High-frequency stimulation of the subthalamic nucleus suppresses oscillatory β activity in patients with Parkinson's disease in parallel with improvement in motor performance
High-frequency stimulation of the subthalamic nucleus suppresses oscillatory β activity in patients with Parkinson's disease in parallel with improvement in motor performance
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DOI：
10.1523/jneurosci.0282-08.2008
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发表时间：
2008-06-11
影响因子：
5.3
通讯作者：
Brown, Peter
中科院分区：
文献类型：
--
作者：
Kuehn, Andrea A.;Kempf, Florian;Brown, Peter
丘脑底核（STN）高频刺激（HFS）是治疗严重帕金森病（PD）患者的一种成熟疗法，但其作用机制尚不清楚。 β (13-30 Hz) 频段的过度振荡同步与 PD 患者的运动迟缓有关。因此，我们测试了这样的假设：STN HFS 所产生的临床益处伴随着局部 β 活性的抑制。为此，我们探讨了 STN HFS 对 11 名 PD 患者停止 HFS 后立即从 STN 记录的振荡局部场电位 (LFP) 活动的影响。仅对停止 HFS 后表现出暂时持续的临床获益的患者进行分析。 STN HFS 导致刺激结束后 12 秒内 STN LFP β 活性显着降低，并且同一时间段内 β 带中运动皮质-STN 一致性降低。 LFP β 活性的减少与简单运动任务期间的运动幅度相关，因此更少量的 β 活性与更好的任务表现相关。当考虑 5-12 Hz 频段的功率时，这些特征不存在。我们的研究结果表明，HFS 可能通过调节同步振荡的病理模式来发挥作用，特别是通过减少 PD 的病理性 β 活性。
High-frequency stimulation (HFS) of the subthalamic nucleus (STN) is a well-established therapy for patients with severe Parkinson's disease (PD), but its mechanism of action is unclear. Exaggerated oscillatory synchronization in the beta (13-30 Hz) frequency band has been associated with bradykinesia in patients with PD. Accordingly, we tested the hypothesis that the clinical benefit exerted by STN HFS is accompanied by suppression of local beta activity. To this end, we explored the after effects of STN HFS on the oscillatory local field potential (LFP) activity recorded from the STN immediately after the cessation of HFS in 11 PD patients. Only patients that demonstrated a temporary persistence of clinical benefit after cessation of HFS were analyzed. STN HFS led to a significant reduction in STN LFP beta activity for 12 s after the end of stimulation and a decrease in motor cortical-STN coherence in the beta band over the same time period. The reduction in LFP beta activity correlated with the movement amplitude during a simple motor task, so that a smaller amount of beta activity was associated with better task performance. These features were absent when power in the 5-12 Hz frequency band was considered. Our findings suggest that HFS may act by modulating pathological patterns of synchronized oscillations, specifically by reduction of pathological beta activity in PD.