Dopaminergic therapy promotes lateralized motor activity in the subthalamic area in Parkinson's disease
Dopaminergic therapy promotes lateralized motor activity in the subthalamic area in Parkinson's disease
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DOI：
10.1093/brain/awl358
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发表时间：
2007-02-01
期刊：
影响因子：
14.5
通讯作者：
Brown, Peter
中科院分区：
文献类型：
--
作者：
Androulidakis, Alexandros G.;Kuehn, Andrea A.;Brown, Peter
用左旋多巴治疗帕金森病患者对丘脑下核（STN）的运动和运动相关反应模式有深远的影响，反映在局部场电位（LFP）上。最显著的变化是伽马频带的反应性增强，但尚不清楚后者本身是一种病理特征，可能与左旋多巴诱导的运动障碍有关，还是主要是生理上的。没有帕金森病的人的大脑皮层中的伽马带反应发生在运动的对侧，因此我们假设左旋多巴可以恢复帕金森病患者的生理模式，那么左旋多巴后皮层下伽马反应应该发生偏侧化。因此，我们研究了11名帕金森病患者（年龄59岁，6±2.7岁，3名女性）在左旋多巴开和关时进行单侧和对侧自定节奏操纵杆运动时STN LFP活性的运动相关变化。在关闭状态下，两侧对称的伽马波段功率增加发生在运动开始前后。左旋多巴后，这一特征在运动对侧的丘脑底区变得更加明显。这种不对称反应模式的生理性质在两名无帕金森病的震颤患者的STN中得到证实。虽然左旋多巴治疗在帕金森病患者中没有导致低频（8-30 Hz）功率抑制的偏侧化，但它确实增加了功率抑制的程度。这些发现表明，多巴胺能治疗在帕金森病患者的STN中恢复了更生理的反应性模式。
Treatment of patients with Parkinson's disease with levodopa has profound effects on both movement and the pattern of movement-related reactivity in the subthalamic nucleus (STN), as reflected in the local field potential (LFP). The most striking change is the promotion of reactivity in the gamma frequency band, but it remains unclear whether the latter is itself a pathological feature, possibly associated with levodopa induced dyskinesias, or is primarily physiological. Gamma band reactivity in the cerebral cortex of humans without Parkinson's disease occurs contralateral to movement, so we posited that lateralization of subcortical gamma reactivity should occur following levodopa if the latter restores a more physiological pattern in patients with Parkinson's disease. Accordingly, we studied movement-related changes in STN LFP activity in 11 Parkinson's disease patients ( age 59 6 +/- 2.7 years, three females) while they performed ipsi- and contralateral self-paced joystick movements ON and OFF levodopa. A bilaterally symmetrical gamma band power increase occurred around movement onset in the OFF state. Following levodopa this feature became significantly more pronounced in the subthalamic region contralateral to movement. The physiological nature of this asymmetric pattern of gamma reactivity was confirmed in the STN of two tremor patients without Parkinson's disease. Although levodopa treatment in the Parkinson's disease patients did not lead to lateralization of power suppression at lower frequencies (8-30 Hz), it did increase the degree of power suppression. These findings suggest that dopaminergic therapy restores a more physiological pattern of reactivity in the STN of patients with Parkinson's disease.