Cerebral blood flow responses to dorsal and ventral STN DBS correlate with gait and balance responses in Parkinson's disease.
Cerebral blood flow responses to dorsal and ventral STN DBS correlate with gait and balance responses in Parkinson's disease.
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DOI：
10.1016/j.expneurol.2012.12.003
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发表时间：
2013-03
影响因子：
5.3
通讯作者：
Perlmutter, J. S.
中科院分区：
文献类型：
--
作者：
Hill, K. K.;Campbell, M. C.;McNeely, M. E.;Karimi, M.;Ushe, M.;Tabbal, S. D.;Hershey, T.;Flores, H. P.;Hartlein, J. M.;Lugar, H. M.;Revilla, F. J.;Videen, T. O.;Earhart, G. M.;Perlmutter, J. S.
丘脑下核（STN）深部脑刺激（DBS）对步态和平衡的影响各不相同，其潜在机制尚不清楚。由于STN的解剖异质性，DBS的位置可能会改变运动益处。本研究的目的是：(1)比较背侧（D-STN）和腹侧（V-STN）脑电刺激对步态、平衡和区域脑血流（rCBF）的影响；(2)研究rCBF的变化与D-STN或V-STN脑电刺激引起的步态和平衡变化之间的关系。我们使用经过验证的图谱注册来定位并通过电极接触刺激37名帕金森病患者的D-STN和V-STN区域。在受试者内，双盲和平衡设计控制了DBS设置，我们测量了PET rCBF在先验感兴趣区域的反应，并量化了DBS关闭、单侧D-STN DBS和单侧V-STN DBS期间的步态和平衡。任何一个部位的DBS都增加了步长，但没有产生显著的组水平的步态速度、节奏或平衡变化。这两个部位都增加了皮层下区域的rCBF，并在皮层和小脑区域产生了不同的变化。DBS诱导的步态速度变化与V-STN DBS期间运动前皮质rCBF变化有关（r = - 0.40, p = 0.03），与D-STN DBS期间小脑前叶rCBF变化有关（r = - 0.43, p = 0.02）。dbs引起的步态变化与选定的皮质和小脑区域的rCBF反应相对应。这些关系在D-STN和V-STN DBS中有所不同，表明DBS通过依赖于DBS位置的不同神经元通路起作用。
The effects of subthalamic nucleus (STN) deep brain stimulation (DBS) on gait and balance vary and the underlying mechanisms remain unclear. DBS location may alter motor benefit due to anatomical heterogeneity in STN. The purposes of this study were to (1) compare effects of DBS of dorsal (D-STN) versus ventral (V-STN) regions on gait, balance and regional cerebral blood flow (rCBF) and (2) examine relationships between changes in rCBF and changes in gait and balance induced by D-STN or V-STN DBS. We used a validated atlas registration to locate and stimulate through electrode contacts in D-STN and V-STN regions of 37 people with Parkinson disease. In a within-subjects, double-blind and counterbalanced design controlled for DBS settings, we measured PET rCBF responses in a priori regions of interest and quantified gait and balance during DBS Off, unilateral D-STN DBS and unilateral V-STN DBS. DBS of either site increased stride length without producing significant group-level changes in gait velocity, cadence or balance. Both sites increased rCBF in subcortical regions and produced variable changes in cortical and cerebellar regions. DBS-induced changes in gait velocity related to premotor cortex rCBF changes during V-STN DBS (r = −0.40, p = 0.03) and to rCBF changes in the cerebellum anterior lobe during D-STN DBS (r = −0.43, p = 0.02). DBS-induced changes in gait corresponded to rCBF responses in selected cortical and cerebellar regions. These relationships differed during D-STN versus V-STN DBS, suggesting DBS acts through distinct neuronal pathways dependent on DBS location.
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影响因子：
2.6
作者：
Campbell MC;Karimi M;Weaver PM;Wu J;Perantie DC;Golchin NA;Tabbal SD;Perlmutter JS;Hershey T
通讯作者：
Hershey T
影响因子：
3.5
作者：
Franchignoni F;Horak F;Godi M;Nardone A;Giordano A
通讯作者：
Giordano A
影响因子：
11
作者：
HUGHES, AJ;DANIEL, SE;LEES, AJ
通讯作者：
LEES, AJ
影响因子：
14.5
作者：
Hershey, Tamara;Campbell, Meghan C.;Perlmutter, Joel S.
通讯作者：
Perlmutter, Joel S.
影响因子：
2
作者：
Guehl, D;Dehail, P;Burbaud, P
通讯作者：
Burbaud, P