Closed-Loop Deep Brain Stimulation Is Superior in Ameliorating Parkinsonism
Closed-Loop Deep Brain Stimulation Is Superior in Ameliorating Parkinsonism
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DOI：
10.1016/j.neuron.2011.08.023
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发表时间：
2011-10-20
期刊：
影响因子：
16.2
通讯作者：
Bergman, Hagai
中科院分区：
文献类型：
--
作者：
Rosin, Boris;Slovik, Maya;Bergman, Hagai
连续高频脑深部电刺激（DBS）是一种广泛用于晚期帕金森病（PD）治疗的疗法。然而，DBS效应的潜在机制仍然是个谜，是一个正在进行的辩论的主题。在这里，我们提出并测试了一个闭环刺激策略PD的1-甲基-4-苯基-1，2，3，6-四氢吡啶（MPTP）的灵长类动物模型的PD。应用苍白球闭环刺激导致基底神经节（BG）放电率和模式的变化之间的分离，提供了对PD病理生理学的见解。此外，皮质-苍白球闭环刺激对运动不能以及皮质和苍白球放电模式的影响显著大于标准开环DBS和匹配的对照刺激范例。因此，闭环DBS范例，通过调节病理振荡活动，而不是BG皮层网络的放电率，可以提供更有效的管理先进的PD。这种策略有可能在其他大脑疾病中有效，其中可以识别病理性神经元放电模式。
Continuous high-frequency deep brain stimulation (DBS) is a widely used therapy for advanced Parkinson's disease (PD) management. However, the mechanisms underlying DBS effects remain enigmatic and are the subject of an ongoing debate. Here, we present and test a closed-loop stimulation strategy for PD in the 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) primate model of PD. Application of pallidal closed-loop stimulation leads to dissociation between changes in basal ganglia (BG) discharge rates and patterns, providing insights into PD pathophysiology. Furthermore, cortico-pallidal closed-loop stimulation has a significantly greater effect on akinesia and on cortical and pallidal discharge patterns than standard open-loop DBS and matched control stimulation paradigms. Thus, closed-loop DBS paradigms, by modulating pathological oscillatory activity rather than the discharge rate of the BG-cortical networks, may afford more effective management of advanced PD. Such strategies have the potential to be effective in additional brain disorders in which a pathological neuronal discharge pattern can be recognized.