered plasticity of the human motor cortex in Parkinson's disease
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DOI：
10.1002/ana.20692
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发表时间：
2006-01-01
影响因子：
11.2
通讯作者：
Fukuyama, H
中科院分区：
文献类型：
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作者：
Ueki, Y;Mima, T;Fukuyama, H
对侧外周神经和大脑皮层的干预性配对联想刺激（IPAS）可以增强初级运动皮层（M1）的兴奋性。本研究探讨了多巴胺是否对帕金森病（PD）患者M1的联想长期增强样效应有贡献。研究对象为18名右撇子PD患者和11名年龄匹配的健康右撇子志愿者。所有患者在停药12小时后用左旋多巴替代（PD-off）进行研究。10例患者用药后也进行评估（PD-on）。WAS包括对手腕右侧正中神经的单次电刺激和随后对左侧M1的经颅磁刺激，刺激间隔为25毫秒（每5秒240对刺激，持续20分钟）。IPAS可提高PD患者右拇短外展肌的运动诱发电位振幅。WAS不影响左拇短外展肌的运动诱发电位振幅。多巴胺替代后PD-off患者WAS前后运动诱发电位幅度之比升高。因此，多巴胺可能调节人类M1的皮质可塑性，这可能与高阶运动控制有关，包括运动学习。
Interventional paired associative stimulation (IPAS) to the contralateral peripheral nerve and cerebral cortex can enhance the primary motor cortex (M1) excitability with two synchronously arriving inputs. This study investigated whether dopamine contributed to the associative long-term potentiation-like effect in the M1 in Parkinson's disease (PD) patients. Eighteen right-handed PD patients and 11 right-handed age-matched healthy volunteers were studied. All patients were studied after 12 hours off medication with levodopa replacement (PD-off). Ten patients were also evaluated after medication (PD-on). The WAS comprised a single electric stimulus to the right median nerve at the wrist and subsequent transcranial magnetic stimulation of the left M1 with an interstimulus interval of 25 milliseconds (240 paired stimuli every 5 seconds for 20 minutes). The motor-evoked potential amplitude in the right abductor pollicis brevis muscle was increased by IPAS in healthy volunteers, but not in PD patients. WAS did not affect the motor-evoked potential amplitude in the left abductor pollicis brevis. The ratio of the motor-evoked potential amplitude before and after WAS in PD-off patients increased after dopamine replacement. Thus, dopamine might modulate cortical plasticity in the human M1, which could be related to higher order motor control, including motor learning.