Effects of dopaminergic treatment on functional cortico-cortical connectivity in Parkinson’s disease
Effects of dopaminergic treatment on functional cortico-cortical connectivity in Parkinson’s disease
复制标题
多巴胺能治疗对帕金森病功能性皮质-皮质连接的影响
DOI：
10.1007/s00221-014-4115-6
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发表时间：
2014
影响因子：
2
通讯作者：
T. Bäumer
中科院分区：
文献类型：
--
作者：
S. Zittel;C. Heinbokel;J. Vegt;E. Niessen;C. Buhmann;C. Gerloff;H. Siebner;A. Münchau;T. Bäumer
摘要
帕金森病（PD）患者背侧运动前区（PMd）与初级运动区（M1）之间的相互作用以及M1之间的半球间抑制（IHI）受损。我们使用双部位经颅磁刺激比较首次应用左旋多巴与长期多巴胺能治疗对PD患者这些相互作用的影响。12名未经治疗的PD患者在首次摄入左旋多巴之前和之后进行了研究。在11例接受常规多巴胺能药物治疗约3年的患者中评价了慢性多巴胺能药物治疗的效果。其中9名患者在停药过夜后也进行了测量。对于IHI，条件刺激（CS）施加到左侧M1，然后测试刺激（TS）施加到右侧M1，反之亦然，以6-10 ms的刺激间间隔（ISI）在单独的块中。接下来，以亚阈值强度对左侧PMd施加CS，然后以4和6 ms的ISI对左侧M1施加TS。结果进行了比较，17个年龄和性别匹配的控制。在原发性PD患者中，左旋多巴降低了左向右IHI，但没有改变PMd-M1连接。相比之下，抑制性PMd-M1连接存在于慢性多巴胺能刺激下的早期疾病患者中，但在ISI为4 ms的低刺激强度下的原发PD患者中不存在。首次接触左旋多巴对皮质-皮质通路产生不同的影响，而不是慢性多巴胺能刺激PD，这表明在PD过程中皮质-皮质回路的反应性发生了变化。
Abstract
Interactions between dorsal premotor cortex (PMd) and primary motor cortex (M1) and interhemispheric inhibition (IHI) between M1 are impaired in Parkinson’s disease (PD). We used dual-site transcranial magnetic stimulation to compare effects of first-time levodopa application with chronic dopaminergic therapy on these interactions in PD. Twelve untreated PD patients were studied before and after their first-ever intake of levodopa. The effects of chronic dopaminergic medication were evaluated in 11 patients who had received regular dopaminergic medication for approximately 3 years. Nine of these patients were also measured after overnight withdrawal of medication. For IHI, conditioning stimuli (CS) were applied to left M1 followed by test stimuli (TS) over right M1 and vice versa in separate blocks at interstimulus intervals (ISI) of 6–10 ms. Next, CS were applied to left PMd at subthreshold intensity followed by TS over left M1 at ISIs of 4 and 6 ms. Results were compared to 17 age- and gender-matched controls. In de novo PD patients, levodopa reduced left-to-right IHI, but did not alter PMd–M1 connectivity. In contrast, inhibitory PMd–M1 connectivity was present in early disease patients under chronic dopaminergic stimulation, but not in de novo PD patients at low stimulus intensities at an ISI of 4 ms. First-time exposure to levodopa exerts different effects on cortico-cortical pathways than chronic dopaminergic stimulation in PD, suggesting a change in the responsiveness of cortico-cortical circuits during the course of PD.
影响因子：
2.7
作者：
Fling, Brett W.;Seidler, Rachael D.
通讯作者：
Seidler, Rachael D.