Deep brain stimulation effect on anterior pallidum reduces motor impulsivity in Parkinson's disease.
Deep brain stimulation effect on anterior pallidum reduces motor impulsivity in Parkinson's disease.
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DOI：
10.1016/j.brs.2021.11.006
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发表时间：
2022-01
影响因子：
7.7
通讯作者：
Mills KA
中科院分区：
文献类型：
--
作者：
Moussawi K;Kim MJ;Baybayan S;Wood M;Mills KA
丘脑底核或苍白球内部的深部脑刺激 (DBS) 用于治疗帕金森病的运动症状。在控制多巴胺能药物的减少后，前者可能会恶化冲动和强迫行为。然而，苍白球 DBS 对 PD 患者此类行为的影响尚不清楚。我们假设通过前额叶连接将更大的刺激传播到苍白球将减少运动冲动。七名帕金森病患者的苍白球内部 DBS 设置稳定 3 个月，病程为 13 ±1.3 年，蒙特利尔认知评估为 26.8 ±1.1，每名患者都有两种刺激设置，这些设置基于导线放置和组织激活量的重建而定义，目标是沿 DBS 电极的背侧或腹侧位置，但仍在苍白球内部。受试者在每个定义的刺激设置中关闭和开启 DBS 来执行停止信号反应时间任务，这与苍白球分区的刺激效果程度相关。组织激活量与右前额连接 GPi 之间的距离较短，与停止信号反应时间任务的冲动性较小相关（r=0.69，p<0.05）。与非前额连接的苍白球内部的组织激活重叠量越大，与冲动性的增加相关。这些数据可用于优化有问题冲动的 PD 患者或其他涉及冲动行为的疾病（例如物质使用障碍）的 DBS 编程。
Deep Brain Stimulation (DBS) of the subthalamic nucleus or globus pallidus internus is used to treat the motor symptoms of Parkinson’s disease. The former can worsen impulsive and compulsive behaviors after controlling for the reduction of dopaminergic medications. However, the effect of pallidal DBS on such behaviors in PD patients is less clear. We hypothesized that greater stimulation spread to the pallidum with prefrontal connectivity would reduce motor impulsivity. Seven Parkinson’s patients with stable globus pallidus internus DBS settings for 3 months, disease duration of 13 ±1.3 years, and Montreal Cognitive Assessment of 26.8 ±1.1 each had two stimulation settings defined based on reconstructions of lead placement and volume of tissue activation targeting either a dorsal or ventral position along the DBS electrode but still within the globus pallidus internus. Subjects performed a stop signal reaction time task with the DBS turned off vs. on in each of the defined stimulation settings, which was correlated with the degree of stimulation effect on pallidal subregions. A shorter distance between the volume of tissue activation and the right prefrontally-connected GPi correlated with less impulsivity on the stop signal reaction time task (r=0.69, p<0.05). Greater volume of tissue activation overlap with the non-prefrontally-connected globus pallidus internus was associated with increased impulsivity. These data can be leveraged to optimize DBS programming in PD patients with problematic impulsivity or in other disorders involving impulsive behaviors such as substance use disorders.
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影响因子：
1.9
作者：
Coblentz, Ailish;Elias, Gavin J. B.;Fasano, Alfonso
通讯作者：
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影响因子：
158.5
作者：
Follett, Kenneth A.;Weaver, Frances M.;Reda, Domenic J.
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影响因子：
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作者：
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DOI：
10.1146/annurev-clinpsy-032813-153705
发表时间：
2014-01-01
期刊：
ANNUAL REVIEW OF CLINICAL PSYCHOLOGY, VOL 10
影响因子：
--
作者：
Averbeck, B. B.;O'Sullivan, S. S.;Djamshidian, A.
通讯作者：
Djamshidian, A.
DOI：
10.1073/pnas.0805903105
发表时间：
2008-11-11
影响因子：
11.1
作者：
Forstmann, Birte U.;Dutilh, Gilles;Wagenmaker, Eric-Jan
通讯作者：
Wagenmaker, Eric-Jan