Improved efficacy of temporally non-regular deep brain stimulation in Parkinson's disease.
Improved efficacy of temporally non-regular deep brain stimulation in Parkinson's disease.
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DOI：
10.1016/j.expneurol.2012.09.008
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发表时间：
2013-01
影响因子：
5.3
通讯作者：
Grill WM
中科院分区：
文献类型：
--
作者：
Brocker DT;Swan BD;Turner DA;Gross RE;Tatter SB;Koop MM;Bronte-Stewart H;Grill WM
高频脑深部电刺激是治疗帕金森病运动症状的有效方法。然而，在帕金森氏病中，规则与非规则时间刺激模式的相对临床疗效仍不清楚。为了确定对治疗帕金森病重要的非规则时间模式的刺激的时间特性，我们使用交替手指敲击任务比较了帕金森病受试者中的时间规则刺激与四种非规则刺激模式的功效。还在帕金森基底神经节的生物物理模型中评价了刺激模式，该模型在β频率范围内表现出突出的振荡活动。刺激的时间模式差异提高运动任务的性能。三个不规则的刺激模式，提高性能的手指敲击任务比时间规律的刺激。在计算模型中，脑深部电刺激的所有模式都抑制β带振荡活动，并且抑制程度与刺激模式的临床疗效密切相关。与常规刺激相比，改善运动性能的三种非常规刺激模式也比常规刺激更有效地抑制了计算模型中的β带振荡活动。这些数据表明，刺激的时间模式是脑深部电刺激治疗帕金森病的临床疗效的重要考虑因素。此外，非规则模式的刺激可以比规则刺激更有效地改善运动症状并抑制基底神经节中的病理性节律活动。因此，脑深部电刺激的非规则模式可能具有有用的临床和实验应用。
High frequency deep brain stimulation is an effective therapy for motor symptoms in Parkinson's disease. However, the relative clinical efficacy of regular versus non-regular temporal patterns of stimulation in Parkinson's disease remains unclear. To determine the temporal characteristics of non-regular temporal patterns of stimulation important for treatment of Parkinson's disease, we compared the efficacy of temporally regular stimulation with four non-regular patterns of stimulation in subjects with Parkinson's disease using an alternating finger tapping task. The patterns of stimulation were also evaluated in a biophysical model of the parkinsonian basal ganglia that exhibited prominent oscillatory activity in the beta frequency range. The temporal patterns of stimulation differentially improved motor task performance. Three of the non-regular patterns of stimulation improved performance of the finger tapping task more than temporally regular stimulation. In the computational model all patterns of deep brain stimulation suppressed beta band oscillatory activity, and the degree of suppression was strongly correlated with the clinical efficacy across stimulation patterns. The three non-regular patterns of stimulation that improved motor performance over regular stimulation also suppressed beta band oscillatory activity in the computational model more effectively than regular stimulation. These data demonstrate that the temporal pattern of stimulation is an important consideration for the clinical efficacy of deep brain stimulation in Parkinson's disease. Furthermore, non-regular patterns of stimulation may ameliorate motor symptoms and suppress pathological rhythmic activity in the basal ganglia more effectively than regular stimulation. Therefore, non-regular patterns of deep brain stimulation may have useful clinical and experimental applications.
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影响因子：
5.3
作者：
Baker, Kenneth B.;Zhang, Jianyu;Vitek, Jerrold L.
通讯作者：
Vitek, Jerrold L.
影响因子：
1.2
作者：
Feng, Xiao-Jiang;Shea-Brown, Eric;Rabitz, Herschel
通讯作者：
Rabitz, Herschel
影响因子：
158.5
作者：
Follett, Kenneth A.;Weaver, Frances M.;Reda, Domenic J.
通讯作者：
Reda, Domenic J.
影响因子：
168.9
作者：
LIMOUSIN, P;POLLAK, P;BENABID, AL
通讯作者：
BENABID, AL
影响因子：
1.7
作者：
Birdno, Merrill J.;Kuncel, Alexis M.;Grill, Warren M.
通讯作者：
Grill, Warren M.