Benefits of pallidal stimulation in dystonia are linked to cerebellar volume and cortical inhibition.
Benefits of pallidal stimulation in dystonia are linked to cerebellar volume and cortical inhibition.
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DOI：
10.1038/s41598-018-34880-z
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发表时间：
2018-11-21
影响因子：
4.6
通讯作者：
Urgošík D
中科院分区：
文献类型：
--
作者：
Fečíková A;Jech R;Čejka V;Čapek V;Šťastná D;Štětkářová I;Mueller K;Schroeter ML;Růžička F;Urgošík D
苍白球脑深部电刺激（GPi DBS）在肌张力障碍中的临床受益相对缓慢地增加，表明运动网络中的缓慢塑性过程。对22例慢性GPi DBS治疗的各种分布和病因的肌张力障碍患者和22例健康受试者进行了经颅磁刺激引起的运动皮层短潜伏期内抑制检查。考虑到GPi DBS的长期临床结局和状态，分析了灰质体积和皮质内抑制之间的关系。GPi DBS的急性效应与运动反应缩短相关，而长期治疗患者的灰质具有更好的临床结局，显示辅助运动区和小脑蚓部肥大。此外，患者小脑半球的体积与皮质内抑制的改善相关，无论DBS状态如何，皮质内抑制在患者中的效果通常低于对照组。重要的是，良好的反应GPi DBS表现出类似水平的短潜伏期内抑制运动皮层作为健康对照，而非反应者无法增加it.All这些结果支持多层次的影响，有效的DBS对运动网络的肌张力障碍，并建议潜在的生物标志物的反应，这种治疗。
Clinical benefits of pallidal deep brain stimulation (GPi DBS) in dystonia increase relatively slowly suggesting slow plastic processes in the motor network. Twenty-two patients with dystonia of various distribution and etiology treated by chronic GPi DBS and 22 healthy subjects were examined for short-latency intracortical inhibition of the motor cortex elicited by paired transcranial magnetic stimulation. The relationships between grey matter volume and intracortical inhibition considering the long-term clinical outcome and states of the GPi DBS were analysed. The acute effects of GPi DBS were associated with a shortening of the motor response whereas the grey matter of chronically treated patients with a better clinical outcome showed hypertrophy of the supplementary motor area and cerebellar vermis. In addition, the volume of the cerebellar hemispheres of patients correlated with the improvement of intracortical inhibition which was generally less effective in patients than in controls regardless of the DBS states. Importantly, good responders to GPi DBS showed a similar level of short-latency intracortical inhibition in the motor cortex as healthy controls whereas non-responders were unable to increase it. All these results support the multilevel impact of effective DBS on the motor networks in dystonia and suggest potential biomarkers of responsiveness to this treatment.
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