Rapid Response of Parkinsonian Tremor to STN-DBS Changes: Direct Modulation of Oscillatory Basal Ganglia Activity?
Rapid Response of Parkinsonian Tremor to STN-DBS Changes: Direct Modulation of Oscillatory Basal Ganglia Activity?
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DOI：
10.1002/mds.22536
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发表时间：
2009-06-15
影响因子：
8.6
通讯作者：
Krauss, Joachim K.
中科院分区：
文献类型：
--
作者：
Blahak, Christian;Baezner, Hansjoerg;Krauss, Joachim K.
虽然丘脑底核（subthalamic nucleus，DBS）的脑深部电刺激（deep brain stimulation，DBS）已被证明对帕金森病（Parkinson's disease，PD）的震颤和其他主要症状有效，但DBS的确切作用机制仍不清楚。我们使用计算机三维运动分析结合表面肌电图，分析了9例PD患者在停止STN-DBS和随后重新开始STN-DBS期间静息震颤幅度和频率的时间过程。停止STN-DBS后，静息震颤幅度迅速增加，2分钟后达到最大幅度（平均值+/- 95% CI：34.3 +/- 13.8分钟; P < 0.01），随后稳定在中等水平。30分钟后重新开始刺激导致震颤活动在1分钟内迅速、几乎完全抑制（1.4 +/- 1.3 mm; P < 0.01），此外，9名患者中有7名在几秒钟内增加震颤频率。这些发现支持了STN-DBS通过直接干扰震颤中涉及的基底神经节网络的神经传递而起作用的假设。(C)2009运动障碍协会
Although deep brain stimulation (DBS) of the subthalamic nucleus (STN) has proved to be effective for tremor and other cardinal symptoms in Parkinson's disease (PD), the precise mechanisms of action of DBS are still unclear. We analyzed the time course of resting tremor amplitude and frequency during discontinuation and subsequent reinitiation of STN-DBS in nine PD patients, using a computerized three-dimensional motion analysis combined with surface electromyography. Following discontinuation of STN-DBS, resting tremor amplitude rapidly increased, reaching maximum amplitude after 2 min (mean +/- 95% CI: 34.3 +/- 13.8 min; P < 0.01), subsequently stabilizing at a medium level. Reinitiation of stimulation after 30 min resulted in rapid, nearly complete suppression of tremor activity within 1 min (1.4 +/- 1.3 mm; P < 0.01) and, furthermore, increased tremor frequency within a few seconds in seven of nine patients. These findings support the hypothesis that STN-DBS acts by direct interference with the neurotransmission of basal ganglia networks involved in tremor. (C) 2009 Movement Disorder Society