Effects of stimulation of the subthalamic area on oscillatory pallidal activity in Parkinson's disease
Effects of stimulation of the subthalamic area on oscillatory pallidal activity in Parkinson's disease
复制标题
DOI：
10.1016/j.expneurol.2004.05.009
复制
发表时间：
2004-08-01
影响因子：
5.3
通讯作者：
Di Lazzaro, V
中科院分区：
文献类型：
--
作者：
Brown, P;Mazzone, P;Di Lazzaro, V
帕金森病 (PD) 中基底神经节内的神经元放电模式受到干扰。特别是，在没有多巴胺能治疗的情况下，神经元元件有在 20 Hz 左右同步的趋势，而在多巴胺能治疗后，这种活动可以被更高频率（> 70 Hz）的自发同步所取代 [J.神经科学。 21（2001）1033；脑126(2003)2153]。在两名 PD 患者（3 侧）中，我们发现以 20 Hz 左右的频率刺激底丘脑区域会加剧内苍白球（人类基底节的主要输出结构）中类似频率的同步。相反，以 > 70 Hz 的频率刺激丘脑底区域会抑制 20 Hz 左右的苍白球活动。临床上，以相似的高频刺激丘脑底区域可以逆转帕金森病，并构成帕金森病深部脑刺激治疗的基础。结果指出了一种可能的共同机制，通过该机制，多巴胺能治疗与非常高频率下丘脑活动的同步相关，以及由治疗性刺激底丘脑区域所施加的同步抑制了基底神经节在 20 Hz 左右输出的异常且可能有害的同步。如果这种活动不受较高频率同步的控制，那么病态的 20 Hz 振荡可能会级联通过基底神经节，并在后续处理级别中增加。 (C) 2004 Elsevier Inc. 保留所有权利。
The pattern of neuronal discharge within the basal ganglia is disturbed in Parkinson's disease (PD). In particular, there is a tendency for neuronal elements to synchronise at around 20 Hz in the absence of dopaminergic treatment, whereas this activity can be replaced by spontaneous synchronisation at much higher frequencies ( > 70 Hz) following dopaminergic treatment [J. Neurosci. 21 (2001) 1033; Brain 126 (2003) 2153]. In two PD patients (3 sides), we show that stimulating the subthalamic area at around 20 Hz exacerbates synchronisation at similar frequencies in the globus pallidus interna, the major output structure of the human basal ganglia. In contrast, stimulating the subthalamic area at > 70 Hz suppresses pallidal activity at about 20 Hz. Clinically, stimulation of the subthalamic area at similar high frequencies reverses parkinsonism and forms the basis of therapeutic deep brain stimulation in PD. The results point to a possible common mechanism by which both dopaminergic treatment associated synchronisation of subthalamic activity at very high frequency and synchronisation imposed by therapeutic stimulation of the subthalamic area inhibit an abnormal and potentially deleterious synchronisation of basal ganglia output at around 20 Hz. If this activity is unchecked by synchronisation at higher frequency, then pathological 20-Hz oscillations may cascade through the basal ganglia, increasing at subsequent levels of processing. (C) 2004 Elsevier Inc. All rights reserved.