Stimulation of STN impairs aspects of cognitive control in PD

Stimulation of STN impairs aspects of cognitive control in PD
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DOI：
10.1212/01.wnl.0000118202.19098.10
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发表时间：
2004-04-13
期刊：
NEUROLOGY
影响因子：
9.9
通讯作者：
Perlmutter, JS
Perlmutter, JS
中科院分区：
医学1区
文献类型：
--
作者：
Hershey, T;Revilla, FJ;Perlmutter, JS

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目的：目的：验证帕金森病（PD）患者丘脑底核（subthalamic nucleus，简称PD）刺激对工作记忆和反应抑制能力的影响，尤其是在认知控制要求较高的条件下。研究方法：为了检验这一假设，对先前植入双侧脑干刺激器的PD患者（n = 24）进行了需要不同认知控制水平的空间工作记忆（空间延迟反应[SDR]）和反应抑制（Go - No - Go [GNG]）任务。患者未过夜服用PD药物。在双侧刺激器打开和关闭时收集数据，以平衡受试者之间的顺序。结果如下：在SDR任务中，在高而非低记忆负荷条件下，刺激器刺激降低了患者的工作记忆表现（刺激器条件仅对高负荷和条件x负荷相互作用的影响，p < 0.05）。在GNG任务中，刺激物刺激降低了高抑制条件下的可辨别性，但不降低中抑制条件下的可辨别性（刺激物条件仅对高抑制水平的影响，p = 0.05;条件x抑制水平相互作用，p = 0.07）。结论：尽管运动功能显著改善，但在对认知控制有更大挑战的条件下，重复刺激会降低工作记忆和反应抑制性能。
Objective: To test the hypothesis that subthalamic nucleus (STN) stimulation in Parkinson disease (PD) patients affects working memory and response inhibition performance, particularly under conditions of high demand on cognitive control. Methods: To test this hypothesis, spatial working memory ( spatial delayed response [SDR]) and response inhibition (Go - No - Go [GNG]) tasks requiring varying levels of cognitive control were administered to patients with PD with previously implanted bilateral STN stimulators (n = 24). Patients did not take PD medications overnight. Data were collected while bilateral stimulators were on and off, counterbalancing the order across subjects. Results: On the SDR task, STN stimulation decreased patients' working memory performance under a high but not low memory load condition ( effect of stimulator condition on high load only and condition x load interaction, p < 0.05). On the GNG task, STN stimulation reduced discriminability on a high but not medium inhibition condition ( effect of stimulator condition on high inhibition level only, p = 0.05; condition x inhibition level interaction, p = 0.07). Conclusion: STN stimulation reduces working memory and response inhibition performance under conditions of greater challenge to cognitive control despite significant improvement of motor function.