Noisy vestibular stimulation improves autonomic and motor responsiveness in central neurodegenerative disorders
Noisy vestibular stimulation improves autonomic and motor responsiveness in central neurodegenerative disorders
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DOI：
10.1002/ana.20574
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发表时间：
2005-08-01
影响因子：
11.2
通讯作者：
Kwak, S
中科院分区：
文献类型：
--
作者：
Yamamoto, Y;Struzik, ZR;Kwak, S
已知前庭神经影响延髓心血管区域的神经元回路，并通过小脑蚓部影响基底神经节和边缘系统。通过嘈杂的前庭电刺激（GVS），它可能会改善钝反应的退化神经元回路的多系统萎缩或帕金森病患者，或两者兼而有之。我们评估了24小时噪声GVS对7例多系统萎缩患者的长期心率动力学和12例左旋多巴反应性帕金森病或左旋多巴无反应性帕金森病患者的日间躯干活动动力学的影响。后者患者中的六名还通过连续性能测试检查了认知性能。与假刺激相比，嘈杂的GVS显著增加了心率的短程或高频波动，表明自主神经，特别是副交感神经，反应性得到改善。由自相关测量探测的躯干活动模式的远程antipersistence显着增加了嘈杂的GVS，提示运动迟缓的休息到活动的过渡加快。连续性能测试的平均反应时间也显着降低了嘈杂的GVS，没有显着的变化，无论是遗漏或委员会的错误率，这是在认知任务，这是提高电机执行的暗示。总之，嘈杂的GVS有效地促进了多系统萎缩或帕金森病患者的神经退行性大脑，或两者兼而有之，包括那些对标准左旋多巴治疗无反应的患者;它也有效地改善了这些患者的自主神经和运动反应。
The vestibular nerves are known to influence neuronal circuits in the medullary cardiovascular areas and, through the cerebellar vermis, the basal ganglia and the limbic system. By means of noisy galvanic vestibular stimulation (GVS), it might be possible to ameliorate blunted responsiveness of degenerated neuronal circuits of patients with multi system atrophy or Parkinson's disease, or both. We evaluated the effect of 24-hour noisy GVS on long-term heart rate dynamics in 7 patients with multi system atrophy and on daytime trunk activity dynamics in 12 patients with either levodopa-responsive Parkinson's disease or levodopa-unresponsive parkinsonism. Six of the latter patients were also examined for cognitive performance by means of a continuous performance test. Short-range or high-frequency fluctuations of heart rate were significantly increased by the noisy GVS compared with sham stimulation, suggestive of improved autonomic, especially parasympathetic, responsiveness. Long-range antipersistency of trunk activity patterns probed by an autocorrelation measure was significantly increased by the noisy GVS, suggestive of quickening of bradykinesic rest-to-active transitions. The mean reaction time of the continuous performance test was also significantly decreased by the noisy GVS, without significant changes in either the omission or commission error ratios, which is suggestive of improved motor execution during the cognitive task. In conclusion, the noisy GVS is effective in boosting the neurodegenerative brains of patients with multi system atrophy or Parkinson's disease, or both, including those unresponsive to standard levodopa therapy; it is also effective in improving these patients' autonomic and motor responsiveness.